Carlos José Reis de Campos

Dreams and Epilepsy

SUMMARY: The relationship between dreams and epilepsy is illustrated by two patients whose awake epileptic seizures and recurrent dreams during night sleep had similar content. In both of our cases the EEG showed right anterior temporal spike discharge, suggesting a role for the temporal lobe in the association between dreams and seizures.

Effect of brain serotonin level on induced hippocampal paroxysmal activity in rats

Experiments were performed to study the involvement of brain 5-HT in an experimental model of epilepsy induced by repeated electrical stimulation of the dorsal hippocampus of rats. The experiments included: (1) systemic injections of 5-hydroxytryptophan (5-HTP) and p-chlorophenylalanine (pCPA) and (2) electrolytic lesions of the midbrain raphe nuclei. The pCPA group showed a significant increase while animals which received systemic injections of 5-HTP showed a great reduction in the electrographic seizure activity. Although several reports have shown that midbrain raphe lesions do not modify the epileptic susceptibility, we observed a clear enhancement in the epileptiform activity in lesioned animals. The results presented here support the view that serotonergic systems may exert a tonic inhibitory effect on hippocampal epileptic activity.

LATERALIZACAO DAS FUNCOES MUSICAIS NA EPILEPSIA PARCIAL

Fourteen right handed patients with partial epilepsy (Epileptic Group) and with a median age of 31 years were divided into two groups (Right and Left), according the laterality of paroxystic activity in the eletroencaphalogram. Of the 14 patients, 42.8% (6/14) presented a focus at the right side while the others 57.2% (8/14) presented a focus at the left. The Control Group consisted of 31 right handed individuals with a median age of 30 years and with no previous history of neurological disease or epileptic seizures. All the individuals had no musical skills. They carried out Music Abilities Tests including Spontaneous Rhythm, Elemental Music Functions Perception (tone color, duration, pitch, intensity and rhythm) and Complex Strutures Tests (recognition and reproduction of corporal rhythmic movements). We concluded that the focus at the right and the left cerebral hemisphere affect the development of the melodic recognition functions while in cases with focus at the left cerebral hemisphere, rhythmic reproduction and organization are more impaired when compared to the Control Group.Fourteen right handed patients with partial epilepsy (Epileptic Group) and with a median age of 31 years were divided into two groups (Right and Left), according the laterality of paroxystic activity in the electroencaphalogram. Of the 14 patients, 42.8% (6/14) presented a focus at the right side while the others 57.2% (8/14) presented a focus at the left. The Control Group consisted of 31 right handed individuals with a median age of 30 years and with no previous history of neurological disease or epileptic seizures. All the individuals had no musical skills. They carried out Music Abilities Tests including Spontaneous Rhythm, Elemental Music Functions Perception (tone color, duration, pitch, intensity and rhythm) and Complex Strutures Tests (recognition and reproduction of corporal rhythmic movements). We concluded that the focus at the right and the left cerebral hemisphere affect the development of the melodic recognition functions while in cases with focus at the left cerebral hemisphere, rhythmic reproduction and organization are more impaired when compared to the Control Group.

Modificação do metodo "kindling" para obtenção de status epilepticus experimental em ratos

: Taber et al. (1977) introduced new model of epilepsy to obtain experimental status epilepticus in mice, through a modification of the kindling method (Goddard et al. 1969). The aim of this paper is to report the effect of Tabers modification on a new animal specie (rats). Bipolar, twisted steel electrodes were stereotaxically implanted into the CA1-CA3 regions of the dorsal hippocampus. After one week the animals received 2 h stimulation sessions, one stimulus per minute, during which a sustained electrographical and behavioral seizures were induced. Different patterns of electrographical discharges as well as tonic-clonic convulsions were observed. The animals which were submitted to 3 stimulating sessions respectively 7, 14 and 21 days after surgery showed an increase in the epileptic activity. This has been interpreted as a plastic neural modification of the hippocampus similar to that observed during learning and memory consolidation. In comparison to other inducing kindling methods this one permits a more rapid elicitation of the phenomenon. For this reason this method will provide a good epilepsy model for the study of anticonvulsant drugs and basic mechanisms involved in the epileptic activity.Taber et al. (1977) introduced new model of epilepsy to obtain experimental status epilepticus in mice, through a modification of the kindling method (Goddard et al. 1969). The aim of this paper is to report the effect of Tabers modification on a new animal specie (rats). Bipolar, twisted steel electrodes were stereotaxically implanted into the CA1-CA3 regions of the dorsal hippocampus. After one week the animals received 2 h stimulation sessions, one stimulus per minute, during which a sustained electrographical and behavioral seizures were induced. Different patterns of electrographical discharges as well as tonic-clonic convulsions were observed. The animals which were submitted to 3 stimulating sessions respectively 7, 14 and 21 days after surgery showed an increase in the epileptic activity. This has been interpreted as a plastic neural modification of the hippocampus similar to that observed during learning and memory consolidation. In comparison to other inducing kindling methods this one permits a more rapid elicitation of the phenomenon. For this reason this method will provide a good epilepsy model for the study of anticonvulsant drugs and basic mechanisms involved in the epileptic activity.

Epilepsy and anxiety

We have analyzed 155 subjects with STAI (State-Trait Anxiety Inventory): 75 epileptic patients and 80 normal subjects used as a control group. A higher trait-anxiety score (chronic anxiety) than that of controls was found for the epileptic group. For the epileptic group higher levels of the A-trait occurred in patients with EEG abnormalities with left temporal localization. We have also observed that the shorter the epilepsy lasts (less than two years), the higher the trait-anxiety levels. Convulsions and awareness loss during epileptic seizures do not modify state and trait-anxiety scores.

