Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Infections with malaria are increasing in Europe and Northern America and are also spreading in tropical endemic areas. A falciparum variety of malaria known as cerebral malaria is the most well-known neurological complication, caused by Plasmodium falciparum and characterised by a fulminant course with disturbances of consciousness and facultative seizures or focal neurological deficits. 50% of deaths caused by malaria are due to cerebral involvement. Pathologically a disseminated vasculomyelinopathic disorder is seen. Immunological changes, vascular-hypoxic disturbances and metabolic-toxic factors contribute to these pathological findings. Facts on diagnostic, differential diagnostic and therapeutic procedures are presented. Beside the severe and life-threatening cerebral malaria some unspecific cerebral symptoms are seen, such as cerebellar ataxia and chorea. Spinal disease and peripheral nerve involvement, polyradiculitis and especially psychiatric disorders have also been described. Every neurological and psychiatric disorder presented first in tropical areas or malaria-endemic regions requires malaria diagnostic tests. In our geographical region, any previous history of a journey to the tropics is an important pointer; in particular, neurological or psychiatric symptoms can be important pointers to malaria.
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PMID:[Neurologic complications of malaria infection]. 844 77

We conducted a randomized multicenter clinical trial on 397 patients ranging in age from 2 to 70 years to assess the effectiveness of treatment of the first unprovoked epileptic seizure. Subjects seen within 7 days after a first witnessed tonic-clonic seizure with or without partial onset were randomized to immediate treatment (carbamazepine, phenytoin, phenobarbital, or sodium valproate) or to treatment with the same drugs only after seizure recurrence. We excluded individuals with acute symptomatic seizures, progressive neurologic disorders, or gross psychiatric illness. Thirty-six of 204 subjects randomized to treatment and 75 of 193 randomized to delayed treatment experienced seizure recurrence during follow-up. The cumulative time-dependent risk of relapse among treated subjects was 25% by 24 months. The corresponding figure for untreated subjects was 51%. The risk of relapse was 2.8 times higher (95% CI, 1.9 to 4.2) for untreated subjects. There were no interactions between age and EEG findings (the only predictors of risk of relapse) and treatment effects. We conclude that treatment of the first seizure with antiepileptic drugs leads to a significant reduction of the risk of relapse.
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PMID:Randomized clinical trial on the efficacy of antiepileptic drugs in reducing the risk of relapse after a first unprovoked tonic-clonic seizure. First Seizure Trial Group (FIR.S.T. Group) 816 53

Of 298 patients who had temporal lobectomies for intractable epilepsy, 4 (1.3%) developed post-ictal psychosis for the first time after surgery. All were males of normal intelligence with no pre-operative psychiatric disorder. Psychosis followed both complex partial and generalised seizures. The psychotic symptoms showed polymorphic features. Right temporal lobectomy may increase the susceptibility to post-ictal psychosis in patients who are not seizure free after surgery, particularly in the first post-operative year.
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PMID:Post-ictal psychosis after right temporal lobectomy. 845 45

For those conditions in which loss of consciousness is the main issue, such as epilepsy, factors that contribute to risk of seizure recurrence are central to the determination of driver safety. Thus, high- and low-risk groups may be identified and factors that contribute to high risk checked. These factors also serve to develop a program to reduce such risk in the future. In the population with seizure disorders, young males under age 25 have the highest risk for traffic accidents and violations. Other factors associated with high risk are partial complex seizure type, history of drug toxicity with anticonvulsant medications, alcohol abuse or poor compliance for medications, and history of psychiatric illness. For conditions such as cerebrovascular accidents or Parkinson's disease, the recognition of the diagnosis alone is insufficient to determine driver competence. In these illnesses, the task is to recognize levels of failure of individual skills and function that specifically render a person incompetent for safe driving. Such a precise determination is currently not possible in individuals with cerebrovascular accidents or other forms of brain injury (e.g., trauma) or degenerative brain disease (e.g., Parkinson's disease). There is intuitive and general agreement that there are those so severely affected that driving has become impossible or very dangerous. Alternately, there are also those with these conditions whose driving skills and competence are virtually unaffected and pose no risk to traffic safety. Physicians vary widely in their ability and experience in judging the competence and safety of those in between these two extremes. For this reason, a standardized approach is essential both to ensure the avoidance of unnecessary bias as well as to ensure the safety of the driver and the general public. At some time in the future when all the necessary driving skills are identified and appropriate tests are developed to judge them, a battery of tests for the elderly at age 65 and at regular intervals thereafter may be used. Until then, some form of clinical judgment and legal regulation may have to be adopted. One option would be to adopt a rule similar to that in the United Kingdom where all persons with TIAs or cerebrovascular accidents would automatically suspend driving for 3 months because of the high risk for recurrence of both cerebrovascular as well as ischemic heart disease in that interval.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Seizure disorders, diabetes mellitus, and cerebrovascular disease. Considerations for older drivers. 850 82

Psychogenic nonepileptic seizures (NES) are commonly encountered in clinical practice, and they may pose difficult diagnostic problems. For appropriate evaluation and treatment of NES, a multidisciplinary team approach is needed; typically, a neurologist with expertise in epilepsy, a psychologist or psychiatrist, and a support staff should be involved. Psychogenic NES have no single initial clinical manifestation, and various etiologic factors may contribute to their development. Of importance, psychogenic NES are "real" seizures that may be as disabling as epileptic seizures. Most often, they occur on a subconscious level, and the patient may have no control over their occurrence. Precipitation or termination of a habitual seizure during video-electroencephalographic monitoring has often been used to distinguish NES from epileptic seizures, but the results can sometimes be misleading. Numerous additional diagnostic techniques can be used to assist in making the diagnosis. Treatment is based on the type of psychiatric disorder present. Favorable prognostic factors include being female and having an independent lifestyle, normal electroencephalographic findings, higher intelligence, and no prior psychotherapy.
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PMID:Psychogenic nonepileptic seizures. 891 4

