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Wolf F, Japaridze N, Muthuraman M, Wiegand G, Kadish N, Stephani U, Siniatchkin M. PB15. Neurophysiological biomarker for the clinical development of tuberous sclerosis. Clin Neurophysiol 2018. [DOI: 10.1016/j.clinph.2018.04.640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Siniatchkin M, Andrasik F, Kropp P, Niederberger U, Strenge H, Averkina N, Lindner V, Stephani U, Gerber WD. Central Mechanisms of Controlled-Release Metoprolol in Migraine: A Double-Blind, Placebo-Controlled Study. Cephalalgia 2016; 27:1024-32. [PMID: 17680819 DOI: 10.1111/j.1468-2982.2007.01377.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
β-Blockers are widely used in the prophylaxis of migraine and have been described as very effective drugs in many studies. Some investigators have demonstrated that the clinical improvement of migraine corresponds to the normalization of the contingent negative variation (CNV), a slow cortical potential measuring cortical information processing. However, most of these studies have contained a variety of methodological pitfalls, which we attempted to address in the current study. Twenty patients suffering from migraine without aura were randomly divided into two groups. The groups were treated either with controlled-release metoprolol or placebo for 3 months, using a double-blind design. Twice before and once after each month of the treatment the CNV was recorded. After 3 months, a significant reduction of migraine frequency, duration and intensity was demonstrated for the metoprolol compared with the placebo group. The CNV was characterized by a marked reduction of the amplitude of the total CNV and postimperative negative variation and normalization of the eartly CNV habituation following treatment. Therefore, metoprolol may exert its prophylactic effect in migraine through the influence on cortical information processing and excitability represented by the CNV.
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Affiliation(s)
- M Siniatchkin
- Neuropaediatric Department, Christian-Albrechts-University of Kiel, Kiel, Germany.
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Lang N, Esser W, Evers S, Kellinghaus C, Nguento A, Schlegel U, Gaida B, Gburek-Augustat J, Altenmüller DM, Burghaus L, Hoffmann F, Fiedler B, Bast T, Rehfeld T, Happe S, Seitz RJ, Boor R, Stephani U. Intravenous levetiracetam in clinical practice--Results from an independent registry. Seizure 2015; 29:109-13. [PMID: 26076852 DOI: 10.1016/j.seizure.2015.03.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 03/06/2015] [Accepted: 03/26/2015] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Most common clinical studies with antiepileptic drugs do not reflect medical everyday practice due to their strict in- and exclusion criteria and specifications of treatment regimens. Here we present a large non-interventional registry with the intention to evaluate the spectrum of applications in daily use and the efficacy and tolerability of intravenously given levetiracetam (LEV-iv). METHODS In a prospective approach of 17 neurological and neuropediatric centres in Germany LEV-iv treated patients of all ages were included over a period of 10 months. The observational period was 10 days with daily documentation of LEV-iv administration, type and frequency of seizures, currently used drugs and doses, and adverse events (AEs). In addition, treatment efficacy and tolerability were assessed by patients and physicians at study end as well as practicability of LEV-iv using a five-step scale. RESULTS In 95 patients LEV-iv was administered, 93 were included into the analysis. The median LEV-iv dose was 1500 mg (range 110-6000 mg) per day. Median age was 66 years (range 0.7-90.3 years). The majority of patients (n=70, 75%) suffered from status epilepticus (SE, n=55, 59%) and acute seizure clusters (n=15, 16%). Of those with SE, 41 patients (75%) had SE for the first time. Acute seizure clusters and SE terminated in 83% after LEV-iv administration. A total of 29 adverse events were reported in 17 of the 95 patients from the safety set. Ten of these were at least possibly related to LEV-iv treatment. Slight decrease of blood pressure during the infusion (3 patients each) was captured most frequently. No serious side effect was observed. Physicians rated the efficacy and tolerability of LEV-iv treatment as good or very good in 78% and 82% of the cases, respectively. CONCLUSION In this large observational study of everyday practise the use of LEV-iv exhibited a remarkable good response and tolerability in patients with acute onset seizures (mostly SE). Further randomized controlled studies, like the established status epilepticus trial (ESET) are needed to confirm these findings.
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Affiliation(s)
- N Lang
- Department of Neurology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - W Esser
- Department of Neurology, Städtisches Klinikum, Karlsruhe, Germany
| | - S Evers
- Department of Neurology, Lindenbrunn Hospital, Coppenbrügge, Germany
| | - C Kellinghaus
- Department of Neurology, Klinikum, Osnabrück, Germany
| | - A Nguento
- Department of Neurology, Asklepios Klinikum Uckermark, Schwedt, Germany
| | - U Schlegel
- Department of Neurology, Ruhr University, Bochum, Germany
| | - B Gaida
- Department of Neurology, University Hospital, Greifswald, Germany
| | - J Gburek-Augustat
- Department of Neuropediatrics, University Hospital, Tübingen, Germany
| | | | - L Burghaus
- Department of Neurology, University Hospital, Köln, Germany
| | - F Hoffmann
- Department of Neurology, Krankenhaus Martha-Maria, Halle, Germany
| | - B Fiedler
- Department of Neuropediatrics, University Hospital, Münster, Germany
| | - T Bast
- University Children's Hopsital, Heidelberg, Germany
| | - T Rehfeld
- Department of Neurology, Dietrich Bonhoeffer Klinikum, Neubrandenburg, Germany
| | - S Happe
- Department of Neurology, Klinik Maria Frieden, Telgte, Germany
| | - R J Seitz
- Department of Neurology, University Hospital, Düsseldorf, Germany
| | - R Boor
- Northern German Epilepsy Centre for Children and Adolescents, Raisdorf, Germany
| | - U Stephani
- Department of Neuropediatrics, University Hospital Schleswig-Holstein, Kiel, Germany.
