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

The Apostle Paul had a chronic disease. Epilepsy is offered as the most likely hypothesis. Interpretation of parts of the Pauline epistles suggests the possibility of facial motor and sensitive disturbances coming after ecstatic seizures. Though unusual, there are, however, case histories of patients who experienced ecstatic auras.
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PMID:[Saint Paul disease. Ectasia and exstatic seizures]. 767 19

Systematic review of antemortem clinical information on randomly selected Alzheimer disease (AD) patients revealed that approximately 40% of the patients had a recorded fever of > or = 39.2 degrees C at or near death. Using isolation and quantitation techniques appropriate for analysis of human brain mRNAs, we found that low levels of inducible heat-shock protein 70 (hsp70) mRNAs were present in cerebellum of afebrile AD patients and that mRNA levels were usually lower in two brain regions affected in AD, i.e., hippocampus and temporal cortex. Levels of hsp70 mRNAs were increased three- to 33-fold in cerebellum of febrile patients compared with levels in patients whose recorded temperatures were < or = 37.5 degrees C. Levels of hsp70 mRNAs were also increased in hippocampus and cortex of these febrile patients, but to a lesser extent than cerebellum. Heat-shock cognate 70 (hsc70) mRNAs were present at highest levels in afebrile cerebellum and were also present in the other brain regions. In cerebellum of patients with the highest temperatures, hsc70 mRNAs were induced severalfold over basal levels. Although there was a low and variable induction of hsc70 mRNAs in temporal cortex of these patients, there was no evidence for any induction in hippocampus. Increased heat-shock 70 mRNA levels did not correlate with hypoxia, coma, hypertension, hypoglycemia, seizures, or medication. These results indicate that a specific agonal stress, namely fever, can increase the levels of heat shock 70 mRNAs in AD brain; however, there is no evidence to suggest that affected regions of AD brain have higher overall levels of these mRNAs. Failure to obtain adequate agonal state information could result in inaccurately identifying short-term stress-related changes in postmortem brain as neuropathology characteristic of a chronic disease state.
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PMID:Heat-shock 70 messenger RNA levels in human brain: correlation with agonal fever. 779 18

Epilepsy is a chronic disorder characterized by recurrent unprovoked epileptic seizures. Not all epileptic seizures indicate the existence of an epileptic disorder; many represent a natural response of the normal brain to transient noxious insults that are not likely to be repeated (reactive seizures). Not only is it important to distinguish conditions associated with these relatively benign epileptic events from epilepsy, but also it is important to recognize the many types of epileptic seizures and many types of epilepsy, reflecting different underlying anatomic and pathophysiologic substrates, which determine therapy and prognosis. Acute care for an epileptic seizure, therefore, includes search for an underlying treatable cause and protection against recurrence, if necessary. Neurologic consultation in the emergency department can help avoid unnecessary diagnostic procedures and treatments, particularly in patients with reactive seizures and established epileptic disorders. Communication with the patient's continuing care physician is an essential part of the emergency department management plan.
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PMID:Overview of seizures. 795 90

Between October 1988 and December 1992, 167 patients with leukemia receiving marrow transplants from HLA-identical donors and conditioned with cyclophosphamide (120 mg/kg) were randomized to additional treatment with either busulfan (16 mg/kg, n = 88) or total body irradiation (TBI; n = 79). The busulfan-treated patients had an increased cumulative incidence of veno-occlusive disease of the liver, ie, 12% compared with 1% in the TBI group (P = .009). Furthermore, hemorrhagic cystitis occurred in 24% of the busulfan patients versus 8% in the TBI patients (P = .003). In patients with advanced disease beyond first remission or first chronic phase, transplantation-related mortality was 62% among the busulfan-treated patients compared with 12% among the TBI recipients (P = .002). These differences between the two groups were statistically significant in multivariate analysis. Seizures were seen in 6% of the busulfan-treated patients and were absent in the TBI group (P = .03). Grade II-IV of acute graft-versus-host disease (GVHD) was similar in the two groups, but grade III-IV and chronic disease was more common in the busulfan-treated group (P = .04). Death associated with GVHD occurred in 17% of the busulfan-treated group and 2% of the TBI group (P = .003). Patients treated with busulfan had a 3-year actuarial survival of 62%, which was worse than the 76% among those treated with TBI (P < .03). In multivariate analysis, poor survival was associated with advanced disease (P < .0001), no posttransplant septicemia (P = .0006), grade II-IV GVHD (P = .006), and busulfan treatment (P < .02). The incidence of relapse did not differ between the two groups. Relapse-free survival was also similar in the two treatment groups on analysis of data from all patients, children, patients with early disease, and those with acute myeloid leukemia, acute lymphoblastic leukemia, and chronic myeloid leukemia. However, in adults (P = .05) and patients with advanced disease (P = .005), leukemia-free survival was significantly better in those treated with TBI. We conclude that patients treated with busulfan have more early toxicity and an increased transplant-related mortality in patients with advanced disease. TBI is therefore the treatment of choice, especially in adults and patients with advanced disease. However, busulfan is an acceptable alternative for patients with early disease and for those in whom TBI is not feasible.
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PMID:A randomized trial comparing busulfan with total body irradiation as conditioning in allogeneic marrow transplant recipients with leukemia: a report from the Nordic Bone Marrow Transplantation Group. 816 51

