The role of the hepatic metabolisation for the interaction between valproic acid and carbapenem antibiotics

<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_joepi-2016-0009_s_001"><h3>Background</h3><p>Approximately 26% of the burden of neurologic diseases is due to epilepsy. Its negative impact reflects mainly on people with epilepsy (PWE) themselves.</p></sec><sec id="j_joepi-2016-0009_s_002"><h3>Aims</h3><p>To highlight the negative impacts of epilepsy on the lives of PEW’s so as to identify a realistic approach to their individual needs.</p></sec><sec id="j_joepi-2016-0009_s_003"><h3>Methods</h3><p>For recently published papers PubMed and MEDLINE databases were used. In addition relevant references mentioned in the searched articles were also considered.</p></sec><sec id="j_joepi-2016-0009_s_004"><h3>Review and discussion</h3><p>Generalized tonic-clonic seizures and refractory epilepsy are the most important factors burdening PWE’s, resulting in increased injuries and mortality, including Sudden Unexpected Death in Epilepsy (SUDEP). The need of chronic intake of antiepileptic drugs (AEDs) and of epilepsy surgery are also important with regards to potential for side effects, drug interactions, and different surgery risks. PWE harbour more medical and psychiatric comorbidities than the general population and results in a decreased quality of life. Decreased self-esteem and major stigma are also frequent, linked to social, economic and personal negative consequences.</p><p>Age also plays a role, younger people being more stigmatized given the interdiction to drive or difficulty in getting a job. In the elderly, seizures may have an impact on mental status, mood and sleep. Gender may also contribute, particularly involving women in childbearing age, linked to the fear or depression due to the possibility of AED-induced fertility disturbances, foetal malformations, or breast feeding side-effects.</p></sec><sec><h3>Conclusions</h3><p>The burden that PWE face must be considered by all people involved in the management of their epilepsy. The causes may be multifactorial, all interconnected and each one influencing the others.</p></sec></abstract>

The epileptic multifactorial patient’s burden. Review of the topic

<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_joepi-2016-0010_s_001"><h3>Introduction</h3><p>Medial temporal lobe epilepsy (MTLE) is the most frequent form of epilepsy in adulthood. It is classified as local/regional epilepsy. However, there is increasing evidence of the involvement of both temporal lobes and this provides abundant arguments to question this view, and consider MTLE as one of the typical bilateral system epilepsies.</p></sec><sec id="j_joepi-2016-0010_s_002"><h3>Aim</h3><p>To provide a contemporary review of medial temporal lobe epilepsy, discussing the bilateral aspects, with reference to epilepsy surgery.</p></sec><sec id="j_joepi-2016-0010_s_003"><h3>Methods</h3><p>A literature review and a resume of the author’s own experiences with MTLE patients.</p></sec><sec id="j_joepi-2016-0010_s_004"><h3>Results</h3><p>Recent electrophysiological and neuroimaging data provide convincing data supporting that MTLE is a bilateral disease. The uni-and bilateral features form a continuum and the participation rate of the two temporal lobes determine course and surgical perspective of the individual patient.</p></sec><sec id="j_joepi-2016-0010_s_005"><h3>Conclusions</h3><p>The contradictory data of invasive presurgical evaluations of MTLE patients suggest that there need to identify further indicatory markers of bilaterality and thus change the presurgical evaluation from the non-invasive towards the invasive ways. The mechanisms of the interrelationship between the two temporal lobes in MTLE warrants further research.</p></sec></abstract>

