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

Relationship between amplitude and interval of healthy and epileptic children's alpha activity was investigated. A directly proportional, though non-linear (mostly exponential) correlation was found, i. e. the higher the waves, the wider their are, and vice versa, the lower, the narrower. This is a well-known feature of clinical electroencephalography, representing a good organization of EEG elements and, in terms of physiology, suggesting good "co-operation" of the recruitment process excitation and inhibition. Low interval values are matched by equally low amplitude values while inhibition is adequate. At higher interval values, amplitude is seen rising rapidly, inhibition is inadequate resulting in "paroxysmal" alpha activity which is occasionally found assuming the nature of spike and slow wave activity. The appearance of such principal changes in the recruitment process is abrupt, but a certain part of the changes often fails to manifest itself in the EEG curve. Epileptic children's alpha activity has a relatively higher amplitude, slower rhythm and a more regular regulation of amplitudes and intervals as well as that of their ratio. This is in line with the tendency toward hypersynchrony of EEG elements in epileptics. Epileptic spike and wave activity has an opposite sense of regulation as to the relationship of spike amplitudes and intervals, the principle being: the higher the spikes, the shorter the intervals between them. Apart from frequency, amplitude and angular velocity, that is another substantial difference between alpha activity physiological synchronization in vigilance and pathological spike hypersynchronization in petit mal seizure. Changes in vigilance seem to be in agreement with this phenomenon. The nature of recruitment process regulation (given in type of function) appears to be very stable, often remaining unchanged even under pathological conditions. Thus e. g. aplha wave recruitment during vigilance and spike recruitment during seizure are linear in either case. But while in alpha activity the amplitude-interval ratio is directly proportional, in spikes the proportionality is inverse. Alpha activity appears to be accompanied by inhibitory processes, spikes by excitatory processes. The number of active neurones and their synchronization in the course of spike-wave episodes is higher than during alpha activity. For that reason, in the course of epileptic recruitment process, expedient temporal-spatial integration of neuronal activity decreases to be superceded by simplified hypersynchronous reverberation with lower analytical-synthetic ability and lower reflectivity.
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PMID:Formal aspects of vigilance during petit mal paroxysm. 81 Nov

Sodium valproate 400 mg.-1800 mg. daily has been used for 1-4 months in the management of 35 patients with intractable epilepsy. This preliminary report indicates that the agent is a useful addition to anti-convulsant therapy with beneficial effect to the majority of patients with gran mal, petit mal, nyoclonus and akinetic attacks. Temporal lobe epilepsy and other focal cortical seizures responded less well. There were some minor gastrointestinal and neurological side-effects which subsided with time or the reduction of dosage. The transition period while other anticonvulsants were being withdrawn was accompanied by grand mal seizures in 6 patients. It appears that sodium valproate requires 7-10 days to becoms fully active and that other anticonvulsants should be withdrawn only after the patient is established on a maintenance dosage. Comparison with clonazepam suggests that the latter is more effective in the control of petit mal and temporal lobe epilepsy but has more persistent sedative effects. Most patients transferred from other anticonvulsants to sodium valproate felt more alert and able to concentrate better.
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PMID:Sodium valproate in the management of intractable epilepsy: comparison with clonazepam. 81 47

Petit mal absences in childhood are often followed by grand mal seizures in adolescence and a coexistence of both types of seizures is not uncommon at all. It is noteworthy, however, that such a coexistence does not imply immediate transition from one type of seizure into the other one. Hence, a grand mal attack may be prepared by all sorts of focal seizures, psychomotor automatisms or bilateral-synchronous myoclonus but immediately preceding petit mal (with generalized spike-wave discharges) is probably extremely rare. The presented case is characterized by unusually late onset of petit mal and grand mal seizures at age 32 and, following a mild head injury, a few episodes of petit mal status (ictal stupor) at age 52. At that time, a series of petit mal absences and eventually a smooth transition from petit mal to grand mal could be recorded. Uncommon frequency characteristics (especially some interspersed spiking at a rate of 9-15/sec) were found at the onset of the ictal spike-wave activity during the petit mal absences. This is regarded as the expression of failing inhibitory mechanisms which generally prevent the immediate development of a grand mal out of a petit mal absence.
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PMID:Immediate transition from a petit mal absence into a grand mal seizure. Case report. 81 90

