The Postictal State: A Neglected Entity in the Management of Epilepsy

Fisher, Robert S.; Schachter, Steven C.

doi:10.1006/ebeh.2000.0023

Cited by 137 publications

(108 citation statements)

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“…27 In newborn babies, seizures produce sustained neuronal injury and frequently lead to life-long neurologic and developmental disabilities. [27][28][29][30][31][32][33] Alteration in cerebral blood flow regulation contributes to the postictal state. 27 The incidence of cerebral vascular injury during postictal state has been described in adult patients and in newborns.…”

Section: Discussionmentioning

confidence: 99%

“…[27][28][29][30][31][32][33] Alteration in cerebral blood flow regulation contributes to the postictal state. 27 The incidence of cerebral vascular injury during postictal state has been described in adult patients and in newborns. 22,27 Insufficient cerebral blood flow is especially damaging to the neonatal brain because of the rapid development of neurons, reduced antioxidant defenses, and high susceptibility to inflammation.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Enteral Supplements of a Carbon Monoxide Donor CORM-A1 Protect against Cerebrovascular Dysfunction Caused by Neonatal Seizures

Liu

Fedinec

Leffler

et al. 2014

J Cereb Blood Flow Metab

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Cerebral blood flow dysregulation caused by oxidative stress contributes to adverse neurologic outcome of seizures. A carbon monoxide (CO) donor CORM-A1 has antioxidant and cytoprotective properties. We investigated whether enteral supplements of CORM-A1 can improve cerebrovascular outcome of bicuculline-induced seizures in newborn piglets. CORM-A1 (2 mg/kg) was given to piglets via an oral gastric tube 10 minutes before or 20 minutes after seizure onset. Enteral CORM-A1 elevated CO in periarachnoid cerebrospinal fluid and produced a dilation of pial arterioles. Postictal cerebral vascular responses to endothelium-, astrocyte-, and vascular smooth muscle-dependent vasodilators were tested 48 hours after seizures by intravital microscopy. The postictal responses of pial arterioles to bradykinin, glutamate, the AMPA receptor agonist quisqualic acid, ADP, and heme were greatly reduced, suggesting that seizures cause injury to endothelial and astrocyte components of the neurovascular unit. In contrast, in the two groups of piglets receiving enteral CORM-A1, the postictal cerebral vascular responsiveness to these dilators was improved. Overall, enteral supplements of CORM-A1 before or during seizures offer a novel effective therapeutic option to deliver cytoprotective mediator CO to the brain, reduce injury to endothelial and astrocyte components of cerebral blood flow regulation and to improve the cerebrovascular outcome of neonatal seizures.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Enteral Supplements of a Carbon Monoxide Donor CORM-A1 Protect against Cerebrovascular Dysfunction Caused by Neonatal Seizures

Liu

Fedinec

Leffler

et al. 2014

J Cereb Blood Flow Metab

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show abstract

“…This can be further explained by the decrease in serotoninergic neurotransmission in the hippocampus and prefrontal cortex, which stands for the major regulatory stations, regarding the exploratory behavior. Concerning the traumatic epileptic seizure, the underlying mechanism of the decrease in exploratory activity, can be the trauma of the amygdaloidal body (17)(18)(19)(20).…”

Section: Discussionmentioning

confidence: 99%

“…The most commonly considered are the serotoninergic and noradrenergic neurotransmitter systems, which are significantly increased. On the other hand, gamma-aminobutyric acid (GABA), as the representative of the inhibitory neurotransmitters, is decreased (20,23).These disbalances further lead to the lowering of the threshold and induction of discharge. Alterations in neurotransmission balance affects mainly limbic structures, locus caeruleus and colliculi (21,23).…”

Section: Discussionmentioning

confidence: 99%

Exploratory behavior alteration as an epileptic comorbidity in elevated plus maze test

Ademovič¹,

Lekovic²,

Knežević³

et al. 2017

Med podmladak

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Introduction: Epileptic seizure consists of preictal, ictal and postictal period. Postictal period is characterized by a variety of psychiatric phenomenon of which the most frequent ones are anxiety and depressive disorder. Anxiety in rodents can be assessed by measuring the exploratory behavior. Lindane evokes generalized tonic-clonic epileptic seizures in rats, when applied intraperitoneally, due to its lypophilic characteristics. Aim: The aim of this study was to assess exploratory behavior linked with anxiety level in the elevated plus maze test (EPM) upon generalized seizures, induced by lindane in male rats. Material and methods: The experiment was conducted on Wistar albino male rats that were randomly divided into: control group (DMSO, 0.5 ml/kg) and experimental group (lindane, 8 mg/kg) (n=8, each). After the drug injection, the assessment of the seizure intensity lasted for 30 minutes. Descriptive rating scale was used to describe the seizure severity. Subsequently, the EPM testing took place immediately after evoking the seizure (Test 1), after 1h (Test 2) and after 24h (Test 3). Time spent in open areas and number of transitions was further analyzed. Results: Experimental group of animals spent less time in open areas of EPM, when compared to controls in Test 1 and Test 2. The same holds true for the number of transitions to the open area, i.e. lindane-treated animals tend to stay in enclosed parts of the maze in Test1, Test 2. Finally, in Test 3 there was no significant difference between the groups, in any parameter of interest. Conclusion: Lindane-induced generalized epileptic seizures are accompanied by reduced exploratory behavior in the elevated plus maze test, up to 24h after the seizure ended. This finding can be a basis for the further translational research of anxiety as epileptic comorbidity in this experimental model of epilepsy.

