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

(1) Electrical stimulation therapy for patients suffering with labile signs and symptoms, and these include all varieties of acute and chronic pains, seizures and spasticity, has come into fashion and gone, and come again with each new technological advance for the past two hundred years. (2) A proportion of patients with chronic disease have their suffering made worse if they feel deprived of the latest therapy and may be relieved if they are given it in the right circumstances. In this group the relief will usually be temporary and the limited supply of such reactors will promote the cycle of fashion. In a group of 126 patients with chronic pain associated with organic disease who were offered transcutaneous stimulation, only 23 (18%) continued to use it one year after they started. (3) The cycling of therapeutic fashion is assisted not only because relief is often temporary, but also by the difficulty in establishing the normal range of variability from which significant change can be assessed and by the uncertain relationship between signs and symptoms and for the functions of daily living. For these reasons there is an inevitable tendency to temporary over-optimism and it seems impossible to counter this by the execution of a satisfactory clinical trial, since the patient cannot be "blind" and a significant variable is the enthusiasm with which a therapy is surrounded. (4) Electrical stimulation by cutaneous devices or implants can give much benefit to some patients in whom other methods have failed and there are indications, not only from anecdote and clinical impression but also now from experimental physiology, that it may benefit by mechanisms of interaction at the first sensory synapse. It is, however, an over-simplification to regard any therapy as either strictly physiological or simply fraudulent. Like other so-called placebos, physical methods of therapy can presumably act on hormonal systems associated with stress and the experience of pain.
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PMID:Therapeutic electrical stimulation. The transistorized placebo? 37 57

On the basis of an analysis of a paediatric material the author discusses the most important elements influencing the pattern of developmental age epilepsy calling attention to the significance of early aetiological diagnosis since in this early period of life many processes can be treated causatively before epilepsy develops into a chronic disease. The dynamic course of epilepsy and classification difficulties resulting from clinical and electroencephalographic variability of childhood epilepsy are discussed explaining these facts by differences in structural maturity and functional organization at the age of development. It is indispensable to know the classification of seizure circuits for selection of possibly effective symptomatic treatment for prevention of seizures and their sequelae in the neuropsychiatric and social aspects. In the clinical course of a given case there are also individual differences between the seizure-releasing factors and their knowledge helps to avoid the critical threshold of seizure readiness releasing seizures in a given child. Acceptance of certain rules for observation in the everyday life of patients permits an individual prophylaxis of seizures. This shows that prevention of epileptic seizures includes not only causative and symptomatic treatment but also the knowledge of individual seizure-releasing factors which cannot be controlled pharmacologically.
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PMID:[Epilepsy of the developmental age and control of seizure-releasing factors]. 94 85

The author presents some literature which considers epilepsy as a chronic disorder. The disease is a dependent epileptization of secondary foci from the primary ones and related to this phenomena, there is a stage development of the epileptic disease. The report contains results of clinical, EEG, PEG and morphological studies in 617 children which were made during more than 10 years. Clinico-anatomical correlations permitted to detect a relation between the severity of seizures and the degree of the natal brain lesion. An original graphical representation of the initial forms and development of seizures in the newborn and infants is given. The author attempts to give a hypothetical explanation of the acute stage of the pathogenetical process of convulsive disease, based on some laws of electrodynamics.
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PMID:[Clinical picture, pathogenesis and treatment of convulsive seizures in young children]. 99 91

Five patients with an unusual encephalopathy, possible secondary to measles virus infection, are described. Features common to these patients are: an existing chronic disease, neurologic deterioration 2 1/2 to 6 months after a measles infection, and death several weeks later. These events occurred when the chronic disease (e.g. leukemia or neuroblastoma) was in remission. That the measles virus was the causative agent is suggested only by finding in brain and extracranial tissues intracytoplasmic and intranuclear inclusions which contained measleslike particles. Additional clinical features seen in each of the five patients were: seizures, hypertension, and the inappropriate secretion of antidiuretic hormone.
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PMID:Encephalopathy following measles infection in children with chronic illness. 127 Nov 91

The relatively long history of psychology's involvement in the field of epilepsy is discussed. The view of epilepsy is that of a chronic disorder with onset in childhood, at a time when normal development is at risk for interference from the direct and secondary aspects of repetitive seizures, the neurological abnormalities from which they arise, and the clinical interventions that attempt to control them. The objective and scientifically based methods of psychology are viewed as particularly well suited to these topics. Past efforts by psychologists have increased understanding of the syndrome that is epilepsy, and have paved the way for opportunities to further contribute to the theoretically and practically important problems associated with epilepsy.
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PMID:Childhood epilepsy and the role of psychology. 141 85

