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)

In a review of our experience with systemic lupus erythematosus (SLE) since 1975, we found 48 of 266 patients with major central nervous system (CNS) manifestations for which a non-SLE explanation could not be identified. Eleven patients developed more than one type of CNS event. The commonest symptom was seizure (18 patients), followed by brainstem dysfunction (12 patients), psychosis (11 patients), organic brain syndrome (11 patients) and stroke (7 patients). In 19% of cases, CNS manifestations were accompanied by a flare of multisystem SLE disease activity. Anticonvulsants were able to be discontinued safely in the majority of patients with seizures. Most CNS events were self-limited, reversible and not associated with poor outcome unless accompanied by multisystem disease activity. Therapy with corticosteroids did not appear to offer substantial benefit.
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PMID:The incidence and prognosis of central nervous system disease in systemic lupus erythematosus. 155 99

Brain pathology was documented in 10 patients with systemic lupus erythematosus (SLE), 7 of whom had clinical neuropsychiatric SLE prior to death. This was manifested by seizures (5 patients), organic brain syndrome (3 patients) and psychosis (2 patients). Multifocal cerebral cortical microinfarcts, associated with microvascular injury, were documented in 4 patients and in our study constituted the predominant histopathologic abnormality attributable to SLE. Changes of a healed vasculitis in medium sized leptomeningeal vessels were seen in 1 case. Agreement between the clinical and pathologic classification of neuropsychiatric SLE was observed in 7/10 (70%) cases and the strongest association was between the presence of cerebral microinfarcts and seizures (4/5 patients, p less than 0.05). No correlation was observed with anticardiolipin, anti-P, lymphocytotoxic and antineuronal antibodies.
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PMID:Brain pathology in systemic lupus erythematosus. 161 3

We studied the effect of parenteral pulse cyclophosphamide therapy in nine patients with active systemic lupus erythematosus and severe central nervous system involvement. Seven patients had focal neurological deficits and/or seizures associated with abnormalities on cerebrospinal fluid analysis and/or magnetic resonance imaging. Two patients had organic brain syndrome with psychosis and normal cerebrospinal fluid and/or magnetic resonance imaging analysis. Six patients were unresponsive to treatment with high dose corticosteroid. Cyclophosphamide, 0.75-1.0 g/m2 body surface area, was administered intravenously every month for at least 2 months. Eight patients had a complete recovery or recovered with minor residuals. Cyclophosphamide was well tolerated with few side effects. We conclude that parenteral pulse cyclophosphamide is an effective adjunctive therapy for the management of patients with active systemic lupus erythematosus and central nervous system symptoms.
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PMID:Pulse cyclophosphamide for severe neuropsychiatric lupus. 180 42

Legislation leaves a wide margin of freedom of judgement to the medical expert in the forensic assessment of a person's suitability for holding a driver's license. We have to make use of this freedom very cautiously with regard to social aspects as well as to the presently accepted state of scientific knowledge. In cases of first manifestations of epilepsy we must postulate--as a rule of thumb--a seizure-free period of two years with regular medication and clinical and electro-encephalographic checkups. The (epileptic or non-epileptic) "accidental seizure" is characterized by the releasing influence of powerful external noxious factors. In these cases, the patients should be seizure-free for at least six months before driving can be resumed. In all cases, the evaluation depends on the continuous observance of the patients, taking into account any underlying primary illness (alcoholism, cerebral vascular disease, conditions following brain surgery or trauma). The organic brain syndrome is an essential additional factor, together with the feasibility of treatment and the patient's compliance. Evaluation of the clinical picture is of foremost importance, support by EEG-findings, serum levels and psychological tests. Knowledge of cumulative factors, elimination and side-effects of anticonvulsive drugs is essential. According to the present view, medication should be continued over a period of many years. Curative medicine and medical assessment are not mutually exclusive, but require a distinct differentiation in every single case.
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PMID:[Seizures and driver's licence]. 192 83