Status epilepticus (SE) is one of the most common neurologic emergencies in children, adolescents, and young adults. SE may be due to acute neurologic conditions such as meningitis, encephalitis, or stroke, complicated febrile seizures, intractable epilepsy, degenerative diseases, intoxication, or may be the first manifestation of epilepsy. Initial treatment of convulsive SE is usually with an intravenous benzodiazepine (BZD) [lorazepam (LZP) or diazepam (DZP)], phenobarbital (PB), or phenytoin (PHT). LZP is less likely to cause respiratory depression than DZP and is therefore preferred. Sequelae and risk for recurrence of SE are primarily related to the underlying cause. Refractory SE (RSE) is most often symptomatic of an acute neurologic condition or neurodegenerative disease. Treatment for RSE is difficult, usually requiring intensive support of vital functions. Reported treatments for RSE include very high dose PB, continuous infusions of pentobarbital or BZDs (DZP, midazolam), lidocaine, inhalation anesthesia, and propofol. Outcome is related to underlying cause. Nonconvulsive SE may present as confusion or may mimic psychiatric illness. Response to BZDs is usually rapid but may not be sustained. Rapid initiation of oral or rectal valproate may be useful. Epilepsia partialis continua (EPC) is almost always due to an acute or chronic destructive lesion. Surgical treatment may be the only effective modality in some children with EPC. Acute treatment of breakthrough seizures and clusters of seizures at home with rectal BZDs (usually DZP, 0.2-0.5 mg/kg) may prevent progression to SE in some children and adolescents and reduce the need for visits to emergency facilities.
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PMID:Status epilepticus and acute repetitive seizures in children, adolescents, and young adults: etiology, outcome, and treatment. 864 55

An epidemiological inquiry of humancysticercosis due to Taenia solium was carried out in Lagamar, Minas Gerais State, Brazil, in 1992. A survey of 1109 houses with 3344 inhabitants was made. The inquiry included 875 (86%) families and the questionnaire was answered by an informer, who was the father in 80% of the cases. One hundred pigsties, sheltering 406 swines in extremely precarious conditions, were found in 100 (11.4%) houses. A history on taeniasis in some member of the family was verified in 300 (34.2%) houses. A history of seizures was referred to by 125 (14.2%) of families. The outset of convulsion in adult age was characterized in 39 (37.8%) families. A history of mental disorder was reported in 53 (6.0%) of houses. Stool examinations were positive for Taenia spp in 24 (1.3%) of samples examined.
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PMID:[The epidemiological aspects of taeniasis-cysticercosis in an endemic area of Lagamar, Minas Gerais]. 866 34

During a 24-month period, 205 consecutive new referrals to Muhimbili psychiatric unit were studied. Their socio-demographic characteristics, sources of referral, types of treatment received before referral and the nature of their clinical problems were identified. Their neuropsychiatric disorders were classified according to ICD-10. The ratio of males to females was found to be 1.6:1. The average age was 29.3 years. 23.4% of adult patients were unemployed, two fifths of all patients were single and 70% of all subjects had less than eight years of formal education. Whereas 42.9% of all referrals were from other departments of Muhimbili hospital, the remaining were largely from parastatal dispensaries, district and regional hospitals within Dar es Salaam city. At least a fifth of all patients had consulted traditional healers prior to referral and antimalarials had been given inappropriately to 34 patients with mental problems. Mental disorders consisted of functional psychosis, 36.6% of which three quarters were schizophrenia, neurosis (19.5%), seizures (16.6%), substance abuse (8.8%), organic mental disorders (5.3%), headache (4.9%), sexual dysfunction (2.9%). The rest had conduct disorders and pseudocyesis. Seventeen percent of all cases had concomitant physical disorders. Most patients had delayed to seek medical help.
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PMID:Nature of referrals to the psychiatric unit at Muhimbili Medical Centre, Dar es Salaam. 868 72

This article is the 17th installment of our annual review of research concerning the opiate system. It includes papers published during 1994 involving the behavioral, nonanalgesic, effects of the endogenous opiate peptides. The specific topics covered this year include stress; tolerance and dependence; eating; drinking; gastrointestinal, renal, and hepatic function; mental illness and mood; learning, memory, and reward; cardiovascular responses; respiration and thermoregulation; seizures and other neurological disorders; electrical-related activity; general activity and locomotion; sex, pregnancy, and development; immunological responses; and other behaviors.
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PMID:Endogenous opiates: 1994. 874 67

We describe the case of a 34-year-old man who presented intermittent faecal incontinence as a manifestation of cataplexy. The patient's sleep history was positive for the full narcoleptic tetrad (sleep attacks, cataplexy, sleep paralysis and hypnagogic hallucinations) while extensive neuropsychiatric work up was negative for any neurologic or psychiatric illness. Repeat polysomnograms (including a polysomnogram with a full seizure montage) were positive for pathologic sleepiness, but there was no evidence of a seizure disorder. The course of the patient's symptomatology and the favourable response of his symptoms to stimulants and imipramine support the theory that his intermittent loss of sphincter control is part of his narcolepsy-cataplexy.
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PMID:Narcolepsy-cataplexy and loss of sphincter control. 879 17


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