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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two types of heart block which occur extensively in families in the Republic of South Africa are reported. A type I heart block tends to have the pattern of a right bundle-branch block and/or left anterior hemiblock occurring individually or together, and manifesting clinically when complete heart block supervenes, either with syncopal episodes, Stokes-Adams seizures or sudden death. The condition is inherited as an autosomal dominant gene and appears to be progressive in nature; the risk to life appears to be greatest at 3 particular periods:at or soon after birth, during puberty and the early 20s, and again towards middle age. The type II condition also appears to be progressive and is inherited as an autosomal dominant gene. The pattern, however, tends to develop along the lines of a sinus bradycardia with a left posterior hemiblock, again presenting clinically as syncopal episodes. Stokes-Adams seizures or sudden death when complete heart block supervenes. Both conditions are likely to be widely prevalent throughout the Republic of South Africa. The pathogenesis is discussed in relation to the patterns of the conduction disturbances.
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PMID:Progressive familial heart block--two types. 89 53

Repeated rhythmic (every 1-3 sec.) coughs were documented to maintain consciousness up to 39 seconds in 3 patients developing ventricular fibrillation during coronary arteriography. The arterial pressure wave resulting from a cough exceeded that induced by external chest compression in 2 individuals in whom both techniques were employed and in 5 others treated by external compression alone. Cough-induced cardiac compression is self-performed, and compared to external chest compression is less likely to traumatize the chest wall or heart and can be performed in any position on any surface. It is recommended that patients undergoing coronary arteriography be previously trained to cough abruptly and repeatedly every 1-3 seconds. The potential for utilizing this technique in other areas (i.e., CCU, home) is less favorable than in catheterization-induced ventricular fibrillation, but it might be employed successfully in patients with premonitory symptoms of ventricular arrhythmias or Stokes-Adams seizures. The prior training of high risk individuals (and their spouses) to induce effective coughing in the victim might be lifesaving.
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PMID:Self-administered cardiopulmonary resuscitation by cough-induced cardiac compression. 96 Apr 17

The implantation of a permanent pacemaker has been carried out on 159 patients suffering from Adams-Stokes seizures. Elema 588 B electrodes were implanted in 119 patients and Chardack 5818 electrodes in 40 patients. The two types of electrodes differ with regard to both the implantation technique and weight and thickness. No difference was found in the incidence of electrode displacement or survival between the two groups, similarly the experience of the physician with regard to implantation had no influence on the frequency of displacement. Displacement on the other hand occurred significantly more frequently in those patients suffering from heart disease demonstrable by x-ray examination.
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PMID:Displacement of endocardial pacemaker electrodes. A comparison between Elema 588 B and Chardack 5818. 107 Feb 20

Two patients are described who presented with seizures. Electrocardiogram revealed complete heart block with ventricular asystole lasting four to 10 seconds in each case. These Stokes-Adams episodes were controlled with temporary transvenous pacing. Although there was full clinical recovery in each case, both patients continue to have right bundle branch block (RBBB) and left anterior hemiblock (LAH) 1-1/2 years after their initial presentation.
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PMID:Complete heart block mimicking seizure disorder. 112 Mar 78

A patient with an acute anterior wall myocardial infarction complicated by bilateral bundle branch block and paroxysmal AV block is presented. The following new, uncommon or unreported phenomena were documented: the simultaneous occurrence of phase-3 block in the right bundle branch and phase-4 block in the left bundle branch; the simultaneous occurrence of phase-4 block in both main bundle branches; phase-4 left posterior hemiblock associated with escape beats arising from the injured posterior division of the left bundle branch; supernormal conduction in the right bundle branck and 2:1 right bundle branch block related to supernormality. Most of these changes were, of course, not simultaneous, and their successive appearance was related to day-to-day and sometimes hour-to-hour variations in the degree and quality of the multifascicular injury caused by the infarct. In addition, the actions of several drugs upon automaticity and conduction were tested. The effects of amiodarone, lidocaine and isoproterenol were similar to those previously reported under comparable circumstances. At a moment when the patient had repeated episodes of paroxysmal AV block with severe Adams-Stokes seizures, the administration of a single i.v. dose of 0.25 mg of strophanthin suppressed totally the Adams-Stokes attacks through a significant enhancement of ventricular automaticity. If rapid implantation of an artifical pacemaker is not at hand, strophanthin may be life-saving in patients with acute paroxysmal AV block.
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PMID:Electrophysiologic and pharmacologic studies in a patient with acute myocardial infarction complicated by intraventricular and atrioventricular block. 119 12

