Seizure

Loss of consciousness and falling are the key features of syncope. Common accompaniments include tonic and myoclonic muscle activity, eye deviations, automatisms, vocalizations and hallucinations that may render the distinction from epileptic seizures difficult. The frequently increased levels of serum prolactin (SPRL) were observed immediately after generalized and complex partial seizures. Presumably, the hormone release is caused by the propagation of epileptic activity, usually from the temporal lobe to the hypothalamic pituitary axis. Numerous reports have demonstrated that the post-ictal SPRL level may be used to differentiate between epileptic and syncopal, non-epileptic attacks. In order to confirm the hypothesis, the SPRL levels were measured in patients with compex partial seizures (CPS) and patients with vaso-vagal syncopal attacks (VVS). The SPRL levels were prospectively measured for each patient as soon as possible after the event (within 1 hour), then 1 hour after the first determination and finally blood was sampled 24 hours later. During the study period (18 months), 18 patients with CPS and 15 patients with VVS were investigated in total. The mean values of SPRL levels in both groups were increased immediately after the event (CPS group: 1142 ± 305 mIU/l; VVS group: 874 ± 208 mIU/l). The elevated SPRL levels were found in 14 (78%) patients immediately after CPS and in 9 (60%) patients immediately after VVS. After examining the results of the present study we conclude that the elevated serum prolactin level after an epileptic attack is of no significant value in differential diagnosis between epileptic and vaso-vagal syncopal attacks.

The aim of this study was to determine whether lamotrigine can be reintroduced safely and with a benefit in young people who previously had a mild rash associated with the first introduction of this drug. In the first 150 young people (5-19 years old) treated with lamotrigine in a special centre for epilepsy, seven developed a mild rash soon after starting the drug. In none of these cases was the rash severe, nor was there any mucous membrane involvement. The lamotrigine was stopped immediately when the rash was identified and was subsequently reintroduced , using a special very-low-dose-escalation regime, starting with 0.1 mg/day total daily dose, after periods ranging from 47 to 236 days. It was possible to reintroduce the lamotrigine without recurrence of persistent rash and without any adverse effects in all seven cases. The re-introduction of lamotrigine was associated with improvement in five of the seven cases. It is recommended that lamotrigine is stopped as soon as any rash attributable to the drug develops but it may be possible to reintroduce the drug after mild rash using a very-slow-dose-escalation regime, with a benefit in at least some cases.

High prevalence of eating epilepsy has previously been reported from the Central Province of Sri Lanka, though it is considered to be a rare condition in the rest of the world. We prospectively studied 526 patients in a different province for seizure provoking factors. Eating epilepsy was found among 28 patients (5.3%) supporting previous observations.

Recent literature suggests that access to an epilepsy nurse specialist (ENS) may help improve patients understanding and management of their condition and in doing so may decrease morbidity and mortality. This paper describes the role of the ENS at a large tertiary referral epilepsy centre, the National Hospital for Neurology and Neurosurgery (NHNN) in supporting patients with refractory epilepsy in the hospital and community. Approximately 300 patients were referred to the ENS in the first 6 months of the service. A questionnaire was posted to 193 patients, 69% responded. Most patients had multiple seizures each month, took polytherapy, underwent frequent antiepileptic drug (AED) dose changes and often experienced drug side effects. Sixty percent of patients contacted the ENS for urgent medical advice. Important aspects of the service were access by telephone to medication advice, information, support and adequate time to discuss issues. The ENS improved continuity of, and accessibility to, care for patients, has become a key member of the multidisciplinary epilepsy team and has freed up scarce medical time.

KEY POINTS

Seizure semiology represents the dynamic clinical expression of seizures and is an important data
source providing clues to cerebral organization.

Seizure semiology is produced through interactions between seizure onset and propagation within
physiologic and pathologic brain networks.

Semiology can be described in spatial and temporal terms, and depends on both spatial and temporal
characteristics of cerebral electrical activity.

Stereoelectroencephalography studies of electroclinical correlations, including with quantified
signal analysis, have helped elucidate several semiological patterns.

Future research could help improve pattern recognition of complex semiological patterns, possibly
using deep learning methods in a multiscale, multimodal modelization framework.

