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PubMed1990

[Age-related variants of absence in epilepsy in children and adolescents].

Epilepsy consequent to traumas, neuroinfection and perinatal pathology was registered and followed up for 0.5-8 years in 82 patients. At the age of 1.5-15 years they developed absence epileptica. 5 groups of patients were distinguished by type of attack transformation: 1) addition of primary generalized convulsive seizures, 2) addition of secondary generalized convulsive seizures. 3) subsequent addition of absence epileptica to primary generalized convulsive seizures, 4) subsequent addition of absence epileptica to secondary generalized convulsive seizures, 5) transformation of absence epileptica into temporal psychomotor and psychosensory fits. Characteristic for each group EEG readings are delineated.

Adolescent↗
PubMed1999

Evidence for linkage of adolescent-onset idiopathic generalized epilepsies to chromosome 8-and genetic heterogeneity.

Several loci and candidate genes for epilepsies or epileptic syndromes map or have been suggested to map to chromosome 8. We investigated families with adolescent-onset idiopathic generalized epilepsy (IGE), for linkage to markers spanning chromosome 8. The IGEs that we studied included juvenile myoclonic epilepsy (JME), epilepsy with only generalized tonic-clonic seizures occurring either randomly during the day (random grand mal) or on awakening (awakening grand mal), and juvenile absence epilepsy (JAE). We looked for a gene common to all these IGEs, but we also investigated linkage to specific subforms of IGE. We found evidence for linkage to chromosome 8 in adolescent-onset IGE families in which JME was not present. The maximum multipoint LOD score was 3.24 when family members with IGE or generalized spike-and-waves (SW) were considered affected. The LOD score remained very similar (3.18) when clinically normal family members with SW were not considered to be affected. Families with either pure grand mal epilepsy or absence epilepsy contributed equally to the positive LOD score. The area where the LOD score reaches the maximum encompasses the location of the gene for the beta3-subunit of the nicotinic acetylcholine receptor (CHRNB3), thus making this gene a possible candidate for these specific forms of adolescent-onset IGE. The data excluded linkage of JME to this region. These results indicate genetic heterogeneity within IGE and provide no evidence, on chromosome 8, for a gene common to all IGEs.

Adolescent↗
PubMed2007

Lack of evidence of an allelic association of a functional GABRB3 exon 1a promoter polymorphism with idiopathic generalized epilepsy.

PURPOSE: Mutation screening and linkage disequilibrium mapping of the gene encoding the GABA(A) beta(3) subunit (GABRB3) identified a common genetic variant in the exon 1a promoter region (C-allele of rs4906902) which displayed a reduced transcriptional activity and showed a strong allelic association with childhood absence epilepsy (CAE). The present population-based association study tested whether the C-allele of rs4906902 confers susceptibility to CAE or other common syndromes of idiopathic generalized epilepsy (IGE) in a German sample. METHODS: Seven hundred and eighty unrelated German IGE patients (250 CAE, 123 juvenile absence epilepsy, 303 juvenile myoclonic epilepsy (JME), 104 epilepsy with generalized tonic-clonic seizures on awakening) and 559 healthy population controls were genotyped for the single nucleotide polymorphism (SNP) rs4906902. RESULTS: The frequency of the risk-conferring C-allele did not differ significantly between CAE patients (f(C)=0.190) and controls (f(C)=0.183; P=0.376, one-tailed). Similarly, no evidence for an allelic association was found for 373 patients with idiopathic absence epilepsy, 303 JME patients, and the entire IGE sample (P>0.77, two-tailed). CONCLUSION: Our study failed to replicate an association of the common GABRB3 exon 1a promoter SNP rs4906902 with CAE. Moreover, the present results do not provide evidence that the common functional C-variant confers a substantial epileptogenic effect to a broad spectrum of IGE syndromes in the German population.

Alleles↗
PubMed2006

Measuring clusters of spontaneous spike-wave discharges in absence epileptic rats.

