American Clinical Neurophysiology Society’s standardized critical care EEG terminology: Interrater reliability and 2012 version

WCN 2013 No: 856 Topic: 1 — Epilepsy Clinical presentation and neurophysiological findings in patients with pineal region expansions — Our 17 year experience S. Nankovic, S. Hajnsek, A. Bujan Kovac, J. Paladino, Z. Petelin Gadze, V. Sulentic, I. Kovacevic. Dpt. of Neurology, University Hospital Centre Zagreb, Zagreb, Croatia; Dpt. of Neurosurgery, University Hospital Centre Zagreb, Zagreb, Croatia Background: In the neurological and neurosurgical follow up of our patients with pineal region expansions, we have noticed certain clinical and neurophysiological regularities. Objective: To perform retrospective study including 84 patients with pineal region expansions in the period from 1992 to 2009. Patients and methods: The study included 55 women and 29 men. All patients had headache,while 32 patients (38%) hadprimary generalized seizures. Common EEG pattern showed paroxysmal discharges of 3 or more Hz spike-and-wave complexes. Brain MRI showed in 70 patients (83.4%) cysts, and 14 patients (16.67%) had expansive process with compressive effect. Based on the size of the cyst (15 mm or more) and signs of compression on the quadrigeminal plate and of the surrounding veins operation was performed in 70 patients. Results: Pathohistological analysis revealed pineocytomas in 11 cases (15.71%), pinealoblastomas in 2 cases (2.86%), one case of teratoma (1.43%), while 56 patients had cysts (80%). Following surgery clinical condition improved in all patients— patients became seizure-free and headaches significantly decreased, and other symptoms (diplopiae, nausea, vomiting, vertigo and blurred vision) disappeared. Conclusion: Headache and also primary generalized seizures are often present in patients with pineal region expansions. Mass effect on the surrounding veins and compression on the quadrigeminal plate and the aqueduct, together with hemosiderin deposits can be involved in the pathogenesis of seizures. We suggest to perform high resolution brain MRI in all young patients that have seizures and specific EEG changes. doi:10.1016/j.jns.2013.07.063 Abstract — WCN 2013 No: 474 Topic: 1 — Epilepsy Common reference-based indirect comparison meta-analysis of intravenous valproate versus intravenous phenobarbitone in generalized convulsive status epilepticus WCN 2013 No: 474 Topic: 1 — Epilepsy Common reference-based indirect comparison meta-analysis of intravenous valproate versus intravenous phenobarbitone in generalized convulsive status epilepticus F. Brigo, F. Tezzon, L.G. Bongiovanni, R. Nardone. Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Verona, Italy; Division of Neurology, Hospital Franz Tappeiner, Meran, Italy; Department of Neurology, Paracesus Medical University, Salzburg, Austria Background: In the literature, only one randomized control trial (RCT) directly compared intravenous valproate (IV VPA) with intravenous phenobarbitone (IV PB) in the treatment of established generalized convulsive status epilepticus (GCSE). Objective: To compare IV VPA with IV PB in the treatment of GCSE in patients of any age, indirectly estimating their efficacy and safety through a common-reference based indirect comparison meta-analysis (CRBMA) and to evaluate whether CRBMA is reliable and consistent with results of direct head-to-head RCTs. Material and methods: RCTs of IV VPA and IV PB versus IV PHT for GCSE were systematically searched. A random effects model was used to estimate Mantel–Haenszel odds ratios for efficacy and safety of IV VPA versus IV PHT in a standard meta-analysis. Adjusted indirect comparisons were then made between VPA and PB using the obtained results. Results: The CRBMA showed that, compared with PB, VPA does not lead to significantly higher seizure cessation (OR 1.00; 95% CI 0.36–2.76), although it has lower adverse effects (OR 0.17; 95% CI 0.04–0.71). Results of CRBMA are consistent with those of a recently published head-to-head comparison between IV VPA and IV PB. Conclusion: There is no evidence supporting a superiority of IV VPA over IV PB for the treatment of GCSE in terms of efficacy. Some data derived from direct and indirect comparisons suggest that VPA has a better safety profile than PB. In the absence of comparative clinical trials studies, a CRBMA provides some evidence of the relative efficacy and safety of competing AEDs. doi:10.1016/j.jns.2013.07.064 Abstract — WCN 2013 No: 899 Topic: 1 — Epilepsy Anticonvulsant actions of Ska-31 in pilocarpine treated chronic epileptic rats WCN 2013 No: 899 Topic: 1 — Epilepsy Anticonvulsant actions of Ska-31 in pilocarpine treated chronic epileptic rats M.L. Raza, U. Heinemann. Institute of Neurophysiology, Charite Universitatsmedizin, Berlin, Germany Purpose: Pilocarpine-induced status epilepticus or limbic seizure model is use to test activity of new molecules with anticonvulsant potential. In the present study we focused on anticonvulsant effect of SKa-31 (sK-channel opener) in pilocarpine-induced epileptiform activities. Methods: Male Wistar rats (4–5 weeks) were pre-treated with methylscopolamine (1 mg/kg) followed by i.p. administration of pilocarpine (340 mg/kg). 90 min post status epilepticus, diazepam is injected intraperitonealy (10 mg/kg). Animals were observed under video recording for about 5–6 days. Age-matched pilo control group received same protocol except saline instead of hippocampal slices (400 μM) from pilo treated and pilo-controls rats were prepared. Agematched control rats were used that received saline instead of pilocarpine. To induce epileptiform activities in slices 4-aminopyridine (4-AP, 100 μM) is used. Local field potential recordings were performed from medial entorhinal cortex using glass microelectrode filled with ACSF. Results: SKa-31 at 150 and 50 μM blocked SLE in 87% and none of slices respectively. Whereas, in control slices blockade of seizures is observed in 100% of slices. It is noticed that SKa-31 significantly decreased duration of SLEs in 23 ± 4 min of application as well as reduction in amplitude of SLEs.