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

The possibility that epileptic seizures and classic migraine episodes may occur in the same patient is discussed. The probable relationship between the neurophysiological mechanisms which underlie both types of attacks has not yet been agreed upon. The case of a young man who suffered from classic migraine and who presented two convulsive epileptic attacks, preceded by visual aura is described. The EEG showed an epileptogenic occipito-temporal focus which corresponded to the region of the scotoma origin. A possible connection between scotoma in migraine and epileptic discharge is discussed. It is proposed that spreading depression, as the basis of the migraine prodomata, was preceded by a moment of intense neuronal excitation which changed the epileptic intercritical activity into a critical one.
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PMID:Possible interference between migrainous and epileptic mechanisms in intercalated attacks. Case report. 45 90

A survey is presented of the ophthalmological findings in 74 patients with drug-resistant temporal lobe epilepsy, who underwent unilateral anterior temporal lobectomy 1960-1969 at Rigshospitalet, Copenhagen. At follow-up, 1970-1971, one to ten years following the operation, 81% of the patients had no or only few seizures. Preoperatively 11% of the patients suffered from strabismus as compared to an expected frequency of 5%, but this trend just falls short of statistical significance. The visual acuity remained unchanged in all patients following the operation. Preoperatively a visual field defect was observed in 2 patients. At follow-up 51 patients had homonymous hemianopias, in 38 of them this was limited to the upper quadrants, and in 13 patients also included the lower quandrants, but was characterized as a total homonymous hemianopia in only 6 patients. The presence and extent of the visual field defects were correlated to surgical results, age at onset of epilepsy, age at operation, preoperative duration of epilepsy, presence of grand mal, preoperative complications, and neuropathological findings, but without observing any statistically significant conclusions. On the other hand, the extent of the postoperative visual field defect was significantly influenced by the side of the operation, with more and larger defects following right-sided lobectomies. In the 51 patients with postoperative hemianopias, this defect was either unobserved by the patient or regarded as a considerably less important handicap than the frequent and socially invalidating preoperative seizures...
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PMID:Temporal lobe epilepsy and neuro-ophthalmology. Ophthalmological findings in 74 temporal lobe resected patients. 99 32

Cortical blindness is rarely an ictal manifestation. We report the case of a man who developed transient cortical blindness followed by permanent visual deficits during repeated partial seizures. Intermittent visual impairment began at age 14 years. After he had the first generalized seizure at age 28 years, neurologic, ophthalmologic, angiographic, and brain computed tomographic (CT) examinations were normal. Several EEGs showed almost continuous biposterior spike-waves. Over the next several years, frequent partial seizures were associated with transient visual loss and left body twitching or paresthesias. When he was 32, transient blindness occurred during several days of repeated occipital seizures. Permanent left homonymous hemianopia, right homonymous central scotoma, dyschromatopsia, and altered stereopsis followed these seizures. Brain CT demonstrated a new right occipital lesion. Partial seizures arising posteriorly may cause transient cortical blindness and result in permanent visual deficits.
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PMID:Ictal cortical blindness with permanent visual loss. 249 21

In a retrospective study the clinical data of ten consecutive patients with a cavernous angioma (cavernoma) confined to the supratentorial compartment are presented. The lesions were almost equally distributed among the cerebral cortex with three cavernomas each in the parietal and temporal region and two lesions each being located in the frontal and occipital lobes. The predominant clinical symptoms were either focal or generalized seizures which occurred in 8 patients. One patient became symptomatic due to an intracerebral bleeding from the cavernous angioma, one patient developed a visual field defect from an occipitally localized cavernoma. In 7 patients the neurological status on admission was normal, two patients had signs of a slowly progressing psychosyndroma, one patient had a homonymous hemianopia. The time interval from onset of symptoms to final diagnosis showed a considerable variability ranging from one months to 33 years. Only in half of the patients this interval was less than 6 months. CT-scan was the most important radiological procedure for the diagnosis of these malformations, while MRI may be even more sensible in detecting these lesions in the future. The treatment of choice for these tumorous vascular malformations is microneurosurgical extirpation. This can be accomplished with neglectible morbidity leading to a significant decrease of the preoperative incidence and severity of epileptic seizures.
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PMID:Cavernous angiomas of the supratentorial compartment. 251 90