The medial temporal lobe epilepsy is a bilateral disease – novel aspects

<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_joepi-2016-0011_s_001"><h3>Introduction</h3><p>Medial temporal lobe of epilepsy (MTLE) is considered as local/regional epilepsy. However, as was discussed in Part I of this review (Halász, 2016a) there is more evidence regarding the involvement of both temporal lobes so as to consider MTLE as one of the typical bilateral system epilepsies.</p></sec><sec id="j_joepi-2016-0011_s_002"><h3>Aim</h3><p>To provide contemporary review of MTLE in relation to the declarative memory system and the newly recognized hippocampo-frontal memory consolidation during slow wave sleep.</p></sec><sec id="j_joepi-2016-0011_s_003"><h3>Methods</h3><p>A review of the available literature on experimental and clinical data and also the authors own studies in MTLE patients.</p></sec><sec id="j_joepi-2016-0011_s_004"><h3>Review, discussion and results</h3><p>New experimental and clinical neurophysiological data have shown that MTLE is closely linked to the hippocampal memory system. It is likely that hippocampal spiking is the epileptic variations of the normal sharp wave ripple events mediating the encoding and consolidation of memory engrams by a hippocampo-frontal dialogue during slow wave sleep.</p></sec><sec id="j_joepi-2016-0011_s_005"><h3>Conclusions</h3><p>The source of memory impairment in MTLE patients is not merely the cell loss and synaptic transformation of the hippocampal structure, but the every night interference with memory consolidation due to interictal spiking.</p></sec></abstract>

The relationship of medial temporal lobe epilepsy with the declarative memory system

<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_joepi-2016-0012_s_001"><h3>Background</h3><p>Every chronic illness, including epilepsy, has a negative effect on both the quality of life of the sufferer as well as on their relationship with their surroundings.</p></sec><sec id="j_joepi-2016-0012_s_002"><h3>Aims</h3><p>To investigate the quality of life of children suffering from epilepsy and analyse how they assessed and scored their experiences compared to their parents.</p></sec><sec id="j_joepi-2016-0012_s_003"><h3>Materials and methods</h3><p>The study included 209 children with epilepsy and their parents. The research tool was a questionnaire for gathering demographic and clinical data as well as the Pediatric Quality of Life Inventory™ 4.0 Generic Core Scales (PedsQL™ 4.0) questionnaire in two versions, one for 8–12 year olds and one for 13–18 year olds and their parents.</p></sec><sec id="j_joepi-2016-0012_s_004"><h3>Results</h3><p>Cronbach’s alpha coefficient for the entire PedsQL™ 4.0 questionnaire was 0.91 and 0.93 for children with epilepsy and their parents respectively. Children rated their Total Scale Score higher (67.5 points) than their parents (62.5 points). Whilst analyzing children’s functioning in different areas it was observed that girls’ assessments were higher than boys’, except for Emotional Functioning. Both parents and children scored School Functioning the lowest. The greatest agreement of responses was observed in the domain of Physical Functioning, the smallest in the domain of Emotional Functioning.</p></sec><sec id="j_joepi-2016-0012_s_005"><h3>Conclusions</h3><p>Quality of life was rated higher by both age groups of children suffering from epilepsy than by their parents. A statistically significant difference was found when comparing the assessment scores of children and parents in light of the following variables; child age, gender, illness duration, seizure frequency and treatment effectiveness.</p></sec></abstract>

Karol Marcinkowski University of Medical Sciences

The quality of life of children with epilepsy in Poland – the opinion of children and their parents

<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_joepi-2016-0013_s_001"><h3>Background</h3><p>Biofeedback methods represent side effect free complementary options in the treatment of epilepsy. In this paper we review the current status of these methods in terms of clinical study results and their evaluation by systematic review papers. Possible mechanisms of action in biofeedback methods are discussed.</p></sec><sec id="j_joepi-2016-0013_s_002"><h3>Aim</h3><p>To present the current status of biofeedback methods applied to patients with epilepsy.</p></sec><sec id="j_joepi-2016-0013_s_003"><h3>Material and Methods</h3><p>With a literature search up to 10/2016 we screened publications containing the search terms “biofeedback”, “neurofeedback” or “neurotherapy” and “epilepsy” or “seizure” for intervention and population search terms respectively.</p></sec><sec id="j_joepi-2016-0013_s_004"><h3>Results</h3><p>Four different techniques of biofeedback were used to improve seizure frequency in patients with epilepsy. Three of these techniques, measuring EEG (slow cortical potentials and sensory motor rhythm) or electrodermal activity (galvanic skin response, GSR) seem to be promising methods for successful seizure control. Nevertheless, methodological standards in the conducted trials were too low for assured empirical evidence in their efficacy.</p></sec><sec id="j_joepi-2016-0013_s_005"><h3>Conclusions</h3><p>Biofeedback methods could be applied to patients to a greater extent. Probably due to the missing empirical evidence of efficacy and the high demand on patients’ and therapists’ time and commitment and therefore low cost effectiveness, these methods are hardly offered. Especially the relatively new approach of GSR biofeedback represents a promising option here.</p></sec></abstract>

