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

An incidence of tumors of the brain as a cause of drug-resistant epilepsy have been analysed. The analysis included patients operated for epilepsy at the Department of Neurosurgery, Medical Academy in Warsaw between 1987 and 1991. Malignant tumors were found in 21 out 85 patients (24.7%) treated surgically, 22.4% were benign tumors, and 52.9%--lesions of cicatricial character. The most frequent malignant tumor was fibrillary astrocytoma, noted in 57.1% of cases. Neurological examination has revealed discrete symptoms only in 2 out of 21 patients. CT scans have showed non-characteristic focus of decreased density in 12 patients (57.1%). Differentiation of tumor-produced epilepsy and those due to other focal lesions could not be made with the clinical course of seizures and EEG records. Actually, an incidence of tumors of the brain causing seizures refractory to pharmacologic treatment is increasing. Not characteristic clinical course and EEG records as well as CT scans are the main causes of delays in the surgery.
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PMID:[Incidence of brain tumors in cases of chronic epilepsy treated surgically]. 802 35

We report 2 patients with transient abnormalities on magnetic resonance imaging (MRI) associated with partial status epilepticus (SE). A man with a 4-month history of partial seizures had complex partial SE for 9 days, with left temporal maximum on ictal EEG. Left temporal lobe T2 signal was increased on MRI during SE, but cerebral MRI was normal 9 weeks later. A woman with "cryptogenic" temporal lobe epilepsy for 16 years had complex partial SE for 1 week, with right temporal maximum on ictal EEG. T2 Signal was increased over the entire right temporal lobe, extending into the insula, without mass effect, on MRI 1 month after SE ended. Repeat MRI 1 month later showed marked decrease in volume of increased T2 intensity, without gadolinium enhancement, but with mild mass effect over the right anterioinferomesial temporal areas. A gemistocytic astrocytoma was resected. Focal cerebral MRI abnormalities consistent with cerebral edema may be due to partial SE but also may indicate underlying glioma, even in long-standing partial epilepsy. Focal structural imaging changes consistent with neoplasm should be followed to full resolution after partial SE.
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PMID:Focal cerebral magnetic resonance changes associated with partial status epilepticus. 811 55

Small asymptomatic cysts of the pineal gland represent a common incidental finding in adults undergoing computerized tomography or magnetic resonance (MR) imaging or at postmortem examination. In contrast, large symptomatic pineal cysts are rare, being limited to individual case reports or small series. The authors have reviewed 24 cases of large pineal cysts. The mean patient age at presentation was 28.7 years (range 15 to 46 years); 18 were female and six male. Presenting features in 20 symptomatic cases included: headache in 19; nausea and/or vomiting in seven; papilledema in five; visual disturbances in five (diplopia in three, "blurred vision" in two, and unilateral partial oculomotor nerve palsy in one); Parinaud's syndrome in two; hemiparesis in one; hemisensory aberration in one; and seizures in one. Four lesions were discovered incidentally. Magnetic resonance imaging typically demonstrated a 0.8- to 3.0-cm diameter mass (mean 1.7 cm) with homogeneous decreased signal intensity on T1-weighted images, increased signal intensity on T2-weighted images, and a distinct margin. Hydrocephalus was present in eight cases. The cysts were surgically excised via an infratentorial/supracerebellar approach (23 cases) or stereotactically biopsied (one case). Histological examination revealed a cyst wall 0.5 to 2.0 mm thick comprised of three layers: an outer fibrous layer, a middle layer of pineal parenchymal cells with variable calcification, and an inner layer of hypocellular glial tissue often exhibiting Rosenthal fibers and/or granular bodies. Evidence of prior hemorrhage, mild astrocytic degenerative atypia, and disorganization of pineal parenchyma were often present. Postoperative follow-up review in all 24 cases (range 3 months to 10 years) revealed no complications in 21, mild ocular movement deficit in one, gradually resolving Parinaud's syndrome in one, and radiographic evidence of a postoperative venous infarct of the superior cerebellum with ataxia of 1 week's duration in one. Of the patients referred for study, the cysts were most often initially misdiagnosed as a pineocytoma in eight and a pilocytic astrocytoma in three. Only two patients were correctly diagnosed as having pineal cysts. This stresses the importance of recognizing the histopathological spectrum of pineal cysts, as well as correlation with radiographic findings, if a correct diagnosis is to be attained.
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PMID:Symptomatic glial cysts of the pineal gland. 811 58