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Mideksa KG, Santillan-Guzman A, Japaridze N, Galka A, Stephani U, Deuschl G, Heute U, Muthuraman M. Validating the effect of muscle artifact suppression in localizing focal epilepsy. Annu Int Conf IEEE Eng Med Biol Soc 2015; 2014:3841-4. [PMID: 25570829 DOI: 10.1109/embc.2014.6944461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Source localization of an epileptic seizure is becoming an important diagnostic tool in pre-surgical evaluation of epileptic patients. However, for localizing the epileptogenic zone precisely, the epileptic activity needs to be isolated from other activities that are not related to the epileptic source. In this study, we aim at an investigation of the effect of muscle artifact suppression by using a low-pass filter (LPF), independent component analysis (ICA), and a combination of ICA-LPF prior to source localization in focal epilepsy. These techniques were applied on the EEG data obtained from a left-temporal lobe epileptic patient by artificially contaminating the isolated spike interval, present in the four left-temporal electrodes, with a muscle artifact. The results show that the muscle artifact was fully suppressed. Applying the dipole and current-density reconstruction (CDR) source-analysis algorithms on the filtered data, we were able to identify the location of the epileptogenic zone similar to that of the original undistorted data.
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Reinicke C, Muthuraman M, Anwar A, Mideksa K, Siniatchkin M, Stephani U, Japaridze N. Neuronale Netzwerke bei einem Patienten mit frühkindlicher epileptischer Enzephalopathie. KLIN NEUROPHYSIOL 2014. [DOI: 10.1055/s-0034-1370240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- C. Reinicke
- Department of Neuropediatrics, Kiel-University, Germany
| | | | - A. Anwar
- Department of Neurology, Kiel-University, Germany
| | - K. Mideksa
- Department of Neurology, Kiel-University, Germany
| | - M. Siniatchkin
- Institute for Medical Psychology and Medical Sociology, Kiel-University, Germany
| | - U. Stephani
- Department of Neuropediatrics, Kiel-University, Germany
| | - N. Japaridze
- Department of Neuropediatrics, Kiel-University, Germany
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Moeller F, Groening K, Moehring J, Muhle H, Wolff S, Jansen O, Stephani U, Siniatchkin M. EEG-fMRI in myoclonic astatic epilepsy (Doose syndrome). Neurology 2014; 82:1508-13. [DOI: 10.1212/wnl.0000000000000359] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Reinicke C, Möller F, Muthuraman M, Rauf Anwar A, Mideksa KG, Pressler R, Deuschl G, Siniatchkin M, Stephani U, Japaridze N. Neuronal networks in Burst Suppression EEG as revealed by source analysis. KLIN NEUROPHYSIOL 2014. [DOI: 10.1055/s-0034-1371244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Siniatchkin M, Sendacki M, Moeller F, Wolff S, Jansen O, Siebner H, Stephani U. Abnormal Changes of Synaptic Excitability in Migraine with Aura. Cereb Cortex 2011; 22:2207-16. [DOI: 10.1093/cercor/bhr248] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Wandschneider B, Kopp UA, Kliegel M, Stephani U, Kurlemann G, Janz D, Schmitz B. Prospective memory in patients with juvenile myoclonic epilepsy and their healthy siblings. Neurology 2010; 75:2161-7. [DOI: 10.1212/wnl.0b013e318202010a] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Siniatchkin M, Groening K, Moehring J, Moeller F, Boor R, Brodbeck V, Michel CM, Rodionov R, Lemieux L, Stephani U. Neuronal networks in children with continuous spikes and waves during slow sleep. Brain 2010; 133:2798-813. [DOI: 10.1093/brain/awq183] [Citation(s) in RCA: 114] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Sotnikova A, Entenmann A, van Baalen A, Rohr A, Burdelski M, Stephani U, Krause M. Schwere toxische Enzephalopathie nach Überdosierung von N-Acetylcystein bei der Behandlung einer Paracetamol-Intoxikation. Klin Padiatr 2010. [DOI: 10.1055/s-0030-1261400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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de Kovel CGF, Pinto D, Tauer U, Lorenz S, Muhle H, Leu C, Neubauer BA, Hempelmann A, Callenbach PMC, Scheffer IE, Berkovic SF, Rudolf G, Striano P, Siren A, Baykan B, Sander T, Lindhout D, Kasteleijn-Nolst Trenité DG, Stephani U, Koeleman BPC. Whole-genome linkage scan for epilepsy-related photosensitivity: a mega-analysis. Epilepsy Res 2010; 89:286-94. [PMID: 20153606 DOI: 10.1016/j.eplepsyres.2010.01.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2009] [Revised: 12/22/2009] [Accepted: 01/23/2010] [Indexed: 10/19/2022]
Abstract
Photoparoxysmal response (PPR) is considered to be a risk factor for idiopathic generalised epilepsy (IGE) and it has a strong genetic basis. Two genome-wide linkage studies have been published before and they identified loci for PPR at 6p21, 7q32, 13q13, 13q31 and 16p13. Here we combine these studies, augmented with additional families, in a mega-analysis of 100 families. Non-parametric linkage analysis identified three suggestive peaks for photosensitivity, two of which are novel (5q35.3 and 8q21.13) and one has been found before (16p13.3). We found no evidence for linkage at four previously detected loci (6p21, 7q32, 13q13 and 13q31). Our results suggest that the different family data sets are not linked to a shared locus. Detailed analysis showed that the peak at 16p13 was mainly supported by a single subset of families, while the peaks at 5q35 and 8q21 had weak support from multiple subsets. Family studies clearly support the role of PPR as a risk factor for IGE. This mega-analysis shows that distinct loci seem to be linked to subsets of PPR-positive families that may differ in subtle clinical phenotypes or geographic origin. Further linkage studies of PPR should therefore include in-depth phenotyping to make appropriate subsets and increase genetic homogeneity.