The question as to what extent the hematocrit (Hct) is a strong indicator for or against the need for transfusion of whole blood or blood products is still controversial. In order to enable the clinician to make a definite decision, a number of aspects have to be taken into consideration. The human organism has only limited oxygen reserves, and these are even more limited under pathological conditions. Oxygen flux - the amount of oxygen transported by the blood in 1 min - is a critical factor in the oxygenation of the human body. Another critical factor is oxygen consumption, which is highly variable depending on the presence of conditions such as rest, shivering, seizures, hypothermia, etc. Furthermore, different organ systems have different oxygen consumption rates. The ratio of oxygen consumption to oxygen flux is referred to as the oxygen extraction rate or oxygen utilization. Under normal conditions oxygen uptake is independent of oxygen flux, and thus independent of blood flow. Under conditions of organ dysfunction, however, oxygen deficiency may be present without being recognized on standard clinical diagnostic parameters. The normal human organism has a number of possibilities to compensate for acute or chronic anemia, i.e., increases in cardiac output, organ perfusion, 2,3-DPG content, a shift in the oxygen dissociation curve, etc. These compensatory mechanisms may, however, be restricted or cease to function under conditions of acute or chronic disease. Arterial and mixed-venous PO2 and oxygen content are some of the parameters used to assess the oxygen reserves available to the organism even under critical conditions. Although oxygen content is the most significant of these parameters, accurate measurement of this parameter remains a problem of laboratory medicine. PVO2 is of only limited importance under conditions of anemia. Minimum oxygen content or minimum oxygen flux values should under no conditions be approximated during anesthesia or intensive care. The critical Hct as an indicator for or against transfusion of blood or blood products is considerably modified by restricted organ function, anesthesia, intensive care treatment, resuscitation, etc.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Which factors determine the critical hematocrit as an indication for transfusion?]. 153 35

To any parent, a seizure is a frightening event and a diagnosis of epilepsy evokes alarm, misunderstanding and a sense of helplessness. The nurse plays a major role not only in acute seizure management but also in providing long-term support, teaching and counseling. As with any child who has seizures, regardless of the type of medication, close monitoring of drug levels and response is important if seizures are to be controlled and toxicity avoided. An understanding and positive approach to the family is needed in managing this chronic disorder. Through proper management, the nurse promotes parental acceptance and security and enhances the child's self image and independence.
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PMID:Antiepileptic drugs for children: carbamazepine and valproic acid derivatives. 183 74

Data from 50 patients with juvenile myoclonic epilepsy (JME) were analyzed retrospectively to assess the response to drug therapy--long-term seizure control, relapse rates, and confounding factors in seizure recurrence. Valproate is the only available antiepileptic drug that has been shown to be effective in controlling the generalized seizure components of JME--myoclonic, tonic--clonic, and absence seizures--without significant side effects. Data were collected using the EpiMonitor software and represented case follow-up from 2 months to 9 years. Forty-three patients (86%) were seizure free for at least 1 year; 25 patients (50%) relapsed at some point during follow-up. Relapses were precipitated most frequently by fatigue, noncompliance, stress, sleep deprivation, and alcohol consumption. With accurate diagnosis and appropriate therapy, seizures in JME can be adequately controlled, although JME is a chronic disorder that may require lifelong therapy. To minimize relapse, patient management must also focus on patient lifestyle to eliminate or control lifestyle-associated precipitants of seizure relapse.
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PMID:Juvenile myoclonic epilepsy: long-term response to therapy. 250 7

The clinical studies of infusion schedules for cancer chemotherapy have established that this schedule substantially alters the pattern of drug toxicity without necessarily compromising therapeutic effectiveness. Although increased tumor cell killing has not been definitively established, in at least two prospective comparative trials of 5-FU the infusion schedule was superior to bolus delivery in terms of response rate. It is possible that the infusion schedule may be the primary determinant of the effectiveness of hepatic arterial chemotherapy, and preliminary reports of prospective trials comparing systemic infusion with hepatic infusion do suggest that response rates for both routes are similar. An important consideration with regard to infusion schedules is establishing whether or not tumor cell resistance is augmented by the continuous exposure. Almost all chronic disease therapy necessitates maintaining adequate drug levels to ensure disease control including infections, seizure disorders, arthritis, and cardiovascular diseases. For cancer, the intermittent schedule of drug delivery has been dictated by the concept of the primacy of dose and the substantial toxicity associated with these agents. With the technological capability of providing an ambulatory setting for infusion chemotherapy and the substantial modification of toxicity, therapeutic regimens may be more cost effective with the constant infusion schedule.
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PMID:Systemic infusional chemotherapy for liver metastasis: an improved schedule for 5-fluorouracil. 294 91

Barbiturates are considered first line antiepileptic drugs in third world countries due to traditional and economic reasons. This prospective uncontrolled study of 52 patients aged 15 to 64 years (mean 24) demonstrates that patients who become refractory to barbiturates are mainly those with partial seizures with or without generalization or with a focal EEG abnormality (71%). Seizures tend to become refractory approximately 6 years after barbiturates were started. Progressive barbiturate withdrawal over a period of two to 8 months (mean 5) with institution of treatment with carbamazepine, phenytoin or sodium valproate allowed complete barbiturate withdrawal in 42 of the 52 patients (81%). Furthermore monthly seizure frequency in those in whom barbiturates were withdrawn decreased from 7.1 to 1.7 per patient. An improvement in mental status was observed but not measured. These results show that barbiturates should not be first-choice drugs in patients who have a chronic disease such as epilepsy, and indicate a schedule for barbiturate withdrawal which is safe and independent of hospitalization or monitoring of antiepileptic drug serum concentrations.
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PMID:Barbiturate-refractory epilepsy: safe schedule for therapeutic substitution. 310 57


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