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

We describe the clinical presentation, pulmonary function tests, chest radiograph, and computed tomography findings, response to hormonal treatment, and duration of survival of nine patients with pulmonary involvement in tuberous sclerosis complex with follow-up over an average of 17 years (range, 1 to 35 years) since diagnosis. All patients were female, and the average age at onset of symptoms was 16 years (range, 3 months to 39 years); pulmonary symptoms did not develop until an average age of 33 years (range, 22 to 46 years). There was an average delay of 8 years before the correct diagnosis was made. The most common presenting clinical features were seizures, pneumothorax, bleeding into a renal angiomyolipoma, dyspnea, and typical skin changes. Pulmonary function tests commonly demonstrated obstruction to airflow and reduced single-breath diffusing capacity. Chest radiograph and computed tomography characteristically demonstrated diffuse interstitial infiltrates with cystic changes. Two asymptomatic patients with mild pulmonary involvement have remained in stable condition without hormonal therapy. The remaining seven patients had moderate to severe airflow obstruction; of these, five underwent hormonal therapy. Three patients had a clinical response to treatment. Two patients who did not receive hormonal treatment died of progressive respiratory failure. Most patients with pulmonary involvement in tuberous sclerosis have a slowly declining clinical course. Although the available data are limited, they suggest that a trial of hormonal therapy is recommended both for symptomatic patients and for those with declining pulmonary function. Tuberous sclerosis complex should be suspected in all patients with the diagnosis of lymphangioleiomyomatosis.
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PMID:Pulmonary tuberous sclerosis. 781 75

A retrospective investigation was performed to determine whether patients undergoing transurethral surgery soon after cardiac surgery experienced increased morbidity or mortality rates. From 1986 to 1990, 24 patients first underwent open heart surgery and then either transurethral prostatectomy, bladder tumor resection or bladder cup biopsy during the same hospital stay. Postoperative complications included significant hematuria in 2 patients (8%), mild stress incontinence in 1 (4%) and bladder perforation in 1. One patient died of a spontaneous pneumothorax 17 days after the urological operation. None of these patients had had a previous myocardial infarction. The outcome of these patients was compared to that of 115 men who underwent transurethral prostatectomy for presumed benign disease during 1990. Complications of transurethral prostatectomy in this group included significant gross hematuria in 5 men, while 6 experienced urinary retention (1), atrial fibrillation (1), delirium (1), myocardial infarction (1), seizure (1) and intraoperative urethral injury (1). There was 1 death from multiple postoperative complications. Morbidity and mortality rates did not differ significantly between the 2 groups. Transurethral surgery performed after cardiac surgery during the same hospital stay appears to be safe, provided the patient is stable.
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PMID:Safety of transurethral surgery in the early postoperative period following an open cardiac procedure. 812 22