The Washington Psychosocial Seizure Inventory (WPSI) clinical scales were developed via an empirical item selection approach and have been used widely to measure aspects of psychosocial functioning of patients with epilepsy. However, these empirically derived clinical scales have not been assessed psychometrically using a modern item response theory-based model. The goals of this study were to: (1) evaluate how items in each clinical scale performed in such a way as to represent the underlying constructs being measured; and (2) derive a shorter version while maintaining measurement precision. WPSI item response data from 145 adults with epilepsy collected for an evaluation study of an intervention to pact negative attributional style in epilepsy were used. The dichotomous Rasch model suitable for the true-false response choices was used to analyse each clinical scale separately. Most items within each scale fit the measurement model well, with very few exceptions. All items, therefore, were retained. A method, based on computerised adaptive testing (CAT), is offered for shortening the WPSI using a psychosocial outcomes item bank derived from the study. Individuals' specific levels of functioning are used to derive measures of their psychosocial functioning with a minimum number of items.

Epilepsy is one of the most common neurological diseases and the most common neurological chronic disease in childhood. Electroencephalography (EEG) still remains one of the most useful and effective tools in understanding and treatment of epilepsy. To this end, many computational methods have been developed for both the detection and prediction of epileptic seizures. Techniques derived from linear/nonlinear analysis, chaos, information theory, morphological analysis, model-based analysis, all present different advantages, disadvantages, and limitations. Recently, there is the notion of selecting and combining the most robust features from different methods for revealing various signals' characteristics and making more reliable assumptions. Finally, intelligent classifiers are employed in order to distinguish epileptic state out of normal states. This chapter reviews the most widely adopted algorithms for the detection and prediction of epileptic seizures, emphasizing on information theory based and entropy indices. Each method's accuracy has been evaluated through performance measures, assessing the ability of automatic seizure detection/ prediction.

Yoga is an age-old traditional Indian psycho-philosophical-cultural method of leading one's life, that alleviates stress, induces relaxation and provides multiple health benefits to the person following its system. It is a method of controlling the mind through the union of an individual's dormant energy with the universal energy. Commonly practiced yoga methods are 'Pranayama' (controlled deep breathing), 'Asanas' (physical postures) and 'Dhyana' (meditation) admixed in varying proportions with differing philosophic ideas. A review of yoga in relation to epilepsy encompasses not only seizure control but also many factors dealing with overall quality-of-life issues (QOL). This paper reviews articles related to yoga and epilepsy, seizures, EEG, autonomic changes, neuro-psychology, limbic system, arousal, sleep, brain plasticity, motor performance, brain imaging studies, and rehabilitation.

Background: Epilepsy is a common condition with up to 1% prevalence in the general population. In the perioperative course of neurologic surgery patients, the use of prophylactic and therapeutic antiepileptic drugs is a common practice. Nonetheless, there is limited evidence supporting the use of prophylactic antiepileptics to prevent perioperative seizures and there are no guidelines for which anesthetic technique is preferred. Objective: To discuss the seizurogenic potential of anesthetic drugs and to discuss intraoperative seizures in neurosurgical patients. Method: We performed a search of the literature available in PubMed and Ovid MEDLINE. We also included articles identified in the review of the references of these articles. Results: The incidence of seizures is heterogenic among neurosurgical patients. Seizure prophylaxis is widely administered despite limited available evidence of its effectiveness. In epileptic patients the recommendation is to continue antiepileptic drugs in the perioperative setting. In these patients, anesthesiologists may also limit the use of medications that alter the seizure threshold and avoid medications that pose significant pharmacological interaction with antiepileptic drugs. Conclusion: In conclusion, a knowledgeable multidisciplinary perioperative team is essential to avoid, identify and treat intraoperative seizures competently. In patients with a history of epilepsy it is recommended to continue antiepileptic therapy. Therefore, clinical judgment should guide the decision of administering seizure prophylaxis in neurosurgery patients according to an individual assessment of potential risk for seizures. Furthermore, there is a need for randomized controlled trials that support new protocols and/or guidelines for anesthetic and perioperative regimens to prevent and treat intraoperative seizures.

In the neurology literature it is well established that anti-epileptic drugs (AEDs) lead to bone loss (osteopenia and osteoporosis). Several large epidemiologic studies have found twice the fracture rate in persons with epilepsy compared to the non-epilepsy population. While an increasing level of awareness for preventative measures and screening by neurologists and primary care physicians are recommended, so far no one has attempted to address how knowledge related to calcium and exercise, health beliefs (based on the Health Belief Model) and self-efficacy (confidence in abilities) impact osteoprotective behaviors in epilepsy, based on the Precaution Adoption Process Model (PAPM). The seven-stage PAPM, unlike other health behavior theories where a person is either practicing or not practicing the behavior, conceptualizes behavior change as dynamic and occurring over time. Validated instruments were used to assess knowledge, health beliefs, self-efficacy and stages of the precaution...