The antiepileptic efficiency of dipropylacetate (DPA) was studied in 80 epileptic children who suffered either from seizures resistant to previous medication, so-called idiopathic epilepsy or progressive myoclonus epilepsy. The average peroral daily dosage of DPA was 21 mg/kg divided into 2 to 3 doses. DPA was most effective in cases with 1) so-called idiopathic epilepsy (genuine petit mal, photogenic epilepsy, myoclonic petit mal in older children), 2) seizures beginning in later childhood years, 3) photosensitive and hyperventilation-sensitive seizures, 4) EEG showing symmetric generalized spike-slow wave complexes provoked by photostimulation, 5) EEG without generalized disturbance or focal findings, 6) normal neurological and mental status, 7) progressive myoclonus epilepsy. DPA may thus be recommended for the treatment of the above-mentioned cases and, due to good treatment results, also tried in other types of epilepsy.
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PMID:Experiences on the use of dipropylacetate in the treatment of childhood epilepsy. 81 72

A study was conducted in 9 children with petit mal epilepsy to compare the plasma levels of ethosuximide after divided daily administration with those after single daily administration. The children received their previously established dose in divided doses for 4 wk, single morning doses for 4 wk, and again in divided doses for 4 wk. None of the children suffered petit mal seizures during the study. Three had grand mal seizures but the frequency did not differ between the dosage regimens. Plasma levels during the single-dose period peaked more rapidly and fell more quickly than during the other periods, but mean levels remained in the therapeutic range. The mean half-life of the drug in these children was 29 hr. For reasons not understood, plasma levels generally were lower in the second divided dose period than in the other two periods. No adverse experiences were reported during the study. The data indicate that ethosuximide is clinically effective when given in a single daily dose. This regimen offers advantages in convenience and possibly in patient compliance.
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PMID:Ethosuximide dosage regimens. 81 88

The incidence rates of epileptic seizures and epileptic seizures with centrotemporal (Rolandic) discharges were found to be 134/100,000 and 21/100,000, respectively. These were determined in an epidemiological study in a population consisting of 52,252 children aged 0-15 years in a county in the northern part of Sweden. Epileptic seizures with Rolandic discharges represented about 16% of all the epileptic seizures (febrile convulsions not included). They were four times more common than classic petit mal with 3/sec spike-and-wave activity.
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PMID:Benign epilepsy of children with centrotemporal EEG foci. A study of incidence rate in outpatient care. 81 42

Between 3700 and 3900 children are admitted annually to this children's hospital. During the past four years a total of 455 children with convulsions were admitted for investigation. 255 of these cases were calcified as epilepsy, 202 as febrile convulsions and 28 as neonatal convulsions. A quarter of the epileptic children showed fits of the petit mal type. There were only 5 cases of infantile propulsive petit mal. High frequency of fits and, in particular, status epilepticus, were very rarely seen in the present study. A case of self-induced photosensitive epilepsy, later combined with psychomotor epilepsy, is referred to in detail. Of 149 children with grand mal epilepsy, 36 were classed as idiopathic, and 88 as symptomatic cases. 37 of the symptomatic cases showed focal epilepsy with generalisation. It was concluded from the clinical course and the EEG that the combined effects of familial predisposition towards fits and exogenous cerebral lesions were operative factors in 14 patients. Children with febrile, convulsions possessed an EEG suggestive of a familial predisposition towards fits in slightly more than 50% of the cases. No cause could be found for the seizures in 5 infants with neonatal convulsions, but the mother of one of these infants was an epileptic herself, undergoing treatment with anticonvulsive drugs in high dosage and a withdrawal syndrome was suspected in this particular case. 17 infants with neonatal convulsions were symptomless on leaving hospital and remained so during the first year of life. Of the remaining cases, 10 showed neurological disturbances and one died. There was only one case in which neonatal convulsions progressed directly to epilepsy. The peak incidence of the first appearance of fits occurred during the first year of life (136 children), with 18% of the entire case material presenting within the first 6 months. 108 children presented with fits for the first time during the second year of life. Thereafter, the tendency towards the development of fits for the first time in life declined with increasing age.
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PMID:[Aspects of epilepsy in childhood (author's transl)]. 81 19

