OBJECTIVEContinuous spike-and-wave during slow wave sleep (CSWS) syndrome is one of the presentations of electrical status epilepticus during sleep (ESES). The purpose of this study was to investigate the characteristics of CSWS syndrome in children.

METHODSBetween 2007 and 2009, a total of 778 nocturnal long-term or 24-hr video-EEG records were included. The EEG, clinical and neuroimaging characteristics were studied in children who met standard criteria for CSWS.

RESULTSNine children met standard criteria for CSWS in video-EEGs. Their ages ranged 6 to 13 years. Their EEGs were characterized by continuous spike-and-wave (SW) discharges during non-rapid eye movement (NREM) sleep, accounting for 85%-100% of the period of NREM sleep. Clinically, these children had various types of epileptic seizures and exhibited different degrees of neuropsychiatric impairments, language dysfunction, and/or behavioral disturbances. Neuroimaging abnormalities were found in 6 cases, including atelencephalia or atrophy, gray matter heterotopia and leucomalacia.

CONCLUSIONSThis study indicates the characteristics of CSWS syndrome in clinical manifestations, EEG and neuroimaging examinations. This will be helpful in understanding CSWS syndrome.

Adolescent ; Child ; Electroencephalography ; Humans ; Sleep ; physiology ; Status Epilepticus ; diagnosis ; drug therapy ; physiopathology ; Syndrome

Child ; Fructose ; administration & dosage ; analogs & derivatives ; therapeutic use ; Humans ; Male ; Status Epilepticus ; drug therapy

OBJECTIVES: To study the effect of gap junction blockers, quinine (QUIN) and carbenoxolone (CBX), on hippocampal ripple energy expression in rats with status epilepticus (SE). METHODS: A total of 24 rats were randomly divided into four groups: model, QUIN, valproic acid (VPA), and CBX ( RESULTS: Ripple expression was observed in the hippocampal CA1, CA3, and dentate gyrus regions of normal rats. After 10 minutes of PILO injection, all groups had a gradual increase in mean ripple energy expression compared with 1 day before modeling, with the highest expression level before chloral hydrate injection in the model, VPA and CBX groups ( CONCLUSIONS The change in ripple energy can be used as a quantitative indicator for early warning of seizures, while it cannot predict seizures in the interictal period. Gap junction blockers can reduce ripple energy during seizures.
Animals ; Gap Junctions ; Hippocampus ; Pilocarpine ; Rats ; Seizures ; Status Epilepticus/drug therapy*

Background AND PURPOSE: Status epilepticus (SE) is one of the major neurological emergency that requires immediate treatment to avoid significant morbidity and mortality. Thus, understanding the cause, features and prognosis of SE is important for the evaluation and treatment of this condition. We retrospectively reviewed the possible cause and clinical outcome of adult patients treated for SE at the Hallym Univrsity Hospital from 1994 to 1998. METHODS: For the identification of patients, we searched the data bank for patients meetinf criteria of SE who were 18 year or older, and their medical records were reviewed. We also investigated the relationships between cause, response to anticonvulsant therapy and short-term clinical outcome. RESULTS: The selected 127 patients wer 84 males and 43 females, aged 18 to 85 yeats (meen age: 49.5 years). The possible etiologies of SE were withdrawal of AED (n=27, 21.3%), anoxia (n=22, 17.3%), CNS infection (n=20, 15.7%), stroke (n=16, 12.6%), alcohol-related (n=15, 11.8%), metabolic (n=8, 6.3%), unknown (n=7, 5.5%), drug inroxicatio (n=5, 3.9%), trauma (n=4, 3.2%) and cerebral tumor (n=3, 2.4%). in 77 patients (n=77, 60.6%), SE was successfully aborted with first-line therapy, which usually included diazepam with or without phenytoin. The food responders to AEDs occurred in patients with AED withdrawal, alcohol-related, stroke, unknown, and trauma, The poor response related to anoxia, drug intoxication and CNS infection. Seventy nine patients (62.2%) had food outcome, but nineteen patients (14.9) were died. Anoxia, drug intoxication, CNS infection and metabolic abnormalities were associated with particularly poor outcome compared with other etiologies. CONCLUSION: This study indicates that the etiology of SE may help predict both the intial response to drug therapy and short-term clinical outcome.
Adult* ; Anoxia ; Diazepam ; Drug Therapy ; Emergencies ; Female ; Humans ; Male ; Medical Records ; Mortality ; Phenytoin ; Prognosis ; Retrospective Studies ; Status Epilepticus* ; Stroke