Background: Śilājatu (Shilajit; SJ) is claimed in traditional Indian medical practice to be useful in the treatment of nervous disorders, epilepsy and as antistress.
Aim: To investigate whether SJ possesses antiepileptic and antipsychotic activities in rodents.
Materials and Methods: Isonicotinyl hydrazine (INH), pentylenetetrazole (PTZ), apomorphine, phenytoin, diazepam, haloperidol and other chemicals of analytical grade were procured from standard companies. The antiepileptic activity of SJ was assessed using maximal electro shock (MES)-induced seizures in rats, INH and PTZ-induced seizures in mice. The antipsychotic effect of SJ was evaluated using apomorphine-induced climbing and stereotyped behaviours respectively, in mice and rats.
Settings and Designs: SJ (25 and 50 mg/kg, p.o.) was given orally once daily for 15 days in all the rodent models. On the test day, SJ was administered 1 h prior to electric shock or chemical inducers (INH/PTZ/apomorphine) in experimental animals; the animals were then observed for different phases of seizures and psychotic behaviours. In addition, gamma-aminobutyric acid (GABA) content in the brain of rats and mice was estimated in seizure models.
Statistical Analysis: The data were expressed as mean ± standard error of mean. Statistical comparisons were performed by one-way ANOVA followed by Tukey's post-test using Graph Pad Prism version 5.0, USA. A P < 0.05 was considered significant.
Results and Conclusions: SJ pretreatment significantly inhibited the seizures induced by MES, INH and PTZ in a dose dependent manner. Further, SJ augmented brain GABA levels to normal, decreased by INH and PTZ in mice brain. SJ pretreatment also significantly inhibited the climbing and stereotyped behaviours induced by apomorphine. The present data seems to confirm the antiepileptic activity of SJ which may be because of enhancing the GABAergic system. The antipsychotic activity observed may be due to anti-dopaminergic and/or GABA-mimetic actions.

People with epilepsy frequently experience problems in marriage including reduced marital prospects, poor marital outcomes and diminished quality of married life. Conversely, marriage might impact epilepsy self-management and quality of life in people with epilepsy. There is little in published literature on marriage and epilepsy, so there is a need for psycho-behavioral research. Here, we focus on arranged marriages which, although now rare in western cultures, are widely prevalent in South Asian communities. Arranged marriages, in which families rather than individuals choose marital partners, are particularly problematic because epilepsy is frequently hidden during marital negotiations as well as later. From the psycho-behavioral perspective, marital prospects, outcomes and satisfaction should be examined in relation to the type of marriage (arranged vs. love) and whether or not epilepsy is hidden. Additionally, culturally-relevant tools to appraise marital quality and epilepsy s...

Background: The parental role is crucial in the management of children with epilepsy before, during, and after the seizures. It is crucial to ascertain the sufficient knowledge, attitude, and proper practice of the caregivers about epilepsy; however, caregivers with high self-efficacy are more able to achieve caregiving tasks of epilepsy children at the best level.
Purpose: To assess the effect of an educational intervention on the knowledge, attitude, reported practice and self-efficacy of caregivers of children with epilepsy.
Methods: A pretest-posttest quasi-experimental design was used to carry out the study, in which a convenient sample of 60 caregivers for epilepsy children was chosen from the outpatient clinics of Al-Ahrar Zagazig Teaching Hospital. The candidates were asked to fill up a questionnaire as a pre-test, and then were exposed to a tailored educational intervention about epilepsy before being reassessed again using the same questionnaire.
Results: Most of caregivers were married females, and mainly mothers. Although caregivers generally had low level of knowledge, attitudes, reported practices, and self-efficacy about epilepsy before the educational intervention, they improved significantly after the educational intervention. The educational program was a significant independent positive predictor of caregivers’ scores of knowledge, attitudes, practice and self-efficacy.
Discussion: The study findings demonstrate significant improvements in the knowledge, attitude, and reported practice as well as the self-efficacy scores of caregivers of children with epilepsy following the implementation of the educational intervention, which reflects the importance of providing educational intervention to improve the knowledge, attitude, practice, and self-efficacy of epilepsy children caregivers.

