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

During a 4-year period, four patients presented with transient disturbances in neurologic function that were diagnosed as seizures in two and transient ischemic attacks in the other two. Computed tomography (CT scan), both with and without contrast, was normal in all four patients. Isotopic brain scans (3 patients), cerebral angiograms (4 patients), and lumbar punctures (4 patients) were normal. Electroencephalograms (EEG) were normal in two patients and abnormal in two patients (consisting of focal slowing). Within 4.5 months, all patients developed symptoms and signs of a brain tumor, and in all four, CT scan now revealed a large mass lesion which at surgery was shown to be a malignant astrocytoma. These four patients constituted 4% of the total number of patients with malignant astrocytomas that were seen at the NYU Medical Center during this same time period. It is stressed that the CT scan may be normal early in the course of patients with brain tumors, particularly if they present with a transient disturbance in neurologic function. The first evidence of the tumor in such patients may be a slow-wave abnormality on the EEG. Patients who are suspected of having a brain tumor should, if the initial CT scan is normal, have the scan repeated later.
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PMID:Transient neurologic disturbances, brain tumors, and normal computed tomography scans. 661 11

Tuberous sclerosis was diagnosed in 21 patients (13 female, 8 male) at an age of 3 months to 17 years, 8 of them being younger than 1 year at the time of diagnosis. 14 cases occurred sporadic, 7 patients had a positive familial history of the disease. The diagnosis was based on typical cutaneous lesions (white spots in 19, adenoma sebaceum in 12), cerebral seizures (20 patients) and intracranial calcifications which were found in all 17 patients who were investigated by cranial computerized tomography, especially in all 5 patients who were investigated in the first year of life. In addition two patients showed tumors arising from the region of the frontal horns. Histological examination which was performed in one of them showed the typical picture of a subependymal giant cell astrocytoma. Seizures occurred within the first year of life in 15 of 20 patients. The most common seizure type were infantile spasms (11 patients), grand mal (10 patients) and partial seizures (7 patients). In two children Todd's palsies were observed. Mental retardation of variable degree was observed in 11 patients. Cystic renal lesions were found in one patient with severe haematuria and they were suspected in 3 others on ultrasonographic examination. Retinal phakoma was found in only one patient, cardial rhabdomyoma was suspected in another one who suffered from congenital multifocal atrial tachycardia. The diagnosis in the first year of life was based upon the typical trias of white spots, seizures and intracranial calcifications on CT examination.
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PMID:[Tuberous sclerosis. Clinical and computer tomography findings in infancy and childhood]. 672 96

Brain tumors are, after leukemias, the most frequent fatal neoplasms of infancy. The clinical features and symptoms are often markedly different from those observed in the adult forms, according to the peculiar anatomy and behaviour of the child. Persistent headache, vomiting, astenia , behavioral alterations may be the precocious findings. Later, some more specific and suggestive signs such as strabismus, dyplopia , fast head size increase, funduscopic alterations, ataxia, paresis and nystagmus may be observed. On their appearance a prompt diagnostic work-up should be performed. The tumors of the posterior fossa (cerebellar astrocytoma and medulloblastoma, brainstem glyoma , hependimoma in decreasing order of frequency) generally cause precocious symptoms because of the small dimension of the subtentorial space; the presence in this region of several fundamental nuclei and pathways may explain how also small tumors may cause severe deficits. Supratentorial tumors (astrocytoma, malignant glyoma , hependimoma , craniofaringioma ) often show a more prolonged latency and may begin with signs of endocranial hypertension, seizures, or sometimes with hormonal troubles according to the involved anatomic structures. Hypothalamic astrocytoma is responsible of an extreme weight loss as far as to a cachetic status, due to the hyperincretion of GH. Finally, plexus papilloma, dermoid, optic nerve glyoma , oligodendroglyoma , germinoma, teratoma are responsible of a small number of child brain tumors, with different localization and symptomatology.
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PMID:[Clinical course of brain tumors in childhood]. 673 95