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Affiliation(s)
- C G F de Kovel
- Complex Genetics Group, Division Biomedical Genetics, University Medical Centre Utrecht, Utrecht, The Netherlands.
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Moeller F, Siniatchkin M, LeVan P, Stephani U, Dubeau F, Gotman J. Dynamic analysis of absence seizures in humans – an EEG fMRI study. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)70724-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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van Baalen A, Boor R, Stephani U, Stephani U, Häusler M, Kluger G. Febrile infection responsive epileptic syndrome (FIRES): A novel non-encephalitic encephalopathy in children admitted to ICU? Z Geburtshilfe Neonatol 2009. [DOI: 10.1055/s-0029-1222785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Neubauer BA, Waldegger S, Heinzinger J, Hahn A, Kurlemann G, Fiedler B, Eberhard F, Muhle H, Stephani U, Garkisch S, Eeg-Olofsson O, Müller U, Sander T. KCNQ2 and KCNQ3 mutations contribute to different idiopathic epilepsy syndromes. Neurology 2008; 71:177-83. [PMID: 18625963 DOI: 10.1212/01.wnl.0000317090.92185.ec] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To explore the involvement of M-type potassium channels KCNQ2, Q3, and Q5 in the pathogenesis of common idiopathic epilepsies. METHODS Sequence analysis of the KCNQ2, Q3, and Q5 coding regions was performed in a screening sample consisting of 58 nuclear families with rolandic epilepsy. Subsequently, an association study was conducted for all discovered variants in a case-control sample comprising 459 German patients with idiopathic generalized epilepsy (IGE) and 462 population controls. RESULTS An in-frame deletion of codon 116 in KCNQ2 (p.Lys116del) and a missense mutation in KCNQ3 (p.Glu299Lys) were detected in two index cases exhibiting rolandic epilepsy and benign neonatal convulsions. Both mutations resulted in reduced potassium current amplitude in Xenopus oocytes. Mutation analysis of families with rolandic epilepsy without neonatal seizures discovered three novel missense variations (KCNQ2 p.Ile592Met, KCNQ3 p.Ala381Val, KCNQ3 p.Pro574Ser). The KCNQ2 p.Ile592Met variant displayed a significant reduction of potassium current amplitude in Xenopus oocytes and was present only once in 552 controls. Both missense variants identified in KCNQ3 (p.Ala381Val and p.Pro574Ser) were present in all affected family members and did not occur in controls, but did not show obvious functional abnormalities. The KCNQ3 missense variant p.Pro574Ser was also detected in 8 of 455 IGE patients but not in 454 controls (p = 0.008). In KCNQ2, a silent single nucleotide polymorphism (rs1801545) was found overrepresented in both epilepsy samples (IGE, p = 0.004). CONCLUSION Sequence variations of the KCNQ2 and KCNQ3 genes may contribute to the etiology of common idiopathic epilepsy syndromes.
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Affiliation(s)
- B A Neubauer
- Department of Pediatric Neurology, University of Giessen-Marburg, Feulgenstrasse 12, D-35385 Giessen, Germany.
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Haag A, Knake S, Hamer HM, Boesebeck F, Freitag H, Schulz R, Baum P, Helmstaedter C, Wellmer J, Urbach H, Hopp P, Mayer T, Hufnagel A, Jokeit H, Lerche H, Uttner I, Meencke HJ, Meierkord H, Pauli E, Runge U, Saar J, Trinka E, Benke T, Vulliemoz S, Wiegand G, Stephani U, Wieser HG, Rating D, Werhahn K, Noachtar S, Schulze-Bonhage A, Wagner K, Alpherts WCJ, Boas WVE, Rosenow F. The Wada test in Austrian, Dutch, German, and Swiss epilepsy centers from 2000 to 2005: a review of 1421 procedures. Epilepsy Behav 2008; 13:83-9. [PMID: 18358786 DOI: 10.1016/j.yebeh.2008.02.012] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2007] [Revised: 02/04/2008] [Accepted: 02/19/2008] [Indexed: 11/18/2022]
Abstract
Twenty-six Austrian, Dutch, German, and Swiss epilepsy centers were asked to report on use of the Wada test (intracarotid amobarbital procedure, IAP) from 2000 to 2005 and to give their opinion regarding its role in the presurgical diagnosis of epilepsy. Sixteen of the 23 centers providing information had performed 1421 Wada tests, predominantly the classic bilateral procedure (73%). A slight nonsignificant decrease over time in Wada test frequency, despite slightly increasing numbers of resective procedures, could be observed. Complication rates were relatively low (1.09%; 0.36% with permanent deficit). Test protocols were similar even though no universal standard protocol exists. Clinicians rated the Wada test as having good reliability and validity for language determination, whereas they questioned its reliability and validity for memory lateralization. Several noninvasive functional imaging techniques are already in use. However, clinicians currently do not want to rely solely on noninvasive functional imaging in all patients.
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Affiliation(s)
- A Haag
- Interdisciplinary Epilepsy Center at the University Hospitals Giessen and Marburg, Germany.