Spike-wave discharges (SWDs) characterizing absence epilepsy appear in closely packed aggregated sequences, which gave rise to the name "pyknolepsy" for this disease. In WAG/Rij rats, genetically prone to absence epilepsy, spontaneous SWDs seem to occur in clusters as well. Here, we aimed to quantify the seizures' clusters. SWDs sequences were extracted from long-term (complete estrous cycle) EEG recordings of adult female WAG/Rij rats. Spectral characteristics and half-decay time of autocorrelation functions (AC-tau) were calculated for time series of i(SWD) (proportion of time occupied by spike-wave activity), measured for subsequent periods. The clusters were characterized by means of AC-tau calculated for time series of i(SWD). The absence seizures were indeed clustered in a minute range. The clustering had a non-periodical character, since no significant and consistent periodicity was found in the minute range. AC-tau correlated positively with propensity of SWDs: i.e. the aggravation of absence epilepsy led to longer sequences of paroxysms and thus to a less random distribution. AC-tau was not sensitive to various phases of the estrous cycle, but was larger in the dark than in the light periods. We suggest that AC-tau can be used to quantify aggregation of epileptic events in the search for physiological basis of its temporal clustering.

Algorithms↗
PubMed2004

Genetic architecture of idiopathic generalized epilepsy: clinical genetic analysis of 55 multiplex families.

PURPOSE: In families with idiopathic generalized epilepsy (IGE), multiple IGE subsyndromes may occur. We performed a genetic study of IGE families to clarify the genetic relation of the IGE subsyndromes and to improve understanding of the mode(s) of inheritance. METHODS: Clinical and genealogic data were obtained on probands with IGE and family members with a history of seizures. Families were grouped according to the probands' IGE subsyndrome: childhood absence epilepsy (CAE), juvenile absence epilepsy (JAE), juvenile myoclonic epilepsy (JME), and IGE with tonic-clonic seizures only (IGE-TCS). The subsyndromes in the relatives were analyzed. Mutations in genes encoding alpha1 and gamma 2 gamma-aminobutyric acid (GABA)-receptor subunits, alpha1 and beta1 sodium channel subunits, and the chloride channel CLC-2 were sought. RESULTS: Fifty-five families were studied. 122 (13%) of 937 first- and second-degree relatives had seizures. Phenotypic concordance within families of CAE and JME probands was 28 and 27%, respectively. JAE and IGE-TCS families had a much lower concordance (10 and 13%), and in the JAE group, 31% of relatives had CAE. JME was rare among affected relatives of CAE and JAE probands and vice versa. Mothers were more frequently affected than fathers. No GABA-receptor or sodium or chloride channel gene mutations were identified. CONCLUSIONS: The clinical genetic analysis of this set of families suggests that CAE and JAE share a close genetic relation, whereas JME is a more distinct entity. Febrile seizures and epilepsy with unclassified tonic-clonic seizures were frequent in affected relatives of all IGE individuals, perhaps representing a nonspecific susceptibility to seizures. A maternal effect also was seen. Our findings are consistent with an oligogenic model of inheritance.

Adolescent↗
PubMed1998

Anatomical and functional aspects of mu opioid receptors in epileptic WAG/Rij rats.

Involvement of opioid systems in the pathogenesis of absence epilepsy has been postulated. However, the role of the mu opioid receptor has not been fully elucidated as yet. In the present study the role of this receptor in absence epilepsy was investigated autoradiographically and pharmacologically. The density of mu opioid receptors in discrete brain areas was quantified in WAG/Rij rats, which are regarded as a genetic model of primarily generalized absence epilepsy and in three control groups of non-epileptic rats. The autoradiographic study showed an abundance of mu opioid receptors (labelled with [3H]DAMGO) in the structures involved in generation and propagation of spike-wave discharges, such as the thalamus, cortex and striatum. A significant decrease in the mu receptor density was found only in the frontal cortex of epileptic WAG/Rij rats. In the pharmacological study, the effect of mu opioid receptor activation in different brain structures of WAG/Rij rats on the number of complexes of spike-wave discharges was investigated. DAMGO (0.02 and 0.07 microg/0.5 microl) was bilaterally injected into the thalamus, striatum and frontal cortex. DAMGO resulted in a dose-related increase in the number of spike-wave discharges after intracortical and intrastriatal administration by approximately 200-300% and after intrathalamic administration by approximately 500%. The injection of DAMGO into those structures had no significant effect of any kind on the behavior measured, except for passive behavior which was reduced after intrastriatal injection. The high density of mu opioid receptors in the areas involved in the genesis of spike-wave discharges, as well as the highest responsiveness of thalamic mu opioid receptors to the epileptogenic effects of DAMGO, suggest involvement of mu receptors in the genesis of spike-wave discharges.