A 35-year-old woman presented with visual hyperacuity and seizures. Radionuclide and CT scans revealed a frontal lobe mass lesion consistent with an astrocytoma. Subtotal removal was necessary due to proximity of the tumor to the motor strip. Initial histopatho logic interpretation was malignant glioma (astrocytoma Grade 2 or 3). Megavoltage irradiation was delivered to a midsagittal dose of 6300 rad in seven weeks. Subsequent review of the slides revealed the tumor to be a microcystic ganglioglioma. The patient is well five and one-half years after treatment. It is important to separate these low grade neoplasms from the more ominous astrocytomas in regard to prognosis after resection and irradiation.
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PMID:Microcystic ganglioglioma treated by partial removal and radiation therapy. 709 89

Seven patients who had partial elementary seizures on the same side as the cerebral lesion are described. In six patients the seizures were partial motor, and one patient had seizures which ware partial elementary with sensory symptomatology. Four patients had frontal lesions, two parietal, and one parietotemporal. Five patients out of seven had lesions in the right cerebral hemisphere. There were three cases with astrocytoma, two with infarction, and one each with meningioma and tuberculoma. The clinical significance and pathophysiological mechanisms of this rare ipsilateral sign are discussed.
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PMID:Ipsilateral seizures. 714 Jun 67

Brain tumors associated with tuberous sclerosis are often found in the wall of the ventricles near the foramen of Monro and present with symptoms of increased intracranial pressure due to occlusion of the CSF pathway. The authors reported a case of such a brain tumor which presented predominantly focal neurological signs because of a large cyst function. This 8-year-and-4-month old girl experienced her first seizure attack at the age of 1-year-and-3-month. Six moths before admission, she complained of headache which lasted for several days. CT scans at that time revealed mass lesions in both lateral ventricles which were mildly dilated. A round low density area, considered to be a cyst, was found lateral to the calcified tumor of the left lateral ventricle extending into the adjacent parenchyma. Two months later, she noticed weakness in her right extremities, difficulty in buttoning and tendency to stumbling, and these were slowly progressive. Her past history was non-contributory. CT examinations of her mother and elder brother with adenoma sebaceum indicated that both had multiple calcifications in the ventricular walls and they were clinically diagnosed as having an incomplete form of tuberous sclerosis. On admission to the Department of Neurosurgery, Shinshu University Hospital on March 23, 1979, the patient was noted to have right hemiparesis and hyper-reflexia. She could barely walk but was unable to write with her right hand. Fundoscopic examination was normal. On general physical examinations, characteristic skin lesions including adenoma sebaceum, shagreen patch and depigmented patches were found. The second CT scans taken at the time of admission revealed that the low density area markedly enlarged, while the size of the tumors and ventricles remained essentially unchanged. A left parietal craniotomy was performed with a preoperative diagnosis of cystic tumor of the lateral ventricle associated with tuberous sclerosis. The tumor in the left lateral ventricle was found extending from the trigone to the anterior horn beyond the foramen of Monro. Histopathological diagnosis of typicaL benign giant-celled astrocytoma was made. The immediate postoperative course was uneventful except for a temporary worsening of the right motor weakness. V-P shunt was necessary because she developed signs and symptoms of increased intracranial pressure due to hydrocephalus two weeks after operation. At the time of dismissal from the hospital one month postoperatively, she was neurologically free except for the mild right hemiparesis. To the best of our knowledge, the present case is the first reported in the literature, in which a brain tumor associated with cyst formation verified in a patient of tuberous sclerosis.
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PMID:[Cystic brain tumor associated with tuberous sclerosis -familial occurrence of tuberous sclerosis with normal intelligence- (author's transl)]. 724 95

A 4-week-old infant experienced prolonged central sleep apnea requiring resuscitation. At 6 months of age he developed episodic obstructive apnea (diagnosed as laryngospasm by direct laryngoscopy) with an abnormal EEG and a normal computed tomography (CT) scan, and at 14 months of age he developed hemiparesis due to a gemistocytic astrocytoma grade III-IV. Following removal of the mass, he has had occasional seizure activity, but no further episodes of obstructive apnea.
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PMID:Astrocytoma in an infant with prolonged apnea. 742 32