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van Baalen A, Jacobs J, Alfke K, Caliebe A, Stephani U. Kaudales Regressionssyndrom - kaudale Agenesie. Klin Padiatr 2008; 220:86-7. [DOI: 10.1055/s-2007-993193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Grünewald A, Djarmati A, Lohmann-Hedrich K, Farrell K, Zeller JA, Allert N, Papengut F, Petersen B, Fung V, Sue CM, O'Sullivan D, Mahant N, Kupsch A, Chuang RS, Wiegers K, Pawlack H, Hagenah J, Ozelius LJ, Stephani U, Schuit R, Lang AE, Volkmann J, Münchau A, Klein C. Myoclonus-dystonia: significance of large SGCE deletions. Hum Mutat 2008; 29:331-2. [PMID: 18205193 DOI: 10.1002/humu.9521] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Myoclonus-dystonia (M-D) is an autosomal-dominant movement disorder caused by mutations in SGCE. We investigated the frequency and type of SGCE mutations with emphasis on gene dosage alterations and explored the associated phenotypes. We tested 35 M-D index patients by multiplex ligation-dependent probe amplification (MLPA) and genomic sequencing. Mutations were found in 26% (9/35) of the cases, all but three with definite M-D. Two heterozygous deletions of the entire SGCE gene and flanking DNA and a heterozygous deletion of exon 2 only were detected, accounting for 33% (3/9) of the mutations found. Both large deletions contained COL1A2 and were additionally associated with joint problems. Further, we discovered one novel small deletion (c.771_772delAT, p.C258X) and four recurrent point mutations (c.289C>T, p.R97X; c.304C>T, p.R102X; c.709C>T, p.R237X; c.1114C>T, p.R372X). A Medline search identified 22 articles on SGCE mutational screening. Sixty-four unrelated M-D patients were described with 41 different mutations. No genotype-phenotype association was found, except in patients with deletions encompassing additional genes. In conclusion, a rigorous clinical preselection of patients and careful accounting for non-motor signs should precede mutational tests. Gene dosage studies should be included in routine SGCE genetic testing.
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Affiliation(s)
- A Grünewald
- Department of Neurology, Lübeck University, Lübeck, Germany
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Pohlmann-Eden B, Stephani U, Krägeloh-Mann I, Schmitt B, Brandl U, Holtkamp M. [Management of refractory status epilepticus from a neurologic and neuropediatric perspective]. Nervenarzt 2008; 78:871-82. [PMID: 17457562 DOI: 10.1007/s00115-007-2257-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Status epilepticus is a frequent neurologic emergency that is refractory to benzodiazepines and phenytoin in 60% to 70% of cases. Patients commonly require management in an intensive care unit incorporating aggressive treatment with intravenous anaesthetics. Treatment guidelines commonly comment on initial pharmacologic management in detail, as they can refer to data from randomised controlled trials. In contrast, recommendations for the management of refractory status epilepticus often are sparse, as they rely on data from retrospective or uncontrolled prospective studies only. Since status epilepticus is refractory in every third patient, a critical analysis of the available data and a review focussing on the further management of this condition are urgently needed. The Koenigstein Team, a panel of expert epileptologists and neuropediatricians, discussed at its 31(st) meeting in March 2006 the clinical and experimental aspects and implicit prognostic variables of refractory status epilepticus. Here we present the results of that discussion and state recommendations from a neurologic and neuropediatric perspective for current und future management of refractory status epilepticus.
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Affiliation(s)
- B Pohlmann-Eden
- Epilepsie-Zentrum Bethel, Evangelisches Krankenhaus Bielefeld, Bielefeld, Germany
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Lohmann-Hedrich K, Neumann A, Kleensang A, Lohnau T, Muhle H, Djarmati A, Konig IR, Pramstaller PP, Schwinger E, Kramer PL, Ziegler A, Stephani U, Klein C. Evidence for linkage of restless legs syndrome to chromosome 9p: Are there two distinct loci? Neurology 2007; 70:686-94. [DOI: 10.1212/01.wnl.0000282760.07650.ba] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Hartmann H, Herchenbach J, Stephani U, Ledaal P, Donnerstag F, Lücke T, Das AM, Christen HJ, Hagedorn M, Meins M. Novel mutations in exon 6 of the GFAP gene affect a highly conserved if motif in the rod domain 2B and are associated with early onset infantile Alexander disease. Neuropediatrics 2007; 38:143-7. [PMID: 17985264 DOI: 10.1055/s-2007-985902] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Alexander disease is a rare disorder of cerebral white matter due to a dysfunction of astrocytes. The most common infantile form presents as a megalencephalic leukodystrophy. Mutations of the GFAP gene, encoding Glial Fibrillary Acidic Protein, have been recognized as the cause of Alexander disease. Glial Fibrillary Acidic Protein is the major intermediate filament protein in astrocytes, its functional rod domain is conserved in sequence and structure among other intermediate filament proteins. We report here two cases of infantile Alexander disease with early onset and severe course, caused by DE NOVO mutations A364 V and Y366C. Both affected GFAP residues are part of a highly conserved coiled-coil trigger motif in the C-terminal end of segment 2B, probably required for the stability of intermediate filament molecules. Comparable effects are seen with mutations of the corresponding residues of the gene coding for keratin 14, another intermediate filament, this further supports the hypothesis that these positions of the trigger motif are generally critical for a normal function of intermediate filaments.
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Affiliation(s)
- H Hartmann
- 1Department of Paediatrics, Hannover Medical School, Hannover, Germany.
