Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Plasminogen activator inhibitor-1 (PAI-1) is a serpin proteinase inhibitor which regulates fibrinolysis and the proteinase cascade of tumour invasion. In this study, PAI-1 was identified in the cerebrospinal fluid (CSF) from patients without neurological disease and patients with various neurological disorders. The mean level of PAI-1 in the CSF of 28 patients without central nervous system (CNS) disease was 0.28 +/- 0.03 (SEM) ng/ml. CSF PAI-1 was significantly increased in the following diagnostic categories:dementia (Alzheimer's disease), cerebral infarction, CNS infection, alcohol withdrawal seizures and CNS neoplasia. In all these disorders, with the exception of CNS infection, PAI-1 was also increased as a fraction of total CSF protein. CSF PAI-1 was not increased in patients with hydrocephalus or idiopathic seizure disorders. Complementary plasma samples were available for 18 of the 128 CSF specimens studied. For these cases, there was no correlation between plasma PAI-1 and CSF PAI-1 levels. PAI-1 may represent a non-specific marker of disease in the central nervous system.
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PMID:Plasminogen activator inhibitor-1 in the cerebrospinal fluid as an index of neurological disease. 805 48

One hundred and twenty three children with difficult to control epilepsy (DCE) were studied. Etiological factors which predominated included an age of onset less than 2 years (71.5%), male sex (69%), mixed, secondarily generalized, or complex partial seizures (77%), mental retardation (64%) and neurological abnormalities (52%). Static neurological disease was seen in 63%, with only 17% having idiopathic disease. Identifiable epileptic syndromes were noted in less than half the children. The surface EEG was abnormal in 84%, and correlated with the clinical seizure type in 81%. CT and MRI were helpful in diagnosis in only 38 and 48%, respectively, and even less so in therapy decisions, 7 and 16%, respectively. Prior therapy revealed the use of polytherapy in 61% and suboptimal dosages in 78%. In the 100 patients with adequate follow up, 67% showed a good response, i.e., 35% complete and 32% more than 50% reduction in seizures. Only 11% were total nonresponders, and most were severely retarded. Major treatment strategies employed included switching to monotherapy, supranormal dosages and avoidance of sedative anticonvulsants. Side effects were noted in 41% with 8 cases being life threatening. Overall mortality was 4%. We concluded that risk factors for DCE included early age of onset, mental retardation and certain seizure types. EEG was more helpful than neuroimaging. Treatment responses were favorable, especially in those with normal intellect and the use of normal or high dose monotherapy.
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PMID:Difficult to control epilepsy in childhood--a long term study of 123 cases. 807 11

Sudden unexpected death in epilepsy (SUDEP) has been ascribed to cardiac arrhythmia, possibly triggered by cerebral events. Young, noncompliant, substance-abusing males with convulsions may be at risk. EEG/ECG studies have not shown significant cardiac arrhythmias in these and other seizure patients. We reviewed resting ECGs in 75 epilepsy patients and compared ventricular rate, PR interval, QRS duration, and QT interval corrected for heart rate (QTC) with normal ECGs recorded in age-matched patients without cardiac or neurologic disorders. No potentially lethal arrhythmias were noted in the seizure patients. Patients who fit the previously-described profile of high risk of SUDEP had more abnormal ECGs and ventricular rate was faster in these patients than in other epileptics. Patients with complex partial and secondarily generalized seizures had faster ventricular rates than other epileptics. No differences were noted in QRS duration or PR interval. QT was longer in patients with complex partial seizures than in control ECGs or other epileptic patients. These findings suggest that resting ECG has low diagnostic yield in epilepsy patients without cardiac symptoms. The factors possibly predisposing to SUDEP may relatively increase resting heart rate, however, and relatively increased QT interval with complex partial seizures may indicate some differences, possibly neurally-mediated, in cardiac excitability which could contribute to SUDEP.
Seizure 1993 Mar
PMID:Electrocardiography in epilepsy patients without cardiac symptoms. 816 76

Two patients developed a disabling amnesic syndrome after seizures associated with oral theophylline treatment. Such seizures are more likely in the elderly, in the presence of pre-existing neurological disease, and when theophylline is given with certain antibiotics and cimetidine. The mechanism of neuronal injury may be by the excessive release of endogenous excitotoxic glutamate.
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PMID:Amnesic syndrome after theophylline associated seizures: iatrogenic brain injury. 820 47

