Etiologic and Preventive Aspects of Epilepsy in the Child–Bridging the Gap Between Laboratory and Clinic

Lombroso, Cesare; Burchfiel, James L.

doi:10.1111/j.1528-1157.1987.tb05752.x

Cited by 11 publications

(2 citation statements)

References 41 publications

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“…The most cogent justification for such analysis derives from the conflicting data and deductions reached in animal experimentation when compared with those from the clinical arena. An older review discussing some of the gaps between the bench and the crib seems still pertinent (Lombroso and Burchfiel, 1987). To underline these apparent gaps, Table 1 summarizes the main conclusions derived from investigations of human NBs, while Table 2 lists some of the main conclusions derived from a plethora of experiments on neonatal animals subjected to convulsions.…”

Section: Clinical Observationsmentioning

confidence: 99%

Neonatal Seizures: Gaps Between the Laboratory and the Clinic

Lombroso

2007

Epilepsia

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Summary: Seizures in neonates (NBs) remain the most frequent neurological problem in the nursery. Considerable debate about their consequences exists between data and deductions reached through animal experimentations and those obtained through clinical investigations. The main conflicting issues are whether seizures in NBs can plant the roots for epileptogenesis and cause long-term deficits. The purpose of this chapter is to evaluate both laboratory and clinical results. Methods: Clinical data will be presented, including a 20-yearlong cohort of NBs. This will be followed by the main seminal discoveries obtained in neonatal models. The phenomenon of transient or persistent dysmaturity following NB seizures will be discussed in relation to etiological factors. Results: The findings and deductions from animal models support the notions that epileptogenesis and cognitive deficits result from NB seizures. These conclusions contrast with clinical investigations maintaining that NB seizures, per se, are symptomatic markers of preexisting or of ongoing morbidities. The reasons for contrasting views will be discussed. Suggestions will be advanced for more animal models whose seizures are consistent with the etiologies and the phenotypes of human NB seizures.

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Section: Clinical Observationsmentioning

confidence: 99%

Neonatal Seizures: Gaps Between the Laboratory and the Clinic

Lombroso

2007

Epilepsia

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“…The genesis of this supplement can be traced to an article written 20 years ago, analyzing what was to be learned about the prophylaxis of acquired epilepsies, their possible consequences and management (Lombroso and Burchfiel, 1987). To answer these questions, there are several categories of basic phenomena that need elucidation: (1) It is necessary to identify the insults that may be epileptogenic.…”

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Introduction to the Supplement

Lombroso¹

2007

Epilepsia

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Epileptogenic effect of hypoxia in the immature rodent brain

Jensen

Applegate

Holtzman

et al. 1991

Annals of Neurology

238

189

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The response to cerebral hypoxia/ischemia may be different in the neonate compared to other age groups. An in vivo model was developed in the rat to determine whether there are age-dependent differences in the effects of hypoxia on electroencephalographic (EEG) activity. EEG recordings were obtained from Long Evans hooded rats deprived of oxygen at five ages: postnatal days 5 to 7, 10 to 12, 15 to 17, 25 to 27, and 50 to 60. Oxygen concentration was varied from 0, 2, 3, and 4% between animals. EEGs were recorded in all animals before, during, and at 1 hour after exposure to the hypoxic condition and at 1 to 7 days afterward in a subset of animals. All animals were deprived of oxygen until the onset of apnea and bradycardia to 20 to 40% of baseline heart rate values. Hypoxia resulted in isoelectric EEG significantly more frequently in the animals deprived of oxygen at postnatal days 25 to 27 and 50 to 60 than in the younger age groups. A highly significant effect was that the animals deprived at postnatal days 5 to 17 revealed a high incidence of epileptiform EEG activity during hypoxia. In contrast, the older animals exhibited only rare isolated EEG spikes before reaching an isoelectric EEG. The severity of hypoxia-induced epileptiform EEG changes was highest in the animals subjected to moderately hypoxic conditions (3% and 4% oxygen) at postnatal days 10 to 12. Furthermore, epileptiform changes persisted for hours to days following prolonged episodes of hypoxia in the younger animals. This study demonstrates a unique response of the immature brain to exhibit epileptiform activity during hypoxia.

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Etiologic and Preventive Aspects of Epilepsy in the Child–Bridging the Gap Between Laboratory and Clinic

Cited by 11 publications

References 41 publications

Neonatal Seizures: Gaps Between the Laboratory and the Clinic

Neonatal Seizures: Gaps Between the Laboratory and the Clinic

Introduction to the Supplement

Epileptogenic effect of hypoxia in the immature rodent brain

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