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

Four examples of astrocytic tumorettes (microscopic to minute foci of glioma) are described herein. They include one malignant astrocytoma and three low grade astrocytomas. The first patient, who died of heart failure, was found incidentally to havour a small malignant astrocytoma at the time of autopsy. The other three patients with astrocytomas of low grade in malignancy, ranged from 18 to 25 years in age, and presented with intractable seizures. Electroencephalography defined a temporal lobe focus in all three patients. Subsequently, all three underwent a unilateral temporal lobectomy with resection of the epileptic focus. Careful histological examinations on the removed tissues from each patient revealed that each of them had a minute astrocytoma. The histogenesis of benign and malignant astrocytomas and the importance of surgical exploration in the management of the patients with intractable seizure disorders are discussed.
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PMID:Astrocytic tumorette: microscopic to minute foci of glioma unexpectedly found in autopsy or surgical specimens. 345 65

Employment of postoperative brain irradiation in the initial management of high-grade malignant glial tumors has now become standard. The addition of conventional chemotherapy to irradiation has not significantly improved median survival beyond 1 year. We treated 25 consecutive patients (13 pilot patients and 12 protocol patients) with histologically confirmed unresectable grade 3 or 4 malignant gliomas with high-dose BCNU (carmustine) followed by autologous bone marrow transplantation and whole brain irradiation. Within 3 weeks of initial surgery, each patient had autologous bone marrow stored (median 2 X 10(8) nucleated cells/kg), and then received BCNU 1,050 mg/m2 intravenously (IV). Peripheral granulocytes recovered (greater than 500/microL) at a median of 19 days (range, 10 to 37 days), and platelets recovered (greater than 20,000/microL) at a median of 18 days (range, 13 to 40 days), following bone marrow infusion. Patients received 60 Gy whole brain irradiation when granulocytes were greater than 1,500/microL. Toxicity was well tolerated. Nausea occurred in 19 patients (76%); however, only eight patients (32%) experienced vomiting (mild in three, moderate in five). Eleven patients (44%) did not require empiric antibiotics, six of whom never developed an absolute granulocyte count less than 500/microL. Three patients with a poor performance status died early (one seizure with vomiting and asphyxiation; one, klebsiella urinary tract infection (UTI) with bacteremia; one, candidal pneumonia), and one additional patient who was performing well died of pulmonary hemorrhage. The 13 pilot patients have now been followed for a median of 23 months, with a significant survival advantage compared with the 52 consecutive historical control patients who received similar surgery and radiotherapy without high-dose BCNU (P = .037). The overall study group of 25 patients also has a significant survival advantage when compared with the same historical control group, with a projected median survival of 26 months (P = .007). This new approach using early postoperative intensive therapy consisting of high-dose BCNU, autologous bone marrow transplantation, and whole brain irradiation appears to significantly improve survival.
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PMID:Prolongation of survival for high-grade malignant gliomas with adjuvant high-dose BCNU and autologous bone marrow transplantation. 355 37

It is well known that convulsion is one of serious adverse reactions of x-ray contrast media. The occurrence of the convulsion seems to be very rare in general population. However, a few reports noticed recently that patients with brain metastases or gliomas developed this complication relatively frequently and the terms, as contrast-induced convulsion or contrast media-associated (induced) seizure, were used. We performed 12,479 cranial CT examinations with contrast enhancement during the last nine years. The amount of 100 ml in adult or 2 ml/kg in children of 65% Angiografin (methylglucamine diatrizoate) was given intravenously and five patients had contrast media-associated seizures. Case 1: A 37-year-old man with right frontal anaplastic glioma was treated surgically and with radiochemotherapy and hyperthermia. In spite of anticonvulsant therapy, general or left hemiconvulsions occurred sometimes. The patient had contrast-induced general convulsion at 16th CT examination which revealed enhancement in the wall of surgical tissue defect. At 26th CT study, he developed general convulsion again. Case 2: A 47-year-old man with anterior callosal anaplastic glioma was treated surgically and with radiochemotherapy and hyperthermia. After then, he had contrast media-associated general convulsion at 10th CT examination which showed enhanced lesions. Case 3: A 63-year-old woman had been treated surgically for lung cancer. Five years later, CT revealed a ring enhancement in the left frontal lobe. Radiation reduced the lesion gradually.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical course and CT findings in patients with contrast media-associated seizures]. 359 1

Eight cases are presented to summarize our experience with patients initially evaluated for the new onset of either seizure activity or focal transient neurological deficits. Each was found to have a normal computed tomographic (CT) scan with and without iodinated contrast infusion. All subsequently returned with a CT scan indicative of a glioma 2 weeks to 39 months later. The apparent reasons for the difficulty in early diagnosis of glioma in certain instances are discussed. A review of the literature with an analysis of the conglomerate data is presented. These cases probably represent a subset of gliomas undergoing anaplastic dedifferentiation from relatively benign to more malignant forms. Recommendations for clinical and radiographic follow-up are outlined.
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PMID:Clinical manifestation of glioma before computed tomographic appearance: the dilemma of a negative scan. 361