Analgesics, Opioid↗
PubMed2004

Cortical-area specific block of genetically determined absence seizures by ethosuximide.

Absence epilepsy is characterised by a paroxysmal loss of consciousness, of abrupt onset and termination, and is associated with a bilateral synchronous spike and wave discharge (SWD) on the electroencephalogram. Absence seizures involve an interplay between thalamic and cortical structures, although most research has so far focussed on sensory thalamic nuclei and the reticular thalamic nucleus (RTN). Thus, microinfusion of ethosuximide (ETX), a first choice anti-absence drug, into either the ventrobasal thalamus or RTN of the genetic absence epilepsy rat from Strasbourg (GAERS), a validated rat model of absence epilepsy, does not produce immediate cessation of seizure activity, as is seen following systemic administration. As recent evidence indicates a seizure initiation site within the peri-oral region of the primary somatosensory cortex (S1po), we have now applied ETX into S1po as well as the somatosensory cortex forelimb region (S1FL) and the motor cortex (M1) of freely moving GAERS. Microinfusion of 10 or 20 nmol/side of ETX into S1po produced an immediate cessation of seizure activity. A less marked response was produced when even a higher dose (200 nmol/side) was infused into S1FL. No reduction of SWD was seen when ETX was infused into M1. Microinfusion of CGP 36742 (5 nmol/side), a GABA(B) antagonist, produced immediate cessation of seizure activity in both S1po and M1 and a delayed effect in S1FL. These data suggest that the ability of ETX to abolish genetically determined absence seizures is cortical-area specific and support the involvement of S1po in the initiation of SWDs.

Animals↗
PubMedDate not supplied

[Haloperidol induces changes in the electrocorticogram of rats with genetic petit mal epilepsy].

The WAG/Rij rats, a genetic animal model of human absence epilepsy, were injected with D2 autoreceptor antagonist haloperidol. Increase in the amount of spike-wave discharges and the prevalence of short spike-wave discharges was observed. The pattern of spike-wave discharge sequence changed in a characteristic way. The findings may testify to participation of dopaminergic system both in the processes of generation and cessation of the spike-wave complex absence epilepsy.

Animals↗
PubMed2002

Familial association of neuropsychological traits in patients with generalized and partial seizure disorders.

To investigate familial effects of neuropsychological deficits associated with seizure disorders, we studied 65 families, in which 1 member had epilepsy. The disorders included childhood absence epilepsy (CAE), juvenile myoclonic epilepsy (JME) and temporal lobe epilepsy (TLE). Age-appropriate tests were administered to assess sustained attention, encoding and verbal memory, executive and focused attention and attentional flexibility/impulsivity. CAE probands attained lower scores than other probands in visual sustained attention and the ability to focus on and execute a visual-motor task. Scores of the unaffected relatives tended to fall between those of the probands and the controls. JME relatives had lower scores than other relatives in tests of visual and auditory sustained attention and attentional flexibility, and showed greater variability in response time. Behavioral information of this type may aid in the specification and differentiation of genetic linkages in affected families.

Adolescent↗
PubMed2001

Genetic predisposition to severe myoclonic epilepsy in infancy.

PURPOSE: To address genetic predisposition to febrile convulsions (FCs) and epilepsy as an etiologic background of severe myoclonic epilepsy in infancy (SMEI). METHODS: Familial antecedents of epilepsy and FCs were analyzed in four groups of patients with SMEI (65 cases), FCs (57 cases), childhood absences (67 cases), and a control group of patients with no neurologic problems (64 cases). RESULTS: Patients with SMEI and those with FCs had significantly increased incidence of FCs in their relatives compared with those with absence epilepsy and with the control group. The incidence of epilepsy in relatives of patients with SMEI and absence epilepsy was increased compared with that in the control group and reached statistical significance. Epilepsy in relatives with SMEI had the characteristics of idiopathic generalized epilepsy. CONCLUSIONS: A genetic predisposition could determine three types of epileptic syndromes: FCs, idiopathic generalized epilepsy, and SMEI.

Adolescent↗
PubMed2005

Distribution of D1-like and D2-like dopamine receptors in the brain of genetic epileptic WAG/Rij rats.