A door-to-door survey was made in Kelibia, Tunisia to determine the prevalence of major neurologic disorders, including epilepsy. The survey was made according to a World Health Organization (WHO) protocol (1981). All individuals responding positively to the screening tool were examined by a neurologic team using well-defined diagnostic criteria. One hundred forty-one individuals, alive on prevalence day (July 1, 1985), were identified as having active epilepsy, giving a crude prevalence ratio of 4.04 per 1,000 and an age-adjusted (on WHO population) prevalence ratio of 3.64 per 1,000. Prevalence ratios increase with age (in children and young adults with the highest prevalence ratio at approximately 20 years) and decrease after 40 years. The most frequently identified type was generalized convulsive seizures (93%). The most frequently associated conditions were cerebral palsy and mental retardation.
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PMID:Prevalence of epilepsy in Kelibia, Tunisia. 824 52

Impairment of cellular energy metabolism plays an important role in the expression of brain injury resulting from a variety of acute neurologic disorders. The role of mitochondrial energy metabolism in excitotoxic perinatal brain injury was assessed by studying the toxicity of aminooxyacetic acid (AOAA), an inhibitor of mitochondrial malate-aspartate shunt, in postnatal (PND) 7 rats. Intrastriatal injection of AOAA produced seizures and dose-dependent excitotoxic injury. The neuronal damage was attenuated by pyridoxine suggesting involvement of pyridoxal dependent mechanisms. The lesion was selectively blocked by the NMDA antagonist MK-801 but not the AMPA antagonist GYKI-52466. Furthermore, AOAA potentiated NMDA, but not AMPA or 1S,3R-ACPD, induced brain injury. The data suggest that regional impairment of cellular energy metabolism is an important determinant of selective vulnerability to excitotoxic injury in perinatal rats. Furthermore, the role of impaired energy metabolism is particularly relevant to NMDA receptor mediated brain injury.
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PMID:Aminooxyacetic acid produces excitotoxic brain injury in neonatal rats. 825 96

We report the findings of a total population survey of Thugbah community in the Eastern Province of Saudi Arabia (SA) to determine its point prevalence of neurological diseases. During this two-phase door-to-door study, all Saudi nationals living in Thugbah were first screened by trained interviewers using a pretested questionnaire (sensitivity 98%, specificity 89%) administered at a face-to-face interview. Individuals with abnormal responses were then evaluated by a neurologist using specific guidelines and defined diagnostic criteria to document neurological disease. The questionnaire was readministered blind by a neurologist to all those with abnormal responses and a 1-in-20 random sample of those without abnormal responses, respectively. The family members of an individual with an abnormal response were also screened to improve accuracy. A total of 23,227 Saudis (98% of the eligible subjects) were screened and those residing in Thugbah on the reference date (22,630) were used to calculate the point prevalence rates. Forty-two percent of those screened were in the first decade of life and only 1.5% were more than 60 years old. There were marginally more females (50.2%) than males (49.8%). Consanguineous marriages especially between first cousins were present in 54.6%. The demographic characteristics of Thugbah community were similar to those in other parts of SA. The overall crude prevalence ratio (PR) for all forms of neurological disease was 131/1,000 population. All subsequent PRs are per 1,000 population. Headache syndromes were the most prevalent disorder (PR 20.7). The PR for all seizure disorders was 7.60, and the epilepsies (6.54) were more frequent than febrile convulsions (0.84). Mental retardation, cerebral palsy syndrome, and microcephaly were common pediatric problems with PRs of 6.27, 5.30 and 1.99, respectively. Stroke, Parkinson's disease, and Alzheimer's disease were uncommon with respective PRs of 1.8, 0.27 and 0.22. Central nervous system (CNS) malformations (0.49) such as hydrocephalus and meningomyelocele were more prevalent than spinal muscular atrophy (0.13), congenital brachial palsy (0.13) and narcolepsy (0.04). Multiple sclerosis was rare (0.04). Osteoarthritis and low back pain syndromes were the main non-neurological conditions seen. The major medical diseases that may be neurologically relevant were diabetes mellitus, hypertension, and connective tissue disorders.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:A community survey of neurological disorders in Saudi Arabia: the Thugbah study. 827 77

