Response to adrenocorticotropic in attention deficit hyperactivity disorder-like symptoms in electrical status epilepticus in sleep syndrome is related to electroencephalographic improvement: A retrospective study

Altunel, Attila; Altunel, Emine Özlem; Sever, Ali

doi:10.1016/j.yebeh.2017.06.019

Cited by 13 publications

(8 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In 2002, Chen and colleagues observed that selective COX2 inhibitors decreased membrane excitability and decreased back propagation action potential induced Ca2+ influx, a key feature of LTP. Taken together, normalization of these genes' expression by ACTH may underlie better control of calcium homeostasis and hyperexcitability that is required for normal neural network function and subsequently preventing cognitive dysfunction; as such, this may be part of the molecular mechanisms for improved outcome seen with ACTH treatment (Sher and Sheikh, 1993;Hernan et al, 2014;Altunel et al, 2017bAltunel et al, , 2017a.…”

Section: Discussionmentioning

confidence: 99%

Differential regulation of gene expression pathways with dexamethasone and ACTH after early life seizures

Brabec

Ouardouz²,

Mahoney

et al. 2022

Preprint

View full text Add to dashboard Cite

Early-life seizures (ELS) are associated with persistent cognitive deficits such as ADHD and memory impairment. These co-morbidities have a dramatic negative impact on the quality of life of patients. Therapies that improve cognitive outcomes have enormous potential to improve patients’ quality of life. Our previous work in a rat flurothyl-induction model showed that administration of adrenocorticotropic hormone (ACTH) at time of seizure induction led to improved learning and memory in the animals despite no effect on seizure latency or duration. Administration of dexamethasone (Dex), a corticosteroid, did not have the same positive effect on learning and memory and has even been shown to exacerbate injury in a rat model of temporal lobe epilepsy. We hypothesized that ACTH exerted positive effects on cognitive outcomes through beneficial changes to gene expression and proposed that administration of ACTH at seizure induction would return gene-expression in the brain towards the normal pattern of expression in the Control animals whereas Dex would not. Twenty-six Sprague-Dawley rats were randomized into vehicle- Control, and ACTH-, Dex-, and vehicle-ELS. Rat pups were subjected to 60 flurothyl seizures from P5 to P15. After seizure induction, brains were removed and the hippocampus and PFC were dissected, RNA was extracted and sequenced, and differential expression analysis was performed using generalized estimating equations. Differential expression analysis showed that ACTH pushes gene expression in the brain back to a more normal state of expression through enrichment of pathways involved in supporting homeostatic balance and down-regulating pathways that might contribute to excitotoxic cell-damage post-ELS.

show abstract

Section: Discussionmentioning

confidence: 99%

Differential regulation of gene expression pathways with dexamethasone and ACTH after early life seizures

Brabec

Ouardouz²,

Mahoney

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…The most commonly used medicines for SES include benzodiazepines, valproate, levetiracetam, corticosteroids, and/or IVIG which may lead to EEG and clinical improvement of SES cases [27]. A pooled analysis of 575 cases showed that antiepileptic drugs (AEDs, n = 495) were associated with improvement in 49% of patients, with benzodiazepines (n = 171) in 68%, and steroids (n = 166) in 81% [28], although the results of the present research showed that only 33.33% of SES cases benefited from combined AEDs.…”

Section: Discussionmentioning

confidence: 99%

A follow-up study in children with status epilepticus during sleep: From clinical spectrum to outcome