Two patients with occipital lobe arteriovenous malformation (AVM) underwent two-stage resection of their lesions. The intervals between operations were eight and 12 days. Prior to surgery, the patients had normal neuro-ophthalmologic examination results and both experienced a reversible homonymous hemianopsia after the initial, partial resection of the AVM. Frequent seizures with visual hallucinations developed in the early postoperative period, with gradual improvement of the visual field defect. The pattern and duration of visual disturbances and the nature of the visual field defects in each patient had similar characteristics. The second operation with complete resection of the AVMs left normal visual fields.
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PMID:Removal of occipital arteriovenous malformations with sparing of visual fields. 722 19

Occasionally patients in the stroke age-bracket over 40 have unexplained transient cerebral ischemic attacks in association with normal cerebral angiograms. From this group 120 have been collected in whom the transient episodes resembled the neurological accompaniments of migraine. According to symptoms, the patients were categorized as follows: Visual accompaniments (patients with only ordinary scintillating scotoma were excluded), 25; visual and paresthesias, 18; visual and speech disturbance, 7; visual, and brain stem symptoms, 14; visual, paresthesias, and speech disturbance, 7; visual, paresthesias, speech disturbance and paresis, 25; recurrence of old stroke deficit, 9; miscellaneous, 8. In establishing the diagnosis angiography is advisable in all but classical cases. Typical of migrainous accompaniments are the buildup and migration of visual scintillations, the march of paresthesiae, and progression from one accompaniment to another, characteristics that do not occur in thrombosis and embolism. Diagnosis facilitated when 2 or more similar episodes have occurred or migraine-like scintillations are present. Headache occurred in 50% of cases. Other cerebrovascular processes, coagulation disorders, and cerebral seizures must be ruled out.
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PMID:Late-life migraine accompaniments as a cause of unexplained transient ischemic attacks. 738 4

In 8 patients in whom it was uncertain whether they had occipital or temporal lobe (TL) epilepsy, clinical, scalp EEG, and radiologic features were correlated with the sites of seizure onset as determined by depth EEG. The 8 patients were selected from > 40 with occipital epilepsy because they had (a) an aura considered to be of occipital lobe (OL) origin, (b) an occipital interictal epileptic focus, (c) an OL lesion, or (d) a combination of all of these. Scalp EEG and clinical patterns suggested temporal involvement in all, however. Extracranial EEG recordings were often misleading, showing multilobar interictal epileptic abnormalities, and seizure onset was of poor localizing value and did not clarify the problem sufficiently. Intracranial EEG recordings showed that seizure onset could be ordered along an occipitotemporal gradient. Consistent OL seizure onset was observed in patients who had only elementary visual auras. Those who had inconsistent aura or no aura, suggesting OL origin, had onset of most attacks in the TL. All patients had a seizure spread pattern suggesting early TL involvement. To prevent visual field defect, surgical approaches included temporal resection when temporal seizure origin or spread was demonstrated; although occasionally this produced excellent results, it was of limited benefit in most patients, even when some seizures were proven to originate in TL structures. In patients with malignant epilepsy and in those with an occipital lesion, occipital resection should be considered.
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PMID:Occipitotemporal epilepsies: evaluation of selected patients requiring depth electrodes studies and rationale for surgical approaches. 842 68