The purpose of the study was to examine the psychometric properties of the revised Liverpool Seizure Severity Scale. The scale has been adapted to increase its content validity and its potential for detecting change attributable to antiepileptic drug treatment. Ninety-seven patients completed the revised scale of which 32 completed it for both major and minor seizures. Reliability of the revised scale was conducted using assessment of internal consistency and test-retest. T-tests were conducted to assess the ability of patients to differentiate between major and minor seizures on scores of the seizure-severity scale. The psychometric properties of the scale were not adversely affected by either the increase in the number of items or the additional response scores. Patients completing the two scales of major and minor seizures were able to reliably differentiate between the two. We have attempted to improve the Liverpool Seizure Severity Scale in order to enhance its reliability, validity and sensitivity to change. The amendments we have made have not adversely affected its psychometric properties and we hope that it will make it more acceptable for use in clinical trials of new antiepileptic drug treatment. The revised scale is currently being applied to a number of clinical trials.

Purpose: Ehlers-Danlos syndrome (EDS) comprises a variety of inherited connective tissue disorders that have been described in association with various neurological features. Until now the neurological symptoms have not been studied in detail; therefore, the aim of this review is to analyze the possible association between EDS, epilepsy and periventricular heterotopia (PH). Methods: We have carried out a critical review of all cases of epilepsy in EDS patients with and without PH. Results: Epilepsy is a frequent neurological manifestation of EDS; generally, it is characterized by focal seizures with temporo-parieto-occipital auras and the most common EEG findings epileptiform discharges and slow intermittent rhythm with delta-theta waves. Epilepsy in EDS patients is usually responsive to common antiepileptic therapy; very few cases of drug resistant focal epilepsy requested surgical treatment, with favorable results in terms of outcome. Epilepsy is the most common presenting neurological manifestation associated with PH in EDS patients. Abnormal anatomic circuitries (including heterotopic nodules) could generate epilepsy in patients with PH. Conclusion: Among the principal neurological manifestations, epilepsy and PH have a considerable importance and can influence the long-term evolution of these patients. We hypothesize that PH may determine the epileptic manifestations in patients with EDS; much remains to be learnt about the relationships between nodules and the epileptic manifestations in EDS syndrome.

In this paper we propose an automatic newborn seizure detection using heart rate variability (HRV). Our algorithm is based on the electrocardiogram (ECG) from which, heartbeat changes were obtained and HRV signals were extracted. Linear and nonlinear features of HRV signals are calculated. Linear features consist of time domain, frequency domain and time-frequency features, while nonlinear features are extracted from Poincare plot and detrended fluctuations analysis (DFA). Extracted time domain features are average and standard deviation of HRV signals, which were used due to respiratory disorders at the seizure time. Frequency analysis was handled using power spectral density (PSD). Wigner-Ville distribution as a powerful and enhanced analysis tool was used for timefrequency feature extraction. Optimal features were selected using forward sequential feature selection algorithm and KNN was used for classification. Our algorithm was tested on ECG recordings of eight newborns with seizure, and reached the sensitivity of 91.32% and specificity of 80.1%. These results suggest reliable modeling of automatic nerve system based on HRV.

Objective: To determine whether carbamazepine monotherapy in epilepsy patients is or is not associated
with prolongation of the QTc interval.
Methods: This case-control study enrolled 100 consecutive
patients with generalized tonic-clonic seizures. Fifty patients were already taking carbamazepine for a variable time, and the rest (n=50) were not on any antiepileptic drug. The QTc interval was calculated after doing a resting 12-lead ECG examination on a single occasion.
Results: Of the 50 patients who had received arbamazepine, 11 patients displayed prolongation of their QTc interval, while 8 patients out of the 50 in the control group had QTc interval prolongation after correction for gender; p-value
=0.49, OR 1.36, 95% CI 0.54-3.29.
Conclusion: This study demonstrated no statistically significant association between carbamazepine monotherapy and prolongation of the QTc interval. Carbamazepine does not seem to prolong the QT
interval when used as monotherapy for epilepsy. The presence of prolonged QTc interval in such patients should prompt a search for co-factors that prolong this interval, such as multiple medications, electrolytes disturbances, structural heart disease, and congenital long QT interval syndromes.

First and foremost, I wish to thank the participants in the study. Thank you for open-heartedly sharing your experiences and thoughts with me. The study was funded through a research fellow position at Oslo University Hospital (OUS). Lars Nordsletten, departmental head of the Research and Development clinic for surgery and neurology, has been my formal supervisor during the period of my fellowship; thank you for the funding and your trust. The thesis has allowed me to go in depth in my special interest of area; it has been a long and good journey. General Practitioner and associate professor Ole Rikard Haavet in the Faculty of Medicine at the University of Oslo, has been my main supervisor. Thank you for your regular supervision sessions in your office; these have been a stabilizing factor and have provided inspiration for the work. Your advice during the many phases of the study and your professional input, your acute assessments of the text, and your constant reminders of "the red thread" have been a great help.

