PURPOSE: To develop a fast and robust seizure anticipation program and test its usefulness in seizure prediction and localization of epileptic focus. METHODS: The video-EEG monitoring was performed in 20 epilepsy patients. The NPISI (Nonlinear Periodicity of Inter-Spike Intervals) of each channel and averaged NPISI of all channels were calculated in pre-ictal and ictal periods of 21 epileptic seizures. Seizure prediction times of NPISI in each channel and all channels were determined. RESULTS: There were eight mesial TLE, twelve neocortical epilepsies. The significantly reduced NPISI prior to seizure onset was observed in 20 seizures (95.2%) by NPISI of single EEG channel and in 14 seizures (66.7%) by the averaged NPISI of all channels. Time of seizure anticipation was 17.3+/-7.3 min by single channel NPISI and 14.0+/-6.0 min by all channel NPISI prior to the seizure onset. The earliest NPISI reduction was detected at electrodes concordant to the seizure focus in 6/20 (30.0%) seizures, electrodes adjacent to the focus in 5/20 (25.5%), mirror electrodes contralateral to the seizure focus in 4/20 (20.0%), and irrelevant electrodes to the focus in 5/20 (25.5%). CONCLUSIONS: This study demonstrated that the reduction of NPISI could predict epileptic seizures long before clinical seizure onset. Although the earliest NPISI reduction was observed at or near to epileptic focus in most cases, pre-ictal changes of NPISI occurred far beyond the epileptic focus. These findings suggest that pre-ictal NPISI reduction may reflect a widespread facilitation of brain before the seizure onset.
Brain ; Electrodes ; Electroencephalography ; Epilepsy* ; Humans ; Periodicity* ; Seizures

No abstract available.
Seizures*

Intermittent administrations of dopaminergic agents in hemiparkinsonian rat enhances the behavioral response to subsequent administration of the drugs. This phenomenon is known as "priming" and thought as comparable to drug-induced dyskinesia in patients with Parkinson's disease. We investigated the behavioral and electrophysiological changes in 6-hydroxydopamine (6-OHDA)-lesioned hemiparkinsonian rats after repeated administrations of apomorphine. Administration of apomorphine (0.32 mg/kg, intraperitoneal, i.p.) twice daily for 6 days enhanced the rotation induced by apomorphine from 341 turns/hour at the beginning to 755 turns/hr at the end. At the same time, the response to selective D2 agonist quinpirole (0.26 mg/kg, i.p.) was also enhanced from 203 to 555 turns/hr. Extracellular single unit recording revealed no significant difference in the basal firing rates of substantia nigra pars reticulata (SNr) neurons between the ipsilateral and contralateral side of the 6-OHDA lesion regardless of the repeated administrations of apomorphine. In SNr of the lesion side, the units with burst firing pattern were found more frequently after repeated administrations of apomorphine and the suppressive effect of quinpirole on the firing rate was enhanced. These findings suggest that the increased percentage of the burst units is the important electrophysiological change in the development of enhanced response to selective D2 agonist.
Animal ; Apomorphine/*pharmacology ; Dopamine Agonists/*pharmacology ; MPTP Poisoning/physiopathology ; Male ; Oxidopamine/toxicity ; Parkinsonian Disorders/*physiopathology ; Quinpirole/pharmacology ; Rats ; Rats, Sprague-Dawley ; Receptors, Dopamine D2/*drug effects ; Substantia Nigra/*drug effects/physiology

We report a rare case of meningioangiomatosis in a 22 year-old man who has refractory partial seizures. Seven of 11 seizures had ictal onset zone at the perilesional medial and orbitofrontal areas of frontal lobe and 4 seizures arose from the mesial temporal area. After having lesion resection and an anterior temporal lobectomy with amygdalohippocam-pectomy, the patient no longer suffered from seizures. The epileptogenic foci were found not only in the intra-/peri-lesional area but also in remote area.
Anterior Temporal Lobectomy ; Epilepsy* ; Frontal Lobe ; Humans ; Seizures ; Young Adult

No abstract available.
Cerebellopontine Angle* ; Intraoperative Neurophysiological Monitoring* ; Neuroma, Acoustic*

PURPOSE: Primary CNS lymphoma(PCNSL) is a rare brain tumor which has poor prognosis. It is sensitive to steroid or radiation therapy(RT), but the effect is transient. Recently, many centers have tried to increase survival rate and to lower recurrence rate by combined chemotherapy. Aim of this study is to investigate the response rate, performance status change and complications after combined modality treatment in our patients with PCNSL. PATIENTS AND METHODS:Fifteen consecutive PCNSL patients were included in this study. There was no immune compromized patient. All patients underwent pre-radiation systemic MTX, 1g/m 2, plus 6 doses of intrathecal MTX at 12mg per dose. Cranial RT(WBRT 40Gy, Boost 14.4Gy) was followed by two cycles of intravenous infusion of high dose cytarabine(Ara-C). We reviewed medical records, radiologic findings for evaluation of response and performance status. RESULTS: Seven patients completed this protocol. Response rate(CR + PR/total) after radiation and after completion of combined modality were 80% and 87%, respectively. No patients showed the decrease in performance status 20 more than pre-treatment status during treatment. Four CSF cytology positive patients had undergone all negative conversion after completion of intrathecal MTX chemotherapy. CONCLUSION: The addition of chemotherapy to cranial RT for initial treatment of PCNSL had favorable response rate, CSF cytology negative conversion rate, and maintaining performance status. But, we also have observed treatment failure including life threatening compications and non-responder. Therfore, careful monitoring of medical status should warranted and neuropsychological functions should also be evaluated.
Brain Neoplasms ; Central Nervous System* ; Cytarabine* ; Cytosine* ; Drug Therapy* ; Humans ; Infusions, Intravenous ; Lymphoma* ; Medical Records ; Methotrexate* ; Prognosis ; Recurrence ; Survival Rate ; Treatment Failure