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      Electrocorticographic description of the effects of anticonvulsant drugs used to treat lidocaine‐induced seizures

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          Abstract

          Introduction

          Local anesthetics are widely used in clinical practice. While toxicity is rare, these drugs can cause potentially lethal seizures.

          Objective

          In the present study, we investigated the electrocorticographic (ECoG) and electromyographic patterns of seizures induced by acute lidocaine (LA) toxicity and treated with anticonvulsant drugs. The study used adult male Wistar rats to describe of the seizure‐related behavior of LA and investigated the treatment with anticonvulsant drugs.

          Results

          The use of LA resulted in clear changes in the ECoG pattern, which presented characteristics of Status epilepticus, with increased intensity in all brainwaves. The decomposition of the cerebral waves showed an increase in the beta and gamma waves that may be related to tonic–clonic seizure. Although the treatment with anticonvulsants drugs reduces the power of brainwaves at frequencies between 1 and 40 Hz compared to the LA group, but only diazepam (DZP) was able to decrease the intensity of oscillations. The muscle contraction power also indicated a difference in the effectiveness of the three treatments.

          Conclusion

          The sum of the evidence indicates that LA causes status epilepticus and that DZP is the most effective treatment for the control of these seizures, by restoring the systemic values to levels close to those recorded in the control group.

          Abstract

          Lidocaine (LA) intraperitoneally resulted in changes in the electrocorticographic pattern, with characteristics of Status epilepticus. Treatment with diazepam reduces the power of brainwaves at frequencies between 1 and 40 Hz compared to the LA group.

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          Most cited references45

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          Evidence-Based Guideline: Treatment of Convulsive Status Epilepticus in Children and Adults: Report of the Guideline Committee of the American Epilepsy Society.

          The optimal pharmacologic treatment for early convulsive status epilepticus is unclear.
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            • Book: not found

            Guide for the Care and Use of Laboratory Animals : Eighth Edition

            (2011)
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              Intracranial electroencephalographic seizure-onset patterns: effect of underlying pathology.

              Because seizures originate from different pathological substrates, the question arises of whether distinct or similar mechanisms underlie seizure generation across different pathologies. Better defining intracranial electroencephalographic morphological patterns at seizure-onset could improve the understanding of such mechanisms. To this end, we investigated intracranial electroencephalographic seizure-onset patterns associated with different epileptogenic lesions, and defined high-frequency oscillation correlates of each pattern. We analysed representative seizure types from 33 consecutive patients with drug-resistant focal epilepsy and a structural magnetic resonance imaging lesion (11 mesial temporal sclerosis, nine focal cortical dysplasia, six cortical atrophy, three periventricular nodular heterotopia, three polymicrogyria, and one tuberous sclerosis complex) who underwent depth-electrode electroencephalographic recordings (500 Hz filter, 2000 Hz sampling rate). Patients were included only if seizures arose from contacts located in lesional/peri-lesional tissue, and if clinical manifestations followed the electrographic onset. Seizure-onset patterns were defined independently by two reviewers blinded to clinical information, and consensus was reached after discussion. For each seizure, pre-ictal and ictal sections were selected for high-frequency oscillation analysis. Seven seizure-onset patterns were identified across the 53 seizures sampled: low-voltage fast activity (43%); low-frequency high-amplitude periodic spikes (21%); sharp activity at ≤13 Hz (15%); spike-and-wave activity (9%); burst of high-amplitude polyspikes (6%); burst suppression (4%); and delta brush (4%). Each pattern occurred across several pathologies, except for periodic spikes, only observed with mesial temporal sclerosis, and delta brush, exclusive to focal cortical dysplasia. However, mesial temporal sclerosis was not always associated with periodic spikes nor focal cortical dysplasia with delta brush. Compared to other patterns, low-voltage fast activity was associated with a larger seizure-onset zone (P = 0.04). Four patterns, sharp activity at ≤13 Hz, low-voltage fast activity, spike-and-wave activity and periodic spikes, were also found in regions of seizure spread, with periodic spikes only emerging from mesial temporal sclerosis. Each of the seven patterns was accompanied by a significant increase in high-frequency oscillations upon seizure-onset. Overall, our data indicate that: (i) biologically-distinct epileptogenic lesions share intracranial electroencephalographic seizure-onset patterns, suggesting that different pathological substrates can affect similarly networks or mechanisms underlying seizure generation; (ii) certain pathologies are associated with intracranial electroencephalographic signatures at seizure-onset, e.g. periodic spikes which may reflect mechanisms specific to mesial temporal sclerosis; (iii) some seizure-onset patterns, including periodic spikes, can also be found in regions of spread, which cautions against relying on the morphology of the initial discharge to define the epileptogenic zone; and (iv) high-frequency oscillations increase at seizure-onset, independently of the pattern.
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                Author and article information

                Contributors
                dicatrina@gmail.com
                hamoyufpa@gmail.com
                Journal
                Brain Behav
                Brain Behav
                10.1002/(ISSN)2157-9032
                BRB3
                Brain and Behavior
                John Wiley and Sons Inc. (Hoboken )
                2162-3279
                25 December 2020
                February 2021
                : 11
                : 2 ( doiID: 10.1002/brb3.v11.2 )
                : e01940
                Affiliations
                [ 1 ] Laboratory of the Pharmacology and Toxicology of Natural Products Institute of Biological Sciences Federal University of Pará Belém Brazil
                [ 2 ] Laboratory of Experimental Neuropathology João de Barros Barreto University Hospital Federal University of Pará Belém Brazil
                Author notes
                [*] [* ] Correspondence

                Dielly Catrina Favacho Lopes, Laboratório de Neuropatologia Experimental, Hospital Universitário João de Barros Barreto, Universidade Federal do Pará. Rua dos Mundurucus, N 4487, 66073‐000 Guamá, Belém, Pará, Brasil.

                Email: dicatrina@ 123456gmail.com

                Moisés Hamoy, Laboratório de Farmacologia e Toxicologia dos Produtos Naturais, Instituto de Ciências Biológicas, Universidade Federal do Pará. Rua Augusto Corrêa, N 01, 66075‐110 Guamá, Belém, Pará, Brasil.

                Email: hamoyufpa@ 123456gmail.com

                Author information
                https://orcid.org/0000-0001-5095-0168
                https://orcid.org/0000-0002-6226-4269
                Article
                BRB31940
                10.1002/brb3.1940
                7882171
                33369278
                cf485250-cf8a-4165-bad0-72e60c153cc6
                © 2020 The Authors. Brain and Behavior published by Wiley Periodicals LLC

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 14 May 2020
                : 22 October 2020
                : 22 October 2020
                Page count
                Figures: 8, Tables: 0, Pages: 11, Words: 6151
                Funding
                Funded by: Universidade Federal do Pará , open-funder-registry 10.13039/501100007382;
                Categories
                Original Research
                Original Research
                Custom metadata
                2.0
                February 2021
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.9.7 mode:remove_FC converted:14.02.2021

                Neurosciences
                electrocorticography,electromyography,epilepsy,lidocaine,seizure
                Neurosciences
                electrocorticography, electromyography, epilepsy, lidocaine, seizure

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