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Query: UMLS:C0014544 (epilepsy)
 64,704 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Seven boys aged between 14 months and 13 years with focal or multifocal partial epilepsy had very unusual seizures, characterized by series of periodic bilateral spasms. These consisted of a brief, complex movement of slight to severe intensity, mainly involving the axial muscles, with raising of the shoulders, adversion of the eyes and head, often with rictus-type facial grimaces and occasional stretching of the legs and emission of a guttural sound. The ictal EEG showed a pattern of periodic complexes, characterized by a slow wave with superimposed fast activity. This form of epileptic seizure is resistant to treatment and is found only in patients affected by a brain disease consisting of a fixed or progressive encephalopathy. These observations document the existence of a rare form of seizure or epileptic event, not yet included in the International Classification of epileptic seizures and clinically relevant because of its diagnostic and prognostic implications.
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PMID:Periodic spasms: an unclassified type of epileptic seizure in childhood. 312 18

A case of reversible encephalopathy after one dose of ifosfamide/mesna in an epileptic 15-year-old girl is reported. No other pathology could be responsible for the symptoms. An epilepsy or a toxicity induced by vincristine were discussed. Nevertheless, the possible role of phenobarbital, known to induce hepatic microsomal activity, seems the more probable mechanism.
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PMID:Ifosfamide/mesna related encephalopathy: a case report with a possible role of phenobarbital in enhancing neurotoxicity. 313 98

A nap sleep EEG with at least one full sleep cycle has been recorded in 3 groups of children free from diffuse encephalopathy and presenting with partial epilepsy with onset after the age of 3 years: 15 cases with typical benign epilepsy with centrorolandic spikes (BERS), 15 cases with partial symptomatic epilepsy without clinical or radiological evidence of a cerebral lesion, and 12 cases with partial epilepsy symptomatic of a proven cerebral lesion. The time course of paroxysmal abnormalities was quantified according to individual sleep stages; the number of foci was also quantified in the waking vs sleeping state. Paroxysmal abnormalities are significantly enhanced by sleep in all 3 groups: throughout sleep stages in BERS, in slow sleep stages only in the other groups. The enhancement is more striking in BERS, where a clear decrease of abnormalities is also found upon awakening. There is no major difference between the 2 symptomatic groups, with a greater enhancement of paroxysms in the proven lesional group. Contrary to the other groups, only the group including those patients with a documented cerebral lesion showed a significant increase in the number of foci during sleep: numerous foci were found in these patients that were distinct from the primary lesional focus. Under the conditions of our study, the nap EEG seems to provide an accurate evaluation of sleep-induced changes of paroxysmal activity in partial epilepsies of childhood.
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PMID:[Napping sleep EEG in partial childhood epilepsy]. 314 63

We report 6 cases of particular type of myoclonic epilepsy with non-progressive encephalopathy. It consists of a syndrome characterized by an onset of seizures in the first year of life, frequent myoclonic status, generalized spikes and waves on EEG and an unfavourable outcome with encephalopathy. At the beginning, the diagnosis is difficult, the symptomatology later suggests a progressive encephalopathy. In the present study, a detailed analysis of the early electroencephalographic aspects and of the arguments in favour of a non-progressive encephalopathy is proposed. Hypothesis of perinatal vascular lesions mainly involving the central areas is forwarded.
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PMID:[Myoclonic epilepsy with non-progressive encephalopathy]. 314 48

Mitochondrial encephalomyopathy involves a disturbance of the mitochondrial respiratory chain, as a result of which the blood lactate level is elevated. In stress situations a lactate acidosis can occur. The disease may be subdivided into three main syndromes: Kearns-Sayre syndrome (KKS), "myoclonus epilepsy with ragged red fibers syndrome" (MERRF), and "mitochondrial myopathy, encephalopathy, lactic acidosis and strokelike episodes syndrome" (MELAS). There are also several intermediate forms. Ophthalmological symptoms are frequent and occasionally have to be treated surgically. A 20-year-old male patient with a mixed form of these syndromes including elements of KSS and MERRF had to undergo cataract extraction. The authors decided to perform the operation under local anesthesia and sedation, with the anesthetist on standby. No problems arose. In all cases where mitochondrial encephalomyopathy is suspected the diagnosis should be confirmed by a muscle biopsy and the risk of cardiac arrest, respiratory insufficiency, and epileptic seizures ruled out prior to surgery. Local anesthesia with sedation appears to be the most favorable form of anesthesia provided the maximum dose is observed and a substance with a high convulsion threshold is chosen. Perioperative monitoring by an anesthetist and temporary provision of a cardiac pacemaker are necessary.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Anesthesia for eye operations in mitochondrial encephalomyelopathy]. 318 52