For most authors, hereditary epilepsy is restricted to a certain number of neuropsychiatric diseases liable to be transmitted and associated to epileptic seizures : such as the progressive epilepsy myoclonia of Ramsay-Hunt, or some neuroectodermoses (Bourneville's tuberous sclerosis). But those diseases are quite rare compared to the majority of the epileptic population we meet everyday. Yet it seems to us that there is a genetic predisposition in some patients suffering from epilepsy, generalized from the start, called idiopathic epilepsy (grand mal, petit mal, massive myoclonias), where no cerebral lesion can be found. For this research, we have undertaken the study of two families, one with three children, the other with two homozygous twins. All the children were suffering from clinical epilepsy. The altered state of the E.E.G. of the parents who do not have obvious apparent epileptic seizures, confirms the genetic role of certain idiopathic epilepsies. A study of bibliography accompanies the topic of this presentation.
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PMID:[The epileptic heredity in several comitial children]. 81 44

A brief discussion of the manifestations of limbic lobe discharge as opposed to discharge in neocortical temporal lobe structures is given. The opinion is expressed that, apart from certain characteristic limbic auras, the manifestations of psychomotor epilepsy are those of inactivation of brain stem mechanisms subserving consciousness. A brief discussion of other manifestations of inactivation of brain stem mechanisms subserving various other functions, as seen in other clinical patterns of epileptic discharge, follows. Hippocampal sclerosis is put forth as the cause rather than the result of seizures in both the juvenile and the adult age groups. It is proposed that limbic lobe structures have a low threshold for initiating epileptic discharge when injured, are predisposed to injury and give rise to discharge which has preferential access to brain stem structures. It is stated that petit mal absences and psychomotor attacks are clinically indistinguishable. The further opinion is expressed that the 3 per second wave and spike EEG pattern associated with petit mal is an epiphenomenon dependent upon the maturational stage of development of the brain at the time when the causative lesion responsible for epilepsy is acquired. The view that the 3 per second wave and spike pattern is a direct correlate of the clinical manifestations of epilepsy, in those patients who show this pattern, is challenged. It is concluded that the pattern is the result of rostral brain stem discharge acting upon the cortex. The view is offered that two factors are necessary for the development of epilepsy: (1) an adequate pathological basis in the form of a cerebral lesion and (2) a greater or lesser predisposition toward inadequate biochemical mechanisms tending to check or control the spread of seizure discharge, the latter being in all probability at least partially genetically determined. It is concluded that triggering cortical foci exist in nearly all cases of epilepsy, though the participation of brain stem structures is essential to explain many of the clinical and EEG manifestations of the attack.
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PMID:The distinction between absence petit mal and psychomotor seizures. 82 98

This study is an attempt to investigate cases of temporal lobe epilepsy, the starting point being a large number of psychiatric patients. The data presented in this study suggest that a certain number of schizophrenic-like psychoses are produced by temporal seizural activity. There is some evidence that if there is a centrencephalic seizure at the beginning of such a psychotic state, the patient's behavior will have confusional characteristics (perhaps a postictal centrencephalic state). Some findings suggest that the side localization of the temporal lobe focus affects the feature of the psychotic state. None of the nine patients with periodic psychoses had schizoid or paranoid premorbid personality. As to the interictal behavioral disorders of epileptics, we have noticed that two patients with hysteroepilepsy and two with compensation neurosis had dominant temporal lobe focus. Of 10 cases with behavior disorders, all had grand mal or petit mal epilepsy, and none had a temporal lobe focus. Although this study is not based on sufficient data, it may provide working hypotheses for further research.
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PMID:Psychiatric aspects of temporal lobe epilepsy. 82 4


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