Biofeedback as complementary treatment in patients with epilepsy – an underestimated therapeutic option? Review, results, discussion

<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_joepi-2016-0014_s_001"><h3>Introduction</h3><p>Numerous reviews of the currently established concepts, strategies and diagnostic tools used in epilepsy surgery have been published. The focus concept which was initially developed by Forster, Penfield and Jasper and popularised and enriched by Lüders, is still fundamental for epilepsy surgery.</p></sec><sec id="j_joepi-2016-0014_s_002"><h3>Aim</h3><p>To present different conceptual views of the focus concept and to discuss more recent network hypothesis, emphasizing so-called “critical modes of an epileptogenic circuit”.</p></sec><sec id="j_joepi-2016-0014_s_003"><h3>Method</h3><p>A literature search was conducted using keywords: presurgical evaluation, epileptic focus concepts, cortical zones, diagnostic tools.</p></sec><sec id="j_joepi-2016-0014_s_004"><h3>Review and remarks</h3><p>The theoretical concepts of the epileptic focus are opposed to the network hypothesis. The definitions of the various cortical zones have been conceptualized in the presurgical evaluation of candidates for epilepsy surgery: the seizure onset zone versus the epileptogenic zone, the symptomatogenic zone, the irritative and functional deficit zones are characterized. The epileptogenic lesion, the “eloquent cortex” and secondary epileptogenesis (mirror focus) are dealt with. The current diagnostic techniques used in the definition of these cortical zones, such as video-EEG monitoring, non-invasive and invasive EEG recording techniques, magnetic resonance imaging, ictal single photon emission computed tomography, and positron emission tomography, are discussed and illustrated. Potential modern surrogate markers of epileptogenicity, such as <italic>High frequency oscillations, Ictal slow waves/DC shifts, Magnetic resonance spectroscopy, Functional MRI,</italic> the use of <italic>Magnetized nanoparticles</italic> in MRI, <italic>Transcranial magnetic stimulation, Optical intrinsic signal</italic> imaging, and <italic>Seizure prediction</italic> are discussed. Particular emphasis is put on the EEG: Scalp EEG, semi-invasive and invasive EEG (Stereoelectroencephalography) and intraoperative electrocorticography are illustrated. Ictal SPECT and <sup>18</sup>F-FDG PET are very helpful and several other procedures, such as dipole source localization and spike-triggered functional MRI are already widely used. The most important lateralizing and localizing ictal signs and symptoms are summarized. It is anticipated that the other clinically valid surrogate markers of epileptogenesis and epileptogenicity will be further developed in the near future. Until then the concordance of the results of seizure semiology, localization of epileptogenicity by EEG and MRI remains the most important prerequisite for successful epilepsy surgery.</p></sec><sec id="j_joepi-2016-0014_s_005"><h3>Conclusions and future perspectives</h3><p>Resective epilepsy surgery is a widely accepted and successful therapeutic approach, rendering up to 80% of selected patients seizure free. Although other therapies, such as radiosurgery, and responsive neurostimulation will increasingly play a role in patients with an unresectable lesion, it is unlikely that they will replace selective resective surgery. The hope is that new diagnostic techniques will be developed that permit more direct definition and measurement of the epileptogenic zone.</p></sec></abstract>