Seizures after traumatic brain injury may cause acute deterioration in level of consciousness, signal the presence of significant intracranial pathology, herald potentially lethal status epilepticus and carry some risk for the development of a chronic disorder. Specific implications of immediate, early and late seizures are different and vary across age groups. While there is a consensus to manage status epilepticus aggressively, and some agreement to treat a seizure once it has begun, no such unanimity exists about management of patients who have one or more seizures after injury. This article identifies controversies about seizures that occur after traumatic brain injury in paediatric and adult populations. It concludes with a summary of research imperatives for the future.
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PMID:Posttraumatic seizures: consensus and controversies. 827 96

For more than a century, epilepsy was characterized as a chronic disease, with little chance of remission or cure. It was also considered a progressive disease in which seizures led to more seizures. Experimental work in animals provided additional support for the notion that seizures could beget seizures. However, the earliest clinical observations in humans were based on highly selected, largely refractory patients. Furthermore, the experimental work in animals bore little relation to naturally occurring seizures and epilepsy in humans. Evidence from multiple sources regarding the nature and natural history of seizures and epilepsy in humans has repeatedly demonstrated that in most cases of occurrence of seizures itself does not influence the long-term outcome of epilepsy. Consequently, interventions to prevent seizures early in the course of a seizures disorder do not alter the natural history of seizure disorders with respect to whether remission will occur in the long term. That outcome is largely predetermined by other factors, many of which are not currently amenable to intervention. In some rare syndromes, deterioration is progressive. In these instances, it is the underlying syndrome, not the seizures, that is primarily responsible for the deterioration. In addition, extremely prolonged seizures (which are rare) may also directly cause damage. These are exceptions rather than, as previously believed, the rule. The available human data strongly suggest that seizures do not beget seizures and that epilepsy in humans is usually not a progressive disorder.
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PMID:Do seizures beget seizures? An assessment of the clinical evidence in humans. 916 5

Epilepsy is a chronic disorder that first appears in childhood. Seizure types and presentation vary from dramatic and obvious to subtle and discrete. Accurate identification of the seizure type is imperative to ensure proper disease management. The International league Against Epilepsy has developed two classification systems--the classification of Epileptic Seizures and the classification of Epilepsies and Epileptic Syndromes--to assist in the provision of an International language of epilepsy, to improve the diagnosis and management of seizures, and to establish prognostic criteria. Knowledge of the classification systems of seizures, seizure types, and management of seizures is essential in the delivery of health promotion, disease prevention, and anticipatory guidance for the child with epilepsy. The primary care practitioner is often the first person consulted when medical questions or problems arise, and therefore is in a key position to detect seizures, monitor treatment, and educate the family. A comprehensive knowledge of pediatric epilepsy will allow the practitioner to provide the additional resources needed to coordinate the care of this special population.
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PMID:Diagnosing pediatric epilepsy: an update for the primary care clinician. 956 Aug 31

Epilepsy is a chronic disorder in which onset occurs primarily during childhood and adolescence. Traditionally, treatment of childhood epilepsy emphasizes neurologic aspects over psychological factors. The attention to the seizure control in the clinical setting will not address the full range of quality of life problems of childhood epilepsy. Many of the psychosocial difficulties that plague adults with epilepsy develop from the complications associated with this early onset. Children with epilepsy have a high prevalence of behavior problems and learning problems. Assessing quality of life in pediatric epilepsy is especially important because children are in critical periods of development during which many cognitive and social skills are being learned. This study presents a simplified inventory of quality of life, with cultural, personal, social and relationship aspects. This investigation makes possible to the professional knowledge about children and a best direction of their conducts.
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PMID:[Quality of life in childhood epilepsy]. 1034 21

Rasmussen's syndrome is a chronic disorder characterized by uncontrollable focal seizures and eventually epilepsia partialis continua, ipsilateral hemiparesis, developmental arrest, and cerebral inflammation. Viral and autoimmune etiologies have been postulated. A patient is presented who illustrates the wide variability of clinical and radiographic presentations in this disorder. The patient is an 8-year-old female who developed intermittent facial twitching at 2 years of age that eventually progressed to epilepsia partialis continua. Electroencephalography demonstrated clinical seizures that emanated from the right parasagittal area. Cranial magnetic resonance imaging revealed pronounced atrophy of the right caudate nucleus, globus pallidus, and putamen, with mild increased T2-weighted signal in the right striatum, without accompanying cortical atrophy. Ictal single-photon emission computed tomography revealed markedly reduced uptake in the right hemisphere that was maximum in the right basal ganglia. Cerebrospinal fluid, blood, and urine collected for metabolic and immunologic screening and DNA testing for a wide variety of disorders were all unremarkable. Neuropsychologic testing demonstrated difficulties in memory, attention, and calculation. Brain biopsy revealed mild microglial activation, rare glial nodules, and collections of lymphocytes and histiocytes, consistent with the clinical diagnosis of Rasmussen's syndrome. After a modified hemispherectomy, she demonstrated marked clinical improvement.
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PMID:Unusual presentation and MRI findings in Rasmussen's syndrome. 1059 78

In order to select a new medication for a patient with epilepsy, it would be helpful to have an idea of which drug might have the greatest overall chance for success. Since epilepsy is a chronic disorder, the long-term effectiveness and tolerability of the medications are very important. Here, we compared gabapentin, lamotrigine, topiramate and vigabatrin using Kaplan-Meier survival analysis to see how long patients chose to stay on each drug and if they stopped, why they stopped. The results seem to suggest the type of responses to be expected in a hospital seizure clinic.
Seizure 2000 Jun
PMID:A comparison of four new antiepileptic medications. 1088 Feb 92


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