The authors present their experience with six children who developed anaplastic astrocytomas after receiving treatment for low-grade astrocytomas. Five children were from a series of 55 children with optic chiasmatic-hypothalamic gliomas who have been studied since 1976. The sixth child initially had a low-grade astrocytoma of the thalamus. The mean age of the children at initial presentation was 5.3 years. Five children were treated with surgery and radiation therapy; one child with a chiasmatic-hypothalamic glioma received radiation therapy alone. The amount of external radiation therapy used in all children was 50-52.5 Gy delivered in standard fractionations over approximately 6 weeks to include the volume of the original tumor plus a margin of 2 cm. The time to anaplastic transformation varied between 2 and 10 years (mean, 6.4 years). At tumor recurrence, the children had seizures or symptoms and signs of raised intracranial pressure. The location of the second tumor in all patients was either at the primary site or within the field of radiation therapy. Five of the six children underwent a second craniotomy and subtotal resection of their malignant gliomas. One child had positive cerebrospinal fluid cytology and multiple intraspinal metastatic tumor nodules detected by magnetic resonance imaging. On histopathological examination, four children had anaplastic astrocytoma, and two had glioblastoma multiforme. Four of the six children have died of their anaplastic astrocytomas (mean time from diagnosis of anaplastic astrocytoma to death, 10 months). Two children underwent chemotherapy and spinal irradiation for their anaplastic astrocytomas, and are currently alive and undergoing treatment. The possible mechanisms by which anaplastic tumors have developed in children treated previously for low-grade astrocytomas is discussed. The data suggest that radiation therapy may have played an integral role in the genesis of anaplastic astrocytomas in these children.
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PMID:Development of anaplastic changes in low-grade astrocytomas of childhood. 812 71

The morbidity associated with gross total removal of pediatric posterior fossa tumors is well recognized although it is rarely isolated from other factors that comprise the management morbidity for these tumors. This study reviews (1) the operative and postoperative complications in 105 patients and (2) the neurological morbidity in a subset of 91 patients undergoing gross total removal of their tumor between 1982 and 1992. Gross total removal was achieved in 102 patients with a single procedure. Two patients with residual tumor underwent early repeat craniotomy for excision and 1 is being followed without repeat resection. Intra- and postoperative complications occurred in 33 patients and included hematoma requiring craniotomy (3), gastrointestinal hemorrhage (2), hydrocephalus requiring shunt placement (9), wound problems (4), and pseudomeningocele formation requiring additional treatment (5). Delayed onset hydrocephalus requiring shunting occurred in 2 patients and spinal deformity in 4 patients. Worsening of preoperative deficit (new cranial nerve palsies, worsening ataxia, bulbar dysfunction including apnea, mutism and seizures) occurred in 41% of patients operated on for primitive neuroectodermal tumors (PNET) (14/34), 53% of ependymomas (10/19), and 30% of astrocytomas (15/50). No patient who had a choroid plexus tumor was worsened by the procedure. Complete recovery of new postoperative deficits occurred in 14% of PNET (2/14), 50% of ependymoma (5/10) and 47% of astrocytoma (7/15), most often within 6 months of the procedure. Residual neurological morbidity, due to persistence of preoperative symptoms or due to deficits that occurred as the result of the surgical procedure, was assessed in a subgroup of 91 patients followed for an average of 48 months (2-147 months). This assessment did not include morbidity due to adjuvant therapy. Sixty-two percent of patients continued to exhibit abnormal cerebellar or bulbar signs. Forty-three percent of the total population exhibited limitation in function due to residual deficit. Only 38% of patients were both functionally normal and had a normal neurological examination at last follow-up.
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PMID:The surgical and natural morbidity of aggressive resection for posterior fossa tumors in childhood. 814 78

Tuberous sclerosis (TSC) is an autosomal dominant condition with characteristic skin lesions, mental handicap, seizures and the development of hamartomas in the brain, heart, kidneys and other organs. Linkage studies have shown locus heterogeneity with a TSC gene mapped to chromosome 9q34 and a second, recently identified on 16p13.3. We have analysed DNA markers in eight hamartomas and one tumour from TSC patients and found allele loss on 16p13.3 in three angiomyolipomas, one cardiac rhabdomyoma, one cortical tuber and one giant cell astrocytoma. We suggest that the TSC gene on 16p13.3 functions like a tumour suppressor gene, in accordance with Knudsen's hypothesis.
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PMID:Loss of heterozygosity on chromosome 16p13.3 in hamartomas from tuberous sclerosis patients. 816 74

To investigate the relationship of temporal lobe hypometabolism demonstrated on PET to surgical outcome and underlying pathology, we reviewed 30 consecutive epilepsy patients who underwent interictal PET studies with 18F fluorodeoxyglucose before temporal lobectomy. Two interpreters blindly reviewed the PET studies and graded them for degree, extent, and location of temporal lobe hypometabolism. Pathologic analysis of en bloc resected tissue showed mesial temporal sclerosis (n = 22), astrocytoma (n = 2), and no pathologic diagnosis (n = 6). Outcome (24 to 40 months' follow-up) was rated as seizure-free (21 patients), significantly improved (five patients), and not significantly improved (four patients). Both the degree and extent of the temporal lobe hypometabolism demonstrated on PET were strongly associated with subsequent seizure control. Pathologic findings, however, did not correlate with degree of PET hypometabolism or subsequent outcome. These data demonstrate that in patients judged to have temporal lobe epilepsy, the presence of temporal lobe hypometabolism is associated with a positive outcome after ipsilateral temporal lobectomy.
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PMID:Temporal lobe hypometabolism on PET: predictor of seizure control after temporal lobectomy. 814 46

