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Query: UMLS:C0014547 (focal epilepsy)
 1,627 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Primary intraparenchymal tumors of the brain are important etiologic factors in partial or focal epilepsy. Indolent low-grade gliomas may be associated with a long-standing seizure disorder refractory to medical treatment. Surgical resection of the neoplasm and the epileptogenic area may render patients seizure-free. Removal of the tumor alone may also be associated with an excellent survival rate and surgical outcome. Conventional neurosurgical procedures are restricted in patients with tumors that are deep-seated lesions or involve functional cerebral cortex. Computer-assisted stereotactic surgical procedures have been developed for biopsy and resection of intra-axial brain-mass lesions. Stereotactic tumor resection may allow pathological determination of intracranial lesions and produce a worthwhile reduction in seizure activity in some patients with intractable partial epilepsy.
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PMID:Epilepsy and brain tumors: implications for treatment. 212 72

A night-time polygraphic sleep recording was performed in 14 patients with late onset partial epilepsy receiving chronic carbamazepine monotherapy. All patients had unstable nocturnal sleep patterns as indicated by significantly altered sleep continuity parameters compared with normal controls. Patients with poor seizure control tended to show greater alterations of sleep stability compared to patients in complete clinical remission but the difference failed to reach statistical significance. Epileptic patients also showed less REM sleep and longer REM latencies compared with normal controls, the most altered REM values being observed in patients with poor seizure control. These data confirm that polygraphic sleep alterations are seen in patients with symptomatic focal epilepsy and indicate that these abnormalities occur irrespective of seizure recurrence.
Epilepsy Res
PMID:Sleep patterns in patients with late onset partial epilepsy receiving chronic carbamazepine (CBZ) therapy. 212 55

Seventy patients with intractable epilepsy were surgically treated. Thirty-three patients underwent a stereotactic procedure and in all as a first-stage operation fornicotomy was performed. Because of inadequate results in 14 patients, an additional stereotactic intervention was necessary; the targets were amygdala, thalamus, and Forel's H-field, and the final outcome of these patients was 9 (27%) seizure-free, 19 (58%) improved, and 5 (15%) unchanged. In 3 patients a selective amygdalo-hippocampectomy was performed with 2 seizure-free patients and one with improvement. Topectomy in focal epilepsy in 5 patients resulted in freedom from seizures in all cases. In 23 patients a lobectomy was performed; 10 (43%) were seizures-free, 8 (35%) were improved, and 5 (22%) were unchanged. In 6 patients only a pathological lesion was resected. Our results speak in favour of ablative surgery. However, stereotactic operations are indicated in cases with secondary generalization and dissipated foci on the dominant hemisphere.
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PMID:Surgical treatment of epilepsy. 212 1

As many as 99 patients with focal epilepsy were examined for recognition of the emotional-prosodic++ speech characteristics, non-vocal acoustic complexes, acoustic and acoustic vocal memory as well as for noise stability of the acoustic vocal system. The presence, character and intensity of psychopathological abnormalities identified in those patients were estimated at a time. The correlation and factorial analyses made it possible to discover the existence of significant relationships between the two lines of abnormalities. Several types of such relationships have been described. It is assumed that in some cases, disorders of impressive emotional psychoacoustic functions may represent one of the pathogenetic mechanisms of mental disorders associated with focal cortical epilepsy.
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PMID:[Disorders of recognition of emotional and prosodic characteristics of speech in various mental disorders in patients with focal cortical epilepsy]. 217 Dec 67

We report 3 cases of epilepsy with bilateral occipital calcifications followed up for several years. These cases were compared with 21 published cases and were found to differ from the classical Sturge-Weber syndrome on several points: 1) the disease appeared around the age of 5 years and consisted of focal epilepsy without neurological or mental disorders; 2) the epilepsy was easy to control during 2 to 5 years. This was followed by a diffuse encephalopathy with severe, treatment-resistant epilepsy, Gerstmann's syndrome, optic ataxia, cerebellar syndrome and slow activity at EEG. It appears from these 3 cases that: 1) occipital calcifications may be unilateral at the onset of the disease; 2) visual evoked potentials are affected at a late stage, and 3) CT scans are of considerable value in the prognosis of benign epilepsy in childhood.
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PMID:[Epilepsy and bilateral occipital calcifications: 3 cases]. 219 37

This article reviews the application of magnetoencephalography (MEG) in clinical epileptology and epilepsy research. MEG recordings of interictal as well as ictal epileptiform discharges helped to improve non-invasive localization of epileptic foci in patients with focal epilepsy. Several studies showed good agreement of the localizations obtained from MEG compared with those from invasive electrical recordings. Thus, MEG may become a potentially useful technique in the pre-surgical evaluation of epilepsy patients. As evidenced from studying the penicillin focus in animals and spike propagation in humans, MEG also may contribute to further understand the basic mechanisms of epilepsy and thus may be useful in epilepsy research. Directions of future research include recording from a large number of channels covering a wide area of the head, long-term recording to study mechanisms involved in the transition of interictal to ictal state, and recording of slow magnetic field shifts associated with interictal and ictal epileptiform discharges.
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PMID:Magnetoencephalography in clinical epileptology and epilepsy research. 220 Apr 89