Although high-dose intravenous (IV) methotrexate (MTX) with leucovorin rescue (HDMTX) is effective for certain recurrent primary brain tumors, concern for inducing leukoencephalopathy has restrained its use as adjuvant therapy following therapeutic brain irradiation (RT). We have conducted a phase I to II clinical trial using four biweekly courses of HDMTX (8 g/m2) in a neoadjuvant setting in ten patients with newly diagnosed high-risk pediatric primary brain tumors. Four patients experienced an objective response after two to four courses of HDMTX alone (medulloblastoma, one; pineoblastoma, one; malignant cerebral astrocytoma, two). All ten patients subsequently received a course of therapeutic RT, and in seven cases, adjuvant chemotherapy with other agents. One patient acquired an acute transient encephalopathy before RT that completely resolved, and another developed a seizure disorder following RT associated with white matter abnormalities on a magnetic resonance imaging (MRI) scan. Five patients have survived a minimum of 33+ months, and four remain in continuous remission. The acute and delayed neurotoxicity of neoadjuvant HDMTX is acceptable, and we favor further use of this neoadjuvant approach in the context of a phase III trial.
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PMID:Preradiation high-dose intravenous methotrexate with leucovorin rescue for untreated primary childhood brain tumors. 325 30

Using noninvasive (echoventriculometry (Echo-VM), REG and invasive (planimetric PEG, graphic recording of the CSF pressure) methods of examination, the authors determined the size of cerebral ventricles and the status of the cerebral hemo- and CSF dynamics in 606 patients with various chronic diseases of the brain (consequences of craniocerebral injury, epilepsy, discirculatory encephalopathy, etc.). According to PEG and Echo-VM findings, two groups of patients were distinguished. In moderate dilatation of cerebral ventricles the most significant finding was an increase in the pulse pressure of the CSF, whereas its mean pressure was normal or slightly elevated. In patients with pronounced hydrocephaly the pulse and mean pressure of the CSF tended to decrease. The progress of hydrocephaly was parallelled by increasing disorders of the cerebral hemodynamics expressed in hindered venous outflow from the cranial cavity and elevated peripheral vascular resistance. Four CSF-related syndromes have been identified (normotension, total CSF hypertension, intraventricular tension, total CSF hypotension) differing in their diagnostic and prognostic significance and in the pathogenesis of disorders of the hemo- and CSF dynamics.
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PMID:[Status of the ventricular system and dynamics of the cerebrospinal fluid changes in chronic brain diseases]. 325 71

Four broad categories of basic phenomena are pertinent to developing ways to prevent epilepsy. These include mechanisms of epileptogenesis, ictal initiation and temporary entrainment by the seizure discharge of normally functioning brain, seizure propagation, and control mechanisms that function both to restrain the cascade of epileptic events culminating in a seizure and to arrest the epileptic event and restore the interictal state. In newborns and children, hypoxia-ischemia is a major factor leading to epileptogenesis, and several schemes are proposed to classify, quantify, and prevent hypoxic-ischemic encephalopathy. Control mechanisms must be better understood in order to develop prophylactic recommendations for epilepsy, and an experimental model of "kindling antagonism" may increase our understanding of these. Programs of prevention of seizures in children will evolve only if basic researchers and clinicians work productively together to develop an adequate understanding of factors important in epileptogenesis and antiepileptogenic control mechanisms.
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PMID:Etiologic and preventive aspects of epilepsy in the child--bridging the gap between laboratory and clinic. 330 92

Despite the immaturity of the newborn brain, the neonatal period is reported to have a very high frequency of seizures. This review concludes that many of the neonatal events that are called seizures probably originate from subcortical structures, have little in common with cortical seizures seen in older individuals, and may not benefit from conventional anticonvulsant treatment. Many studies of anticonvulsants in the newborn have important methodologic problems, compounded by the fact that the seizures tend to spontaneously remit with the resolution of the acute hypoxic-ischemic encephalopathy that is most often the cause. Randomized trials of anticonvulsants in this setting have not been carried out. Even in many of these seizures do not originate in the cortex, they still imply profound cortical disturbance and are associated with high mortality and morbidity. It is unknown if the type and duration of treatment influence the long-term, overall outcome. The seizures usually stop in the newborn period, and anticonvulsants beyond hospital discharge seem unwarranted because they are unlikely to prevent subsequent epilepsy. Newer investigations, including video-EEG and nuclear magnetic resonance studies, may clarify the real significance of neonatal seizures.
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PMID:Neonatal seizures: a commentary on selected aspects. 330 17

This paper calls attention to the methodologies designed to investigate the higher cortical functions in order to elicit signis of encephalopathy in apparently normal conditions. This can be done by testing the blobal hemispheric funcionts or the interhemispheric functional balance. This shows up the clinical sequels that may precede or be the outcome both of transient pathological disorders, such as transient global anemia, migraine, TIAs and subarachnoid hemorrhage without apparent clinical consequences and of nontransient pathological conditions, such as epilepsy, occupational diseases, arterial hypertension and cerebral revascularization.
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PMID:Neurobehavioral investigation as a tool for revealing preclinical disorders. 332 25


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