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At least 19 records

Oxygen desaturations triggered by partial seizures: implications for cardiopulmonary instability in epilepsy

PURPOSE: The occurrence of hypoxemia in adults with partial seizures has not been systematically explored. Our aim was to study in detail the temporal dynamics of this specific type of ictal-associated hypoxemia. METHODS: During long-term video/EEG monitoring (LTM), patients underwent monitoring of oxygen saturation using a digital Spo2 (pulse oximeter) transducer. Six patients (nine seizures) were identified with oxygen desaturations after the onset of partial seizure activity. RESULTS: Complex partial seizures originated from both left and right temporal lobes. Mean seizure duration (+/-SD) was 73 +/- 18 s. Mean Spo2 desaturation duration was 76 +/- 19 s. The onset of oxygen desaturation followed seizure onset with a mean delay of 43 +/- 16 s. Mean (+/-SD) Spo2 nadir was 83 +/- 5% (range, 77-91%), occurring an average of 35 +/- 12 s after the onset of the desaturation. One seizure was associated with prolonged and recurrent Spo2 desaturations. CONCLUSIONS: Partial seizures may be associated with prominent oxygen desaturations. The comparable duration of each seizure and its subsequent desaturation suggests a close mechanistic (possibly causal) relation. Spo2 monitoring provides an added means for seizure detection that may increase LTM yield. These observations also raise the possibility that ictal ventilatory dysfunction could play a role in certain cases of sudden unexpected death in epilepsy in adults with partial seizures.

NASA Program Biomedical Research and Countermeasur↗

Effect of sleep-wake reversal and sleep deprivation on the circadian rhythm of oxygen toxicity seizure susceptibility.

Albino Sprague-Dawley rats were exposed in a previously O2 flushed, CO2 free chamber. The exposure began with attainment of 60 psi (gauge) and the end point was the first generalized oxygen toxicity seizure. Animals were exposed to reversal diurnal conditions since weanlings until their sleep-wake cycles had completely reversed, and then divided into four groups of 20 based on the time of day exposed. The time of exposure to oxygen at high pressure prior to seizure was now significantly longer in the group exposed from 1900 to 2000 hr and a reversal of the circadian rhythm of oxygen toxicity seizure susceptibility was noted. Animals maintained on normal diurnal conditions were deprived of sleep on the day of exposure for the 12 hours prior to exposure at 1900 hr, while controls were allowed to sleep. There was no significant differences in the time prior to seizure between the deprived animals and the controls with an n = 40. Thus the inherent threshold in susceptibility to high-pressure oxygen seizures seems not to be a function of sleep itself, but of some biochemical/physiologic event which manifests a circadian rhythm.

Dexter, J. D.↗

Automatic Detection of Seizures with Applications

There are an estimated two million people with epilepsy in the United States. Many of these people do not respond to anti-epileptic drug therapy. Two devices can be developed to assist in the treatment of epilepsy. The first is a microcomputer-based system designed to process massive amounts of electroencephalogram (EEG) data collected during long-term monitoring of patients for the purpose of diagnosing seizures, assessing the effectiveness of medical therapy, or selecting patients for epilepsy surgery. Such a device would select and display important EEG events. Currently many such events are missed. A second device could be implanted and would detect seizures and initiate therapy. Both of these devices require a reliable seizure detection algorithm. A new algorithm is described. It is believed to represent an improvement over existing seizure detection algorithms because better signal features were selected and better standardization methods were used.

Olsen, Dale E.↗

The control and prevention of seizures in children, a developmental and environmental approach

The clinical effectiveness of neurophysiological and developmental factors in controlling and preventing seizure mechanisms is detailed. It is shown that as cortical control advances with maturation, it requires increasingly severe environmental adversity to release this residual defensive reflex mechanism. Administration of anticonvulsant drugs is discouraged because of possible undesirable neuronal effects on the very young brain.

Lewinn, E. B.↗

Monitor for status epilepticus seizures

This paper describes the sensor technology and associated electronics of a monitor designed to detect the onset of a seizure disorder called status epilepticus. It is a condition that affects approximately 3-5 percent of those individuals suffering from epilepsy. This form of epilepsy does not follow the typical cycle of start-peak-end. The convulsions continue until medically interrupted and are life threatening. The mortality rate is high without prompt medical treatment at a suitable facility. The paper describes the details of a monitor design that provides an inexpensive solution to the needs of those responsible for the care of individuals afflicted with this disorder. The monitor has been designed as a cooperative research and development effort involving the United States Army Armament Research, Development, and Engineering Center's Benet Laboratories (Benet) and the Cerebral Palsy Center for the Disabled (Center), in association with the Department of Neurology at Albany Medical College (AMC). Benet has delivered a working prototype of the device for field testing, in collaboration with Albany Medical College. The Center has identified several children in need of special monitoring and has agreed to pursue commercialization of the device.