Many outstanding studies have reported promising results in seizure forecasting, one of the most challenging predictive data analysis problems. This is mainly because electroencephalogram (EEG) bio-signal intensity is very small, in µV range, and there are significant sensing difficulties given physiological and non-physiological artifacts. Today the process of accurate epileptic seizure identification and data labeling is done by neurologists. The current unpredictability of epileptic seizure activities together with the lack of reliable treatment for patients living with drug resistant forms of epilepsy creates an urgency for research into accurate, sensitive and patient-specific seizure forecasting. Most seizure forecasting algorithms use only labeled data for training purposes. As the seizure data is labeled manually by neurologists, preparing the labeled data is expensive and time consuming, making the best use of the data critical. In this article, we propose an approach that can make use of not only labeled EEG signals but also the unlabeled ones which are more accessible. We use the short-time Fourier transform on 28-s EEG windows as a pre-processing step. A generative adversarial network (GAN) is trained in an unsupervised manner where information of seizure onset is disregarded. The trained Discriminator of the GAN is then used as a feature extractor. Features generated by the feature extractor are classified by two fully-connected layers (can be replaced by any classifier) for the labeled EEG signals. This semi-supervised patient-specific seizure forecasting method achieves an out-of-sample testing area under the operating characteristic curve (AUC) of 77.68%, 75.47% and 65.05% for the CHB-MIT scalp EEG dataset, the Freiburg Hospital intracranial EEG dataset and the EPILEPSIAE dataset, respectively. Unsupervised training without the need for labeling is important because not only it can be performed in real-time during EEG signal recording, but also it does not require feature engineering effort for each patient. To the best of our knowledge, this is the first application of GAN to seizure forecasting.

Epilepsy is a most common and chronic neurological disorder characterized by recurrent unprovoked seizures. The key aim in treating patients with epilepsy is the suppression of seizures. An understanding of focal changes that are involved in epileptogenesis may therefore provide novel approaches for optimal treatment of the seizure. Although the actual pathogenesis of epilepsy is still uncertain, recently growing evidence declare that microglia and astrocytes activations, oxidative stress and reactive oxygen species (ROS) production, mitochondria dysfunction, and damage of blood-brain barrier (BBB) are involved in its pathogenesis. Impaired GABA-ergic function in the brain is probably the most accepted hypothesis regarding the pathogenesis of epilepsy. Clinical neuroimaging of patients and experimental modeling have demonstrated that seizures may induce neuronal apoptosis. Apoptosis signaling pathways are involved in the pathogenesis of several types of epilepsy such as temporal-lobe epilepsy (TLE). The quality of life of patients is seriously affected by treatment-related problems and also by unpredictability of epileptic seizures. Moreover, the available antiepileptic drugs (AED) are not significantly effective to prevent epileptogenesis. Thus, novel therapies that are proficient to control seizure in people who are suffering from epilepsy are needed. The preconditioning method promises to serve as an alternative therapeutic approach, because this strategy has demonstrated the capability to curtail epileptogenesis. For this reason, understanding of molecular mechanisms underlying brain tolerance induced by preconditioning is crucial to delineate new neuroprotective ways against seizure-damage and epileptogenesis. In this review, we summarize the work to date on pathogenesis of epilepsy, and discuss recent therapeutic strategies in treatments of epilepsy. We will highlight that novel therapy targeting such as preconditioning process hold great promise. In addition, we will also highlight the role of gene reprogramming and mitochondrial biogenesis in the preconditioning-mediated neuroprotective events.