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Siniatchkin M, Groppa S, Jerosch B, Muhle H, Stephani U, Siebner H. Excitatory and inhibitory mechanisms of photosensitivity. Clin Neurophysiol 2007. [DOI: 10.1016/j.clinph.2006.11.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Jacobs J, Jacobs J, Boor R, Jansen O, Wolff S, Siniatchkin M, Stephani U. Localization of Epileptic Foci in Children with Focal Epilepsies using 3-Tesla Simultaneous EEG-fMRI Recordings. Clin Neurophysiol 2007. [DOI: 10.1016/j.clinph.2006.11.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Möhring J, Wolff S, Jacobs J, Möller F, Boor R, Siebner HR, Jansen O, Stephani U, Siniatchkin M. Einfluss von Schlaf auf den Sharp-Wave-assoziierten negativen BOLD-Effekt bei Kindern mit fokalen Epilepsien. KLIN NEUROPHYSIOL 2007. [DOI: 10.1055/s-2007-976439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Siniatchkin M, Wolff S, Jacobs J, Möhring J, Möller F, Boor R, Siebner HR, Jansen O, Stephani U. West-Syndrom: Eine EEG-fMRI-Untersuchung der mit Hypsarrhythmie assoziierten neuronalen Netzwerke. KLIN NEUROPHYSIOL 2007. [DOI: 10.1055/s-2007-976417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Lohmann K, Ziegler A, Muhle H, Neumann A, Kleensang A, Lohnau T, König IR, Stephani U, Klein C. Ein zweiter Genort für das Restless-Legs-Syndrom auf Chromosom 9p? Akt Neurol 2007. [DOI: 10.1055/s-2007-987784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Haag A, Knake S, Hamer HM, Boesebeck F, Freitag H, Schulz R, Baum P, Helmstaedter C, Wellmer J, Urbach H, Hopp P, Mayer T, Hufnagel A, Jokeit H, Lerche H, Uttner I, Meencke HJ, Meierkord H, Pauli E, Runge U, Saar J, Trinka E, Benke T, Vulliemoz S, Wiegand G, Stephani U, Wieser HG, Rating D, Werhahn K, Noachtar S, Schulze-Bonhage A, Wagner K, Alpherts W, van Emde Boas W, Rosenow F. The Wada-Test in 2000–2005at German, Swiss and Austrian and Dutch Epilepsy-Centres – the experience of the Arbeitsgemeinschaft für prächirurgische Epilepsiediagnostik und operative Epilepsietherapie e.V regarding 1421 procedures. Akt Neurol 2007. [DOI: 10.1055/s-2007-987750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Neubauer BA, Stefanova I, Hübner CA, Neumaier-Probst E, Bohl J, Oppermann HC, Stö H, Hahn A, Stephani U, Kohlschütter A, Gal A. A new type of leukoencephalopathy with metaphyseal chondrodysplasia maps to Xq25-q27. Neurology 2006; 67:587-91. [PMID: 16924009 DOI: 10.1212/01.wnl.0000230133.11951.75] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The authors report a three-generation family with four male patients presenting with a novel type of X-chromosomal leukoencephalopathy associated with skeletal abnormalities. METHODS The index patient and his brother reached their early motor milestones in due time and had normal language development. Between the ages of 2 and 3 years, first signs of spastic paraplegia were noticed. Furthermore, the patients developed tremor, ataxia, optic atrophy, and spastic tetraparesis. Both boys had broad wrists and knees without significant contractures. A maternal uncle and a granduncle had the same disease. RESULTS Leukoencephalopathy (MRI, MRS) and metaphyseal chondrodysplasia (X-ray, MRI) were diagnosed. MRS showed a reduction of choline-containing compounds in the white matter. An autopsy on one of the patients, who died at age 37 years, revealed an orthochromatic type of leukoencephalopathy. In bone and cartilage tissue, unspecific signs of a mild chondrodysplasia were found. At the PLP gene locus an obligate recombination was observed, which excludes the Pelizaeus-Merzbacher locus on Xq21-22. However, affected males share a fragment of the long arm of chromosome X. CONCLUSION The authors report a new type of leukoencephalopathy associated with metaphyseal chondrodysplasia located on Xq25-q27.
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Affiliation(s)
- B A Neubauer
- Department of Pediatric Neurology, Universities of Giessen.
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Moeller F, Muhle H, Jacobs J, Boor R, Jansen O, Wolff S, Siniatchkin M, Stephani U. P31.1 Functional magnetic resonance imaging in children with absence seizures using 3-tesla simultaneous EEG-fMRI recordings. Clin Neurophysiol 2006. [DOI: 10.1016/j.clinph.2006.06.541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Affiliation(s)
- A van Baalen
- University Medical Center Schleswig-Holstein, Christian-Albrechts-Universität zu Kiel, Germany.
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Ayerdi-Izquierdo A, Stavrides G, Sellés-Martínez JJ, Larrea L, Bovo G, López de Munain A, Bisulli F, Martí-Massó JF, Michelucci R, Poza JJ, Tinuper P, Stephani U, Striano P, Striano S, Staub E, Sarafidou T, Hinzmann B, Moschonas N, Siebert R, Deloukas P, Nobile C, Pérez-Tur J. Genetic analysis of the LGI/Epitempin gene family in sporadic and familial lateral temporal lobe epilepsy. Epilepsy Res 2006; 70:118-26. [PMID: 16707245 DOI: 10.1016/j.eplepsyres.2006.03.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2005] [Revised: 01/30/2006] [Accepted: 03/19/2006] [Indexed: 11/26/2022]
Abstract
Mutations in the LGI1/Epitempin gene cause autosomal dominant lateral temporal lobe epilepsy (ADLTE), a partial epilepsy characterized by the presence of auditory seizures. However, not all the pedigrees with a phenotype consistent with ADLTE show mutations in LGI1/Epitempin, or evidence for linkage to the 10q24 locus. Other authors as well as ourselves have found an internal repeat (EPTP, pfam# PF03736) that allowed the identification of three other genes sharing a sequence and structural similarity with LGI1/Epitempin. In this work, we present the sequencing of these genes in a set of ADLTE families without mutations in both LGI1/Epitempin and sporadic cases. No analyzed polymorphisms modified susceptibility in either the familial or sporadic forms of this partial epilepsy.
