The effects of phenytoin on the penicillin-induced spike focus

Bustamante, Liliana; Lueders, Hans; Pippenger, C. E.; Goldensohn, Eli S.

doi:10.1016/0013-4694(80)90047-4

Cited by 9 publications

(3 citation statements)

References 12 publications

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“…However, it is well known that the morphology of an IED can provide clinical insights to the subject's condition [45]- [47]. Consistent changes in amplitude, duration and sharpness have been described in different sleep stages [48], during pharmacological treatment [49], [50] and, furthermore, after achievement of seizure control, revealing significant decrease in spike amplitude, duration and sharpness [51]. Therefore, the ability to discriminate IEDs based on their morphology has an additional value in the evaluation of treatment efficacity.…”

Section: Discussionmentioning

confidence: 99%

Detection of Interictal Discharges With Convolutional Neural Networks Using Discrete Ordered Multichannel Intracranial EEG

Αντωνιάδης

Spyrou

Martín-López

et al. 2017

IEEE Trans. Neural Syst. Rehabil. Eng.

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Abstract-Detection algorithms for electroencephalography (EEG) data, especially in the field of interictal epileptiform discharge (IED) detection, have traditionally employed handcrafted features which utilised specific characteristics of neural responses. Although these algorithms achieve high accuracy, mere detection of an IED holds little clinical significance. In this work, we consider deep learning for epileptic subjects to accommodate automatic feature generation from intracranial EEG data, while also providing clinical insight. Convolutional neural networks are trained in a subject independent fashion to demonstrate how meaningful features are automatically learned in a hierarchical process. We illustrate how the convolved filters in the deepest layers provide insight towards the different types of IEDs within the group, as confirmed by our expert clinicians. The morphology of the IEDs found in filters can help evaluate the treatment of a patient. To improve the learning of the deep model, moderately different score classes are utilised as opposed to binary IED and non-IED labels. The resulting model achieves state of the art classification performance and is also invariant to time differences between the IEDs. This study suggests that deep learning is suitable for automatic feature generation from intracranial EEG data, while also providing insight into the data.

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Section: Discussionmentioning

confidence: 99%

Detection of Interictal Discharges With Convolutional Neural Networks Using Discrete Ordered Multichannel Intracranial EEG

Αντωνιάδης

Spyrou

Martín-López

et al. 2017

IEEE Trans. Neural Syst. Rehabil. Eng.

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“…or intraperitoneal (i.p.) injections and daily oral administration of PHT were usually used for producing a steady state (Lockard et al, 1975;Wada et al, 1976;Bustamante et al, 1980). It is difficult, however, to produce an exact steady state by these routes because the serum levels show such fluctuation over time.…”

Section: Discussionmentioning

confidence: 99%

Antiepileptic Effects Under Steady State of Phenytoin Serum Levels Produced in Acute Experiments

et al. 1987

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The antiepileptic effects of phenytoin (PHT) were examined during steady-state serum levels. Experiments were conducted on 69 adult male rabbits weighing 2.5-3.5 kg. A steady state of one or two different PHT serum levels per rabbit was produced with intravenous (i.v.) injections of loading and infusion doses. A train of focal and generalized seizure discharges (SDs) induced by electrical stimulation was compared before and after dosing with PHT. The results showed that PHT levels of 10-40 micrograms/ml induce inhibitory effects, shortening the duration of neocortical focal SDs. The inhibitory effects paralleled the PHT levels and were proportionally related to epileptogenicity in individual neocortical areas. At serum levels under approximately 5-10 micrograms/ml, the spread of secondarily generalized SDs originating from neocortical focal SDs was suppressed more than the shortening of the duration of the primary focus. On the other hand, PHT showed no effects or only slight inhibitory effects on hippocampal SDs, and the SDs spread from them even at levels of 15-40 micrograms/ml. Electroshock (ES)-induced generalized SDs were slightly suppressed in duration at levels of 20-30 micrograms/ml. Moreover, both the focal and the generalized SDs were greatly prolonged at high serum levels (greater than 40 micrograms/ml), although such facilitative effects were rare. The clinical contributions of these results to PHT treatment in human epilepsy are discussed.

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“…In the authors' opinion, increased sharpness or spiky nature corresponds to decreased degree of temporal dispersion in the spatially restricted focus, which could be interpreted as consistent with a decrease in the size of the epileptogenic zone. Other authors have found a decrease in the duration of penicillininduced focal spikes by administration of phenytoin, carbamazepine, and phenobarbital [6,7]. Anecdotal experiences have also reported earlier resolution and disappearance of spikes as compared to sharp waves in established cases of focal epilepsy.…”

Section: To the Editormentioning

confidence: 94%