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“…18 A broad range of rhythms, and transitions between different rhythmic regimes, have been observed for these diseases. In epilepsy, the rhythms range from extremely fast (e.g., hundreds of Hertz [27][28][29][30] ) to slow (e.g., a few Hertz 31,32 ) and are bracketed by abrupt transitions at the onset and termination of seizure events. [33][34][35][36] Schizophrenia-characterized as a failure of cognitive integration-manifests in brain rhythms as altered beta and gamma band (15-70 Hz) synchronization.…”

Section: Introductionmentioning

confidence: 99%

Introduction to Focus Issue: Rhythms and Dynamic Transitions in Neurological Disease: Modeling, Computation, and Experiment

Kaper

Kramer

Rotstein

2013

Chaos: An Interdisciplinary Journal of Nonlinear Science

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Rhythmic neuronal oscillations across a broad range of frequencies, as well as spatiotemporal phenomena, such as waves and bumps, have been observed in various areas of the brain and proposed as critical to brain function. While there is a long and distinguished history of studying rhythms in nerve cells and neuronal networks in healthy organisms, the association and analysis of rhythms to diseases are more recent developments. Indeed, it is now thought that certain aspects of diseases of the nervous system, such as epilepsy, schizophrenia, Parkinson's, and sleep disorders, are associated with transitions or disruptions of neurological rhythms. This focus issue brings together articles presenting modeling, computational, analytical, and experimental perspectives about rhythms and dynamic transitions between them that are associated to various diseases. To have and to hold-and to oscillate-in sickness and in health. INTRODUCTIONDynamic phenomena, such as rhythmic oscillations and waves, are ubiquitous in the nervous system and have been associated with cognition and motor behavior in both health and disease. [1][2][3][4][5] Oscillations in different frequency ranges have been associated with healthy brain function, including learning, memory, spatial navigation, attention, sleep, and motor behavior. 2,6-14 Wave-like phenomena have been associated with sensory processing 15 and working memory. 16 Rhythmic neuronal activity-and transitions between rhythms-are also central phenomena in neurological disease. 5,17 Perhaps the most famous manifestations occur in epilepsy, which is characterized as a paroxysmal cerebral dysrhythmia (see, e.g., Ref. 18 A broad range of rhythms, and transitions between different rhythmic regimes, have been observed for these diseases. In epilepsy, the rhythms range from extremely fast (e.g., hundreds of Hertz 27-30 ) to slow (e.g., a few Hertz 31,32 ) and are bracketed by abrupt transitions at the onset and termination of seizure events. [33][34][35][36] Schizophrenia-characterized as a failure of cognitive integration-manifests in brain rhythms as altered beta and gamma band (15-70 Hz) synchronization. 22,37 In Alzheimer's disease, brain rhythms shift to power at lower frequencies, and the coherence of fast rhythms decreases. 23,38,39 In Parkinson's disease, pathologically exaggerated beta oscillations characterize the abnormal rhythms. 25,[40][41][42][43][44] Transitions between dynamic regimes have been observed during sleep, and abnormal transitions have been associated with sleep disorders. 26,[45][46][47][48][49][50][51] Finally, the slow waves of cortical spreading depression 52 underlie the reduction of excitability in neuronal tissue associated with migraine, 53,54 in particular, migraine with aura. 52 On the three fronts of modeling, computation, and experiment, there have been a series of important recent advances, and many new avenues of research have emerged. These include: (1) new techniques to record high-density brain activity; 55-57 (2) theoretical advances and clinical a...

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The Postictal State: A Neglected Entity in the Management of Epilepsy

Cited by 137 publications

References 58 publications

Enteral Supplements of a Carbon Monoxide Donor CORM-A1 Protect against Cerebrovascular Dysfunction Caused by Neonatal Seizures

Enteral Supplements of a Carbon Monoxide Donor CORM-A1 Protect against Cerebrovascular Dysfunction Caused by Neonatal Seizures

Exploratory behavior alteration as an epileptic comorbidity in elevated plus maze test

Introduction to Focus Issue: Rhythms and Dynamic Transitions in Neurological Disease: Modeling, Computation, and Experiment

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