The longterm effects of pacemaker therapy have been investigated in 337 patients with bradycardia and congestive heart failure with or without Adams-Stokes syncope. The cumulative survival rate in patients with Adams-Stokes seizures without congestive heart failure (group I) is markedly better than in patients with Adams-Stokes seizures and congestive heart failure (group II). The death rate is highest in patients with congestive heart failure as sole indication for pacemaker implantation (Group III). In the patients from group II (mainly with slight to moderate decompensation) there was a higher percentage of improvement than in those from group III (chiefly with severe congestive heart failure), in whom cardiac decompensation improved in approximately half the cases. These findings do not prompt excessive enthusiasm about the longterm results in patients with bradycardia and severe congestive heart failure. The indication subsists where there is resistance to drug therapy, or digitalis intolerance, or where treatment with a provisional pacemaker produces good results.
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PMID:[Proceedings: Pacemaker implantation bradycardia and cardiac insufficiency. Preliminary report]. 121 81

A patient with 2 : 1-block and right-bundle-branch block is described, who developed a high-degree-AV block distal to the bundle of His during electrophysiological investigations. Rapid atrial pacing caused total AV block distal to the His bundle. Rapid pacing from the right ventricle also caused total AV block after sudden discontinuation of pacing. The duration of total AV block was 25 to 60 seconds and the preautomatic time 2300-4750 msec according to rate and duration of stimulation. These methods are considered as good tools to evaluate patients with severely diseased conduction system, who might develop total AV block or Adams-Stokes seizures.
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PMID:[Electric stimulation as a means for the diagnosis of atrioventricular conduction disorders]. 121 74

A 35-year-old man was hospitalized after a sudden onset of transient syncopal attack without accompanying complaints of headache or nausea. He was slightly disorientated but neurologically normal. He had a blood pressure of 150/90mmHg and a pulse rate of 40/min. An ECG showed marked sinus brady-cardia with ventricular escaped rhythm followed by advanced atrioventricular (AV) block. Some components of conducted ventricular beats showed aberration. There was no significant ST or T wave abnormality in normally captured QRS components except for prominent T in leads II, III and aVF. At first, we thought that he might require temporary pacing because of Adams-Stokes attack. However, after administration of atropine sulfate, the ECG returned to normal sinus rhythm with heart rate of 88/min. Then he began to complain of headache followed by a convulsive seizure. A CT scan and angiogram revealed a ruptured aneurysm at the top of the basilar artery, which was successfully clipped. A wide spectrum of ECG changes can be demonstrated in practically all patients with subarachnoid hemorrhage (SAH). Prolonged QT interval, ST-T changes, U wave, sinus tachycardia, or ventricular premature complex are the common abnormalities probably caused by increased circulating catecholamine. As bradyarrhythmia in patients with SAH is an uncommon finding, its mechanism has not yet been defined. Transient sinus bradycardia with advanced AV block in this patient might have been caused not by elevated intracranial pressure (Cushing phenomenon) but by drastic discharge of the parasympathetic nerve. This case serves to illustrate the vigilance required in determining whether abnormalities of cardiac rhythm are instrumental in causing neurological symptoms and signs or a disorder of cerebral function.
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PMID:[A case of subarachnoid hemorrhage with sick sinus and advanced AV block]. 151 79

In the late 1950s, nonsurgical catheter therapies for the treatment of various disorders did not exist, although surgery was at its highest level of development in the classic sense: extirpation of organs, incision and drainage, diagnostic biopsy. Today we live in an era of diagnostic and therapeutic methods based on catheters: observation, aspiration, drainage, stretching, and manipulation by means of relatively atraumatic tubes. The development of catheter techniques has spawned undreamed-of specialties, industries, and professional societies. Although catheters had been used before then in research laboratories, Furman's clinical application of electrode-tipped venous catheters in treating patients with complete heart block and Stokes-Adams seizures represents a turning point. This advance may be regarded as the catalytic and seminal event for the growth of catheter technologies, which are so prominent in the world of medicine today, and their application to many fields of medicine and surgery.
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PMID:Transvenous pacing: a seminal transition from the research laboratory. 268 65

A previously healthy woman experienced Adams-Stokes attacks ten weeks after the initiation of antithyroid medication for Graves' disease. The patient manifested advanced atrioventricular (A-V) block requiring a temporary transvenous pacemaker. The site of heart block was localized to the A-V node by utilizing a His bundle electrogram. With control of the hyperthyroid state, normal A-V conduction was restored. Review of the literature identified twenty-five additional cases of second or third degree A-V block associated with Graves' disease, ten of whom had Adams-Stokes syncope or convulsive seizures. The A-V nodal block was reversible with cure of the primary endocrine disease. It is postulated that excessive thyroid hormone has a direct effect on the cardiac conduction system, specifically, the region of the A-V node and bundle of His. Recommendations are made regarding the recognition and management of patients at risk for developing heart block associated with Graves' disease.
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PMID:Second and third degree atrioventricular block with Graves' disease: a case report and review of the literature. 616 53


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