An 18-year-old woman with systemic lupus erythematosus developed neuropsychiatric disorders, including aseptic meningoencephalitis, organic brain syndrome and seizure. A series of computed axial tomography scans revealed the progression of marked atrophy of the right cerebral hemisphere for a period of 3 years without occlusion or stenosis of large vessels on cerebral angiography. I-123 IMP single photon emission computed tomography disclosed a markedly decreased uptake of I-123 IMP in the right cerebral hemisphere, and also in the left cerebellar hemisphere (crossed cerebellar diaschisis), which disappeared within 2 years.
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PMID:Cerebral hemiatrophy in systemic lupus erythematosus: report of a case. 227 27

Magnetic resonance (MR) imaging and computed tomography (CT) are useful for the evaluation of central nervous system (CNS) lupus. This report describes the use of cranial MR and CT in 21 patients with systemic lupus erythematosus (SLE) with acute neuropsychiatric symptoms manifested by headache, seizures, focal neurological deficits, psychosis, or organic brain syndrome. Computed tomography was found to be insensitive and detected only diffuse atrophy (two cases), cerebral infarct (one case), and intracerebral haemorrhage (one case) in the 21 patients. Cranial MR images obtained with a General Electric 1.5 tesla Signa unit detected labile and fixed areas of increased proton intensity interpreted as focal oedema (eight cases), infarct (10 cases), haemorrhage (one), atrophy (seven), and acute sinusitis (two). Focal oedema was characterised by labile, high intensity lesions in the gray or white matter of the cerebellum, cerebrum, or brain stem, which completely resolved after aggressive corticosteroid treatment. Most high intensity reversible or fixed lesions evident on MR were not apparent on cranial CT images. In several patients sequential MR images were valuable in monitoring the efforts of treatment. Although histological confirmation of the high intensity brain lesions apparent on MR is desirable, prior necropsy studies suggest that pathological confirmation may be difficult owing to the paucity of recognisable brain lesions in patients with CNS lupus. It is concluded that for the evaluation of acute neuropsychiatric SLE MR is useful and provides more information than cranial CT.
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PMID:Magnetic resonance and computed tomographic imaging in the evaluation of acute neuropsychiatric disease in systemic lupus erythematosus. 261 53

The images of cranial computed tomographies on 7.921 patients aging between 50 and 98 years were analyzed retrospectively concerning the occurrence of WMLA. 3.344 patients were suffering from psychogeriatric disorders (organic brain syndrome, dementia, depressive or delusional psychoses). Neurological diagnoses (stroke, TIA, Parkinson's disease, Huntington's disease, space occupying lesions, seizures, cerebral trauma, vertigo, chronic headache) occurred in 4.577 patients. WMLA was established in 761 cases. The combination of WMLA with cerebral atrophies, with single or multiple infarcts and with both infarcts and atrophy will be demonstrated within 4 groups: 1. organic brain syndrome and dementia, 2. depression and delusional states, 3. stroke and TIA, 4. other neurological diagnoses. In group one the combination of WMLA with atrophy and infarcts is the most common finding in CT. In group two WMLA without atrophies and infarcts are the main tissue changes in CT. Group three is marked mainly by the occurrence of recent infarcts together with WMLA. In group four again WMLA only, in some cases together with multiple infarcts, do occur mainly. Compared to the cases without WMLA in each group WMLA is seen in cases with organic brain syndromes and dementias three to five times more than in the other diagnostic groups. WMLA in computed tomography seems to be a common finding in patients and healthy individuals of old age. Therefore the diagnostic and differential diagnostic significance for brain diseases in old age is limited. Nevertheless in the field of psychogeriatric disorders it may be possess a certain value to understand the nature of such diseases. This value will be discussed and demonstrated considering the pathogenesis of WMLA on the basis of neuropathological results.
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PMID:[Periventricular attenuation of the density of cerebral hemisphere white matter in computerized tomography of neuropsychiatric patients in the 2d half of life. Diagnostic significance and pathogenesis]. 322 Apr 19

