Chemical-Induced Seizures: Mechanisms, Consequences and Treatment


by

Feng R. Tang

DOI: 10.2174/97816080527451110101
eISBN: 978-1-60805-274-5, 2011
ISBN: 978-1-60805-600-2



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Indexed in: Web of Science, Scopus, Chemical Abstracts

Since the Tokyo Sarin Subway Attack, the threat of chemical warfare agents has migrated from the battlefield to become a major concern...[view complete introduction]

Table of Contents

FOREWORD

- Pp. i

Lionel Lee

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PREFACE

- Pp. ii

Feng Ru Tang and Weng Keong Loke

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List of Contributors

- Pp. iii-iv (2)

Feng Ru Tang and Weng Keong Loke

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Genetic, Molecular, Neuroanatomic, and Electrophysiologic Mechanisms of Chemically Induced Seizures

- Pp. 3-16 (14)

Ernest C. Lee and Stefanos N. Kales

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Seizures Associated with Warfare Nerve Agents: Pathophysiology, Clinical Symptoms and Supportive Interventions

- Pp. 17-28 (12)

Oleg Dolkart, Ron Ben-Abraham and Avi A Weinbroum

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Seizures and Other Neurological Symptoms Induced by Organophosphates,Including Warfare Nerve Agents

- Pp. 29-38 (10)

Adam-Scott Feiner, Bertrand Yersin, Andreas Stettbacher, Sergei Bankoul, Christophe Baumberger and Pierre-Nicolas Carron

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Organophosphate Toxicity Relating to Exposure Route and Type of Agent

- Pp. 39-48 (10)

Marloes J.A. Joosen, Marcel J. van der Schans, August B. Smit and Herman P.M. van Helden

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Therapeutic Effects of Drug Combinations Targeting Muscarinic and Adrenoreceptors during Soman Poisoning

- Pp. 49-66 (18)

Weng Keong Loke and Lai Kwan Ho

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Chemically Induced Experimental Models of Absence Epilepsy

- Pp. 67-79 (13)

Rezzan Gulhan Aker, Filiz Yilmaz Onat and Demet Kinay

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Kainic Acid Induced Seizures and Brain Damage: Mechanism and Relevant Therapeutic Approaches

- Pp. 80-88 (9)

Feng Ru Tang, Koichi Kato and Weng Keong Loke

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Pilocarpine and Nerve Agents Induced Seizures: Similarities and Differences

- Pp. 89-106 (18)

Feng Ru Tang, Koichi Kato and Weng Keong Loke

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Index

- Pp. 107-108 (2)

Bentham Science Publishers

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Foreword

In recent history, chemical warfare nerve agents have been used as a weapon in the battlefield as well as an instrument to spread panic by terrorists on innocent public. Unfortunately, because of limited scientific interest, there are not many laboratories engaged in chemical defence research in the world to help mitigate the threats. Hence, several gaps still exist in understanding of the toxic effects of such agents in the victims for the immediate and longer term. For example, we do not have a thorough understanding on the pathophysiological and behavioural changes after nerve agent poisoning to help us explain the psychological, mental effects and neurological impairment reported in victims with chronic signs and systems. This situation is not helped by the lack of experience and scarcity of clinical cases in daily clinical practice; doctors hardly ever see patients whose conditions have any similarity to casualties of nerve agent intoxication.

Drs Feng Ru Tang and Weng Keong Loke from Singapore are to be commended for this initiative to edit and organize an eBook, “Chemical-induced seizures: mechanisms, consequences and treatment”. It represents a collection of the latest scientific understanding in this topic of nerve agents and their deleterious impact from the relatively limited number of world renowned specialists in this field. Furthermore each article list several relevant references thus collating into this eBook the relevant information from publications and articles, which are currently spread over a wide range of journals and books. Both Dr Tang and Dr Loke have been researching in epilepsy and in the medical effects of chemical warfare agents for many years. I am confident that this eBook will not only benefit scientists, and doctor but also policy and emergency planners for national emergencies and security.

Professor Lionel Lee
Defence Medical and Environmental Research Institute
DSO National Laboratories
Singapore.


Preface

At the turn of the 20th century, following the Tokyo Sarin Subway Attack, the threat of chemical warfare agents has migrated from the battlefield to become a major concern for homeland security in the 21th century. While current fielded antidotes are able to mitigate acute high mortality arising from exposure to nerve agents, achieving effective neuroprotection in subjects with nerve agent induced prolonged seizures or status epilepticus is currently lacking. To overcome this challenge, establishing an improved understanding on the mechanism linking seizure onset during chemical (including nerve agents) poisoning to the subsequent cascade of biochemical, neurotoxicological, pathophysiological, genomic and behavioral changes post exposure is vital. Due to ethical, safety and chemical surety related issues, looking for surrogate chemicals also become important for chemical defense research. In this eBook, internationally well-known clinicians and basic research scientists with expertise on chemical-induced seizures will update readers on the relevant areas. In Chapter 1, Lee and Kales, review the basic principles of seizure generation, relevant microscopic neuroanatomy, neuroelectrophysiology, neurotoxicology and molecular genetics along with specific examples of chemicals known to elicit seizures. In Chapters 2 and 3, Feiner et al. and Dolkart et al. present nerve agent-induced neurological symptoms, diagnosis of nerve agent intoxication, pre-hospital assistance and intra-hospital management of seizures. In Chapter 4, Joosen et al. discuss about specific neuroanatomical routes for soman-induced seizure generation and spreading, neurotoxicology profiles and effects on neurogenesis and cognition. Loke and Ho summarize their research findings in Chapter 5 and suggest that manipulating central a2-adrenergic and cholinergic receptors may produce neuroprotective effects in nerve agent poisoned animals with established status epilepticus. In Chapters 6, 7, 8, seizure models induced by other chemicals are reviewed by Aker et al., Tang et al., Tang and Loke respectively. Tang and Loke systemically compare the mechanisms of seizure generation, the subsequent neuropathological, genomic, and neurobehavioral changes between pilocarpine- and nerve agent-induced seizure models, and suggest that pilocarpine model may be a surrogate model for nerve agent-induced seizures. Doctors (civil and military), paramedics and medical students will find this eBook informative and timely for the current battle against asymmetric terrorist conflicts.

