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

Systemic lupus erythematosus (SLE) can produce profound disturbances in the central nervous system, characterized by encephalopathy, focal neurologic deficits, cerebral infarction, psychosis, and seizures. We used 31P nuclear magnetic resonance (NMR) spectroscopy to determine the in vivo levels of high-energy phosphates in the central nervous system of 10 patients with SLE and 10 age-matched normal controls. 31P NMR spectroscopy was performed on a 1.5-Tesla unit equipped with a dual-tuned 1H-31P surface coil and a software-directed DRESS (depth resolved surface coil spectroscopy) pulse sequence. This procedure detected ADP, ATP, sugar phosphates, phosphocreatine (PCr), inorganic phosphate, phosphomonoesters, and phosphodiesters in the brain tissue of all study subjects. Levels of ATP in the deep white matter of 10 SLE patients were significantly decreased compared with the levels in 10 normal controls, as quantitated by the ratio of ATP:ATP + ADP (mean +/- SD 0.81 +/- 0.11 versus 0.91 +/- 0.05; P less than 0.02). In a subgroup of 4 patients, PCr levels were decreased to a greater extent than the ATP levels. NMR spectroscopic alterations were not related to obvious anatomic lesions, as determined by standard cranial proton magnetic resonance imaging. In 4 SLE patients with markedly abnormal 31P NMR spectra, treatment with prednisone (80 mg/day) normalized the levels of ATP and PCr. Restoration of a normal 31P profile was accompanied by an obvious improvement in the patients' mental status and clinical symptoms. 31P NMR spectroscopy is a powerful new technique for monitoring high-energy phosphate metabolism, and may be particularly useful for characterizing central nervous system disease in patients with neuropsychiatric SLE.
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PMID:Depletion of high-energy phosphates in the central nervous system of patients with systemic lupus erythematosus, as determined by phosphorus-31 nuclear magnetic resonance spectroscopy. 236 38

Lycanthropy, an unusual psychiatric syndrome involving the delusion of being an animal, usually occurs as a transient symptom of severe psychosis. A review of the historical and modern medical literature, as well as of contemporary anthropological reports, suggests multiple etiologies for lycanthropy, including seizure disorders and use of psychotomimetic drugs. A clinical illustration is presented in which the delusion of being an animal in human form has persisted for over 15 years and has been refractory to treatment. The authors speculate that disturbances of self-identity may combine with neurological abnormalities to produce some cases of this syndrome.
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PMID:Lycanthropy and self-identification. 240

In this theoretical review, the value of the kindling phenomenon in enhancing our understanding of clinical disorders associated with epilepsy is evaluated. The kindling phenomenon is first described. Kindling is suggested to be a viable model of complex partial seizure (CPS) disorders with secondary generalization. Moreover, it is shown how kindling has been used as a conceptual tool which suggests novel psychiatric therapies. Finally, the value of kindling as a model of psychopathology associated with limbic epilepsy is discussed. It is concluded that studies of the effects of kindling on emotional behavior may offer a model of how limbic seizures in humans increase the vulnerability of patients to external precipitants of psychopathology, including anxiety and depression. Studies of the effects of kindling on dopaminergic function are also reviewed. This line of investigation holds promise for enhancing our understanding of hyperdopaminergic consequences of limbic epilepsy. Furthermore, these studies have created testable hypotheses that may explain the complex relationship between epilepsy and psychosis.
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PMID:Does kindling model anything clinically relevant? 240 14

In a medical emergency, when rapid diagnosis is essential, a thorough examination of the skin often provides clues to the underlying illness. Dermatologic lesions may suggest the etiology of common medical emergencies, such as coma, seizure, shock, chest pain, hemorrhage, respiratory distress, acute abdomen and acute psychosis. Since examination of the skin is rapidly and easily performed, it should be included in the evaluation of a patient with a medical emergency.
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PMID:Skin clues to medical emergencies. 240 77

Three patients with affective disorders with psychotic features were refractory to various combinations of psychotropic agents (antipsychotics, antidepressants, and lithium). Closer scrutiny revealed a seizure history in two patients and unusual neuropsychiatric features in the third patient. Subsequent substitution of carbamazepine for the antipsychotic resulted in control of the patients' psychoses. The authors describe clinical features that may identify the patient who may respond to carbamazepine. The mechanism of carbamazepine's psychotropic effects through its hypothesized ability to inhibit limbic system kindling is discussed. The case reports emphasize the need for careful neuropsychiatric assessment of patients who are refractory to conventional treatments.
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PMID:Mood disorders in the psychoneurologic borderland: three cases of responsiveness to carbamazepine. 249 64