Presurgical diagnosis of epilepsies – concepts and diagnostic tools

<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_joepi-2016-0015_s_001"><h3>Introduction</h3><p>The role of cellular immunity in the pathogenesis of epilepsy, as an interaction between immunity and clinical and neurobiological variables is not properly understood.</p></sec><sec id="j_joepi-2016-0015_s_002"><h3>Aim</h3><p>The aim of the current study was to investigate the possible relationship between epilepsy forms, gender, focus localization, lateralization, handedness and cellular immunity with seizures frequency, their severity and length of therapeutic remission in partial forms of epilepsy.</p></sec><sec id="j_joepi-2016-0015_s_003"><h3>Material and methods</h3><p>Ninety two patients (38 men and 54 women) were included in the study. Symptomatic epilepsy was diagnosed in 40 patients and the cryptogenic form was diagnosed in 52 patients. The amount of different lymphocyte clusters were evaluated and they were transformed into nominal variables for MANOVA analysis. MANOVA was used for the analysis of the interrelationship between nominal fixed factors (epilepsy forms, gender, handedness, and focus laterality, and immunity variables) and dependent variables (remission and seizure frequency and their severity).</p></sec><sec id="j_joepi-2016-0015_s_004"><h3>Results</h3><p>Simple partial seizure (SPS) and complex partial seizure (CPS) frequencies were under the influence of interaction between immune and neurobiological variables. SPS, and in particular sensory SPS, were associated with CD4/CD8 ratio, gender, left temporal focus and handedness. The highest frequencies of SPS were revealed in cases of low CD4/CD8 ratio combined with left temporal focus, female gender and left-handedness. The maximal CPS frequency was observed in patients with a left frontal focus combined with a high B-lymphocyte level. The more severe seizures were revealed in left-handers with low CD8 and high CD4/CD8 ratio and in frontal left focus and a high T-lymphocyte level. There was a correlation between CD4 cell level and length of remission.</p></sec><sec id="j_joepi-2016-0015_s_005"><h3>Conclusion</h3><p>The complex multifarious connections between neurobiological, immune and clinical variables in patients with partial forms of epilepsy really exist.</p></sec></abstract>

The interrelationship between clinical and immunity variables in epilepsy

<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_joepi-2016-0016_s_001"><h3>Introduction</h3><p>Patients with pharmacoresistant epilepsy are usually treated with two or more antiepileptic drugs (AEDs). The search for therapeutically efficacious AED combinations is still a challenging issue for clinicians and epileptologists throughout the world.</p></sec><sec id="j_joepi-2016-0016_s_002"><h3>Aim</h3><p>To determine the interaction profile for the combination of retigabine (RTG) and oxcarbazepine (OXC) in both, the model of tonic-clonic seizures, the maximal electroshock (MES)-induced seizure model and chimney test (motor performance) in adult male albino Swiss mice.</p></sec><sec id="j_joepi-2016-0016_s_003"><h3>Methods</h3><p>Isobolographic analysis (type I) was applied to characterize interactions for the combination of RTG with OXC with respect to its anticonvulsant and acute side (neurotoxic) effects, as determined in the MES and chimney tests, respectively.</p></sec><sec id="j_joepi-2016-0016_s_004"><h3>Results</h3><p>The combination of RTG with OXC at the fixed-ratios of 1:3, 1:1 and 3:1 produced additive interactions in the MES test in mice. Similarly, the combination of RTG with OXC at the fixed-ratio of 1:1 produced additive interaction with a tendency towards sub-additivity in the chimney test in mice. Measurement of total brain concentrations of both AEDs revealed that RTG did not affect total brain concentrations of OXC and inversely, OXC had no impact on RTG’s total brain concentrations, confirming pharmacodynamic interaction between the drugs.</p></sec><sec id="j_joepi-2016-0016_s_005"><h3>Conclusions</h3><p>The additive pharmacodynamic interactions in both the MES and chimney tests in mice were observed for the combination of RTG with OXC.</p></sec></abstract>

Additive interactions between retigabine and oxcarbazepine in the chimney test and the model of generalized tonic-clonic seizures in mice