OBJECTIVE: To study the clinical features of electrical status epilepticus during sleep (ESES) in children, as well as the clinical effect of methylprednisolone pulse therapy in children with ESES. METHODS: A retrospective analysis was performed using the clinical data of 78 children with ESES. Among these children, 56 children who had had the failure of antiepileptic drugs were treated with methylprednisolone pulse therapy at a dose of 15-20 mg/(kg·d) for three courses. Each course of treatment was 3 days, followed by oral prednisone [1-2 mg/(kg·d)] for 3 days. The role of methylprednisolone pulse therapy in eliminating ESES, controlling clinical seizures, and improving intelligence and behaviors was analyzed. RESULTS: The mean age of onset of epilepsy in 78 children was 6.8±2.4 years, and the mean age for the first occurrence of ESES was 7.6±2.5 years. Compared with normal children, children with ESES had delayed intelligence development and higher scores of some behavior problems. Methylprednisolone pulse therapy had an overall response rate of 73% (41/56) on clinical seizures, and the overall response rate on electroencephalography (EEG)/spike-wave index was 70% (39/56) after treatment. There were significant improvements in verbal intelligence quotient, performance intelligence quotient and full intelligence quotient, and significant reductions in the scores of learning problems, impulse-hyperactivity and hyperactivity index after treatment (P<0.05). The overall recurrence rate after 1-year follow-up was 29% (11/38). CONCLUSIONS ESES often presents around school age and impairs children's intelligence and behaviors. Methylprednisolone pulse therapy has a marked efficiency in reducing clinical seizures and EEG discharges in children with ESES and can improve intelligence and behavior development, but the recurrence rate remains high.
Anticonvulsants ; Child ; Child, Preschool ; Electroencephalography ; Follow-Up Studies ; Humans ; Methylprednisolone ; therapeutic use ; Retrospective Studies ; Sleep ; Status Epilepticus ; drug therapy

Adolescent ; Child ; Child, Preschool ; Electroencephalography ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Status Epilepticus ; diagnosis ; drug therapy ; etiology

OBJECTIVETo study the effect of a microRNA-132 antagonist on lithium-pilocarpine-induced status epilepticus (SE) in young Sprague-Dawley (SD) rats.

METHODSForty-five 3-week-old SD rats were randomly and equally divided into epilepticus model group, microRNA-132 antagonist group, and microRNA-132 antagonist negative control group. The young SD rat model of SE was established using lithium-pilocarpine. For the microRNA-132 antagonist group and the negative control group, pretreatment was performed 24 hours before the model establishment. Behavioral observation was performed to assess the latency of SE and success rate of induction of SE. The scale of Lado was used to evaluate the seizure severity. Electroencephalography (EEG) was used to assess the frequency and amplitude of epileptiform discharges. The mortality rate was calculated in each group.

RESULTSThere was no significant difference in the success rate of induction of SE between the three groups (P>0.05). Compared with the microRNA-132 negative control group and the epilepticus model group, the microRNA-132 antagonist group had significantly prolonged SE latency after model establishment (P<0.05), a significantly lower Lado score of seizure (P<0.05), significantly lower frequency and amplitude of epileptiform discharges on EEG (P<0.05), and a slightly reduced mortality rate.

CONCLUSIONSThe treatment with the microRNA-132 antagonist shows an inhibitory effect on the development and progression of lithium-pilocarpine-induced SE in young SD rats. The inhibition of microRNA-132 is likely to be a potential target or direction for drug treatment of SE.

