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

Ninety-one patients operated on for focal epilepsy between 1952 and 1973 have been followed regularly. Nontumoral lesions were found in 68 patients, and tumors in 23. Of the 50 patients without tumor who have been followed for more than 2 years, 30% were seizure-free, 50% improved, while only 20% did not benefit from the operation. There was no operative mortality. Ventricular asymmetry in the pneumoencephalogram was associated with a better prognosis than when there was no or symmetrical enlargement. The time between the onset of seizures and the operation did not affect the prognosis, but early operation is important to achieve better and quicker rehabilitation. There was a positive correlation between the postoperative ECoG and EEG and the clinical results.
 ...
PMID:A follow-up study of 91 patients operated on for focal epilepsy. 81 93

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.
 ...
PMID:Epilepsy and brain tumors: implications for treatment. 212 72

A new operative approach has been designed for the relief of medically intractable focal epilepsy. It is intended particularly to be used in those cases where the epileptogenic lesion lies in "unresectable" cortex; that is, those cerebral regions subserving speech, memory, and primary motor and sensory function. The procedure is based upon experimental evidence indicating 1) that epileptogenic discharge requires substantial side-to-side or horizontal interaction of cortical neurons, and 2) that the major functional properties of cortical tissue depend upon the vertical fiber connections of the columnar units. The technique requires severing of tangential intracortical fibers while preserving the vertical fiber connections of both incoming and outgoing nerve pathways and of the penetrating blood vessels which also have a vertical orientation. In this study, the effect of multiple subpial transection was assessed on both function and seizure control. The effect on function was reviewed in 32 cases; only 20 cases were evaluated with respect to seizure control, since a follow-up period of 5 years or more (5 to 22 years) is required before conclusions can be drawn. Multiple subpial transection was applied to the precentral gyrus in 16 cases, the postcentral gyrus in six, Broca's area in five, and Wernicke's area in five. With respect to function, the major finding was that none of the 32 patients has suffered a clinically significant behavioral deficit (although subtle deficits could be detected by careful neurological examination). Complete control of seizures has been obtained in 11 (55%) of the 20 cases evaluated. Nine patients developed recurrent seizures consequent to progressive disease unsuspected before operation (Rasmussen's encephalitis in five, tumor in three, and subacute sclerosing panencephalitis in one). In none of these cases, however, did the recurrent seizures arise in the transected zone. Thus, the results indicate that multiple subpial transection is about as effective as standard excisional therapy, and can be successfully employed when epileptogenic lesions encroach upon cortical territories, the removal of which would be functionally incapacitating.
 ...
PMID:Multiple subpial transection: a new approach to the surgical treatment of focal epilepsy. 250 54

It is difficult to prove the existence of secondary epileptogenesis in man. In the majority of cases of human focal epilepsy, where the cause is likely to be trauma, infection, or vascular disease, the occurrence of additional or new epileptogenic foci is usually attributed to multiple primary injuries (maturing at different rates), or to progressive disease. Cerebral tumor is the only common cause in which the probability of multiple primary lesions is vanishingly low. Therefore, a personally followed series of cases of cerebral tumor seen as epilepsy are reviewed in which clinical, electrophysiologic, and pharmacologic data are analyzed for evidence of secondary epileptogenesis. Such evidence was found in 34% of our tumor patients. It was possible to demonstrate, in humans, the three stages of secondary epileptogenesis previously documented in animals. A pharmacologic test is described that separates the reversible from the irreversible stage of secondary epileptogenesis and allows prediction of the results of surgical removal of the primary focus.
 ...
PMID:Secondary epileptogenesis in man. 392 Oct 8

Report of an eight-year-old boy presenting with untreatable focal epilepsy and slowly progressing hemiparesis combined with personality changes. Continuous diagnostic efforts eventually resulted in the diagnosis of a primary intracranial rhabdomyosarcoma several months later. The delay in making the correct diagnosis was due to the fact that the malignant process originated as a diffuse involvement of the leptomeninx, and only in later stages a tumor mass developed. Nosology and histogenesis of primary intracranial rhabdomyosarcomas are discussed.
 ...
PMID:Primary rhabdomyosarcoma of the leptomeninx. Clinical, neuroradiological and pathological aspects. 609 65

Tumors of the cerebral hemispheres comprise a big variety of histologic tumor types. Therefore, in the literature usually only specific subgroups such as benign gliomas and temporal lobe tumors are reported. In this study we report on 44 tumors of the cerebral hemispheres, including 9 angiomas. Apart from the treatment results concerning event free survival, the neurological and neuropsychological outcome of the patients were assessed. A peculiarity in the hemispheric tumors is their association with focal epilepsies. In 94% of our patient series, epileptic seizures had been the first tumor associated symptom and approximately 62% developed focal epilepsy. Seizure types, their association with tumor location and histology, the success of tumor therapy in concern of the epilepsy and the significance of the electroencephalogram in the follow up care of these patients were assessed separately.
 ...
PMID:[Tumors of the cerebral hemispheres in children and adolescents. Results of treatment, residual syndromes and focal epilepsy]. 775 3