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Affiliation(s)
- A Ayerdi-Izquierdo
- Unitat de Genètica Molecular, Dept. de Genòmica i Proteòmica, Institut de Biomedicina de València - CSIC, Jaume Roig, 11. E46010 València, Spain
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Jacobs J, Jacobs J, Boor R, Jansen O, Wolff S, Siniatchkin M, Stephani U. Localisation of Epileptic Foci in Children with Focal Epilepsies using 3-Tesla Simultaneous EEG-fMRI Recordings. KLIN NEUROPHYSIOL 2006. [DOI: 10.1055/s-2006-939186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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33
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Siniatchkin M, Groppa S, Jerosch B, Muhle H, Stephani U, Siebner H. Excitatory and inhibitory mechanisms of photosensitivity. KLIN NEUROPHYSIOL 2006. [DOI: 10.1055/s-2006-939289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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34
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Groppa S, Siniatchkin M, Siebner H, Stephani U. The excitability of the motor cortex is less modifiable by repetitive acoustic stimulation in patients with generalised epilepsy. Akt Neurol 2006. [DOI: 10.1055/s-2006-953346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Affiliation(s)
- A van Baalen
- Universitätsklinikum Schleswig-Holstein, Schwanenweg 20, Kiel 24105, Germany.
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Möller F, Ulmer S, Wolff S, Stephani U, Jansen O. Kortikale Reorganisation bei Kindern mit konnataler spastischer Hemiparese - eine funktionelle Magnetresonanztomographie-(fMRT-)Studie. ROFO-FORTSCHR RONTG 2005; 177:1552-61. [PMID: 16302137 DOI: 10.1055/s-2005-858620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE We applied fMRI to investigate atypical cortical activation in patients with connatal spastic hemiparesis using voluntary movements of the hand, foot, and tongue. The relation between the findings from fMRI and the motor dysfunction was examined. MATERIALS AND METHODS 11 patients with connatal spastic hemiparesis were studied. Eight of these patients had periventricular leukomalacia (PVL), and three patients had cortical-subcortical lesions. To evaluate the severity of motor impairment tests for the upper and lower limb were performed. fMRI data were obtained in a block design using hand, foot, and tongue movements. As a control group, 14 healthy volunteers were examined with the fMRI protocol. RESULTS A laterally cortical representation of the paretic foot was found in three patients with PVL. In patients with cortical-subcortical lesions, tongue movements were associated with cortical activation restricted to the unaffected hemisphere. Movements of the paretic limb showed more ipsilateral activation in patients with PVL than in patients with cortical-subcortical lesions. CONCLUSION Different types of structural damage such as PVL and cortical-subcortical lesions show differences in fMRI examination.
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Affiliation(s)
- F Möller
- Sektion für Neuroradiologie der Klinik für Neurochirurgie Universitätsklinikum Schleswig-Holstein, Campus Kiel.
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Groppa S, Siniatchkin M, Siebner H, Stephani U. Influence of intermittent photic stimulation on the temporal aspects of cortical silent period in subjects with and without epilepsy - a TMS based study. Akt Neurol 2005. [DOI: 10.1055/s-2005-919555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Siemes H, Brandl U, Helmstädter C, Kurlemann G, Rating D, Sälke-Kellermann RA, Stephani U, Uberall M, Wiemer-Kruel A, Bergmann L. Optimierung der Epilepsietherapie von Kindern und Jugendlichen mit Lamotrigin. Klin Padiatr 2005; 217:222-9. [PMID: 16032548 DOI: 10.1055/s-2004-822634] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Lamotrigine is a broadly effective antiepileptic drug in mono- and add-on therapy for children and adolescents with focal and generalized epilepsies. Some epileptologists consider lamotrigine as the drug of primary choice in older school children and adolescents because of its good tolerability (no increase of body weight, no impairment of cognitive functions, due to new data probably no teratogenic properties). Lamotrigine can be used with good efficacy in numerable epilepsy diseases, such as tuberous sclerosis, juvenile neuronal lipofuscinosis and Rett syndrome. The first studies show that lamotrigine is also effective in children under 2 years of age. For therapy of difficult-to-treat epilepsies the combination of lamotrigine with valproate has proved as especially useful. This clinical observation is supported by new results of animal experiments. The dose-dependant and typical CNS side effects vertigo, ataxia, nausea, tremor and diplopia are found most frequently. The rate of allergic skin rashes which was very high before 1998 has decreased markedly by new dosage guidelines and is now as low as in older antiepileptic drugs. Lamotrigine does not impair cognitive functions, especially not memory and language. It has mood-stabilizing features and may improve quality of life. In animal experiments lamotrigine shows antiepileptogenic and neuroprotective effects.
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Affiliation(s)
- H Siemes
- Fachklinik Hohenstücken, Neurologisches Rehabilitationszentrum für Kinder und Jugendliche.
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Ebach K, Joos H, Doose H, Stephani U, Kurlemann G, Fiedler B, Hahn A, Hauser E, Hundt K, Holthausen H, Müller U, Neubauer BA. SCN1A mutation analysis in myoclonic astatic epilepsy and severe idiopathic generalized epilepsy of infancy with generalized tonic-clonic seizures. Neuropediatrics 2005; 36:210-3. [PMID: 15944908 DOI: 10.1055/s-2005-865607] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Severe myoclonic epilepsy in infancy (SMEI), severe idiopathic generalized epilepsy of infancy (SIGEI) with generalized tonic clonic seizures (GTCS), and myoclonic astatic epilepsy (MAE) may show semiological overlaps. In GEFS+ families, all three phenotypes were found associated with mutations in the SCN1A gene. We analyzed the SCN1A gene in 20 patients with non-familial myoclonic astatic epilepsy -- including 12 probands of the original cohort used by Doose et al. in 1970 to delineate MAE. In addition, 18 patients with sporadic SIGEI -- mostly without myoclonic-astatic seizures -- were analyzed. Novel SCN1A mutations were found in 3 individuals. A frame shift resulting in an early premature stop codon in a now 35-year-old woman with a borderline phenotype of MAE and SIGEI (L433fsX449) was identified. A splice site variant (IVS18 + 5 G --> C) and a missense mutation in the conserved pore region (40736 C --> A; R946 S) were detected each in a child with SIGEI. We conclude that, independent of precise syndromic delineation, myoclonic-astatic seizures are not predictive of SCN1A mutations in sporadic myoclonic epilepsies of infancy and early childhood.