Objective: The C3435T, a major allelic variant of the ABCB1 gene, is proposed to play a crucial role in drug-resistance in epilepsy. The C/C genotype carriers reportedly are at higher risk of pharmacoresistance to AEDs, but only in some studies. The hypothesis of the C-variant associated risk and resistance to antiepileptic drugs (AEDs) has been hampered by conflicting results from inadequate power in case-control studies. To assess the role of C3435T polymorphism in drug-resistance in epilepsy, a systematic review and meta-analysis was conducted. Methods: Databases were obtained from the Cochrane Library, MEDLINE, EMBASE, major American and European conference abstracts, and www.google.my for genetic association studies up to February 2010. All the case-control association studies evaluating the role of ABCB1 C3435T in pharmacoresistance to AEDs were identified. The new definition of treatment outcome from International League Against Epilepsy (ILAE) was used for including studies for sub-analysis. To measure the strength of genetic association for the gene variant, the odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using models of both fixed- and random-effects for comparisons of the alleles and genotypes with co-dominant (C/C vs. T/T, C/T vs. T/T), dominant (C/C + C/T vs. T/T), and recessive (C/C vs. C/T + T/T) models in overall and in ethnicity subgroups. The 19 studies were selected for the next sub-analysis based on the new definition of drug-responsiveness and drug-resistance from ILAE. The same analysis was also performed for treatment outcome and ethnicity subgroups. Results: A total of 22 association studies including 3231 (47.8%) drug-resistant patients and 3524 (52.2%) drug-responsive patients or healthy controls (genotyped for C3435T) were pooled in this meta-analysis. The allelic association of ABCB1 C3435T with risk of drug-resistance was not significant under fixed-effects model, 1.06 (95% CI 0.98-1.14, p = 0.12) and random-effects model, 1.10 (0.93-1.30, p = 0.28) in overall and in the subgroup analysis by ethnicity. Similar results were also obtained for all genetic models in the stratified analyses by new definition of drug-resistance by ILAE and ethnicity subgroups. There was no publication bias. Conclusion: We failed to show an association between the ABCB1 C3435T polymorphism and the risk of drug-resistance suggesting a revision in contribution of this polymorphism in the multi-drug transporters hypothesis of pharmacoresistance to AEDs in epilepsy. © 2010 British Epilepsy Association.

Amongst children with epilepsy, research has shown that most have a negative self-concept and consequently a low level of self-esteem. This elusive concept of the self is constantly being assessed and reassessed by each child throughout the process of social development. Early literature has suggested that children with disabilities, especially chronic medical or biological disabilities, typified by epilepsy and diabetes, are more susceptible to the development of psychopathology and negative self-concepts.

The purpose of this study was to investigate the anticonvulsant activity of the volatile oil of nutmeg, the dried seed kernel of Myristica fragrans Houtt, using well-established animal seizure models and to evaluate its potential for acute toxicity and acute neurotoxicity. The volatile oil of nutmeg (nutmeg oil) was tested for its effects in maximal electroshock, subcutaneous pentylenetetrazole, strychnine and bicuculline seizure tests. All the experiments were performed at the time of peak effect of nutmeg oil. Nutmeg oil showed a rapid onset of action and short duration of anticonvulsant effect. It was found to possess significant anticonvulsant activity against electroshockinduced hind limb tonic extension. It exhibited dose dependent anticonvulsant activity against pentylenetetrazoleinduced tonic seizures. It delayed the onset of hind limb tonic extensor jerks induced by strychnine. It was anticonvulsant at lower doses, whereas weak proconvulsant at a higher dose against pentylenetetrazole and bicuculline induced clonic seizures. Nutmeg oil was found to possess wide therapeutic margin, as it did not induce motor impairment when tested up to 600 µ µ µ µ µL/kg in the inverted screen acute neurotoxicity test. Furthermore, the LD 50 (2150 µ µ µ µ µL/kg) value was much higher than its anticonvulsant doses (50-300 µ µ µ µ µL/kg). The results indicate that nutmeg oil may be effective against grand mal and partial seizures, as it prevents seizure spread in a set of established animal models. Slight potentiation of clonic seizure activity limits its use for the treatment of myoclonic and absence seizures.

—The Hilbert Huang Transform (HHT) has been used extensively in the time-frequency analysis of electroencephalogra-phy (EEG) signals and Brain-Computer Interfaces. Most studies utilizing the HHT for extracting features in seizure prediction have used intracranial EEG recordings. Invasive implants in the cortex have unknown long term consequences and pose the risk of complications during surgery. This added risk dimension makes them unsuitable for continuous monitoring as would be the requirement in a Body Area Network. We present an HHT-based system on Field Programmable Gate Array (FPGA) for predicting epileptic seizures using scalp EEG. We use bandwidth features of Intrinsic Mode Functions and obtain a classification accuracy of close to 100% using patient-specific classifiers in software. Details of FPGA implementation are also given.

Sparteine is a quinolizidine alkaloid extracted from Lupinus that has numerous pharmacological properties both in humans and animal models. In the central nervous system, sparteine reduces locomotor activity, has light analgesic effects, also has no effects on short-term memory or spatial learning and does not induce changes in behavior or electroencephalographic (EEG) activity. However, the anticonvulsant profile of sparteine is not fully characterized in experimental animals and there are no data in humans. Therefore, the present review focuses on the experimental evidence supporting the anticonvulsant action of sparteine in models of acute seizures and status epilepticus (SE), as well as its possible mechanisms of action. The evidence that supports the anticonvulsant effect of (-)-Sparteine sulfate includes the inhibition of seizures induced by maximal electro-stimulation, a delay in the onset of convulsive behavior and the prolongation of survival time in mice treated with pentylenetetrazole (PTZ). Additionally, sparteine delays the onset of convulsive behavior and decreases the severity and mortality of rats treated with PTZ and pilocarpine. Sparteine decreases amplitude and frequency or blocks the epileptiform activity induced by PTZ, pilocarpine and kainic acid. Sparteine may decrease hyper excitability through the activation of the M2 and M4 subtypes of mAChRs, which is a probable mechanism of action that together with its systemic effects may favor its anticonvulsant effects against seizures and SE.