The objective of the study was to evaluate neonatal survival and subsequent disabilities in infants with extremely low gestational age in relation to perinatal events and neonatal treatment. A retrospective follow-up study was performed based on medical records, questionnaires to parents and recordings of contact with health authorities. All infants with a gestational age 28 completed weeks or less, who were admitted to the Department of Neonatology, Rigshospitalet, within 24 hours of age during the period January 1, 1987 - December 31, 1990 were included. During this period the basic therapeutic approach was a combination of minimal handling and early nasal-continuous positive airway pressure (CPAP) ("minitouch"). Main outcome measures were: mortality, healthy survival and disabled survival. Variables related to outcome were: risk factors present at birth (gestational age, birth weight, gender, place of birth (Rigshospitalet/other hospital), mode of delivery, Apgar score at five minutes; interventions in the neonatal period (intermittent positive pressure ventilation and treatment of hypotension); complications in the neonatal period (intracranial haemorrhage grade II-IV, periventricular leucomalacia, pneumothorax, seizures and septicaemia). One hundred and ninety-seven infants without major malformations were included. The mortality rate was 29%. Among infants with gestational age 24-25 weeks 49% died versus 24% of infants born after 26-28 weeks (p = 0.004). Mean gestational age was 26.7 weeks (range 24-28) and mean birth weight 994 g (range 525-1630). Fifty-five infants (28%) were small-for-gestational age. One hundred and fifty-five infants (79%) were born in our hospital and 115 (58%) were delivered by caesarean section. A total of 140 infants (71%) survived until discharge and none died between discharge and follow-up. At follow-up at a mean uncorrected age of 48 months information was obtained about all infants, except two (1%) who had emigrated; 75 (54%) had no impairments, 31 (22%) had minor impairments, 17 (12%) were moderately disabled, and 15 (11%) were severely disabled. Of the 197 infants 121 (61%) were treated with intermittent positive pressure ventilation, 83 (42%) with dopamine for hypotension, and 92 (47%) received parenteral nutrition. In 64 infants (33%) the course was complicated with intracranial haemorrhage (ICH) grade II-IV, in 17 (9%) with seizures, in 23 (12%) with pneumothorax, in 21 (11%) with septicaemia, and in 10 (5%) with necrotizing enterocolitis. Sixty infants (31%) needed medical or surgical closure of a persistent ductus arteriosus. In 11 infants (6%) cystic periventricular leucomalacia occurred, 10 infants (5%) developed retinopathy of prematurity stage 3-4, and 35 infants (24%) received supplementary oxygen at 28 days of age. Risk factors present at birth for adverse outcome were: Apgar score <7 at five minutes, birth weight <1000 g, male sex and birth in another hospital than Rigshospitalet, For adverse outcome in surviving infants only, ICH grade II-IV was the only significant risk factor.
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PMID:Infants with gestational age 28 weeks or less. 890 83

Secondary pneumothorax occurs as a symptom of an underlying pulmonary disease. We report the case of an 18-year-old woman with tuberous sclerosis (Bourneville's disease) and recurrent pneumothoraces. Clinical outcome was favorable 6 months after bilateral videothoracoscopic pleurectomy. The complete triad of tuberous sclerosis (TS) (mental retardation, seizures, adenoma sebacium) is not always present in those who develop pulmonary involvement. When TS involves the lung it is clinically and pathologically indistinguishable from lymphangioleiomyomatosis (LAM). The very rare pulmonary involvement of TS and LAM are problems primarily of women in childbearing age. A pneumothorax can be the first symptom of TS or LAM.
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PMID:[Secondary spontaneous pneumothorax in tuberous sclerosis]. 1182 39

The electrocardiogram (ECG) is of critical importance in the diagnosis of acute myocardial infarction. Clinical conditions such as acute pericarditis, esophageal rupture, pancreatitis, subarachnoid hemorrhage, perforated duodenal ulcer, pneumothorax and status following elective DC cardioversion result in ECG changes that include ST elevation and T wave inversion. This report aims to increase the awareness of non-cardiac syndromes, with ECG abnormalities mimicking acute myocardial infarction, and thus to avoid unjustified thrombolytic therapy. We describe the case of a patient after epileptic seizures and pathological EEG pattern. The ECG showed repolarization abnormalities suggestive of evolving acute myocardial infarction. The cardiac enzymes (except normal Troponin I) were severely elevated and coronary angiography was normal.
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PMID:[The clinical significance of postictal electrocardiographic changes mimicking acute myocardial infarction]. 1264 80

We describe a prospective two year study aimed at assessing information collected throughout a geographically defined region as a basis for clinical governance, quality improvement and service planning in neonatal intensive and special care. All 13 Northern Ireland units returned a range of socio-demographic, obstetric and neonatal data for all admissions or readmissions within 28 days of life. 8.2% of all live births required neonatal intensive or special care, with a requirement of 374 and 645 days per 1,000 births for intensive and special care respectively. In total there were 4,205 episodes of care provided for 3,946 infants (18,072 days of intensive and 31,141 days of special care). Complications arising during intensive care episodes included the following: septicaemia/bacteraemia (7.6%), necrotising enterocolitis (2.8%), pneumothorax (4.6%), patent ductus arteriosus (6.5%) and seizures (6.9%). Opportunities for quality improvement exist in a number of areas with potential for further reduction in morbidity. Comparisons with published criteria demonstrate the value of this type of information for local, regional and national quality improvement initiatives and service planning.
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PMID:Making information available for quality improvement and service planning in neonatal care. 1292 57