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Affiliation(s)
- K Ebach
- Department of Neuropediatrics, University of Giessen, Giessen, Germany
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Krämer G, Dennig D, Schmidt D, Schmitz B, Stefan H, Steinhoff BJ, Stephani U, Stodieck S. Generika in der Epilepsietherapie: Was ist zu beachten? Akt Neurol 2005. [DOI: 10.1055/s-2005-866893] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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41
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Neubauer BA, Waltz S, Grothe M, Hahn A, Tuxhorn I, Sander T, Kurlemann G, Stephani U. Photosensitivity: genetics and clinical significance. Adv Neurol 2005; 95:217-26. [PMID: 15508925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Affiliation(s)
- B A Neubauer
- Department of Neuropediatrics, Zentrum Kinderheilkunde und Jugendmedizin, Giessen, Germany
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42
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van Baalen A, Stephani U. Detection of Single Muscle Fiber Movements (Fibrations) in SMA Type I by High Resolution Ultrasound. KLIN NEUROPHYSIOL 2004. [DOI: 10.1055/s-2004-831918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Siniatchkin M, Kirsch E, Arslan S, Stegemann S, Gerber WD, Stephani U. Migraine and asthma in childhood: evidence for specific asymmetric parent-child interactions in migraine and asthma families. Cephalalgia 2004; 23:790-802. [PMID: 14510925 DOI: 10.1046/j.1468-2982.2003.00436.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In spite of the fact that migraine often manifests as a familial disorder, the role of the family in migraine has not been adequately explored. In this study parent-child interactions in 20 families with a child suffering from migraine were analysed and compared with 20 healthy families and 20 families with an asthma child. The families had to solve a puzzle within a limited time. Parent-child interactions within migraine and asthma families were asymmetric, revealing a disease-specific interpersonal context in the family. Communication with the affected child in migraine families was significantly more directive, with more specific instructions and less help, towards migraineurs than with the healthy siblings. Dominance of parents and submissive behaviour of children were the main features of interactions. In asthma families interactions were more conflicting and less cooperative. This study demonstrated a specific, asymmetric, pattern of family interactions predisposing children either to migraine or asthma.
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Affiliation(s)
- M Siniatchkin
- Institute of Medical Psychology, Christian-Albrechts-University of Kiel, Kiel, Germany.
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Santer R, Muhle H, Suormala T, Baumgartner ER, Duran M, Yang X, Aoki Y, Suzuki Y, Stephani U. Partial response to biotin therapy in a patient with holocarboxylase synthetase deficiency: clinical, biochemical, and molecular genetic aspects. Mol Genet Metab 2003; 79:160-6. [PMID: 12855220 DOI: 10.1016/s1096-7192(03)00091-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We report the clinical course and biochemical findings of a 10-year-old, mentally retarded girl with late-onset holocarboxylase synthetase (HCS, gene symbol HLCS) deficiency and only partial response to biotin. On treatment, even with an unusually high dose of 200mg/day, activities of the biotin-dependent mitochondrial carboxylases in lymphocytes remained below 50% of the mean control values. Not only urinary 3-hydroxyisovaleric acid excretion has been persistently elevated, but also plasma and, with even higher concentrations, cerebrospinal fluid 3-hydroxyisovaleric acid have not normalized. The unusual and insufficient response of this patient to biotin treatment can be explained by the effect of the combination of the common HLCS allele IVS10 +5 g>a on one chromosome and a truncating mutation on the other. This case illustrates mechanisms involved in the genotype-phenotype correlation that unequivocally exists in HCS deficiency.
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Affiliation(s)
- R Santer
- Department of General Pediatrics, University Children's Hospital Kiel, Germany.
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Gölge M, Schütz C, Dreesmann M, Kuhtz-Buschbeck JP, Hoppe B, Wenzelburger R, Stephani U, Illert M. Grip force parameters in precision grip of individuals with myelomeningocele. Dev Med Child Neurol 2003; 45:249-56. [PMID: 12647926 DOI: 10.1017/s0012162203000483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The aim of this study was to characterize impairments of hand function in individuals with myelomeningocele (MMC) using a quantitative method. A grip-lift task was studied in 29 individuals with MMC (17 females, 12 males; mean age 12 years 4 months, SD 5 years 6 months; range 4 to 28 years) and 29 age- and sex-matched control participants. A small object (weight 200 g) was grasped and lifted with a precision grip of the dominant hand and grip forces (GF) and time intervals were measured. Sensibility was examined with a two-point discrimination test. In those with MMC, the latency between GF onset of the thumb and index finger and ensuing preload duration were both significantly prolonged (p<0.01). Fingertip forces were excessively high and variable. Several parameters differed significantly between those with MMC and control individuals: GF peak, GF at start of loading, mean GF, and the SDs of the GF during static holding. Although the two-point discrimination task indicated deficits of sensibility, these did not correlate with grip force parameters. Results demonstrate that fine motor skills in patients with MMC are impeded by slowness and inadequate adjustments of manipulative forces.
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Affiliation(s)
- M Gölge
- Department of Physiology, Christian-Albrechts-University, Kiel, Germany.
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Meins M, Brockmann K, Yadav S, Haupt M, Sperner J, Stephani U, Hanefeld F. Infantile Alexander disease: a GFAP mutation in monozygotic twins and novel mutations in two other patients. Neuropediatrics 2002; 33:194-8. [PMID: 12368989 DOI: 10.1055/s-2002-34495] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Alexander disease (AD) is a rare disorder of cerebral white matter due to a dysfunction of astrocytes. The most common infantile form presents as a megalencephalic leukodystrophy. Recently, heterozygous de novo mutations in the glial fibrillary acidic protein gene (GFAP) have been demonstrated to be associated with AD. We report heterozygous mutations in GFAP in 5 patients, including a pair of monozygotic twins, with clinical and neuroradiological features of infantile AD. Novel mutations were detected affecting nucleotides 304 T --> C (L97 P) and 730 G --> C (R239 P) in two other patients. None of the parents of our patients carried the mutations stressing dominant de novo mutations as the cause of AD. The presence of an identical mutation 250 G --> A (R79 H) in both monozygotic twins with infantile AD points to the origin of these GFAP mutations in germ cells or very early postzygotic stages.