The authors report on 51 infants with intracranial tumours treated in an eleven-year period; these infants represent 13% of the total population of children with intracranial tumours who have been operated on in the same institution during the same period of time. Males (28 cases) were slightly more frequent. Astrocytomas (17 cases), medulloblastomas (12 cases), and ependymal tumours (5 cases) were the commonest histologic types. Signs and symptoms of increased intracranial pressure were by far the most frequent clinical manifestations, followed by seizure disorders. Thirty tumours were localized within the supratentorial, and 21 within the subtentorial compartment. The parasellar region (10 cases) and the lateral cerebral ventricles (8 cases) for the supratentorial tumours, the inferior cerebellar vermis and fourth ventricle (13 cases) for the infratentorial tumours appeared to be the preferred topographic locations. Craniotomies were carried out in 44 infants, with a total or radical removal of the tumour in 19 cases, a subtotal removal in 6 cases, and a partial removal in 17 cases. In 3 cases only a biopsy procedure was performed. Twenty-nine of these patients required an ancillary procedure such as CSF shunting. Three subjects underwent a biopsy procedure and 1 infant the insertion of a CSF shunting device only. Surgery was not performed in 5 cases. Overall, there were two surgical deaths. Two infants died before any surgical treatment could be performed. Radiation therapy was administered to 9 patients when they had reached three years of age. Chemotherapy was given to 21 infants, according to various chemotherapeutic protocols. During the postoperative period 20 deaths (39%) were recorded. Two patients were lost to follow-up. From 1 to 10 years after the operation, 29 patients are still alive, 14 of them (28%) with a normal psychomotor development, 10 (20%) with some neurological or mental deficits, and 5 (10%) with severe psychomotor retardation. There was no apparent correlation in this series between late outcomes and the histological type of the tumour.
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PMID:Intracranial tumours in the first year of life. A report on 51 cases. 821 73

Seventeen patients underwent surgery between 1981 and 1990 for intractable partial epilepsy arising outside the temporal lobe. Twelve had frontal seizure onset, two parietal, two occipital and one diffusely in the hemisphere. Localization was achieved using extraoperative electrocorticography (ECoG) in five cases and intraoperative ECoG was employed in 12. Fifteen patients underwent cortical resections, but two did not subsequently have a resection. Both of these had porencephalic cysts. Of the 15 who had resections six (40%) were seizure free after a mean of 7.3 years. One (7%) was almost seizure free, six (40%) had worthwhile improvement. Pathological examination revealed oligodendroglioma in three, recurrent meningioma in one, vascular malformations in two, glial hamartoma in one and gliosis in six. One case with gliosis initially was shown to have an underlying malignant astrocytoma 2 years later. All these patients had CT abnormalities prior to surgery. Two patients (13%) had no worthwhile improvement. Pathology in these two was ischaemic neurons and arachnoid thickening. Both had normal CT findings preoperatively. One patient had an increased hemiparesis postoperatively. There were three cases of postoperative infection. It is concluded that extratemporal resection can achieve good results for seizure control and intraoperative ECoG is an effective technique for localizing the epileptogenic area. The presence of a structural lesion carries a particularly favourable prognosis for seizure outcome and surgery should, therefore, be strongly considered in patients with intractable partial epilepsy who have evidence of underlying structural pathology.
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PMID:Cortical resections for intractable epilepsy of extratemporal origin: experience with seventeen cases over eleven years. 821 4

The occurrence of cancer and neurological disorders in first- and second-degree relatives of children in the United States and Canada diagnosed with brain tumor before age six was investigated. A pair-matched case-control study with 155 astrocytoma and 166 primitive neuroectodermal tumor (PNET) cases was performed. Cases were identified through the Childrens Cancer Group. Controls were selected by random-digit dialing and matched to cases on age, race, and telephone area code and exchange. Childhood cancers were more common in PNET relatives compared with the general population (standardized incidence ratio [SIR] = 2.5, 95 percent confidence interval [CI] 1.1-4.8, P = 0.02) and with control relatives (odds ratio [OR] = 3.0, CI = 0.5-30, P = 0.29). For astrocytoma, nonsignificant excesses of brain tumor, leukemia/lymphoma, and childhood cancer occurred among case relatives compared with control relatives, but not compared with the general population. Astrocytoma cases were significantly more likely than controls to have a relative with seizures (OR = 2.5, CI = 1.2-4.9, P = 0.009), especially childhood seizures (OR = 3.4, CI = 1.2-12, P = 0.02), epilepsy (OR = 3.0, CI = 0.9-13, P = 0.08), and febrile convulsions (OR = 4.5, CI = 0.9-43, P = 0.07). A family history of stroke was not a risk factor for either type of brain tumor. These results suggest that some childhood brain tumors may result from a genetic susceptibility and that some risk factors may affect childhood astrocytoma and PNET differently.
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PMID:Family history of cancer and seizures in young children with brain tumors: a report from the Childrens Cancer Group (United States and Canada). 821 78


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