Alterations of consciousness with impaired perception and drive persisting over hours to days can be due to a nonconvulsive status epilepticus. This possibility has to be considered not only in patients with already known epilepsy, but also in those with a negative history for seizure disorders. The immediately recorded electroencephalogram (EEG) provides decisive clues. In the case of petit mal status most frequently appear tiredness, reduced vigilance and lack of drive. The EEG shows a generalized spike-wave activity. In status psychomotoricus, the clinical symptomatology varies from case to case. It can be characterized by anxiety, dreamy states or productive-psychotic states with agitation, automatisms and hallucinations. In the EEG a temporal or temporally-accentuated epileptic activity will be recorded. Transitional and mixed forms of petit mal status and status psychomotoricus can also be found. I.v. injections of benzodiazepines (clonazepam, diazepam) are an appropriate therapy for any type of nonconvulsive status epilepticus. Phenytoin is indicated in status psychomotoricus, but contra-indicated in the case of petit mal status.
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PMID:[Epileptic impaired consciousness in adults]. 250 9

Six subjects who suffered from epileptic seizures followed by a schizophrenia-like state were examined. The mean duration between the onset of seizures and the psychotic state was 13.5 +/- 6.6 years (mean +/- S.D.). Five female subjects had episodic psychotic states and one man had a persistent one. Four subjects had localized temporal EEG abnormalities and the EEGs during psychotic states were different in each subject. During the psychotic state, no seizure was seen in the four subjects, a different seizure frequency in the episodic case and an unchanged frequency in the persistent case. The psychotic features were characterized by K. Schneider's first-rank symptoms. In order to understand the mechanisms of psychotic states, it will be useful to take into consideration the excitatory and inhibitory effects of neurotransmitters on limbic discharges.
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PMID:Clinical studies of schizophrenia-like state in epileptic patients. 251 55

The Authors submitted 53 randomly selected patients affected by systemic lupus erythematosus (SLE) to neurologic evaluation to investigate the prevalence of neurologic manifestations, establish relationships to clinical and epidemiological findings and antinuclear antibodies and/or lupus anticoagulant (LAC), as well as to assess the usefulness of electroencephalogram (EEG), saccadic eye movements (SEM) analysis, brain computerized tomography (CT). Twenty-two patients (41.5%) had nervous system involvement on anamnestic and/or clinical examination: there were seizures in 5 patients, headache in 3, involuntary movements in 3, psychosis in 2 and cerebrovascular disorders in 9. The patients were subdivided into 2 groups, with neuro-SLE and without neuro-SLE, according to clinical and/or anamnestic evidence of nervous system involvement. There were no differences between the two groups of patients regarding disease duration, disease activity, presence of antinuclear antibodies and/or LAC. EEG and/or SEM and/or brain CT abnormalities were found in 38 cases, 18 of which had no clinical evidence of neuro-SLE. Instrumental evaluation can thus document subtle nervous dysfunction and offers the possibility of classification into: a) non-neuro-SLE; b) subclinical neuro-SLE; c) overt neuro-SLE.
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PMID:[Neurological manifestations of systemic lupus erythematosus. Study of 53 cases]. 251 98

Minor episodes of aggressive behavior are relatively common in some populations of patients with epilepsy. However, they are probably no more common than in populations who are socially disadvantaged or who have brain damage. The confusion that commonly follows seizures can lead to apparently aggressive behavior. Rarely, the seizure itself may lead to directed aggression; very rarely does it lead to murderous attacks. Although post-ictal psychotic aggression is usually not severe, when it is driven by prominent delusions and hallucinations, it can result in self-destructive acts or serious violence. Clearly, however, it is quite unfair to globally classify epileptics as aggressive, and the time has come to abandon this stereotype.
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PMID:The nature and management of aggression in epilepsy. 252 Oct 95

This paper is concerned with classification, clinical-electroencephalographic correlation, principles of treatment, and pharmaceutic therapy of epileptic psychoses. Based on the system of the physically founded reversible psychoses, classification of epileptic psychoses is developed, which is easy to apply for clinical and research purposes. Its principles are the criteria of disturbance of consciousness and of connexion to epileptic seizures. Epileptic psychoses without disturbance of consciousness frequently go along with a forced normalization of epileptic EEG-changes. This clinical-electroencephalographic correlation is documented by the cases of a depressive-paranoid and a cenesthetic alternative-psychosis. Epileptic psychoses connected to seizures, going along with disturbances of consciousness, however, show, without any exception, a pathological changed EEG. Also in the cases of the often iatrogenically produced epileptic psychoses with disturbances of consciousness yet not connected to seizures, the EEG-results are of decisive diagnostic importance. Each of these three clinical-electroencephalographically defined groups of psychoses calls for concentration on particular pathogenetical aspects concerning a specific pharmaceutic therapy. The respective principles of treatment are developed in subtly differentiated ways and they are provided with suggestion as to medicamental treatment. Schizophrenia-like epileptic psychoses are a model for idiopathic schizophrenias and so important perspective opens up for research.
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PMID:[Epileptic psychoses and their drug treatment]. 256 83


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