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

Data found in the literature and our own observations prompted us to consider the possibility that abnormally enlarged Somatosensory Evoked Potentials (SEPs) may have a diagnostic and physiopathological significance, particularly in a group of diseases which include common clinical features of encephalopathy with stimuli-sensitive myoclonus and epilepsy, whatever their etiology may be (degenerative or storage disease, metabolic, toxic or post-hypoxic encephalopathy...). We discuss the amplitude, morphology, diagnostic and therapeutic contribution of these 'giant' SEPs and pathogenic assumptions with reference to 'cortical reflex myoclonus'. Studies of back-averaged encephalogram, SEPs and long-loop reflexes allow some illustration of a functional hyperreactivity of the sensori-motor cortex, but no conclusive demonstration of its origin.
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PMID:[Significance of abnormally high somatosensory evoked potentials (SEV)]. 393 21

272 cases of childhood epilepsy were studied with brain TC scan to correlate the type of seizure to the possible neurological damage. Children with generalized convulsions had a low incidence of abnormal TC findings if in absence of neurological signs (3/80) (Group A), but a more relevant incidence (13/34) in presence of neurological signs (Group B). 65 children had epileptic encephalopathy (Group C): 15/17 West syndromes and 33/48 Lennox syndromes presented TC abnormalities. The remnant 93 children had partial seizures. In Group D partial epilepsy was free of neurological signs; the incidence of abnormal TC findings was 17/76. An higher incidence (9/17) was found in Group E, where partial epilepsy was accompanied by neurological disturbances.
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PMID:[Value of computerized tomography in childhood epilepsy]. 393 42

The present study, conducted between January 1975 and June 1983, includes 282 adult patients admitted for status epilepticus (SE) in 2 intensive care units (3.5% of all admissions). In their great majority, i.e., 201, patients had no previous history of epilepsy, and initiated the SE during the course of recent affections such as brain or systemic diseases. In 81 patients with previous seizure, epilepsy was idiopathic in 20, and symptomatic in 61, the 3 main causes being cranial traumatism, cerebrovascular accident and chronic alcoholism. SE was of various causes. The most frequent were cerebro-vascular disease, post-anoxic encephalopathy, intoxication, bacterial or viral meningo-encephalitis. In some patients, SE was preceded by manifestations such as convulsions, behavorial disturbances or conscience impairment. One should be aware of these facts and undertake or increase an anticonvulsivant medication at their onset. Duration of SE, when clearly established, was highly variable but had no apparent correlation to sequelae or death occurrences. SE itself was directly related to death in only 2 cases; in all other instances death was the consequence of the primary disease. These results are consistent with previous reports: presently SE occurs more frequently in the course of other affections than in prior epileptic patients. The better vital prognosis of SE is due to the simultaneous conjunction of new anticonvulsivant medication and supportive care associated with the cure of the causative disease.
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PMID:[Status epilepticus in the adult. Epidemiologic and clinical study in an intensive care unit]. 402 53

The authors studied 286 patients with epilepsy with disease onset past the age of 20 years (176 males, 110 females) from the urban and rural populations. In 57% of cases the aetiology of epilepsy was undetermined. Among the known aetiological factors head trauma accounted for 15.5% of cases, inflammatory processes in the central nervous system for 4.5%, alcoholism for 7%, vascular lesions for 6%, tumours for 5.2%, degenerative and atrophic changes for 1.5%. Over 40% of patients had had attacks for up to 15 years and over 18% for over 20 years. In 80% of cases grand mal seizures occurred, and in 33% of these cases more than 12 attacks occurred annually. Six cases of status epilepticus were observed with 2 deaths. The attacks were precipitated by menstruation, alcohol abuse, infection, stressed, television watching. Among the signs accompanying or following the seizures tongue biting and urination prevailed. Neurological signs were demonstrated in 21% of cases, encephalopathy in 65%, other psychic disturbances in 9.5%. Systematic treatment was received by 75% of the patients (over 80% in urban population), and therapy with multiple drugs was most frequent. Drug-resistant epilepsy was found in 34% of cases. The patients from the rural population had a lower educational level and had more children. About 70% of the patients were in employment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Analysis of clinico-social features of epilepsy]. 404 96

We review the development of the classification of the epilepsies. Primary epilepsies are relatively benign, usually age-limited syndromes without clinical or radiologic evidence of brain lesions, and are related to a heritable constitutional predisposition to epilepsy. They usually respond well to antiepileptic drugs. The biochemical correlates of primary generalized epilepsy have been demonstrated in animals and man and have been related to diffuse cortical hyperexcitability, which has been linked to this disorder. The pathophysiology of the primary partial or focal epilepsies is poorly understood but does not appear to depend on focal brain lesions. We suggest that these are due to relatively localized areas of cortical hyperexcitability confined to isolated corticothalamic sectors and depend on interrelations between a constitutional cortical hyperexcitability and normal cortical maturation. The secondary epilepsies are associated with clinical and radiologic evidence of brain lesions and are often resistant to anticonvulsants. Secondary generalized epilepsies, with an associated diffuse encephalopathy, are typified by the Lennox-Gastaut syndrome. The presentation of the secondary partial epilepsies depends on the site of the lesion. The pathogenesis of epilepsy is multifactorial, and a preexisting constitutional predisposition can interact with an acquired diffuse or focal encephalopathy, facilitating the clinical expression of one or the other.
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PMID:Classification of the epilepsies. 405 19