Animals ; Electroencephalography ; Male ; MicroRNAs ; antagonists & inhibitors ; Pilocarpine ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Status Epilepticus ; chemically induced ; drug therapy

OBJECTIVE: To systematically evaluate the efficacy and safety of levetiracetam (LEV) versus phenytoin (PHT) as second-line drugs for the treatment of convulsive status epilepticus (CSE) in children. METHODS: English and Chinese electronic databases were searched for the randomized controlled trials comparing the efficacy and safety of LEV and PHT as second-line drugs for the treatment of childhood CSE. RevMan 5.3 software was used for data analysis. RESULTS: Seven studies with 1 434 children were included. The Meta analysis showed that compared with the PHT group, the LEV group achieved a significantly higher control rate of CSE ( CONCLUSIONS LEV has a better clinical effect than PHT in the treatment of children with CSE and does not increase the incidence rate of adverse events.
Anticonvulsants/adverse effects* ; Child ; Humans ; Levetiracetam/therapeutic use* ; Pharmaceutical Preparations ; Phenytoin/adverse effects* ; Status Epilepticus/drug therapy*

OBJECTIVETo study the efficacy of levetiracetam (LEV) in the treatment of electrical status epilepticus during sleep (ESES) in children.

METHODSThe clinical data of 27 children who were newly diagnosed with ESES and treated with LEV between August 2009 and March 2011 and who were followed up for at least 6 months were retrospectively studied.

RESULTSThe onset age of the 27 children ranged from 9 months to 9 years and 7 months. Partial motion seizures were found in 81% of the children in the early stage. Twenty-three children received LEV treatment after ESES was definitely diagnosed. Of the 23 children, 19 were diagnosed as epilepsy syndrome of benign childhood epilepsy with centrotemporal spikes (BECT). The age of the patients at the beginning of LEV treatment ranged from 1 year and 8 months to 11 years and 9 months. The follow- up duration was 7 to 19 months. The effective rate of LEV for seizure control was 82% and for EEG recovery it was 78% (P<0.05). The other 4 children received LEV treatment before the occurrence of ESES. Seizure control and EEG recovery were noted in two of the 4 children.

CONCLUSIONSLEV treatment is efficacious, to some extent, for both seizure control and EEG recovery in children with ESES.

Adolescent ; Anticonvulsants ; therapeutic use ; Child ; Child, Preschool ; Electroencephalography ; drug effects ; Female ; Humans ; Infant ; Male ; Piracetam ; analogs & derivatives ; therapeutic use ; Retrospective Studies ; Status Epilepticus ; drug therapy ; physiopathology

OBJECTIVETo study the effect of cyclooxygenase -2 selective inhibitor celecoxib on the expression of major vault protein ( MVP) in the brain of rats with status epilepticus and its possible roles in the treatment of refractory epilepsy.

METHODSSixty adult male Sprague-Dawley rats were randomly assigned to blank control (n=16), epilepsy model (n=22) and celecoxib treatment groups (n=22). After the status epilepticus was induced in rats by injecting lithium and pilocarpine, each group had 16 rats enrolled as subjects. Immunohistochemical method and Western blot method were used to detect the expression of MVP in the frontal cortex and hippocampus.

RESULTSThe expression of MVP was significantly higher in the epilepsy model group than in the control group (P<0.01). The expression of MVP in the celecoxib treatment group was significantly decreased compared with the epilepsy model group, but it was still higher than in the control group (P<0.01).

CONCLUSIONSCelecoxib could decrease the expression of MVP in brain tissue of rats with status epilepticus, suggesting that it is promising for the treatment of intractable epilepsy.

Animals ; Blotting, Western ; Brain ; metabolism ; Celecoxib ; pharmacology ; therapeutic use ; Cyclooxygenase 2 Inhibitors ; pharmacology ; Immunohistochemistry ; Male ; Rats ; Rats, Sprague-Dawley ; Status Epilepticus ; drug therapy ; metabolism ; Vault Ribonucleoprotein Particles ; analysis