AHEAD OF PRINT

Volume 32 (2024): Issue 1 (May 2024)

Volume 31 (2023): Issue 1 (November 2023)

Volume 29 (2021): Issue 1 (July 2021)

Volume 28 (2020): Issue 1 (December 2020)

Volume 27 (2019): Issue 1 (February 2019)

Volume 26 (2018): Issue 1-2 (June 2018)

Volume 25 (2017): Issue 1-2 (December 2017)

Volume 24 (2016): Issue 2 (December 2016)

Volume 24 (2016): Issue 1 (June 2016)

Volume 23 (2015): Issue 2 (December 2015)

Volume 23 (2015): Issue 1 (June 2015)

Volume 22 (2014): Issue 2 (December 2014)

Volume 22 (2014): Issue 1 (June 2014)

Volume 21 (2013): Issue 2 (December 2013)

Volume 21 (2013): Issue 1 (June 2013)

Journal of Epileptology

 The Journal of Epileptology – published since 2013 - is an international, open access peer reviewed scientific journal that publishes articles of clinical and experimental epilepsy.   The following categories of epilepsy related topics are accepted for publications: medical hypotheses, basic research, clinical research, reviews and special reports, product investigation, diagnostic and medical technology, case reports, letters to Editor, reports from international and local activities.   The aim of the journal is to widen the international community of readers, research and clinicians interested in various aspects of epilepsy and disseminate interdisciplinary knowledge in all fields related to epilepsy.   The Journal of Epileptology is owned by the Foundation of Epileptology which was established in 1993 by Professor Jerzy Majkowski. The Foundation of Epileptology is the first non-governmental organization in Poland whose priority is to improve the quality of life of persons with epilepsy by improving the diagnostic and therapeutic skills of doctors and by shaping a positive attitude to epilepsy among the public. The Foundation, led by this idea, brings together physicians, psychologists, scientists and academics, social activists and other people who wish to contribute to the development of epileptology and thus provide medical assistance to persons with epilepsy.     About Society   The Foundation of Epileptology was established in 1993 by Professor Jerzy Majkowski who also founded the Department of Neurology and Epileptology at the Medical Centre for Postgraduate Education (CMKP) in 1988. The Foundation of Epileptology is the first non-governmental organisation in Poland to have as its priority the improvement of quality of life of epileptic patients by means of furthering doctors' diagnostic and therapeutic mastery and developing a positive approach to epilepsy among the general public. The Foundation, led by this idea, attracts physicians, psychologists, researchers and academics, social activists and other persons who wish to contribute to the development of epileptology and thereby bring medical assistance to people suffering from epilepsy. The Foundation of Epileptology was registered in the Foundation Register of the District Court for the Municipality of Warsaw on 16 March 1993 and thereby acquired legal status. The Founder appointed the Foundation Council and the Foundation Executive Committee.   The Foundation of Epileptology co-operates with the Polish Society of Epileptology, the Warsaw-based Society for Victims of Epilepsy and their Friends "Calm Head" (Spokojna Głowa) and other domestic and foreign organisations with similar goals. The Foundation of Epileptology is a member of the European Epilepsy Academy (EUREPA) and Professor Majkowski is co-organiser and member of the first Executive Committee and is now a member of the EUREPA Research Advisory Committee. The Executive Committee of the Polish Society of Epileptology shares its headquarters with the Epilepsy Foundationv   Archiving   The archiving of issues published from 2013 to 2017 will occur, and thus all issues published in the current form of the Journal will become available on-line. However, the issues published quarterly under the journal’s earlier name of Epileptologia during 1993 to 2012 will be successively attached and published on journal’s website www.journal-epileptology.com.   Sciendo archives the contents of this journal in Portico - digital long-term preservation service of scholarly books, journals and collections.   Plagiarism Policy   The editorial board is participating in a growing community of Similarity Check System's users in order to ensure that the content published is original and trustworthy. Similarity Check is a medium that allows for comprehensive manuscripts screening, aimed to eliminate plagiarism and provide a high standard and quality peer-review process. 