Audiologic assessment of infants and young children can be confounded by neurologic disorders or neuromaturational delays. In some cases, this results in an inability to assess hearing sensitivity by behavioral measures or by auditory evoked potentials. This case illustrates such an audiologic challenge. Subject DF was born with hydrocephaly, which was treated with repeated shunt surgeries and resulted in seizures and pervasive developmental delays. At 9 months of age, the child was tested by auditory brainstem response (ABR) measurement and found to have no response to sound. Believing that her child had hearing, DF's mother sought a second opinion. Results of an audiologic evaluation at 11 months of age showed no measurable behavioral responses in the sound field and an ABR abnormality that prevented prediction of hearing sensitivity. In contrast, sensitivity prediction by the acoustic reflex and results of both transient-evoked and distortion-product otoacoustic emissions predicted normal peripheral hearing sensitivity. This case illustrates the usefulness of otoacoustic emissions as an additional cross-check measure in pediatric hearing assessment.
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PMID:Otoacoustic emissions as a cross-check in pediatric hearing assessment: case report. 829 75

Epilepsy means are frequent neurologic disorders caused by abnormal electric cerebral discharges of diverse origins. While most epileptic patients experience satisfactory suppression of seizures by drug regimens, a substantial number requires a neurosurgical intervention for improvement. This is particularly the case with epilepsy originating from the temporal lobe. 35 interventions for seizure disorders are actually carried out in Zurich each year. For the whole of Switzerland this could, depending on the criteria for an indication, mean from 150 to 1500 annual intervention. In any case an accurate localization of the epileptic focus is a prerequisite. Over the past years it has been shown that such foci and their surrounding exhibit often an abnormal pattern of glucose utilisation, which can be visualized by PET. In various centers for epileptic disorders worldwide, invasive preoperative neurophysiologic investigations are no longer used in view of these results. In extrapyramidal disorders (i.e. Parkinson's disease or Huntington's chorea), disturbances of basal ganglia occur. PET studies of these areas center around measurements of glucose metabolism, synthesis of dopamine and dopaminergic receptors. Such studies provide new insight into the pathophysiology of these diseases. They provide diagnostic clues in difficult cases and permit assessment of extent and progression of degeneration. Functional PET measurements also open new avenues for clinical pharmacology.
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PMID:[Positron-emission tomography (PET) in epilepsy and extrapyramidal disorders]. 837 95

Epilepsy is the most common neurological disease of women of reproductive age. Until the mid 20-th century, its diagnosis meant no possibility of marriage and children. The advances of therapy, however, have assured that most patients can live a normal life. The major points are underscored including the interaction between epilepsy and pregnancy involving the mechanisms of congenital anomalies. The frequency of attacks during pregnancy. Pregnancy complications under epilepsy. Epilepsy and fetal malformations. Pharmacological mechanisms of teratogenicity: epoxides, free radicals, folic acid deficiency, teratogenicity of new antiepileptics and preparation with indications. Pharmacotherapy before and during pregnancy, including contraception in attack-prone patients: oral contraceptives and hormonal abortion (RU-486). Special pharmacokinetics of antiepileptics during pregnancy; dose selection and adjustment, bleeding risk and vitamin K substitution. The planning of pregnancy in epilepsy and prenatal diagnosis. Regarding indications based on existing data, it can be stated that there is a genetically higher risk of congenital malformations with primary epilepsy of parents. The risk of defect depends on the dose and quantity of medications given irrespective of the type of antiepileptics. In stabilized epilepsy, the probability of giving birth to a normal child is over 90%. The risk of congenital defects in the offspring of seizure-prone parents on genetic, and, in the case of antiepileptic therapy on medicament-toxicological grounds, is on the average 2-3 times higher. There is an elevated danger posed for the fetus by the tonic-clonic seizures of the mother through asphyxia and direct injuries by falling. The risk from an uncontrolled epilepsy is higher than the risk of malformation through antiepileptics. It is possible but statistically not proven that valproate results in an increased rate of spina bifida (1% selective risk). Prenatal diagnosis allows detection of early defects to decide on abortion or preterm birth to reduce the neurological deficit.
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PMID:[Pregnancy, contraception and epilepsy]. 841 47


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