Johnson, Mark↗

Screening EEG in Aircrew Selection: Clinical Aerospace Neurology Perspective

As clinical aerospace neurologists we do not favor using screening EEG in pilot selection on unselected and otherwise asymptomatic individuals. The role of EEG in aviation screening should be as an adjunct to diagnosis, and the decision to disqualify a pilot should never be based solely on the EEG. Although a policy of using a screening EEG in an unselected population might detect an individual with a potentially increased relative risk, it would needlessly exclude many applicants who would probably never have a seizure. A diagnostic test performed on an asymptomatic individual without clinical indications, in a population with a low prevalence of disease (seizure) may be of limited or possibly detrimental value. We feel that rather than do EEGs on all candidates, a better approach would be to perform an EEG for a specific indication, such as family history of seizure, single convulsion (seizure) , history of unexplained loss of consciousness or head injury. Routine screening EEGs in unselected aviation applications are not done without clinical indication in the U.S. Air Force, Navy, or NASA. The USAF discontinued routine screening EEGs for selection in 1978, the U.S. Navy discontinued it in 1981 , and NASA discontinued it in 1995. EEG as an aeromedical screening tool in the US Navy dates back to 1939. The US Navy routinely used EEGs to screen all aeromedical personnel from 1961 to 1981. The incidence of epileptiform activity on EEG in asymptomatic flight candidates ranges from 0.11 to 2.5%. In 3 studies of asymptomatic flight candidates with epileptiform activity on EEG followed for 2 to 15 years, 1 of 31 (3.2%), 1 of 30 (3.3%), and 0 of 14 (0%) developed a seizure, for a cumulative risk of an individual with an epileptiform EEG developing a seizure of 2.67% (2 in 75). Of 28,658 student naval aviation personnel screened 31 had spikes and/or slow waves on EEG, and only 1 later developed a seizure. Of the 28,627 who had a normal EEG, 4 later developed seizures, or .0139% (4/28627). After review of the value of the EEG as a screening tool, the US Navy now uses EEG only for certain clinical indications (head injury, unexplained loss of consciousness, family history of epilepsy, and abnormal neurological exam). Currently the US Navy does not use EEG for screening for any flight applicant without a neurologic indication. In the US Navy, an electroencephalographic pattern is determined to be epileptiform by a neurologist.

Clark, Jonathan B.↗

Effect of circadian rhythm on CNS oxygen toxicity.

The circadian rhythm in susceptibility to oxygen toxicity seizures was investigated by using six groups of 20 male Sprague-Dawley rats (101-196 gm.). The animals were given standard chow, exposed to standard diurnal conditions of light (0700-1900 hr) and dark (1900-0700 hr), and fasted for 15-16 hr prior to exposure to hyperbaric oxygen. The animals were placed in a previously oxygen flushed chamber and raised to 60 psi (gauge) oxygen at a rate of 3 psi/min. Time of exposure started with attainment of 60 psi. End point was first convulsion. The animals' weights were equally distributed within the groups, and the groups were defined by hour of exposure. Time of exposure in minutes prior to seizure was significantly longer in those exposed at 0700-0800 hr and 1000-1100 hr than in four other groups. There was no relationship between animals' weights and time of exposure to seizures. All R values were negative, and the highest R value was -035. These data suggest a definite circadian rhythm in susceptibility to oxygen toxicity seizures.

Hof, D. G.↗

Portable device for detection of petit mal epilepsy

A portable device that analyzes the electroencephalogram to determine if petit mal epilepsy waveforms are present is developed and tested. Clinicians should find it useful in diagnosing seizure activity of their patients. The micropower, battery-operated, portable device indicates a seizure has occurred if three criteria are satisfied: (1) frequencies of 2.5-7 Hz, (2) large-amplitude waves, and (3) minimum number of waves per second. Levels and counts are adjustable, thus insuring high reliability against noise artifacts and permitting each subject to be individually fitted. The device has shown promise in giving the patient a possible mechanism of seizure control or suppression.

Smith, R. G.↗

Measurement and modification of the EEG and related behavior

Electrophysiological changes in the sensorimotor pathways were found to accompany the effect of rhythmic EEG patterns in the sensorimotor cortex. Additionally, several striking behavioral changes were seen, including in particular an enhancement of sleep and an elevation of seizure threshold to epileptogenic agents. This raised the possibility that human seizure disorders might be influenced therapeutically by similar training. Our objective in human EEG feedback training became not only the facilitation of normal rhythmic patterns, but also the suppression of abnormal activity, thus requiring complex contingencies directed to the normalization of the sensorimotor EEG. To achieve this, a multicomponent frequency analysis was developed to extract and separate normal and abnormal elements of the EEG signal. Each of these elements was transduced to a specific component of a visual display system, and these were combined through logic circuits to present the subject with a symbolic display. Variable criteria provided for the gradual shaping of EEG elements towards the desired normal pattern. Some 50-70% of patients with poorly controlled seizure disorders experienced therapeutic benefits from this approach in our laboratory, and subsequently in many others. A more recent application of this approach to the modification of human brain function in our lab has been directed to the dichotomous problems of task overload and underload in the contemporary aviation environment. At least 70% of all aviation accidents have been attributed to the impact of these kinds of problems on crew performance. The use of EEG in this context has required many technical innovations and the application of the latest advances in EEG signal analysis. Our first goal has been the identification of relevant EEG characteristics. Additionally, we have developed a portable recording and analysis system for application in this context. Findings from laboratory and in-flight studies suggest that we will be able to detect appropriate changes in brain function, and feed this information to on-board computers for modification of mission requirements and/or crew status.