Twenty-five asphyxiated term babies were investigated in order to evaluate the prediction of their neurodevelopmental outcome by means of computerized tomography (CT) as compared to neurological symptoms during the neonatal period. Low density (LD) areas, thought to represent hypoxicischaemic lesions, were assessed quantitatively by means of a LD score based on the extent and degree of LD, the total score ranging from 0-36. Neonatal scans were defined according to the time span elapsed between asphyxia and CT as (1) early CT (day 1-7, n = 15), and (2) intermediate CT (day 9-23: n = 14; day 29: n = 1). The newborns were classified according to the neonatal neurological findings as having mild (n = 8, 32%), moderate (n = 9, 36%), and severe (n = 8, 32%) encephalopathy, following the definition of Sarnat and Sarnat (1976). Among the twenty-two survivors, the follow-up (mean age 19.2 +/- 6.0 mts) revealed fourteen (56%) with normal outcome, two (8%) with transient neurodevelopmental anomalies during the first year, and nine (36%) with permanent abnormalities such as cerebral palsy and/or retardation (mainly global) and/or epilepsy. Early CT scans had no predictive value. Intermediate CT, however, showed distinct variations of LD areas which resulted in an LD score well correlated with the later outcome. In particular, a LD score below 14 characterized every baby who developed normally; a prediction not possible in a reliable way be means of neonatal neurological signs. For all abnormal children, the score correlated with the severity of the later neurodevelopmental disorder, except for one with the latest intermediate CT (day 29).
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PMID:Prognostic value of neonatal CT scans in asphyxiated term babies: low density score compared with neonatal neurological signs. 408 97

Recent investigations at several institutes have demonstrated extensive acute brain pathology in experimental animals exposed to single subcutaneous doses of the chemical warfare nerve agents soman or sarin. Lesions include neuronal and neurophil degeneration, necrosis, and in animals that survive for several weeks, a degenerative encephalopathy characterized by mineralization, encephalomalacia, atrophy, and hydrocephalus. The cerebral cortex, amygdaloid complex, hippocampus, and multiple thalamic nuclei are consistently affected. This pattern of injury resembles that described for epilepsy and ischemic brain injury. Some animals have cardiac lesions characterized by acute necrosis with subsequent mild inflammation and fibrosis. Anticonvulsants protect experimental animals from lesion development. In rats, this encephalopathy causes long-range behavioral changes characterized by hyperactivity during routine handling and variances in traditional behavioral tests. The histopathologic features and distribution of lesions in nerve agent-poisoned animals support the hypothesis that epileptiform seizure activity is a major factor in nerve agent pathology. Other localized insults such as ischemia and hypoxia probably contribute to the pathogenesis.
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PMID:Pathology of nerve agents: perspectives on medical management. 409 82

Two patients with intractable epilepsy who had been treated with various combinations of anticonvulsant drugs developed phenytoin encephalopathy. In both patients choreo-athetoid involuntary movements were prominent. Blood phenytoin concentrations were above 30 mug/ml. When phenytoin was given in smaller doses and its level in the blood fell the involuntary movements and other clinical manifestations disappeared.
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PMID:Choreo-athetosis and encephalopathy induced by phenytoin. 415 55

The pharmacotherapy of the psychopathological consequences of damages to the brain suffered in early childhood (erethistic or torpid oligophrenia, characteropathy, episodic psychic disorders in epilepsy, tics, and schizophrenic syndromes in encephalopathy) is discussed.
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PMID:[Treatment of psychopathologic sequelae of early childhood brain damage]. 415 52

Electro-clinical, neuro-radiologic and socio-professional study of 100 epileptic adults, followed by the same physician during 12 to 20 years (average 15 1/2 years), now 30 to 75 years old, all cases of evolutive pathology being excluded. The evolution statistically is more favourable when the epilepsy: has developed late (between 21 and 30 years); ils described as "idiopathic", or with small primary lesion; is characterized by primary generalized fits with strong convulsive component, occurring preferably at awaking. The evolution is less favourable, even unfavourable, when the epilepsy: is secondary to a severe encephalopathy or to extensive focal lesions; has developed during childhood; is characterized by fits with partial start, little tendency to secondary convulsive generalization, and occurring any time of the day or bound to sleep.
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PMID:[Epilepsies in the adult. Can we distinguish progressive types?]. 421 61


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