Pulmonary disease is a rare manifestation of Tuberous Sclerosis. We report a case where the patient presented with seizures, shortness of breath, popular lesions on the face and warty growths over the skin. She was intubated and the lung expanded on the 7th day after a longstanding pneumothorax of 3 months.
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PMID:Tuberous sclerosis--rare presentation as pneumothorax. 1506 37

The developing brain has an increased susceptibility to seizure activity, and neonatal seizures can adversely affect neurodevelopmental outcome. This study aimed to determine the incidence of neonatal seizures in very low birthweight infants and to identify perinatal and postnatal factors associated with the occurrence of clinical seizures. A population-based cohort of 6525 very low birthweight infants born from 1995 through 1999 comprised the study group. Maternal, perinatal, or postnatal variables that showed a significant association with neonatal seizures in a univariate analysis were tested by a multiple logistic regression to assess the independent effect of each variable on the risk of seizures. The overall incidence of seizures was 5.6%. Significant independent predictors of neonatal seizures were decreasing gestational age, male gender, respiratory distress syndrome, pulmonary air leak (pneumothorax and pulmonary interstitial emphysema), intraventricular hemorrhage, periventricular leukomalacia, patent ductus arteriosus, surgical ligation of patent ductus arteriosus, necrotizing enterocolitis, and surgical treatment of necrotizing enterocolitis. Neonatal seizures appear to be associated with major morbidities and surgical interventions in very low birthweight infants. Continuous electroencephalographic monitoring could be warranted in infants following surgical treatment.
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PMID:Risk factors for neonatal seizures in very low birthweight infants: population-based survey. 1507 5

Acute respiratory failure is a common complication of drug abuse. It is more likely to develop in the setting of chronic lung disease or debility in those with limited respiratory reserve. Drugs may acutely precipitate respiratory failure by compromising respiratory pump function and/or by causing pulmonary pathology. Polysubstance overdoses are common, and clinicians should anticipate complications related to multiple drugs. Impairment of respiratory pump function may develop from central nervous system (CNS) depression (suppression of the medulla oblongata, stroke or seizures) or respiratory muscle fatigue (increased respiratory workload, metabolic acidosis). Drug-related respiratory pathology may result from parenchymal (aspiration-related events, pulmonary edema, hemorrhage, pneumothorax, infectious and non-infectious pneumonitides), airway (bronchospasm and hemorrhage), or pulmonary vascular insults (endovascular infections, hemorrhage, and vasoconstrictive events). Alcohol, cocaine, amphetamines, opiates, and benzodiazepines are the most commonly abused drugs that may induce events leading to acute respiratory failure. While decontamination and aggressive supportive measures are indicated, specific therapies to correct seizures, metabolic acidosis, pneumothorax, infections, bronchospasm, and agitation should be considered. Drug-related respiratory failure when due to CNS depression alone may portend well, but in patients with drug-related significant pulmonary pathology, a protracted course of illness may be anticipated.
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PMID:Acute respiratory failure from abused substances. 1529 19

Pertussis in adolescents and adults is common, endemic, and epidemic worldwide, and its incidence is reportedly increasing. Although a number of individuals suffer only a mild cough, many others have symptoms typical of pertussis, causing prolonged cough illness, frequent use of health care resources, missed work and a variety of complications. Symptoms experienced by adolescents and adults include sleep disturbance, weight loss, pharyngeal discomfort, influenza-like symptoms, sneezing attacks, hoarseness, sinus pain, headaches and sweating attacks. Even when symptoms are typical of pertussis, the diagnosis is often not considered in adolescents and adults because of a low awareness of the disease in these age groups. Contrary to common perceptions, complications of pertussis, including some that are serious, are not infrequent in adolescents and adults. These include urinary incontinence, rib fracture, pneumothorax, inguinal hernia, aspiration, pneumonia, seizures and otitis media. Despite underreporting, hospitalization of adults and adolescents does occur. Many believe that adolescents and adults are the groups most commonly infected with pertussis and are now the major source of contagion to infants and young children. Because of the considerable health burden, there is a need for improved vaccination strategies to prevent disease in adolescents and adults and to reduce the risk of transmission to vulnerable infants.
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PMID:Health burden of pertussis in adolescents and adults. 1587 23


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