Intracarotid BCNU (100 mg/m2) and cisplatin (60 mg/m2) were administered to 36 patients with malignant brain tumors recurrent or progressive after cranial irradiation. Courses of therapy were repeated at 4-6 week intervals. Of 23 evaluable patients with recurrent glioma, 9 (39%) had tumor regression by CT scan and 3 had stable disease. The median time to tumor progression for responding patients was 37 weeks. For all patients with primary tumors it was 14 weeks. Six of 9 patients with no prior chemotherapy had a response and 1 had stable disease. Of 14 patients who had received prior chemotherapy, 3 had a response and 2 had stable disease. Survival ranged from 9 weeks to 95+ weeks (median 34 weeks) from start of therapy. Six of 23 patients with primary tumors are alive 1 year or more following therapy. Four of 11 patients with brain metastases had a response and 2 had stable disease. Major neurologic toxicity of intracarotid BCNU and cisplatin appeared cumulative and consisted of reversible hemiparesis in 3% of 118 courses, TIA in 1%, expressive aphasia in 9%, lethargy in 3%, seizures in 12%, and reversible confusion in 1%. Retinal toxicity consisted of mild blurring of vision in 4 patients and ipsilateral blindness in 5 patients. Three of 22 patients who had received supraophthalmic infusion later developed evidence of leukoencephalopathy. Intracarotid BCNU and cisplatin appears to have modest increase in activity over intracarotid cisplatin alone (Cancer 54:794, 1984), however, neurologic and retinal toxicity may also be increased.
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PMID:Phase II trial of intracarotid BCNU and cisplatin in primary malignant brain tumors. 370 37

A 32 year old man affected by grade 1 astrocytoma of the right sylvian region and epileptic seizures, presented gustatory hallucinations as a post-ictal symptom. Spikes of very low voltage during sleep were the only epileptic abnormalities found on his EEG. It is suggested that post-ictal as well as ictal gustatory hallucinations may be a localizing symptom of glioma involving the sylvian region. Furthermore, if systematically searched for, sleep related microspikes may become an EEG sign useful for the diagnosis of brain tumour in patients with epileptic seizures and no epileptic discharges on the awake EEG.
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PMID:Post-ictal gustatory hallucination, sleep related microspikes and glioma of the sylvian region: report of a case. 373 1

A retrospective study of 72 consecutive and nonrandomized patients with malignant glial tumors is presented. The influence of age, sex, location of tumor, initial presenting symptoms, symptomatic preoperative interval, reoperation, extent of tumor removal, histological subtype of tumor, lymphocyte infiltration, and different treatments upon survival time has been evaluated and statistically analyzed. Age was inversely associated with survival with a strong statistical significance (p = 0.0001). Headache was the most common (67%) initial symptom; aphasia and seizure were both present in 45.3% of patients. Initial presenting symptoms had no effect upon survival. Parietal lobe and lymphocyte infiltration had marginally negative effects upon survival (p = 0.097 and p = 0.10 respectively). The amount of tumor removal was marginally associated with an improved survival (p = 0.07). Radiation therapy was strongly associated with an improved survival time (p = 0.0007). The addition of chemotherapy did not affect the survival (perhaps reflecting the small number of patients and inadequate chemotherapy). There was an obvious beneficial effect of reoperation upon survival time, if the patient lived and underwent reoperation later than 16 months after the initial operation (slow-growing tumor). Although median and mean survival times (10 and 20.34 months respectively, SD 7.45 months) were similar to most series reported, our rates of survival (20%, 12.5%, and 7.5% at 2, 3, and 5 years, respectively) were notably higher.
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PMID:Malignant gliomas of the brain. A retrospective study. 373 21

Reactive gliosis was found in a 40-year-old man who presented with intractable seizures thought to be due to a malignant neoplasm. Although two separate lesions located bilaterally in the frontal lobes were evident on the computed tomographic scan, a connection between these lesions along the fibers of the corpus callosum was clearly demonstrated on T2-weighted magnetic resonance images. The unusual radiological appearance of this gliosis, which simulated a malignant butterfly glioma on magnetic resonance imaging (MRI), is reported. Because MRI is still a new modality, its images should be interpreted with judicious caution.
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PMID:Reactive gliosis simulating butterfly glioma: a neuroradiological case study. 378 32

Regional cerebral blood flow (r CBF) was measured by the I.V. 133 Xenon method and use of 27 detectors in 91 patients with complex partial epilepsy in interictal periods (at least 48 h over a complex partial seizure). Some were also examined less than 48 h before or after seizures. All were studied with ictal and interictal electroencephalography (EEG), polysomnography, computed tomography (CT), some had nuclear magnetic resonance scans (MR). The blood flow values were compared with a group of a 20 normal subjects matching for age. A significant decrease of r CBF ranged from 15% to 25% was found in the temporal region in three groups of epileptic patients: with repeated normal CT scans and lateralized EEG abnormalities (N = 46); with cortical atrophy in CT scan (N = 12); with neurosurgical focal lesions on CT and or MR scans glioma, arteriovenous malformation) (N = 10). r CBF was normal or decreased by less than 15% in the other regions of the brain. Patients with repeated normal CT scans and bilateral EEG abnormalities either asynchronous or alternatively observed in the right side or left side on waking EEG or during NREM sleep and REM sleep, did not show reduction in r CBF. In a previous study, r CBF distribution was also found normal during interictal phase in patients with primary generalized epilepsy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Regional cerebral blood flow in partial complex epilepsy with and without the presence of lesions]. 380 89

On the basis of 346 glioma patients operated on in the years 1969-1983, the frequency of epileptic seizures and their importance for the diagnosis as well as the causes of the delay in clearing up the clinical picture were ascertained. Of the 226 patients with an astrocytoma, 51.5 per cent had one or several epileptic fits in the pre-operative period. For the 99 glioblastoma patients, the seizure rate was 33.7 per cent and for the 21 patients with an oligodendroglioma it was 69 per cent. Although in about 80 per cent of the cases epileptic fits were the first symptom of the disease, this important clinical sign led in only 30 per cent to a causal treatment. In another 20 per cent of the courses, the final clarification was initiated by an increase in the frequency of the fits or a change of the kind of the fit. In the remaining 50 per cent of the glioma patients it was only after the additional occurrence of neurological disturbance that the diagnosis could be verified and surgical treatment carried out.
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PMID:[Diagnostic value of epileptic seizures in cerebral gliomas]. 383 99


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