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

The case of a child under continuous anticonvulsant medication, especially barbiturate, since the age of 8 months for atypical seizures is reported. Medication was withdrawn when the child was 7.7 years old. The child was then under care in a Day Hospital with an autistic-like syndrome associated with important disturbances of sleep-waking regulation, complete learning incapability and major EEG abnormalities. The EEG paroxysmal discharges observed in the waking and all-night sleep records gradually decreased and then disappeared as the withdrawal was pursued over a period of several months. During the same period, the child's behaviour markedly improved and his sleep disturbances disappeared. The possibility of iatrogenic effects of early and continuous anti-convulsant therapies is discussed, even though the drug plasma levels remain within ranges generally considered as non-toxic.
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PMID:[Results of long-lasting drug intake on child development; clinical and electrophysiological study during drug withdrawal]. 8 63

The frequency of epileptiform discharges shows a wide intraindividual variability; it is influenced by the sleep-waking cycle and by the different stages of sleep: generalized seizures (tonic-clonic, tonic and myoclonic) are activated in nonrapid eye movement sleep, partial seizures tend to have more complex relationships with sleep states. Generally, sleep stages I and II and transit stages have an activating effect on discharges. Rapid eye movement sleep has an "anticonvulsive" effect and focalizes paroxysmal activity. Sleep recordings are useful for localizing a focus in temporal lobe seizures and for differentiation of epileptic seizures from non-epileptic seizure-like sleep disturbances. EEG after sleep deprivation should be used in patients suspected of suffering from epilepsy whose prior EEGs (including hyperventilation, photic stimulation and short sleep) were normal or yielded borderline abnormalities. Epileptiform discharges can--without clinical seizures--produce arousal reactions and sleep disturbances.
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PMID:[Sleep and epilepsy]. 190 55

Paradoxical or "forced" normalization of the EEG of patients with epilepsy was first described by Landolt in 1953. It refers to conditions where disappearance of epileptiform discharge from the routine scalp EEG is accompanied by some kind of behavioral disorder. The best known of these is a paranoid psychotic state in clear consciousness, which is also known as "alternative" psychosis. Thus, the issue is related to much older observations which indicated a "biological antagonism" between productive psychotic symptomatology and epileptic seizures, which led to the therapy of psychoses with artificially induced convulsions. Apart from psychotic episodes, the clinical manifestations of PN comprise dysphoric states, hysterical and hypochondriacal syndromes, affective disorders, and miscellanea. PN can be observed in both generalized and localization-related epilepsies as a rare complication. A subset where it is more frequently seen are in adults with persistent absence seizures when the latter become finally controlled by succinimide therapy. These seem to be the drugs with the highest hazard of precipitation of PN, but all other AEDs have also been suspected. Sleep disturbance by succinimide treatment may play a crucial role, but a variety of other factors are also involved, including psychosocial factors. The pathogenesis of this condition has given rise to some debate but remains still unresolved. Eleven of the most important hypotheses have been discussed and seem to converge into a more comprehensive hypothesis which basically assumes that, during PN, the epilepsy is still active subcortically, perhaps with spread of discharge along unusual pathways. This activity is supposed to provide energy and, possibly, some of the symptoms included in the psychotic syndrome. A critical clinical condition results, usually with a dysphoric symptomatology, where a development towards psychosis is impending but still depends on the presence or absence of a variety of risk factors. Along with neurophysiological factors such as powerful inhibition of the spread of epileptic discharge, these may also include biographic factors such as the repeated experience of ictal sudden, unexpected loss of consciousness. Because during PN there presumably is ongoing epileptic activity, the differences with respect to other psychotic conditions in epilepsy are probably subtle rather than fundamental. Thus, it could be that ictal psychosis is characterized by a direct expression of epileptic activity, whereas in postictal psychosis a momentum of exhaustion may be added; moreover, in PN the prevailing pathogenic factor could be an abnormally high level of balance between excitatory and inhibitory processes.
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PMID:Acute behavioral symptomatology at disappearance of epileptiform EEG abnormality. Paradoxical or "forced" normalization. 200 2

