Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0014547 (focal epilepsy)
 1,627 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Following acute meningitis associated with severe convulsions in childhood, two patients had chronic, drug-resistant, temporal lobe epilepsy. This disorder was preceded by an entirely natural development, in one case extending for nine years and in the other case for eight years. Each patient was treated with right anterior temporal lobectomy. Classic mesial temporal sclerosis (Ammon's horn sclerosis) was found in both patients. Relief of the epilepsy was associated with remission of the concomitant social and psychiatric handicaps. At least ten years of follow-up are required in the evaluation of the treatment of early brain infections. Chronic focal epilepsy after childhood meningitis with febrile convulsions merits neurosurgical consideration.
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PMID:Focal epilepsy with mesial temporal sclerosis after acute meningitis. 393 14

The effects of delta 9-tetrahydrocannabinol (delta 9-THC), two of its metabolites, 8 beta-hydroxy-delta 9-THC and 11-hydroxy-delta 9-THC, and cannabidiol were comparatively studied by means of an iron-induced cortical focal epilepsy in conscious rats with chronically implanted electrodes. delta 9-Tetrahydrocannabinol produced depression of the spontaneously firing epileptic focus, excitatory behavior, generalized after-discharge-like bursts of epileptiform polyspikes and frank convulsions. The pharmacological profiles of the two metabolites differed from that of the parent compound: 11-Hydroxy-delta 9-THC did not precipitate convulsions, but it did elicit all the other effects of delta 9-THC; the 8 beta-hydroxy derivative, on the other hand, exerted only two delta 9-THC-like effects; that is, it evoked polyspike bursts and convulsions. In contrast, cannabidiol, even in large doses (100 mg/kg) was devoid of all the effects of delta 9-THC. Furthermore, pretreatment with cannabidiol markedly altered the responses to delta 9-THC in the following ways: focal depression was partially blocked, polyspike activity was enhanced and convulsions abolished. Phenytoin pretreatment elicited similar effects, but it failed to block the delta 9-THC-induced convulsions. In general, the cannabinoids exhibit a wide spectrum of CNS effects ranging from focal depression to convulsions; specifically, however, the pharmacological profile of each agent can differ markedly; for example, the convulsant properties of delta 9-THC are not a universal characteristic of this class of drugs.
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PMID:Central excitatory properties of delta 9-tetrahydrocannabinol and its metabolites in iron-induced epileptic rats. 627 53

Kindling is traditionally viewed as a chronic, focal epilepsy model which consistently induces complex partial seizures from limbic structures in animals. This study revealed that primary or exceedingly rapid secondary generalized seizures could also be kindled when stimulation was applied to the lateral geniculate nucleus, a thalamic region involved in sleep regulation and possibly also photosensitive epilepsy. Two experiments were conducted in cats. Experiment 1 compared the development of generalized tonic-clonic convulsions and associated sleep disorders following electrical stimulation of the lateral geniculate nucleus (N = 4) and the amygdala (N = 4). Experiment 2 described the effects of intermittent light stimulation on seizure thresholds in both groups. Three primary findings distinguished the epileptogenic process in those two brain regions. First, generalized electroencephalographic and clinical seizures accompanied the first afterdischarge obtained with thalamic stimulation. In contrast, focal seizures with secondary generalization appeared during a 3- to 4-week period of afterdischarge elicitations from the amygdala. Second, amygdala-kindled cats showed fewer sleep spindles during slow-wave sleep whereas cats kindled in the lateral geniculate nucleus had abnormal sleep spindles approaching spike wave-like activity. Third, only the latter cats showed reduced seizure thresholds in response to photic stimulation. Based on the anatomic substrates involved, the clinical and electrographic profiles observed during kindling and the type of sleep disturbance shown, we concluded that lateral geniculate nucleus kindling may represent primary generalized epilepsy, possibly of a photosensitive nature; alternatively, the rapid propagation of abnormal discharge was also consistent with the important role of the thalamus in secondary seizure generalization.
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PMID:Thalamic kindling: electrical stimulation of the lateral geniculate nucleus produces photosensitive grand mal seizures. 643 40