The densities of the dopamine (DA) D1-like and D2-like receptors were studied by autoradiography in brain regions of rats with (WAG/Rij strain) and without (ACI strain) genetic absence epilepsy. The core of the nucleus accumbens in WAG/Rij rats had a lower density of D1-like receptors than in ACI rats, a reduction of both D1-like and D2-like DA receptors was also found for the dorsal striatum (dorsal caudate-putamen). On the other hand, the density of D2-like receptors was higher in cortical (frontal and parietal) regions and lower in the CA3 region of the hippocampus of WAG/Rij, as compared to ACI rats. These results give new information about possible malfunction of the brain dopaminergic system in the WAG/Rij rat model of absence epilepsy. It seems that there are differences between WAG/Rij and other models of absence epilepsy, especially concerning the role of striatum.

Animals↗
PubMed2005

Morphometric Golgi study of cortical locations in WAG/Rij rats: the cortical focus theory.

Recently it was demonstrated that for the absence epilepsy characteristic spike-wave discharges initially emerge from the somatosensory cortex and quickly involve the rest of the cortex and cortico-thalamic network. This has led to the development of the focal theory of absence epilepsy. In this experiment, this theory was further investigated by studying the neuronal organization of the cortical focal zone, a non-focal zone in genetic epileptic WAG/Rij rats and functional related areas in non-epileptic age matched control rats. A classical Golgi staining technique was used to visualize whole cortical neurons with dendritic and axon arborisation. Apical dendrites of pyramidal cells in epileptic rats were often split, declined and were running in non-perpendicular directions. Quantitative differences between the strains were found for the length of neurons, between focal and control areas mainly for dendritic arborization. A significant "strain-zone" interaction was found for the maximal distance between two points of dendritic arborization, the mean length of a dendritic segment and the number of free terminations of apical dendrites. All this demonstrates that properties of dendrites in the cortical focal area of WAG/Rij rats were at variance with dendritic characteristics outside the focal area and with functional similar areas in non-epileptic controls. These features might reflect the hyperexcitability of somatosensory neurons, which underlie the initiation and spreading of spike-wave discharges in WAG/Rij rats. Finally, these results are in line with the cortical focus theory of absence epilepsy.

Animals↗
PubMed2003

Actions of U-92032, a T-type Ca2+ channel antagonist, support a functional linkage between I(T) and slow intrathalamic rhythms.

Thalamic relay neurons express high levels of T-type Ca(2+) channels, which support the generation of robust burst discharges. This intrinsically mediated form of phasic spike firing is thought to be critical in the generation of slow (3-4 Hz) synchronous oscillatory activity of absence epilepsy. Recordings made from brain slices or whole animals have shown that slow synchronous absence-like activity can be abolished when Ca(2+)-dependent burst firing in relay neurons is interrupted by the pharmacological or genetic inactivation of T-channels. Because succinimide drugs act as incomplete and nonspecific antagonists, we tested whether the novel T-channel antagonist U-92032 could provide stronger support for a role of T-channels in slow oscillatory activity. Ca(2+)-dependent rebound (LTS) bursts were recorded using whole cell current clamp in relay cells of the ventral basal complex (VB) from thalamic slices of adult rats. We used LTS kinetics to measure the availability of T-channels in VB cells after TTX. U-92032 (1 and 10 microM) reduced the maximum rate of depolarization of the isolated LTS by 51% and 90%, respectively, compared with the 35% reduction due to 2 mM methylphenylsuccinimide (MPS), the active metabolite of the antiabsence drug methsuximide. U-92032 (1 and 10 microM) also suppressed evoked, slow oscillations in thalamic slices with a time course similar for observed intracellular effects. Unlike MPS, we observed no substantial effects of short-term U-92032 applications (< or =2 h) on the generation of action potentials in VB cells. Our findings show U-92032 is a more potent, effective, and specific T-channel antagonist than previously studied succinimide antiabsence drugs and that it dramatically reduces epileptiform synchronous activity. This suggests that U-92032 or other specific T-channel antagonists may provide effective drug treatments for absence epilepsy.

Action Potentials↗
PubMed1997

[Television epilepsy].

