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

The authors report a case of a symptomatic choroid plexus cyst located in the right lateral ventricle of a 64-year-old man who presented with focal epilepsy. The cyst was diagnosed by computerized tomography, and was proven pathologically at surgery. Total removal was accomplished, with subsequent disappearance of the seizures. A brief review of the literature is included.
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PMID:Choroid plexus cyst of the lateral ventricle in an elderly man. Case report. 669 71

One hundred patients with focal epilepsy (44 were children) were evaluated with extraoperative electrocorticography via epidural electrode arrays. Localization of the epileptogenic focus was derived predominantly from recordings made during spontaneously occurring seizures. All resection procedures were carried out under general anesthesia. During anesthesia, the recording of sensory evoked responses made it possible to readily identify the sensorimotor region. Of the 100 patients, 72 underwent resection of an epileptogenic focus, and 33 of these were children. Those who did not have a resection either exhibited a diffuse seizure focus, failed to show an electrical seizure discharge in association with the clinical seizure, failed to have a seizure during the period of monitoring, or failed to exhibit conclusive changes for identifying a focus in the interictal record. Fifty-seven patients (29 children and 28 adults) who had a resection have been followed for between 1 and 12 years. Eighteen (62%) of the 29 children and 18 (64%) of the 28 adults enjoyed a good result. Twenty of the 100 patients reported here had temporal lobe epilepsy. They were candidates for recordings with depth electrodes to identify their focus, but they were evaluated instead with epidural recordings; the method is described. In 15 of them, a unilateral focus was identified and they underwent an anterior temporal lobectomy. Pathological changes were found in every case and, in 11 patients, the epidural recordings distinguished between a medial and a lateral focus. Ten of these patients have been followed for 9 months to 3 1/2 years, and seven have had a good result. The observations suggest that epidural electrodes may be used in lieu of depth electrodes for identifying the symptomatic temporal lobe.
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PMID:Surgical management of epilepsy using epidural recordings to localize the seizure focus. Review of 100 cases. 669 89

Wilder Penfield's early studies with Sherrington, Hortega and Foerster led to his life-long studies on the surgical treatment of focal epilepsy. Working with a succession of neurosurgical associates, Penfield contributed a continuing stream of observations on responses of the human cerebral cortex to electrical stimulation. These characterized the detailed topographical distribution of the primary and secondary sensory and motor areas, and the representation of language function in the inferior frontal, superior frontal and temporo-parietal cortex. He defined the role of the hippocampi and the lateral temporal cortex in memory. From these findings, he postulated the centrencephalic integrating system, as a basis for explaining diffuse bilateral seizure activity, and the mechanism of consciousness.
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PMID:The contributions of Wilder Penfield to the functional anatomy of the human brain. 676 68

Intravenous injections of naloxone (0.8 to 2.4 mg) were given to patients with focal epilepsy who had had electrodes implanted in cortical and subcortical structures. There were no changes in interictal spike activity, responses to electrical stimulation, of frequency of spontaneous seizures. These data do not support the hypothesis that opiate peptides are involved in human focal epilepsy.
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PMID:Naloxone and focal epilepsy: a study with depth electrodes. 678 7

The authors analyzed the electroclinical data obtained in the surgical treatment by the open method of 104 children and adolescents with focal and multifocal epilepsy. The indications were frequent epileptic seizures, resistance to drug therapy, clear-cut clinical and electrophysiological correlations with regard to the localization of the epileptic focus. If nonoperative treatment has no effect, it is not advisable to delay surgical intervention by more than 1--2 years. Dynamic EEG examination under conditions of natural sleep, deprivation of sleep or dark adaptation yields complete objective information on the principal focus. The used system of diagnostic and operative intervention ensured favourable outcomes in 88% of the children with focal epilepsy.
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PMID:[Clinico-electrophysiologic analysis of the results of surgical treatment of focal epilepsy in children]. 678 86