We review 160 cases of gliomatosis cerebri from the literature and report an additional three infants and young children who presented with intractable epilepsy, corticospinal tract deficits, and developmental delay in whom a pathologic diagnosis was made. The progressive nature of the encephalopathy in our cases was documented by serial clinical examination, electroencephalograms, magnetic resonance imaging, and positron emission tomographic scans. The natural history of gliomatosis cerebri was determined by a retrospective review of the literature of 160 cases in 85 reports. The most common neurologic symptoms and signs included corticospinal tract deficits (58%), dementia/mental retardation (44%), headache (39%), seizures (38%), cranioneuropathies (37%), increased intracranial pressure (34%), and spinocerebellar deficits (33%). The most commonly involved central nervous system structures were the centrum semiovale and cerebrum (76%), mesencephalon (52%), pons (52%), thalamus (43%), basal ganglia (34%), and the cerebellum (29%). Fifty-two percent of patients were dead within 12 months of onset. Different grades of glial neoplasm may also coexist within gliomatosis cerebri such as astrocytoma with anaplastic astrocytoma, atypical or anaplastic oligodendroglioma, and glioblastoma multiforme. Hypotheses regarding the pathogenesis of gliomatosis cerebri include blastomatous dysgenesis, diffuse infiltration, multicentric origin, in situ proliferation, and "field transformation." The biologic determinants of whether a transformed glial cell behaves as a relatively localized tumor mass or truly loses anchorage dependence to become migratory as well as proliferative are not understood.
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PMID:Gliomatosis cerebri presenting as intractable epilepsy during early childhood. 753 65

Gangliogliomas are generally low grade neoplasms composed of mixtures of neoplastic glial and neuronal elements whose origin and exact nature are still controversial. We studied a series of 60 intracranial gangliogliomas looking for coexistent cortical architectural abnormalities (cortical dysplasia, microdysgenesis) and to determine if tumor behavior correlates with MIB1 (marker of cellular proliferation) labeling. The patients included 34 males and 26 females who ranged in age from 6 months to 55 years (mean 20 years). Thirty-eight tumors (63%) were located in the temporal lobe and 6 (10%) in the frontal lobe. Fifty-four patients (90%) presented with seizures (most with intractable epilepsy) and the duration of seizures ranged from 1 to 38 years (mean 14 years). In all cases, the predominant glioma component resembled a low grade fibrillary astrocytoma. In 14 tumors (23%), an oligodendroglial component was present. In one case, the glial component resembled an anaplastic astrocytoma. The tumors were characterized variously by perivascular chronic inflammation (N = 45, 75%), vascular proliferation (N = 36, 60%), granular bodies (N = 54, 90%), binucleated neurons (N = 36, 60%), calcification (N = 28, 47%), and cystic degeneration (N = 26, 43%). Meningeal involvement by tumor was observed in five (8%) cases. In 38 patients, sufficient tissue was resected to evaluate for the presence of concomitant cortical architectural abnormalities. Cortical architectural abnormalities were identified near to but clearly separate from the tumor in 19 (50%) patients. Only four patients including the anaplastic tumor died with tumor progression. MIB1 indices (positive tumor cells/1,000 tumor cells counted) in 54 cases ranged from 0 to 10.2 (mean 1.1 +/- 1.0).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Cortical architectural abnormalities and MIB1 immunoreactivity in gangliogliomas: a study of 60 patients with intracranial tumors. 754 47

The incidence of seizures related to primary brain tumors is 20-80%. High-dose tamoxifen was recently reported as a novel treatment for patients with malignant gliomas who have failed standard therapies. Tamoxifen inhibits protein kinase C (PKC) in vitro and thus may regulate glioma cell growth by modulating intracellular signal transduction. We report a patient with a recurrent supratentorial pilocytic astrocytoma who had an untoward interaction between high-dose tamoxifen therapy and phenytoin (PHT), drugs that share a common enzyme for metabolism, therefore emphasizing the need to monitor concomitant antiepileptic drug (AED) levels when high-dose tamoxifen therapy is instituted.
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PMID:High-dose tamoxifen in treatment of brain tumors: interaction with antiepileptic drugs. 761 29


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