Television epilepsy (TE) appear to be the variation of photosensitive epilepsy when the fits are provoked by watching TV. 23 patients aged 6-20 years were observed (8-men, 15 women). TE included epilepsy with generalized convulsive fits (34.8%), juvenile absence-epilepsy (17.4%), juvenile myoclonic epilepsy (30.4%), children absence-epilepsy (13.0%) and partial occipital epilepsy (4.4%). "Pure" TE was diagnosed in 26.1% of patients, while the combined TE--in 73.9%. Diagnostic criteria of the syndrome of "pure" TE were formulated.

Adolescent↗
PubMed2005

Effects of Cav3.2 channel mutations linked to idiopathic generalized epilepsy.

Heron and colleagues (Ann Neurol 2004;55:595-596) identified three missense mutations in the Cav3.2 T-type calcium channel gene (CACNA1H) in patients with idiopathic generalized epilepsy. None of the variants were associated with a specific epilepsy phenotype and were not found in patients with juvenile absence epilepsy or childhood absence epilepsy. Here, we introduced and functionally characterized these three mutations using transiently expressed human Cav3.2 channels. Two of the mutations exhibited functional changes that are consistent with increased channel function. Taken together, these findings along with previous reports, strongly implicate CACNA1H as a susceptibility gene in complex idiopathic generalized epilepsy.

Calcium Channels, T-Type↗
PubMed1999

Eye closure related spike and wave discharges: clinical and syndromic associations.

Precipitation of spike and wave (SW) discharges in some epileptic patients by eye closure (EC) has rarely been reported. To disclose the clinical characteristics and classification of syndromes of epileptic patients with SW discharges induced by EC, we investigated 10 patients (1 M, 9 F) showing this peculiar EEG feature. The patients aged between 9-39 years (mean 20.6 +/- 9.058), underwent short-term (1-3.5 hr) video-EEG investigations in order to document the appearance of the SW discharges within 3 seconds of the act of EC, in at least two occasions. Clinical analysis showed that 5 female patients who had the syndrome of juvenile myoclonic epilepsy (JME) had a later onset of epilepsy (13-15 years) than the 3 patients (3 girls) with eyelid myoclonia with absences (EMA) (3-8 years of age at onset). The remaining 2 patients who were diagnosed as childhood absence epilepsy (CAE) and juvenile absence epilepsy (JAE) according to the international classification, did not show photosensitivity on the video-EEG. All but one of the 5 JME patients had experienced myoclonic seizures in intermittent photic stimulation (IPS) at the time of EC, associated with multiple spike and wave discharges. Two of the 3 EMA patients exhibited typical absences with eyelid myoclonia during the act of EC. The high rate of family history of epilepsy in first degree relatives of our patients was an outstanding feature, which could have future implications in research of the genetic basis of epilepsy patients with ECS.

Adolescent↗
PubMed2005

Rhythmic bursting in the cortico-subthalamo-pallidal network during spontaneous genetically determined spike and wave discharges.

Absence seizures are characterized by impairment of consciousness associated with bilaterally synchronous spike-and-wave discharges (SWDs) in the electroencephalogram (EEG), which reflect paroxysmal oscillations in thalamocortical networks. Although recent studies suggest that the subthalamic nucleus (STN) provides an endogenous control system that influences the occurrence of absence seizures, the mechanisms of propagation of cortical epileptic discharges in the STN have never been explored. The present study provides the first description of the electrophysiological activity in the cortico-subthalamo-pallidal network during absence seizures in the genetic absence epilepsy rats from Strasbourg, a well established model of absence epilepsy. In corticosubthalamic neurons, the SWDs were associated with repetitive suprathreshold depolarizations correlated with EEG spikes. These cortical paroxysms were reflected in the STN by synchronized, rhythmic, high-frequency bursts of action potentials. Intracellular recordings revealed that the intraburst pattern in STN neurons was sculpted by an early depolarizing synaptic potential, followed by a short hyperpolarization and a rebound of excitation. The rhythmic hyperpolarizations in STN neurons during SWDs likely originate from a subpopulation of pallidal neurons exhibiting rhythmic bursting temporally correlated with the EEG spikes. The repetitive discharges in STN neurons accompanying absence seizures might convey powerful excitation to basal ganglia output nuclei and, consequently, may participate in the control of thalamocortical SWDs.

Action Potentials↗