The authors investigated 37 patients with established focal epilepsy in terms of the antiepileptic drug (AED) blood levels needed to achieve control or significant abatement of seizures; then they examined the patients by computerized axial tomography (CAT) and grouped them according as they did or did not show evidence of an organic food lesion of the brain. Statistical elaboration of the data revealed that CAT-positive patients required significantly higher mean AED blood levels for clinical effectiveness than did CAT-negative patients; also, single drugs failed to produce control at any plasma level, necessitating recourse to multidrug regimes, significantly more often in the CAT-positive than in the CAT-negative patient group. In the discussion the authors examine the possible reasons for the observed difference of therapeutic responses.
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PMID:Therapeutic plasma levels of some anticonvulsants in focal epilepsy in relation to computerized axial tomography. 678 71

A prospective clinical and EEG study is presented based on 261 children affected by partial seizures with or without focal EEG abnormalities, or by generalized seizures with focal EEG disturbances. From the clinical point of view, the partial seizures were most frequently elementary and motor, quite often associated with generalized seizures (64.36%), appearing in the majority of the cases during the first year of life, with rare frequency (less than 1 seizure/6 months). Perinatal disturbances appear to be the most important etiological factor. Partial epilepsy is often included within a previous neurological syndrome (secondary epilepsy). The clinical outcome is most frequently favorable (71.72%) with therapeutic treatment, especially with respect to the cases of primary epilepsy, characterized by rare seizures, which appear after the first year of life. From the EEG point of view, we noted specific monofocal abnormalities (72.79%), most frequently with temporal and rolandic localisation; during the follow-up the EEG abnormalities presented modifications in 58.89% of the cases, with normalisation in 22.98%.
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PMID:Partial epilepsy in childhood: clinical and EEG study of 261 cases. 680 88

Forty patients with nontumoral epileptogenic lesions who have undergone cortical excision of portions of the frontal lobe for the relief of medically refractory focal epilepsy at the Montreal Neurological Institute during the period 1930-1971 have become and remained seizure free for a minimum period of 5 years (median follow-up 14 years). It seems logical to assume that, in these patients, the essential seizure-producing mechanisms were contained in the excised portions of the frontal lobe and such patients thus represent a pure culture of frontal lobe epilepsy. The clinical, radiological, EEG, surgical, and pathological findings were analyzed. The variability in the clinical pictures and EEG data gives ample testimony of the complex and varied patterns of spread of epileptiform discharges through the brain in patients with epileptiform lesions of the frontal lobe. The data presented also bear on two secondary localizational aspects of frontal lobe epilepsy: (a) how much cortex must be recruited into epileptiform discharge to produce recurring seizures, and (b) how much of the total potentially epileptogenic cortex must be removed to produce a satisfactory reduction of the seizure tendency. These data also emphasize the importance of improving the accuracy of our methods of evaluating these secondary and tertiary localizational aspects of epileptic phenomena.
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PMID:Characteristics of a pure culture of frontal lobe epilepsy. 687 5

Three patients had recurrent focal motor seizures as the first manifestation of nonketotic hyperglycemia (NKHG) of diabetes mellitus. The seizures were characterized by stereotypical tonic changes in body posture and arrest of speech that have been associated with supplementary motor area seizures. Recognition of the link between this unusual form of focal epilepsy and NKHG would help in the early diagnosis and treatment of the serious underlying metabolic disturbance.
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PMID:Tonic fecal seizures in nonketotic hyperglycemia of diabetes mellitus. 701 72

Forty-eight patients who had undergone unilateral temporal lobectomy for the relief of focal epilepsy 6 months to 6 years prior to contact were asked to rate themselves on a questionnaire designed to look at "real-life" memory skills. The temporal lobe patients, as a group, saw themselves as having poorer memories than normals, but only 3 out of 43 items showed significant differences between right-and left-sided lobectomy patients. Our hypotheses that age at operation, reduction in seizure frequency and time since operation (in the left temporal lobe patients only) would determine the extent of subject complaint of memory were fully confirmed. In addition, sex of the patient was found to be a significant variable. The status of subjective and objective measures of memory as indices of "real-life" memory skills is discussed.
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PMID:Self-report of memory skills after temporal lobectomy: the effect of clinical variables. 722 52


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