Epilepsy and epileptogenic activity in EEGs were studied in 168 shunt treated hydrocephalic (HC) children, the mean age at first operation 1.62 years (SD 1.87). 80 patients (47.6%) suffered from epileptic seizures during the follow-up period (mean 8.9 years). The epileptic seizures appeared before the initial shunting, and after the first shunt implantation in 43 (25.6%). There was no correlation between epilepsy and the aetiology of HC, number of shunt revisions, or shunt infections. Sixteen patients suffered from seizures during the neonatal period. Generalized spike and wave activity (SWA) was seen in EEG in eight out of these, and only one was seizure-free at the end of the follow-up period. All eight patients with epileptic seizures during the neonatal period without generalized SWA in EEG were seizure-free, however. SWA was seen in the first EEG prior to shunting in 75/168 patients (44.6%). All those patients who did not receive prophylactic medication, developed epileptic seizures, whereas 68.1% of those who received prophylactic anticonvulsive medication remained free of seizures. Partial epilepsy after shunting manifested itself in 15 patients, but this did not correlate with the side of the shunt or with the side of the SWA in the EEG. Slit ventricles (SLV) developed in 75 patients during the follow-up period, while the ventricles remained normal or dilated in 66 cases (27 patients had no CT follow-up). Epilepsy manifested itself in 8 out of these 141 patients (2 SLV, 6 non-SLV) during the first postoperative year, and in 29 patients in the SLV group and one in the non-SLV group at some time after the first postoperative year.
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PMID:Epilepsy in hydrocephalic children. 232 84

Although cryogenic lesions have been widely used as experimental models of either focal epilepsy or focal BE, the relation between these two disorders has never been discussed. In these experiments EA and gray matter edema were correlatively investigated during the early phase (1 to 23 hr) after a cryogenic lesion in the rabbit. Indexes were developed to allow a quantitative assessment of EA. The indexes demonstrated that the early phase of cryogenic epilepsy is a rapid phenomenon during the first 4-hr postlesion. Epileptic activity precedes BE, and in individual animals, there is a significant positive correlation between the total amount of EA and edema. EA and BE are most likely interrelated at the level of pathophysiological mechanisms. Excitotoxins and ions would be possible candidates mediating both phenomena.
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PMID:Relation between epileptic activities and edema formation after cryogenic injury in the rabbit. 239 20

Although the importance of neuronal synchrony in epilepsy has not been disputed, few attempts have been made to examine quantitatively the relationship between this parameter and seizure occurrence. The specific objective of the present investigation was to determine how the amount and type of synchrony between EEG and single-unit activity in an experimental model of focal epilepsy are related to the occurrence of seizures. This was accomplished by examining EEG/single unit relationships in two types of cobalt-induced epileptogenic focus: (1) foci that initiated seizures, and (2) foci that exhibited only interictal spike activity. These relationships were examined during slow-wave sleep, a time when synchronous neuronal activity is thought to be augmented. In control rats and rats that had seizures, the majority of units exhibited a non-random relationship between unit discharge and the EEG. In cobalt-treated rats that were not observed to have seizures, however, the percentage of units exhibiting EEG/single unit relationships was significantly less than that in either controls or rats that had seizures. This observation, paired with observations of the details of the EEG/single unit relationships, led to the hypothesis that cobalt treatment produces a shift from an inhibition dominated synchrony (observed in controls) to an excitation dominated synchrony (observed in rats that had seizures). Intermediate between these two types of synchrony is a less synchronized state (observed in seizure-free, cobalt-treated rats), which probably results from a loss of inhibition dominated synchrony without a concomitant increase in excitation dominated synchrony.
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PMID:Relationship between single-unit activity and the electroencephalogram in a neocortical, cobalt-induced epileptogenic focus. 244 19

1. Puberty and adolescence mainly can have a bad effect on idiopathic generalized epilepsies. This can show up in the first onset of seizures in adolescence, e.g. as a form of idiopathic grand mal on awakening, juvenile absence epilepsy or juvenile myoclonic epilepsy (impulsive petit mal). Also, already diagnosed absence epilepsy can become worse, e.g. by recurring absence seizures or grand mal seizures or the new onset of grand mal on awakening. 2. Exogenous factors, like changing the time of sleeping and waking, lack of sleep and the abuse of alcohol, play an important role in these types of epilepsy. Cutting out these factors is just as important as the consequent drug treatment on a longterm basis. 3. Drug treatment of idiopathic generalized epilepsy will be done with valproate, barbiturates and ethosuximide. Regarding fatal complications of liver function, which are more frequent than previously thought of, valproate can be recommended as a drug of first choice, especially in early childhood and when a combination of drugs is used. 4. A very good effect of adolescence is seen in children with benign idiopathic focal epilepsy with a centro-temporal spike focus. Antiepileptic treatment with carbamazepine as an agent of first choice can be done less vigorously. 5. Menstruation usually only modifies but does not worsen the natural course of epilepsy. There is still no real therapeutical plan for this rare form of epilepsy. 6. It cannot be a general rule, not to change current medical treatment before or during puberty in order to avoid any worsening of seizures. A decision always has to be made regarding the form of epilepsy and the individual situation, which has to be discussed with the patient and perhaps his family.
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PMID:[Epilepsies in puberty and adolescence. Follow-up and drug therapy]. 245 60


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