Chronic encephalitis and epilepsy (Rasmussen's encephalitis) is a rare progressive disorder of uncertain etiology that usually occurs in children, producing focal epilepsy, hemiparesis, and intellectual deterioration. We identified 13 patients in whom seizures developed in adolescence or adulthood with a pathologic picture of chronic encephalitis. The clinical characteristics were more variable than those occurring in children, with the patients falling into three groups: five patients developed seizures in adulthood, but otherwise showed many resemblances to the childhood form; five developed seizures in adolescence, with similar presentation but rather more benign course than in the younger patients; and three presented with clinical features initially suggestive of a tumor. Occipital onset to the seizures appeared to be more common than in the childhood form, and bilateral disease also occurred.
 ...
PMID:Chronic encephalitis and epilepsy in adults and adolescents: a variant of Rasmussen's syndrome? 904 Jul 32

Surgery has become an accepted treatment modality for carefully selected adults with intractable focal epilepsy. More recently, increasing numbers of pediatric patients with intractable epilepsy are also being referred for surgical consideration. Key elements of surgical candidacy include medically intractable focal epilepsy, a localized epileptogenic zone, and a low risk for new postoperative neurologic deficits. The most common etiologies of the epilepsies in pediatric surgical candidates are malformation of cortical development and low grade tumor but some patients with childhood onset temporal lobe epilepsy due to hippocampal sclerosis also present for early surgery. Based on results from several recent pediatric surgical series, the chance for favorable seizure outcome after surgery is not adversely affected by young age, with seizure-free postoperative outcome reported for 60% to 65% of infants, 59% to 67% of children, and 69% of adolescents, compared to 64% reported in a large, predominantly adult series. Some subgroups of patients have higher percentages of seizure-free outcome, including those with hippocampal sclerosis or low grade tumor. In addition to seizures, developmental issues are also a major concern in children with intractable epilepsy. Few quantitative data are available, but some anecdotal experience suggests that surgical relief of catastrophic epilepsy may result in resumption of developmental progression after surgery, although the rate of development often remains abnormal. In one series, best developmental outcomes were seen in patients with earliest surgery and highest level of preoperative development. For each patient, the timing of surgery must be carefully considered, based on a full assessment of the relative risks and benefits, derived from a detailed presurgical evaluation.
 ...
PMID:Surgical treatment of epilepsy in pediatric patients. 1083 Mar 41

The neurocutaneous melanosis (NCM) is a rare, neuroectodermal dysplasia defined by the association of giant or multiple, nonmalignant pigmented cutaneous nevi with leptomeningeal melanosis or melanoma. As a rule, the cerebral pathological substratum is characterized by a melanocytic infiltration of the leptomeninges, often leading to hydrocephalus. The most frequent clinical symptomatology starts early in life, with convulsive seizures, psychomotor delay, intracranial hyperpression: the prognosis is severe. Malignant melanomas can also occur. One 21 years-old patient affected by NCM with a giant bathing nevus and epilepsy is reported. Her psychomotor development was slightly delayed. Academic progress was disturbed by the frequency of seizures and the multiple dermatological surgeries, and she remained at the elementary school level. Her epilepsy appeared at seven years and became pharmacoresistant. It was a focal, left temporal epilepsy. Neuroimaging investigations were performed repeatedly, and demonstrated the progressive appearance of parenchymal lesions with T1 and T2 shortening, without contrast enhancement, at the pons (11 years), the two hippocampi (14 years), and of an atrophy of the cerebellum and the brainstem (19 years). No hydrocephalus, tumoral aspect, or meningeal involvement were demonstrated. This patient's case is peculiar because her neurological symptomatology consists only of focal epilepsy, unrelated to a tumor, with moderate cognitive impairment despite a rather long course of the disease. Her evolution raises the question of condidency to surgical treatment.
 ...
PMID:An unusual case of neurocutaneous melanosis. 1574 Nov 43

Epilepsy surgery has been proposed as a safe alternative treatment for intractable epilepsy in children, especially for patients with structural brain abnormalities. We studied 24 consecutive children who underwent surgery for intractable epilepsy. There were 12 males and 12 females. The mean age was 6.5 years. The seizures' duration ranged from 6 months to 2 years. The histopathological examination of the resected lesions revealed in 12 cases the presence of a ganglioglioma, in 7 cases dysembryoplastic neuroepithelial tumor, in 1 case a low grade glioma, in 2 cases cortical dysplasia, and in 2 cases cavernous malformations. In 18 cases, the lesions were located in the temporal lobe and in 6 cases the lesions were extratemporal. After a mean follow-up period of 4.4 years, 79% (19/24) of patients were seizure free. There were no permanent neurological deficits or deaths. Surgery for focal epilepsy in children is a safe procedure with favorable results.
 ...
PMID:Benign lesions accompanied by intractable epilepsy in children. 1928 94


1 2 3 Next >>