Data on 50 patients treated surgically for intractable focal epilepsy were analysed. There were 10 hemispherectomies, 32 temporal lobectomies and eight operations to other areas of the brain. The median age at operation was 14 years. 29 patients were found to have mesial temporal sclerosis or sclerotic hemispheres and 17 had alien tissue and one sclerosis with heterotopia. No lesion was found in three cases. The nature of the first seizure was found to relate significantly to pathology. 30 patients had suffered an early convulsion. Between the convulsive insult and the onset of focal epilepsy there was a silent interval, the duration of which was biased by sex and side of lesion. The remaining 20 patients, of whom a highly significant number had alien tissue, had not had an early convulsion before the onset of focal epilepsy. The importance of accurate clinical histories is stressed. Clinical considerations alone predicted the pathology and laterality of the lesion in more than half the series. Regular EEG recordings and repeat scanning were found to be important investigations. Major disorders of behaviour had occurred in 44 patients. As adults, the series were free of severe psychiatric symptoms, but many required years of careful rehabilitation. 31 children had been excluded from normal schools before operation. Postoperatively, many patients continued their education in normal schools. Some required basic remedial teaching, others successfully undertook higher education and training. 49 patients benefited over-all from neurosurgical treatment. 34 had no more habitual epilepsy at all. Full global gains often took at least five years to achieve.
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PMID:Developmental aspects of focal epilepsies of childhood treated by neurosurgery. 643 82

Mutant epileptic E1 mice are thought to have focal epilepsy of hippocampal origin because glucose utilization is increased in the hippocampus (HPC) during seizures in these mice. However, direct electrographic evidence is still lacking for the notion. We recorded electroencephalograms (EEGs) using depth electrodes in E1 and non-epileptic ddY mice. All the mice were subjected to a conventional seizure-provoking maneuver during EEG recording; each mouse was placed on a mesh floor and observed for 3 min, and then tossed up in the air. When the E1 mice showed signs of abortive seizures or prodromal symptoms including squeaking, running and myoclonus, sporadic spikes or sharp waves were generated exclusively in the HPC. When generalized convulsions followed these prodromes, the sporadic discharges evolved into a burst of generalized spikes which again predominated in the HPC. We also observed the cerebral cortex, amygdaloid, caudate, centro-median thalamic and ventral postero-lateral thalamic nuclei, all of which were found to be only secondarily involved. These findings provide the first electrical evidence that E1 mice have a secondarily generalized seizure that has its initiating focus in the HPC.
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PMID:Depth EEG in mutant epileptic E1 mice: demonstration of secondary generalization of the seizure from the hippocampus. 768 Sep 97

In India a common CT finding in epilepsy is a ring/disc enhancing lesion (RDEL). This lesion is hypodense on plain scan and shows a ring or disc-like enhancement on contrast CT scan. This study reports on 186 cases with such lesions, found in 26.1% of all focal epilepsy. It was commoner in children. Fifty-three per cent of the cases had had fits for less than 3 months, 29.6% had had fits for more than 6 months and 17.6% for more than a year. Focal signs were seen in 20% of cases and focal EEG slowing in 57.1%. The lesion cleared on anticonvulsants alone in 75% of cases. At present this is the preferred method of treatment unless there is coexisting CNS tuberculosis or close family contact with TB or extraneural cysticercosis. Biopsy was done in 16 cases and the two commonest causes were found to be cysticercosis and tuberculosis. A review of 58 biopsies in four centres in India is included. The frequency of this entity is apparently highest in India and even in other countries where cysticercosis is common, the lesion is not reported as frequently.
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PMID:Ring or disc enhancing lesions in epilepsy in India. 796 36

