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

Two hundred eighty patients were admitted to an intensive care stroke unit over a one-year period. Subsequent investigation indicated that only 199 of these patients actually had cerebral ischemic or hemorrhagic lesions, 10 had other cerebrovascular lesions, and the remaining 71 patients had unrelated diseases, predominantly seizures. Detailed analysis of 103 stroke patients revealed an overall incidence of 59% hypertension, and 72% had hypertensive, ischemic or valvular heart disease. Fifty percent of the patients had various cardiac arrhythmias, some of which were responsible for the acute cerebrovascular lesion. Fourteen patients died during the acute phase, 11 from apparently irreversible cerebral selling, mainly due to cerebral hemorrhage. Secondary complications such as pneumonia, pulmonary embolism, pressure sores and urinary infection were almost nonexistent, but beneficial effects on the primary cerebral lesions were more difficult to demonstrate.
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PMID:Intensive care management of stroke patients. 100 32

Bicycle tests were used in 250 patients suffering from angina pectoris. The exercise was practised until the prodromal signs of an anginal seizure appeared. The mean values of exercise causing an anginal seizure appeared to be equal to 5.1 plus or minus 0.26 kgm/kg in angina decubitus and angina of effort; 11.9 plus or minus 0.67 kgm/kg is cases of daily seizures of angina of effort; 20.8 plus or minus 0.85 kg/kg in cases of several seizures a week after increased physical exercises, and 29.0 plus or minus 2.21 kgm/kg in cases of rare seizures (once a week or less frequently). This permits to believe that in cases of angina pectoris difficult of diagnosis its severity can be made precise by means of bicycle tests. The physician's assessment of the severity of angina is influenced by the physical activity of the patient in everyday life.
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PMID:[Tolerance of physical exercise in angina pectoris]. 115 21

There are approximately 3,000 women of childbearing age who become spinal cord injured each year in the United States. There are few reports in the literature that address pregnancy, labor and delivery in this patient population. We are reporting on 22 women post spinal cord injury who had 33 pregnancies. There were equal numbers of paraplegic and quadriplegic women. Three pregnancies aborted, one spontaneously. The babies were near normal or normal weight with one exception. The mothers waited 5 years on average to become pregnant. Cesarean section was performed on 43% of pregnancies. Abnormal presentations occurred in over 10% of pregnancies. Indications for cesarean section included 5 that were repeats; the remainder were necessary due to bleeding (1), breech presentation (1), transverse presentation (2), lack of progress (2), onset of labor 1 day post spinal fusion, and a mother's request to have tubal ligation. Epidural anesthesia was selected for 9 deliveries; 6 of these patients had controlled autonomic hyperreflexia. Five general and 4 local anesthetics were used, and 12 patients received no anesthesia. Diagnostic ultrasound and amniocentesis were used selectively. Complications included autonomic hyperreflexia (9), frequent urinary tract infections, infected pressure sores (3, 2 resulting in below-knee amputations), seizures during and after delivery, pneumonia, bladder stones (2), episiotomy dehiscence (1), and breakdown of spinal fusion. The newborns were healthy, although one double footing breech vaginal delivery had an APGAR of 1 at 1 min, 7 at 5 min and 9 at 10 min. One premature baby, who weighed only 1600 g, was a precipitate birth at home unattended. Implications for the care of pregnant SCI women are discussed.
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PMID:Pregnancy, labor and delivery post spinal cord injury. 128 43

Lumbar puncture is indicated in any infant with symptoms suggestive of meningitis (seizures, intractable vomiting and unexplained fever) and in the evaluation of neonatal intracranial bleeding. The infant must be held firmly in the lateral decubitus or sitting position. Under sterile conditions, a 22- to 25-gauge needle is inserted into the L3-4 interspace. The most important complication is unrecognized compromise of respiratory status.
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PMID:Lumbar puncture in infants. 682 91

The goals of surgery in the retarded patient with spinal deformity are to maximize function (for example, free the hands, decrease the occurrence of pressure sores, and so forth). Concomitantly, the goal while treating the patient should be to minimize the interference with social, intellectual, and general development while counting on no operation by the patient. The new tools of internal fixation available to the surgeon have made spinal surgery possible in these patients despite their lack of cooperation and their other medical problems, seizures, and spasticity. Although combined Dwyer instrumentation with subsequent posterior Harrington instrumentation or posterior fusion and Harrington instrumentation alone have been used most commonly, recent favorable experience suggests a larger role for segmental stabilization of the spine because of the greater purchase on the spine and the lack of need for prolonged external mobilization.
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PMID:Perspectives on surgery for scoliosis in mentally retarded patients. 720 81