Dr. Feng Ru Tang
Temasek Laboratories
Singapore

Dr. Weng Keong Loke
Defence Medical and Environmental Research Institute
Singapore

List of Contributors

Editor(s):
Feng R. Tang

National University of Singapore
Singapore




Co-Editor(s):
Weng Keong Loke

Defence Medical and Environmental Research Institute
Singapore




Contributor(s):
Rezzan Gülhan Aker
Department of Pharmacology and Clinical Pharmacology
Marmara University School of Medicine
Istanbul
Turkey


Sergei Bankoul
Swiss Armed Forces, Office of the Surgeon in Chief
Ittigen, 3063 Switzerland, and Swiss Armed Forces
NBC Centre of Competence
Spiez, 3700



Christophe Baumberger
Swiss Armed Forces
NBC Centre of Competence
Spiez, 3700
Switzerland


Ron Ben-Abraham
Post Anesthesia Care Unit and Animal Research Laboratory
Tel Aviv Sourasky Medical Center, and the Sackler Faculty of Medicine
Tel Aviv University
Tel Aviv
Israel


Pierre-Nicolas Carron
Emergency Service
University Hospital (CHUV)
Lausanne, 1011
Switzerland


Oleg Dolkart
Post Anesthesia Care Unit and Animal Research Laboratory
Tel Aviv Sourasky Medical Center, and the Sackler Faculty of Medicine
Tel Aviv University
Tel Aviv
Israel


Adam-Scott Feiner
Emergency Service
University Hospital (CHUV), Lausanne
Switzerland


Lai Kwan Ho
Defence Medical and Environmental Research Institute
DSO National Laboratories
11 Stockport Road
Singapore


Stefanos N. Kales
Harvard Medical School & Harvard School of Public Health
Medical Director, Employee & Industrial Medicine, Cambridge Health Alliance
1493 Cambridge Street, Macht Bldg, The Cambridge Hospital Room 427
Cambridge
MA, 02139
United States


Koichi Kato
Department of Neurosurgery
Tokyo Rosai Hospital
Address correspondence to: Dr. Koichi Kato, 4-13-21 Omoriminami
Ota-ku
Tokyo, 143-0013
Japan


Demet Kinay
I. Neurology Clinic
Bakirköy Research Hospital for Neurology
Neurosurgery and Psychiatry
Istanbul
Turkey


Marloes J.A. Joosen
TNO Defence, Security and Safety
Department of Chemical Toxicology
Lange Kleiweg 137
Rijswijk, 2288GJ
The Netherlands


Ernest C. Lee
Harvard School of Public Health
, Senior Medical Officer, Occupational Health Detachment
Marine Corps Logistics Base Barstow
Bldg 149 James L Day St
Barstow
CA, 92311
United States


Weng Keong Loke
Defence Medical and Environmental Research Institute
DSO National Laboratories
11 Stockport Road
Singapore 117605


Filiz Yilmaz Onat
Department of Pharmacology and Clinical Pharmacology
Marmara University School of Medicine
Istanbul
Turkey


August B. Smit
Center for Neurogenomics and Cognitive Research
Free University
De Boelelaan 1085, 1081HV
Amsterdam
The Netherlands


Andreas Stettbacher
Swiss Armed Forces
Office of the Surgeon in Chief
Ittigen, 3063
Switzerland


Feng Ru Tang
Temasek Laboratories
National University of Singapore
5A, Engineering Drive 1
Singapore 117411
/
Department of Anatomy
Yong Loo Lin School of Medicine
Block MD 10, National University of Singapore
4 Medical Drive
Singapore


Marcel J. van der Schans
TNO Defence, Security and Safety
Department of Chemical Toxicology
Lange Kleiweg 137, 2288GJ
Rijswijk
The Netherlands


Herman P.M. van Helden
TNO Defence, Security and Safety
Department of Chemical Toxicology
Lange Kleiweg 137, 2288GJ
Rijswijk
The Netherlands


Avi A Weinbroum
Post Anesthesia Care Unit and Animal Research Laboratory
Tel Aviv Sourasky Medical Center, and the
Sackler Faculty of Medicine, Tel Aviv University
Tel Aviv
Israel


Bertrand Yersin
Emergency Service
University Hospital (CHUV)
Lausanne, 1011
Switzerland




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