Tratamento cirúrgico das patologias vasculares cerebrais nos pacientes epilépticos

Surgery of arteriovenous malformations (AVM) and of cavernous angiomas (cavernoma) in the majority of cases is indicated subsequently to episodes of bleeding. With the development of techniques for diagnosis and surgery for epilepsy of difficult control, indication for surgery of these vascular lesions has become greater. We present nine patients with cerebral vascular lesions and very frequent crises in spite of adequate clinical treatment. Ages ranged from 12 to 42 years with an average of 25 years; there was a prevalence of the male sex (2:1). Surgery consisted of exeresis of the lesion in all cases and in four there was also resection of the perilesional irritative area shown by electrocorticography. The pathologic study of lesions showed five cases of cavernoma, three cases of AVM, and one case of venous angioma. As to localization, we observed three lesions in the temporal lobe, four in the frontal, and two in the parietal region. Outpatient follow-up showed a reduction in crises in all of the patients, and seven evolved seizure free following surgery.

Hemispheric specialization in partial epilepsy role of dichotic listening cv task and central audiological evaluation in the neuropsychological assessment

We studied 49 patients with partial epilepsy divided into lesional cases (i.e. with lesions on CT scan) and non-lesional cases (i.e. without CT scan lesions), in relation to the Wechsler Intelligence Scale subtests (Coding, Digit span), dichotic listening CV task and Central Auditory Test (SSI, PSI). The aim of this paper was to study the hemispheric prevalence in dichotic listening task with regard to cognitive performance, as well as the presence or absence of central auditory dysfunction. Lesional cases presented a hemisphere prevalence in dichotic listening task with regard to cognitive performance, as well as the non-lesional cases tend to report the stimuli in the same side of EEG focus. Significant differences were found among the lesional and non lesional cases in relation to the digit span score and Coding subtest in right lesional cases versus right non-lesional cases. Both lesional and non-lesional group showed signs of central auditory dysfunction. We suggest that the dichotic listening and SSI and PSI test can be useful for a best comprehension of asymmetric neuropsychological performance in partial epilepsy.

Computerized analysis of snoring in sleep apnea syndrome

UNLABELLED The International Classification of Sleep Disorders lists 90 disorders. Manifestations, such as snoring, are important signs in the diagnosis of the Obstructive Sleep Apnea Syndrome; they are also socially undesirable. OBJECTIVE The aim of this paper was to present and evaluate a computerized tool that automatically identifies snoring and highlights the importance of establishing the duration of each snoring event in OSA patients. MATERIAL AND METHODS The low-sampling (200 Hz) electrical signal that indicates snoring was measured during polysomnography. The snoring sound of 31 patients was automatically classified by the software. The Kappa approach was applied to measure agreement between the automatic detection software and a trained observer. Students T test was applied to evaluate differences in the duration of snoring episodes among simple snorers and OSA snorers. RESULTS Of a total 43,976 snoring episodes, the software sensitivity was 99. 26%, the specificity was 97. 35%, and Kappa was 0. 96. We found a statistically significant difference (p <0. 0001) in the duration of snoring episodes (simple snoring x OSA snorers). CONCLUSIONS This computer software makes it easier to generate quantitative reports of snoring, thereby reducing manual labor.

Epilepsia do lobo temporal: tratamento cirúrgico

The authors report the surgical management of 32 patients with medically intractable seizures. In all cases the epileptiform focus present in the temporal region was demonstrated by electroencephalography. Our report was made up of 14 male patients and 18 female patients. Their ages ranged from 9 to 62 years. The material was divided into two groups. The first, with eighteen patients with cerebral lesion (like gliomas, arteriovenous malformation, epidermoid tumor) demonstrated on the CT scan and MR imaging underwent to lesion resection: in some cases with adjacent irritative area (guided by electrocorticography) out of eloquent zone, the removal of this irritative area was done. The second, with fourteen patients without cerebral expansive lesion; the MR imaging showed mesial temporal sclerosis in eight cases; all the patients of this group underwent to temporal lobectomy; the histopatologic exam showed temporal sclerosis in nine cases and normal brain in five. The postoperative follow-up showed better results in the cases with expansive cerebral lesion (83.4% seizure free) than the cases without that lesion (71.4% seizure free).

Diferenças sexuais na assimetria funcional hemisférica avaliação taquistoscópica verbal utilizando microcomputador: evaluation using: microcomputer verbal tachistos-copic test.

Study of sexual differences for the hemispheric prevalence on visual verbal stimuli using a microcomputer-based tachistoscope technic. Seventeen right-handed individuals, 10 males and 7 females (mean age 32 years old), without neurological or visual abnormalities were studied. The subjects performed a verbal trigram tachistoscope test, using a IBM PC microcomputer compatible. The trigram consists of 80 consonant-vowel-consonant pairs of stimuli presented randomly to right and left visual fields. The evaluation was made through two conditions: T1 and T2. In T1 Experiment stimuli exposition time was 260 ms, and in T2 Experiment the stimuli exposition time was 160 ms. In T1 Experiment 80% of females showed a Right Hemispherical Preference while 100% of males showed a Left Hemispherical Preference. In T2 Experiment, both sexes showed Left Hemispheric Preference. A close relationship between sexual difference and hemispheric preference was found. We point out the importance of stimuli exposition time in determination of sexual differences in lateral hemispherical asymmetry.