Twenty-eight patients underwent electrical stimulation of the centromedian (CM) thalamic nucleus as a neuro-augmentative procedure to control intractable seizures of various types. To assess the correct placement of electrodes, electrical stimulation at 3 and 6 Hz, 1.0 msec and 600-2000 uA pulses in trains of 30-60 sec were used while the EEG was recorded by scalp electrodes. Spontaneous seizure activities of various types were simultaneously recorded. In cases of focal epilepsy depth electrodes were used in order to study the sequence of activation of different structures. Three Hz electrical stimulation induced spike-and-wave complexes accompanied by a typical absence. Eight Hz induced recruiting-like responses with ipsilateral predominance and no clinical manifestations. Interictal spike activity was recorded in the CM in cases of generalized tonic-clonic convulsions (GTCC) and ictal spike pattern in the CM preceded discharges in other areas. In atypical absences cortical and CM discharges occurred simultaneously. It is concluded that the CM participates in the onset of GTCC and typical absences, in the propagation of secondary GTCC but not in myoclonic convulsions.
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PMID:Role of the centromedian thalamic nucleus in the genesis, propagation and arrest of epileptic activity. An electrophysiological study in man. 810 94

We report a case of congenital varicella syndrome after maternal infection during the 10th week of pregnancy. None of the typical abnormalities were manifested at birth; however, the child experienced neonatal tonic convulsions that evolved to refractory focal epilepsy with adversive, complex partial, and secondarily generalized seizures. At the age of 5 years, after a prolonged generalized seizure following cranial trauma, cranial computed tomography (CT) was performed. It led to the misdiagnosis of post-traumatic intracerebral hemorrhage. Afterwards, because of persistent seizures and developmental delay with mild or slight intellectual deficit, the next CT and magnetic resonance imaging (MRI) investigation at 8 years of age disclosed massive malformation of the left cerebral hemisphere. The serologic evidence of varicella-zoster virus-specific IgG antibodies without a history of varicella disease after birth and maternal infection during early pregnancy were crucial to diagnosing the rare syndrome of congenital varicella consisting of isolated brain damage.
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PMID:Congenital varicella syndrome: case with isolated brain damage. 1151 Sep 32

Benign familial infantile convulsions (BFIC) is a recently identified partial epilepsy syndrome with onset between 3 and 12 months of age. We describe the clinical characteristics and outcome of 43 patients with BFIC from six Dutch families and one Dutch-Canadian family and the encountered difficulties in classifying the syndrome. Four families had a pure BFIC phenotype; in two families BFIC was accompanied by paroxysmal kinesigenic dyskinesias; in one family BFIC was associated with later onset focal epilepsy in older generations. Onset of seizures was between 6 weeks and 10 months, and seizures remitted before the age of 3 years in all patients with BFIC. In all, 29 (67%) of the 43 patients had been treated with anti-epileptic drugs for a certain period of time. BFIC is often not recognized as (hereditary) epilepsy by the treating physician. Seizures often remit shortly after the start of anti-epileptic drugs but, because of the benign course of the syndrome and the spontaneous remission of seizures, patients with low seizure frequency do not necessarily have to be treated. If prescribed, anti-epileptic drugs can probably be withdrawn after 1 or 2 years of seizure freedom.
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PMID:Benign familial infantile convulsions: a clinical study of seven Dutch families. 1237 79

Combining electroencephalogram (EEG) and functional MRI (fMRI) allows localization of brain regions activated as a result of epileptic spikes. The statistical analysis of fMRI data usually includes a standard model of the hemodynamic response function (HRF) but it is not known how well this fits the actual HRF of epileptic spikes. The objective of this exploratory study was to compare the activated areas and t-statistical scores obtained with a standard HRF to those obtained with a patient-specific HRF. Eight patients with focal epilepsy were studied. We obtained an estimate of the patient-specific HRFs for each patient at the local maximum of activation in the standard HRF analysis. The activated areas obtained with the patient-specific HRFs were larger or similar to the originally activated areas. Additional activated areas were seen in five patients, and most were compatible with the EEG and anatomical MRI localization of epileptogenic and lesional regions. Using patient-specific HRFs brings increased sensitivity to the analysis of epileptic spikes by EEG-fMRI.
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PMID:Using patient-specific hemodynamic response functions in combined EEG-fMRI studies in epilepsy. 1456 85


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