This self-directed learning module highlights the preexisting comorbid conditions and the medical complications during and after rehabilitation of the patient with stroke. Part of the chapter on stroke rehabilitation in the Self-Directed Medical Knowledge Program for practitioners and trainees in physical medicine and rehabilitation, this article identifies several of the major associated medical problems, such as venous thromboembolism, pneumonia, seizure, and pressure sore; discusses methods of management for each of these problems; and reviews implications of associated conditions, such as heart disease, diabetes, and hypertension, and secondary complications for rehabilitation and outcome.
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PMID:Stroke rehabilitation. 2. Comorbidities and complications. 818 63

We describe 3 patients whose shoulders dislocated as the movements of the arm were restricted during a generalized tonic clonic seizure over an 18-month period. The first patient had both shoulders dislocated when observers sat on his arms during the convulsion. The second patient had a convulsion while in a forced lateral decubitus position and dislocated the shoulder on that side. The third patient dislocated the shoulder and fractured the acromion as she was held by her arms in a chair during a convulsion. Despite the large number of patients with refractory epilepsy under our care, no cases of spontaneous shoulder dislocation occurred during that period of time.
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PMID:Restraining patients and shoulder dislocations during seizures. 1047 99

The recommendation to position a patient having a seizure on a lateral decubitus is aimed at minimizing the risk of aspiration. The authors reviewed the database of the Epilepsy Foundation Clinic of South Florida for patients with epilepsy treated for pneumonia between May 1999 and May 2000 and patients admitted to two university telemetry units who had dislocation of the shoulder during an epileptic seizure. Over 2 months, 2 of 733 adults with intractable seizures had aspiration pneumonia after a generalized tonic clonic seizure (GTCS). Although no study has specifically addressed the problem of aspiration pneumonia in adults with GTCS, our findings suggest this problem is not common. From the two epilepsy centers, 5 of 806 patients dislocated a shoulder during a seizure. Video recordings showed that these patients were positioned in a lateral decubitus by staff while still having the convulsion. The dislocated shoulder in all cases was on the lower side. The risk of shoulder dislocation in a convulsing patient positioned in a lateral decubitus is less than 1%. Nevertheless, dislocations can result in disabling recurrences and are easily preventable. Because aspiration is more likely in the postictal rather than ictal phase of a GTCS, when oral secretions are not usually increased and there is cessation of respiratory movements, lateral decubitus should only be implemented after cessation of the convulsion, In inpatients (such as those on telemetry), secretions may be better managed by bedside aspiration of the oral cavity.
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PMID:Seizures, lateral decubitus, aspiration, and shoulder dislocation: Time to change the guidelines? 1123 62

Both neurologic and medical complications influence outcome after stroke. Space-occupying supratentorial infarcts can cause transtentorial or uncal herniation, which leads to death. Treatments aimed at reducing intracranial pressure in patients with such infarcts are of unproven value. Mass-producing cerebellar infarction may lead to brainstem compression and obstructive hydrocephalus. These lesions often are treated surgically. Although anticonvulsants are not indicated for prophylaxis, the occurrence of epileptic seizures mandates treatment to prevent recurrences. Depression is common in the acute stage of stroke, but is probably not more prevalent after stroke than after myocardial infarction. Although dysphagia is common, it usually is a transient problem. Patients with a decrease of consciousness or brainstem dysfunction usually need tube feeding for a certain period of time. Medical complications, such as fever, infections, hyperglycemia, cardiac disorders, pressure sores, and deep venous thrombosis, are associated with a poor prognosis and should be treated as early as possible. Measures to prevent these complications are part of general care. Hypertension is very common during the week after stroke and should be treated only in case of extremely high values or malignant hypertension. A multidisciplinary approach in the stroke unit is necessary to prevent and manage complications in the acute phase of stroke.
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PMID:Treatment or prevention of complications of acute ischemic stroke. 1468 26

Seizures can cause airway compromise and aspiration. This is a potential concern during inpatient video-EEG monitoring (vEEG), where seizures are provoked for diagnostic purposes. The frequency of aspiration and efficacy of nursing interventions to protect the airway were evaluated in this retrospective study of 590 partial complex (PC) and generalized tonic clonic (GTC) seizures recording during vEEG. 33 seizures (5.6%) occurred while patients were eating or drinking, 14 with food in the mouth at onset. 4 (0.6%) were followed by post-ictal emesis. Supplemental oxygen was provided in 93% of GTC seizures, and oral suctioning in 85%. Lateral decubitus positioning was used in 53%. These interventions were applied in a minority of PC seizures. There were no choking events, one suspected aspiration without subsequent complication, and no aspiration pneumonia. It is uncertain if interventions such as oral suctioning, lateral decubitus positioning, or oxygen administration reduce the risk of aspiration during vEEG.
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PMID:Risk of choking and aspiration during inpatient video-EEG monitoring. 2112 32


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