Fifty patients were examined clinically and neurologically for seven days after pneumoencephalography. Headache was present in 78%, neck stiffness in 34%, pyrexia in 38%, vomiting in 34%, tachycardia in 74%, a change in the level of consciousness in 18%, and abnormal neurological signs in 30%. Of the 13 patients with epilepsy, there was an increased frequency of seizures in four, associated with increased EEG epileptiform activity in three. EEG abnormality either appeared or increased in 74% of cases on the second day after the air study. A mechanism for the production of these sequelae is proposed. It is concluded that these findings indicate that in most cases an organic brain syndrome follows pneumoencephalography.
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PMID:Sequelae to pneumoencephalography. 469 87

The records of 37 patients with systemic lupus erythematosus (SLE) followed at The Children's Hospital of Philadelphia between 1968 and 1978 were reviewed for evidence of central nervous system (CNS) involvement. Criteria for CNS involvement included evidence of organic brain syndrome, electroencephalographic abnormalities with symptoms referable to CNS, or objective neurologic signs. Sixteen of 37 children had CNS involvement (43%). Thirteen patients had CNS involvement at the onset of SLE. Three patients had late onset CNS manifestations 1 to 2 years after the diagnosis of SLE. The most frequently observed symptoms were headache, behavior disorder, lethargy, diplopia, blurred vision, memory alteration, dizziness, and alteration of consciousness. The most frequently observed neurologic signs were seizures, cranial nerve palsy, ataxia, papilledema, nystagmus, meningitis, tremor, rigidity, cortical blindness, and coma. Neuropsychiatric manifestations included organic brain syndrome, functional psychosis, and personality disorder. Laboratory tests showed elevated cerebrospinal fluid opening pressure and protein, negative cultures, and abnormal electroencephalograms and computerized axial tomography scans. Fourteen of 16 children with CNS manifestations are alive. Thirteen had a mean IQ of 89 by the Wechsler Intelligence Tests. Twelve are in educational programs. One required long-term psychiatric care. A residual neurologic abnormality, a seizure disorder, was present in 3. CNS involvement with SLE in children carries a favorable prognosis.
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PMID:Central nervous system involvement in childhood systemic lupus erythematosus. 731 16

The validity of the hypothesis that some of the neuropsychiatric manifestations of systemic lupus erythematosus (SLE) are mediated by the direct effects of antibody binding to neuronal cell membranes is dependent on the demonstration of antineuronal activity within the central nervous system of patients with active central nervous system disease. Using a radiolabelled staphylococcal protein A assay, we tested cerebrospinal fluid from 27 patients with SLE and central nervous system manifestations, and cerebrospinal fluid from 18 additional patients with SLE but free of central nervous system disease for antibody reactive with the cultured human neuronal cell line SK-N-SH. Cerebrospinal fluid from 20 of 27 patients with active lupus central nervous system disease had increased immunoglobulin G (IgG) antineuronal activity compared with cerebrospinal fluid from two of 18 patients with SLE without central nervous system disease. Ninety percent of the patients with psychosis, organic brain syndrome or generalized seizures had increased IgG antineuronal activity as compared with only 25 percent of the patients who presented with hemiparesis or with chorea/hemiballismus. Antineuronal activity per microgram of IgG was concentrated eightfold in the cerebrospinal fluid of patients with active central nervous system disease as compared with the serum activity. Patients with or without active central nervous system disease did not differ significantly in the amount of serum antineuronal binding activity. The results are consistent with the hypothesis that the more diffuse central nervous system manifestations of SLE are a direct result of the interaction of antibody with neuronal cell membranes.
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PMID:Cerebrospinal fluid antibodies to neuronal cells: association with neuropsychiatric manifestations of systemic lupus erythematosus. 746 11


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