The clinical, electroencephalographic and Imaging diagnostic features of the 45 patients of Localization-related Epilepsy who had elementary visual symptoms at seizure onset were investigated. There were 24 males and 21 females aged 19 to 78. Their ages at seizure onset ranged from 1 to 55 with a mean of 15.4. The patients were divided into 3 groups based on the pattern of elementary visual symptoms: Group 1; 23 patients (51%) with only elementary positive visual symptoms, Group 2; 9 patients (20%) with only elementary negative visual symptoms, Group 3; 13 patients (29%) with others. It came to our notice that 8 (18%) patients in Group 3 had positive + negative (P*N) visual seizures such as scintillation scotoma. It was quite difficult to draw a distinction between the P*N seizures and scintillation scotoma in migrainous patients in quality. Therefore, a question arises whether similarities between them are ascribed to the same underlying mechanism. It is possible that the mechanism of the P*N seizures is different from that of the scintillation scotoma, but the both produce the same condition. However, we are not competent to discuss this hypothesis. Further work along this line is necessary. In addition to the elementary visual symptoms, autonomic (69%), focal motor (29%), illusion (29%), vertiginous (22%) manifestations, etc. were also observed. These manifestations suggest that epileptic ictal discharges spread into many different brain areas. Regarding Group 1-3, occurrence of illusional seizures was more common in Group 2. In this group, in only one patient, occipital interictal discharges were observed. The subjects were subclassified into two groups depending on whether the seizures were well controlled (good outcome) or poorly controlled (poor outcome group). On these groups, comparative studies were performed. The poportion of the patients with a family history of convulsive disorder was higher in the latter than that in the former. To the contrary, the poportion of the patients with a etiologic episode was higher in the former than that in the latter. With respect to the imaging study, regardless of localizations, abnormal findings were detected in 25% on CT scan, in 29% on MRI, and in 71% on SPECT. Whether or not these abnormal findings completely or partially agreed with presumed epileptogenic brain region (occipital lobes) was investigated. CT scan was positive (correspondent) in 8%, MRI was positive in 13%, and SPECT was positive in 54%. The incidence of SPECT abnormalities was higher in the poor outcome group (70 %) than that in the good outcome one (43%). We may, therefore, conclude that SPECT seems to be useful for the detection of epileptogenic region, especially in intractable cases. But the incidence of these imaging studies' abnormalities located in occipital lobe was not so high, therefore, there seems to be no doubt that clinical symptoms and EEG findings are most important for diagnosis.
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PMID:[Clinical examination on localization-related epilepsies with elementary visual seizures--clinical, electroencephalographic and imaging diagnostic studies]. 939 83

We report the case of a 58-year-old woman with depression and hypertension in whom aphasia, right-sided hemiparesis, and a possible right visual field defect were identified during recovery from right unilateral electroconvulsive therapy (ECT). The neurologic deficits resolved over a 3-day period; the patient was diagnosed with a reversible ischemic neurologic deficit (RIND). Review of the patient literature suggests that such cerebrovascular events in the setting of ECT are extremely rare and possibly decreasing in frequency. Reasons for such a decrease may include improved screening for predisposing cardiovascular conditions and the widespread use of neuromuscular blockade, ventilatory support, and cardiovascular monitoring during the procedure. Prompt recognition of cerebrovascular events is important to prevent complications such as cerebral edema, seizures, and aspiration, as well as to use new treatments for stroke.
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PMID:Reversible ischemic neurologic deficit after ECT. 966 Oct 93

A 31-year-old female presented with cavernous angioma originating from the optic chiasm manifesting as sudden onset of right retroorbital pain and right visual disturbance. She had a psychomotor seizure 10 years ago. Cavernous angioma at the right basal ganglia had been partially removed at that time. After the operation, the patient had left hemiparesis, but gradually improved. Neurological examination revealed decreased right visual acuity, left homonymous hemianopsia, and left hemiparesis. Magnetic resonance imaging revealed a mixed signal intensity mass at the right optic nerve to the optic chiasm with a low signal intensity rim on T2-weighted imaging, situated at the right basal ganglia where the cavernous angioma had been partially resected. Right frontotemporal craniotomy was performed by the pterional approach. A subpial hematoma was situated at the right optic nerve to the optic chiasm. The hematoma with an angiomatous component was completely resected from the surrounding structure. Histological examination of the specimens confirmed cavernous angioma. Postoperatively, her right visual acuity was slightly improved, but the visual field defect was unchanged. We emphasize the importance of correct diagnosis by magnetic resonance imaging and subsequent resection for preserving and improving the visual function of patients with cavernous angiomas of the optic chiasm.
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PMID:Cavernous angioma of the optic chiasm--case report. 1048 42


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