Peng

Zhu

Wang

et al. 2021

Epilepsy & Behavior

View full text Add to dashboard Cite

To evaluate the correlation between clinical spectrum and therapeutic outcomes and neuropsychological deficits in children with status epilepticus during sleep (SES). Methods: The clinical spectrum of patients with SES was defined as follows: status epilepticus of benign childhood epilepsy with centro-temporal spikes (SEBECTs), atypical benign focal epilepsy during childhood (ABFEC), non-idiopathic focal epilepsy (NIFE), and Landau-Kleffner syndrome (LKS). SES cases were divided into 4 groups according to neuropsychological findings before treatment: developmental delay/ intellectual disability (DD/ID), cognitive impairment (CI), attention deficit and/or hyperactivity behaviors (AHD), and normal group (NG). The therapeutic outcomes were classified into 3 groups: satisfactory response, recurrence, and seizure control. Results: A total of 39 cases (24 males and 15 females) were recruited, including 3 cases with SEBECTs, 26 with ABFEC, 8 with NIFE [2 with focal cortical dysplasia (FCD)], and 2 with LKS. There were 7 patients in the DD/ID group, 8 in the CI group, 19 in the AHD group, and 5 in the NG group. Neuropsychological outcomes were significantly different among clinical spectrum (P < 0.001), and neuropsychological deficits frequently occurred in the ABFEC group or in the NIFE group. Besides, 18 patients in the satisfactory group had satisfactory response to medicine or surgery (2 out of 18 cases with FCD), whereas recurrence was observed at least one session within one year in 16 cases in the recurrence group, and no improvement in spike-wave index and cognition/behavior was noted in 5 patients in the seizure control group, although seizure could be controlled. There were significant differences in therapeutic outcomes among clinical spectrum (P = 0.041), with the worst outcomes in the NIFE group (only 1 out of 8 with satisfactory good response). Conclusions: It is important to categorize patients with SES into epilepsy syndromes, including SEBECTs, ABFPEC, NIFE, and LKS; the clinical spectrum may be a significant determinant to influence the outcomes of SES, including neuropsychological deficits and therapeutic outcomes

show abstract

“…[ 16 ] In the next step, we will expand the samples of this special phenotype in BECT for GWAS analysis to understand the mechanisms, it will also help us to know why the current patients have a lower chance of BECTS type epileptic syndrome. Adamantadine, [ 17 ] steroid hormone, [ 18 ] and surgery [ 19 ] have been reported to have therapeutic effects on ESES, whereas benzodiazepines may be an appropriate alternative. [ 19 , 20 ] Sánchez Fernández and Inutsuka [ 21 , 22 ] found diazepam could significantly reduce the spikes and slows wave index of the non-rapid eye movement sleep sleep period, in the long-term follow-up, a few cases recurred, and the spikes and slows wave index returned to the level before treatment.…”

Section: Discussionmentioning

confidence: 99%

Continuous epileptic negative myoclonus as the first seizure type in atypical benign epilepsy with centrotemporal spikes

et al. 2020

Medicine

View full text Add to dashboard Cite

To figure out which diagnosis is more suitable and which antiepileptic drugs are more sensitive to epileptic negative myoclonus (ENM) as the first seizure type in atypical benign epilepsy with centrotemporal spikes. We reviewed the electroencephalogram (EEG) database of Linyi People's Hospital Affiliated to Shandong University and medical records of patients with ENM onset. The characteristics of epileptic seizures, onset age, treatment process, growth and development history, past disease history, family history, degree of mental deterioration, cranial imaging, and video-EEG were studied retrospectively and followed up. There were 4 cases with ENM onset and 1 with continuous ENM, 3 males and 1 female. The onset age was from 2 years 3 months to 8 years 7 months. The cranial magnetic resonance imaging (MRI) and developmental quotient, as well as the family, personal, and past disease history, were normal. Frequent falls and drops were the main clinical manifestations. Five months after the onset of ENM, case 1 had focal seizures in sleep. ENM was the first and only manifestation in all the other 3 children. Discharges of interictal EEG were in bilateral rolandic areas, especially in midline areas (Cz, Pz), electrical status epilepticus in sleep was found in 3 cases. One child was sensitive to levetiracetam, the other 3 were sensitive to clonazepam. ENM can affect the upper or lower extremities. ENM as the first or only symptom was a special phenomenon in benign epilepsy with centrotemporal spikes (BECTS) variants. Ignorance of midline spikes mainly in Cz or Pz in BECTS might lead to missed diagnosis of ENM. Whether benzodiazepines are viable as a choice of BECTS variants with electrical status epilepticus in sleep when ENM is the first symptom still needs a large sample evidence-based observation.

show abstract

Response to adrenocorticotropic in attention deficit hyperactivity disorder-like symptoms in electrical status epilepticus in sleep syndrome is related to electroencephalographic improvement: A retrospective study

Cited by 13 publications

References 31 publications

Differential regulation of gene expression pathways with dexamethasone and ACTH after early life seizures

Differential regulation of gene expression pathways with dexamethasone and ACTH after early life seizures

A follow-up study in children with status epilepticus during sleep: From clinical spectrum to outcome

Continuous epileptic negative myoclonus as the first seizure type in atypical benign epilepsy with centrotemporal spikes

Contact Info

Product

Resources

About