Sterman, M. B.↗

Comparative lubrication studies of OH-58A tail rotor drive shaft bearings

Comparative lubrication tests were run with OH-58A helicopter tail rotor drive shaft bearings. The tests were run in an outdoor environment with ambient temperatures ranging from 10 to 75 F. Dust was periodically applied to the bearings to simulate field conditions. The cause of bearing failure was associated with dust penetration. Rotor shaft failure was found to be caused by the shaft rotating in the standard rubber collar due to seizure of the bearings. Bearings with a positive rubbing seal having a MIL-G-81322 grease produced lives greater than with bearings having labyrinth seals and a mineral oil paste lubricant. An elongated collar prevented failure of the rotor shaft during bearing seizure. In a limited test, installation of tail boom shrouds over the bearings which excluded dust and water resulted in bearing lives in excess of 1800 hours or 1200 hours greater than the current 600 hours TBO, regardless of the lubricant-bearing combination used.

Dietrich, M. W.↗

Analysis of Space Station Centrifuge Rotor Bearing Systems: A Case Study

A team of NASA bearing and lubrication experts was assembled to assess the risk for the rolling-element bearings used in the International Space Station (ISS) centrifuge rotor (CR) to seize or otherwise fail to survive for the required 10-year life. The CR was designed by the Japan Aerospace Exploration Agency and their subcontractor, NEC Toshiba Space Systems, Ltd. (NTSpace). The NASA team performed a design audit for the most critical rolling-element bearing systems and reviewed the lubricant selected. There is uncertainty regarding the ability of the Braycote 601 grease (Castrol Limited) to reliably provide the 10-year continuous life required without relubrication of the system. The fatigue life of the Rotor Shaft Assembly (RSA) spring loaded face-to-face mount at a 99-percent probability of survival (L1 life) for the ball bearing set was estimated at 700 million hours and the single ball bearing (Row 3) at 58 million hours. These lives satisfy the mission requirements for fatigue. Rolling-element seizure tests on the RSA and fluid slip joint bearings were found unlikely to stop the centrifuge, which can cause damage to the ISS structure. The spin motor encoder duplex angular-contact ball bearings have a hard preload and a large number of small balls have the highest risk of failure. These bearings were not tested for seizure even though they are less tolerant to debris or internal clearance reductions.

Poplawski, Joseph V.↗

Tribology Induced Water Pump Bearing Failure

NASA’s In-Space Propulsion facility experienced two infant mortality water pump bearing failures during a recent refurbishment campaign, the cause or causes of which were unclear. A forensic failure study was undertaken that included site visits, collection and examination of physical evidence and a bearing and pump design review. The pumps are large (2000 hp) vertical turbine design machines that utilize metallic sleeve bearings cooled and lubricated by the pumped fluid (water). Though initial possible root cause for the failures were attributed to improper fabrication and debris contamination, detailed examination of failure surfaces combined with bearing design revealed that the failure mode was thermal seizure brought on by inadequate cooling flow. An unusual contributing factor was that the use of grease as an assembly lubricant, as opposed to a fluid like oil, appears to have exacerbated the rather than alleviated the thermal runaway by blocking water flow. Resolution of the problem was achieved through the design and installation of dedicated bearing lubrication water feed system.

bearings↗

Toxicity studies of a polyurethane rigid foam

Relative toxicity tests were performed on a polyurethane foam containing a trimethylopropane-based polyol and an organophosphate flame retardant. The routine screening procedure involved the exposure of four Swiss albino male mice in a 4.2 liter hemispherical chamber to the products generated by pyrolyzing a 1.00 g sample at a heating rate of 40 deg C/min from 200 to 800 C in the absence of air flow. In addition to the routine screening, experiments were performed with a very rapid rise to 800 C, with nominal 16 and 48 ml/sec air flow and with varying sample rates. No unusual toxicity was observed with either gradual or rapid pyrolysis to 800 C. Convulsions and seizures similar to those previously reported were observed when the materials were essentially flash pyrolyzed at 800 C in the presence of air flow, and the toxicity appeared unusual because of low sample weights required to produce death.

Hilado, C. J.↗

Human Neurological Development: Past, Present and Future

Neurological development is considered as the major human potential. Vision, vestibular function, intelligence, and nutrition are discussed as well as the treatment of neurological disfunctions, coma, and convulsive seizures.

Pelligra, R.↗

Orthomolecular enhancement of human development

The importance of molecules introduced into the human body by the way of foods is emphasized. Examples of orthomolecular therapy are given that range from the control of epileptic seizures, the therapy of mental illness, to the prevention of the common cold.

Pauling, L.↗

Lightweight Face Mask

Lightweight face mask originally developed to protect epileptic patients during seizures could have many other medical and nonmedical applications such as muscular distrophy patients, football linesmen and riot-control police. Masks are extremely lightweight, the lightest of the configurations weighing only 136 grams.

Cason, W. E. I.↗