The group of idiopathic epilepsies encompasses numerous syndromes without known organic substrate. Genetic anomalies are thought to be responsible for pathogenesis, with a monogenic or polygenic model of inheritance. Over the last two decades, a number of genetic anomalies and encoded proteins have been related to particular idiopathic epilepsies and epileptic encephalopathies. Most of these mutations involve subunits of neuronal

There is little evidence on which to judge the optimal treatment for convulsive status epilepticus (CSE) in children. This study compares the effect of intravenous (iv) lorazepam with iv diazepam as the first line of treatment of CSE. We studied all children with prolonged seizures arriving in the Accident and Emergency (A&E) Department in two separate periods. In the first 6-month period iv diazepam was used as standard treatment, in the second 1-year period iv lorazepam was used. We measured latency to stopping of seizure and any adverse events. A successful treatment was defined as one in which the seizure clinically ceased within 15 minutes after siting the iv cannula, requiring no further treatment. Intravenous diazepam (0.32 mg kg −1 ) was used in 17 of 26 patients, whilst iv lorazepam (0.13 mg kg −1 ) was used in 31 of 59. There were no differences between the two groups regarding age, sex and seizure type. The seizure was successfully controlled 15 minutes after siting the iv cannula in 11 (65%) patients treated with diazepam (median time of 3 minutes) and in 20 (65%) patients treated with lorazepam (median time of 5 minutes). These preliminary results suggest that iv lorazepam may be as effective as iv diazepam.

* English after Arabic
رام الله - صدر حديثاً عن المركز الفلسطيني للدراسات الإسرائيلية "مدار" كتاب تحت عنوان: "لمعاينة
الجمهور: الفلسطينيّون في الأرشيفات العسكريّة الإسرائيليّة" لرونة سيلع، ترجمه علاء حليحل، يقع في 530 صفحة، يصف رحلة بحث شاقة تلاحق مصائر الصور الفلسطينية المعتقلة في الأرشيفات الإسرائيلية، سواء أكانت مسروقة من بيوت الفلسطينيين ومن جيوب شهدائهم، أم تلك التي التقطت من داخل القرى ومن سمائها لأهداف عسكرية.

ويضم الكتاب عدداً كبيراً من الصور النادرة وعالية الجودة للحياة في فلسطين، وللأحداث المؤثرة في تاريخها، إلى جانب مجموعة صور ملتقطة من الجو، تظهر المعالم الكاملة لعدد من القرى الفلسطينية المدمرة ببيوتها وشوارعها وحاراتها، بما يتيح استعادة مبناها المعماريّ والجغرافيّ والطوبوغرافيّ.

"لمعاينة الجمهور" كتاب يرصد الطرق التي اتبعتها الأجهزة العسكريّة في إسرائيل، وقبلها، لجمع وحفظ المعارف والمعلومات البصريّة، والأخرى المتعلقة بالفلسطينيّين، على مدار القرن العشرين المنصرم، وكيفية سيطرة الأرشيفات العسكريّة على هذه المعارف وإدارتها إدارة كولونياليّة، بكل ما تحمله الكلمة من معنى، وعلى نحو يشبه تمام ما مارسته قوى الاستعمار الحديث، بل بطرق أكثر تركيباً.

ويبين الكتاب كيف ترتبط غالبيّة المعلومات والمعرفة بخصوص الفلسطينيّين في الأرشيفات العسكريّة بتدابيرَ متنوّعة من النشاطات الاستخباراتيّة لغايات عسكريّة، وما واكبها من سلب قامت به جهات عسكريّة رسميّة من أرشيفات ومجموعات تتبع لمؤسّسات وبيوت خاصّة، وجنود وشهداء وأسرى، وحتى نسخ المعلومات سرّاً وجمع المعلومات المتعلّقة بالفلسطينيّين وبلداتهم لغايات السيطرة والاحتلال.