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Affiliation(s)
- M Meins
- Department of Human Genetics, University of Göttingen, Germany.
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Flink R, Pedersen B, Guekht AB, Malmgren K, Michelucci R, Neville B, Pinto F, Stephani U, Ozkara C. Guidelines for the use of EEG methodology in the diagnosis of epilepsy. International League Against Epilepsy: commission report. Commission on European Affairs: Subcommission on European Guidelines. Acta Neurol Scand 2002; 106:1-7. [PMID: 12067321 DOI: 10.1034/j.1600-0404.2002.01361.x] [Citation(s) in RCA: 126] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The Commission of European Affairs of the International League Against Epilepsy published 'Appropriate Standards for Epilepsy Care Across Europe' which contained recommendations for the use of electroencephalography (EEG) in the diagnosis of epilepsy (Brodie et al. Epilepsia 1997; 38:1245). The need for a more specific basic document of EEG methodology was recognized and the Subcommission on European Affairs was asked to produce more detailed guidelines to be used across Europe recognizing the range of practices in EEG laboratories. There are many general guidelines published on EEG methodology but this document focuses on the diagnosis of epilepsy. Details from previously published guidelines are included in references and in an appendix. These guidelines are not meant to be used as minimal standards but recommendations that can be applied to all EEG laboratories despite variations in equipment.
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Affiliation(s)
- R Flink
- Department of Neuroscience, Clinical Neurophysiology, University Hospital, Uppsala, Sweden.
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48
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Carlsson G, Igelbrink-Schulze N, Neubauer BA, Stephani U. Neuropsychological long-term outcome of rolandic EEG traits. Epileptic Disord 2001; 2 Suppl 1:S63-6. [PMID: 11231228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
BACKGROUND Long-term outcome of rolandic epilepsy (RE) is associated with a diversity of neuropsychological deficits in childhood, although RE is historically considered as a benign epileptic disorder. Dyslexia and other developmental disorders are associated with rolandic EEG traits. AIM To investigate if there is an association between the manifestation of a specific EEG trait of RE and dyslexia. If the EEG traits are causing dyslexia, the cognitive deficits are supposed to be normalised after the EEG trait have resolved. METHOD Thirty adolescents and young adults, who had previously received a diagnosis of dyslexia by standard criteria, were included. Fifteen probands (mean age = 15.9) with dyslexia and rolandic EEG traits were compared with 15 age- and sex-matched controls (mean age = 16.0) with normal EEG. RESULTS There were no statistical differences between the groups according to intelligence (Verbal IQ, Performance IQ and Arithmetical IQ) or spelling ability. However, there was a significant difference between the groups in reading ability of non-related words with the group without RE performing better than the group with RE (p < 0.01). Attentional shifts in dichotic listening with forced or directed attention are generally found in 50-60% in normative samples. However, the present date suggest an impaired attentional shift in dichotic listening test for both groups. Only one third was able to modulate their ear-preference. There were no group differences. CONCLUSION In general, both dyslectic groups did not show significant neuropsychological deficits as compared to standard controls. However, there were more reading errors and a tendency to attention impairments in the group with rolandic EEG trait as compared to the dyslectic group with normal EEG. Possible pathogenic factors are discussed.
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Affiliation(s)
- G Carlsson
- University Department of Neuropediatrics, Children's Hospital, Kiel, Germany.
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Stephani U. Typical semiology of benign childhood epilepsy with centrotemporal spikes (BCECTS). Epileptic Disord 2001; 2 Suppl 1:S3-4. [PMID: 11231216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
The ILAE (1989) has defined benign childhood epilepsy with centro-temporal spikes (BCECTS) as follows: BCECTS is a syndrome of brief, simple, partial, hemifacial motor seizures, frequently having associated somatosensory symptoms which have a tendency to evolve into generalised tonic clonic seizures (GTCS) [1]. Both seizure types are often related to sleep. Onset occurs between the ages of 3 and 13 years (peak 9-10 years) and recovery occurs before the age of 15-16 years. Genetic predisposition is frequent, and there is a male predominance. The EEG has blunt high-voltage centrotemporal spikes, often followed by slow waves that are activated by sleep and tend to shift or spread from side to side.
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Affiliation(s)
- U Stephani
- University department of Neuropediatrics, Children's hospital, Schwanenweg 20, D-24105 Kiel, Germany.
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Müller D, Ankermann T, Stephani U, Kirschstein M, Szelestei T, Luft FC, Willnow TE. Holoprosencephaly and low molecular weight proteinuria: the human homologue of murine megalin deficiency. Am J Kidney Dis 2001; 37:624-8. [PMID: 11228189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
We encountered a child with holoprosencephaly, pulmonary insufficiency, absent circulating vitamin D metabolites, mild albuminuria, and urinary excretion of vitamin D-binding protein. The child displayed a phenotype highly reminiscent of that observed in mice genetically deficient for megalin, a member of the low-density lipoprotein receptor superfamily. Only the Guthrie card was available from the child; the DNA sufficed for a limited haplotype analysis. We were not able to implicate the megalin gene locus directly; however, the possibility of a functional megalin defect in this child remains. To the best of our knowledge, this patient represents the first report that pathologic abnormalities consistent with megalin deficiency are present in humans.
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Affiliation(s)
- D Müller
- Children's Hospital, University of Kiel, Humboldt University of Berlin, Germany
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