Epileptic seizures and headache/migraine: A review of types of association and terminology

Abstract Purpose There are different possible temporal associations between epileptic seizures and headache attacks which have given rise to unclear or controversial terminologies. The classification of the International League Against Epilepsy does not refer to this type of disorder, while the International Classification of Headache Disorders (ICHD-2) defines three kinds of association: 1. migraine-triggered seizure ("migralepsy"), 2. hemicrania epileptica, and 3. post-ictal headache. Methods We performed an extensive review of the literature, not including "post-ictal" and "inter-ictal" headaches. Results On the basis of well-documented reports, the following clinical entities may be identified: (A) "epileptic headache (EH)" or "ictal epileptic headache (IEH)": in this condition headache (with or without migrainous features) is an epileptic manifestation per se , with onset, and cessation if isolated, coinciding with the scalp or deep EEG pattern of an epileptic seizure. EH maybe followed by other epileptic manifestations (motor/sensory/autonomic); this condition should be differentiated from "pure" or "isolated" EH, in which headache/migraine is the sole epileptic manifestation (requiring differential diagnosis from other headache forms). "Hemicrania epileptica" (if confirmed) is a very rare variant of EH, characterized by ipsilateral location of headache and ictal EEG paroxysms. (B) "Pre-ictal migraine" and "pre-ictal headache": when a headache attack is followed during, or shortly after, by a typical epileptic seizure. The migraine attack may be with or without aura, and its seizure-triggering role ("migraine-triggered seizure") is still a subject of debate. A differentiation from occipital epilepsy is mandatory. The term "migralepsy" has not been used uniformly, and may therefore led to misinterpretation. Conclusions On the basis of this review we suggest definitions and a terminology which may become the basis of a forthcoming classification of headaches associated with epileptic seizures

Botulinum toxin type a as a therapeutic agent against headache and related disorders

Botulinum neurotoxin A (BoNT/A) is a toxin produced by the naturally-occurring Clostridium botulinum that causes botulism. The potential of BoNT/A as a useful medical intervention was discovered by scientists developing a vaccine to protect against botulism. They found that, when injected into a muscle, BoNT/A causes a flaccid paralysis. Following this discovery, BoNT/A has been used for many years in the treatment of conditions of pathological muscle hyperactivity, like dystonias and spasticities. In parallel, the toxin has become a “glamour” drug due to its power to ward off facial wrinkles, particularly frontal, due to the activity of the mimic muscles. After the discovery that the drug also appeared to have a preventive effect on headache, scientists spent many efforts to study the potentially-therapeutic action of BoNT/A against pain. BoNT/A is effective at reducing pain in a number of disease states, including cervical dystonia, neuropathic pain, lower back pain, spasticity, myofascial pain and bladder pain. In 2010, regulatory approval for the treatment of chronic migraine with BoNT/A was given, notwithstanding the fact that the mechanism of action is still not completely elucidated. In the present review, we summarize experimental evidence that may help to clarify the mechanisms of action of BoNT/A in relation to the alleviation of headache pain, with particular emphasis on preclinical studies, both in animals and humans. Moreover, we summarize the latest clinical trials that show evidence on headache conditions that may obtain benefits from therapy with BoNT/A

Pushing with Soft Robotic Arms via Deep Reinforcement Learning

Soft robots can adaptively interact with unstructured environments. However, nonlinear soft material properties challenge modeling and control. Learningbased controllers that leverage efficient mechanical models are promising for solving complex interaction tasks. This article develops a closed-loop pose/force controller for a dexterous soft manipulator enabling dynamic pushing tasks using deep reinforcement learning. Force tests investigate the mechanical properties of a soft robot module, resulting in orthogonal forces of 9  13 N. Then, the policy is trained in simulation leveraging a dynamic Cosserat rod model of the soft robot. Domain randomization mitigate the sim-to-real gap while careful reward engineering induced pose and force control even without explicit force inputs. Despite the approximate simulation, the sim-to-real transfer achieved an average reaching distance of 34  14mm (8.1%L  3.4%L), an average orientation error of 0.40  0.29 rad (23°  17°) and applied pushing forces up to 3 N. Such performance is reasonable for the intended assistive tasks of the manipulator. The experiments uncovered that the soft robot interacting with the environment exhibited torsional and counter-balancing movements. Although not explicitly enforced, they emerged from the mechanical intelligence of the manipulator. The results demonstrate the potential of soft robotic manipulation via reinforcement learning

Corrigendum: Child and adolescent behavior inventory (CABI): A new instrument for epidemiological studies and pre-clinical evaluation

Child and Adolescent Behavior Inventory (CABI): A New Instrument for Epidemiological Studies and Pre-Clinical Evaluation Clinical Practice & Epidemiology in Mental Health, 2013, 9: 51-61 Correction: Few corrections have been provided and replaced online in 15th, 20th, 21st and 22nd rows of the Appendix

How shearwaters prey. New insights in foraging behaviour and marine foraging associations using bird-borne video cameras

Abstract Conventional bio-logging techniques used for ethological studies of seabirds have their limitations when studying detailed behaviours at sea. This study uses animal-borne video cameras to reveal fine-scale behaviours, associations with conspecifics and other species and interactions with fishery vessels during foraging of a Mediterranean seabird. The study was conducted on Scopoli's shearwaters (Calonectris diomedea) breeding in Linosa island (35°51′33″ N; 12°51′34″ E) during summer 2020. Foraging events were video recorded from a seabirds' view with lightweight cameras attached to the birds' back. Foraging always occurred in association with other shearwaters. Competitive events between shearwaters were observed, and their frequency was positively correlated to the number of birds in the foraging aggregation. Associations with tunas and sea turtles have been frequent observations at natural foraging sites. During foraging events, video recordings allowed observations of fine-scale behaviours, which would have remained unnoticed with conventional tracking devices. Foraging events could be categorised by prey type into "natural prey" and "fishery discards". Analysis of the video footage suggests behavioural differences between the two prey type categories. Those differences suggest that the foraging effort between natural prey and fishery discards consumption can vary, which adds new arguments to the discussion about energy trade-offs and choice of foraging strategy. These observations highlight the importance of combining tracking technologies to obtain a complete picture of the at-sea behaviours of seabirds, which is essential for understanding the impact of foraging strategies and seabird-fishery interactions. Graphical abstrac