وقد جُمعت هذه الموادّ وفق الكتاب برُمّتها من مصادر ومبدعين فلسطينيّين، أو أنّ قواتٍ يهوديّة/ إسرائيليّة أنشأتها، وهي مواد ذات أهميّة للفلسطينيّين، وتخضع لأجهزة ومنظومات كولونياليّة قمعيّة تقوم بإدارتها والسيطرة عليها. وتشمل هذه المنظومات الرقابة وتقييد الكشف والمعاينة، والشطب وإخفاء المعلومات والسيطرة على هُويّة المخوّلين بمعاينة هذه المواد، ودمغ الملكية على موادّ محتلة وإخضاعها لقوانين الدولة المحتلّة ولمعايير ونُظُم الأرشيفات الاحتلاليّة، والتفسير والتصنيف المغرّضَيْن.

صدر كتاب "لمُعاينة الجمهور" أوّل مرة بالعبريّة، عام 2009، ليقوم بإعادة طرح تصويراتٍ في الحيّز العام، غالبيّتها لم تكن قد عُرضت من قبل، خصوصاً الصور والمواد التابعة للفلسطينيّين، وتلك التي تدور حولهم، حتى سنوات الخمسين من القرن العشرين، وطَرَح لأوّل مرة النقاش حول منظومات وأجهزة السيطرة الكولونياليّة. إلى جانب ذلك، قامت أبحاث أخرى أجرتها سيلع من وقتها وحتى اليوم، بالكشف عن موادّ إضافيّة - بصريّة ونصّيّة- أُخِذت كغنائم أو نُهبت على مرّ القرن العشرين، خصوصاً في بيروت. وعليه، يخصّص الكتاب مساحة معتبرة، أيضاً، لهذه الأرشيفات، ويسعى للكشف عن المواد التي نبشتها سيلع من وقتها، عبر مَساعٍ قضائيّة وفاعليّة بحثيّة.

Ramallah – The Palestinian Forum for Israeli Studies (MADAR) has recently published the Arabic edition of Made Public: Palestinian Photographs in Military Archives in Israel by Rona Sela. Translated into Arabic by Ala Huleihel, the book comprises 530 page. Made Public describes an arduous journey of research to track down the destiny of Palestinian photographs seized in Israeli archives. These were looted from Palestinian homes or pockets of Palestinian martyrs, or taken from within or from the skies of Palestinian villages for military purposes.

Made Public features a large number of rare high quality photographs of life in Palestine and the events that influenced Palestine’s history. It also presents a collection of aerial photographs, unfolding fully the landmarks of a number of destroyed Palestinian villages, including homes, streets and neighbourhoods. Aerial photographs allow restoring the architectural, geographical and topographical structures of these villages.

Made Public provides an account of the methods used by the Israeli pre-state and state military bodies to collect and preserve visual information and other material related to Palestinians throughout the 20th century. It shows how military archives seized control of, and subjected, this data to a colonial administration in every sense and in a manner that exactly identical to the practices of modern colonial powers, but in more sophisticated ways.

Sela describes how the bulk of information and knowledge about Palestinians in the military archives were linked to a variety of measures, including intelligence activities for military purposes. Concomitantly, official military bodies plundered materials from archives and groups affiliated with institutions, private homes, soldiers, martyrs and prisoners. Furthermore, these bodies secretly photocopied information on Palestinians and their towns for the purposes of domination and occupation.

According to Sela, these materials were collected in their entirety from Palestinian sources and creative figures or made by Jewish/Israeli forces. The materials are of relevance to Palestinians. They are managed and controlled by oppressive colonial agencies and structures, which involve censorship, obstruct access, prevent disclosure, delete, conceal information, and control the identity of persons authorised to access these materials. Colonial structures also take possession of, and subject, the materials to the laws of the occupying Power, criteria and regulations of Israeli archives, and malicious interpretation and classification.

Made Public was first published in Hebrew in 2009. It reintroduces representations of the public sphere, the majority of which were proposed earlier. These particularly feature photographs and materials related to, or revolving around, Palestine up until the 1950s. For the first time, a discussion was raised about colonial control systems and agencies. In addition, other research conducted later by Sela reveals that further materials – visual and textual – were taken as booty or looted over the course of the 20th century, particularly in Beirut. Against this backdrop, Sela designates a substantial section of Made Public to address these archives. This section seeks to disclose the materials which Sela has brought to light through judicial pursuits and effective research process

(Book: Human rights as a basis for reevaluating and reconstructing the law, Bruxelles, Bruylant)

This contribution succinctly analyzes the birth and evolution of legal instruments oriented towards the proceeds of crime; and the difficult balance that must be sought when targeting assets between efficient repression and respect of fundamental rights.