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)

In 150 consecutive cases of simple partial epilepsy significant CT abnormalities were found in 68%. The commonest lesion noted was a hypodense lesion on unenhanced scan, with a ring or disc-like enhancement on contrast scan, and surrounding hypodensity. This lesion was seen in 39 cases and was more common in patients below the age of 15 years and in those with shorter duration of fits (less than 6 months). Nineteen of these cases had focal signs, 16 showed focal slow activity on EEG and 17/39 had neither signs nor focal slowing on EEG. Ten cases with a ring or disc enhancing lesion had evidence of tuberculosis elsewhere in the body, three more had a past history of tuberculosis and four others had a history of close contact with a case of tuberculosis. After 3 months of antitubercular treatment, 23 out of 25 patients who were rescanned showed clearing of the lesion. The two who did not were operated upon, and the lesion was shown histologically to be a tuberculoma. Ten other cases have done well, but have not been rescanned. Only one case was not treated with antitubercular therapy. She developed fits, altered consciousness, and meningitis and recovered from this serious illness after starting antitubercular therapy. Though not histologically verified, it seems justified to conclude that in India a ring or disc enhancing lesion is the commonest accompaniment of focal epilepsy, and that at least one third (and probably more) of these lesions are tuberculomas.
 ...
PMID:Focal epilepsy in India with special reference to lesions showing ring or disc-like enhancement on contrast computed tomography. 311 75

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.
 ...
PMID:Ring or disc enhancing lesions in epilepsy in India. 796 36

We report the case of a 10-year-old child from Reunion Island who was hospitalized because of headaches and partial convulsive fits. The brain MRI showed several conglomerated right frontal lesions suggestive of a tumor process. This girl, vaccinated with BCG, had familial risk factors for tuberculosis and a 20-mm tuberculin intradermo-reaction. Given the palpation of an abdominal mass, a thoracoabdominal scan was done, which revealed the presence of mesenteric adenopathies. Their biopsy confirmed the diagnosis of tuberculosis without having to perform neurosurgery. A 2-month quadritherapy and a 10-month dual therapy against tuberculosis led to the disappearance of brain damage and mesenteric adenopathies, with focal epilepsy the only sequela. The tuberculosis incidence in Reunion Island (8/100,000) is comparable with the French average, but the island is surrounded by high-endemic countries. Tuberculomas were responsible for one-third of expanding intracranial lesions in Europe in 1933, and their incidence remains high in developing countries. Even though extrapulmonary or disseminated tuberculosis has become rare in children in industrialized countries, this diagnosis must be kept in mind, in spite of vaccination. In accordance with international guidelines, this case report shows the importance of a systematic extensive check-up (cervical, thoracic and abdominopelvic) when brain tuberculosis is suspected in order to find more accessible tuberculosis lesions and to avoid the side effects of a brain biopsy.
 ...
PMID:[Brain tuberculoma in a 10-year-old child: the diagnosis is in the belly]. 2279 87