Designer drugs, chemically altered compounds derived from federally controlled substances, have become a major cause of addiction and overdose deaths. These drugs include mescaline analogs, synthetic opioids, arylhexylamines, methaqualone derivatives and crack, a new form of cocaine. Sudden changes in mood, weight loss, depression, disturbed sleep patterns, deteriorating school or work performance, marital problems, and loss of interest in friends and social activities may be signs of drug addiction. Life-threatening complications of acute intoxication, such as hyperthermia, seizures, combative and psychotic behavior, and cardiorespiratory collapse, require prompt diagnosis and supportive intervention.
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PMID:Substance abuse: the designer drugs. 202 Nov 4

After a short historical review, the Author describes some relevant new acquisitions supplied by the Electroencephalography in the latest years. In particular, some of the most typical EEG patterns observed in inflammatory and degenerative diseases, in seizure disorders and in sleep disturbances are reviewed. The Author underlines the importance of the EEG as a tool of diagnosis and functional investigation of CNS and the specific fields in which EEG may be supported by the more recent computer-assisted techniques.
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PMID:Conventional electroencephalography as a diagnostic tool: possibilities and limits. 208 22

Clonazepam (1 mg h.s.) and temazepam (30 mg h.s.) were studied in 10 patients diagnosed as having insomnia with nocturnal myoclonus. Each subject underwent two nocturnal polysomnographic recordings while drug-free, two during treatment with clonazepam, and two during treatment with temazepam. Treatment sessions were 7 days long, and recordings were done on nights 6 and 7 of the treatment sessions. A 14-day washout period separated the treatment sessions. The order of drugs used in the first and second treatment sessions was randomized. Objective and subjective sleep laboratory data showed that both drugs improved the sleep of patients with insomnia in association with nocturnal myoclonus. Neither drug significantly reduced the number of nocturnal myoclonic events. Sleep changes were consistent with those produced by sedative benzodiazepines in general. Thus, the data support clinical reports that clonazepam, a benzodiazepine marketed for the indication of seizure, is useful in improving sleep disturbances associated with nocturnal myoclonus. Temazepam, a benzodiazepine marketed for the indication of insomnia, was found to be a suitable alternative to clonazepam in the treatment of insomnia associated with nocturnal myoclonus. The present data and other studies suggest the need for a model that explains why leg movements and sleep disturbances may wax and wane independently.
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PMID:Nocturnal myoclonus: treatment efficacy of clonazepam and temazepam. 287 85

The present article summarizes 10 years of experience in head injury rehabilitation at Loewenstein Rehabilitation Center. The goal of rehabilitation in head injured patients consists of returning to work and adaptation to: interpersonal consequences of disability; new affective needs; and capacity to attend to financial, legal and bureaucratic matters. The achievement of these goals goes far beyond neurological boundaries in the ordinary narrow sense and needs a neuropsycho-social approach. Neuropsycho-social rehabilitation in head injury has multidimensional clinical aspects. Two problems should be emphasised: a) gross neurological disability (mono, hemi, para and triplegia) found in the presence of good cognitive function (patients easy to rehabilitate) and b) minor neurological disability found in the presence of gross cognitive impairment (patients not easy to rehabilitate). Posttraumatic epilepsy needs general criteria for its management. It is preferable to wait for the first seizure in order to start anticonvulsant treatment, except for 3 at risk conditions: 1) diffuse bilateral injury 2) prolonged coma, and 3) intracerebral hematoma. The first 3 years is the maximum at risk period. The traumatic syndrome consisting of impaired insight and behaviour disturbances is underdiagnosed owing to the absence of neurological signs. The sleep disturbances accompanying head injury are usually underestimated.
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PMID:Neuropsycho-social rehabilitation of head injury. 312 29

Sleep disturbances accompany the development of amygdaloid-kindled seizures in cats. Some of these sleep deficits resemble those seen in aged rats; these latter changes in sleep patterns are correlated with memory impairments in the aged animals. In the present study, we examined the hypothesis that sleep deficits after kindling may be related to memory impairments. Rats were kindled for 4 weeks (2-2.5 weeks after stage 5 seizures) and were then allowed a one week recovery period. Sleep patterns were assessed through-out the kindling and recovery periods. The animals were then trained on an inhibitory avoidance apparatus and tested for retention 24 h later. Only transient sleep changes occurred during the development of kindling (to stage 5 seizures). However, continued kindling resulted in significant reductions in several sleep measures which remained depressed for at least one week after the termination of the kindling trials. As a group, kindled rats were impaired in retention of the inhibitory avoidance learned response. In kindled animals, retention performance was significantly correlated with total paradoxical sleep, the ratio of paradoxical/total sleep, and paradoxical sleep, the ratio of paradoxical/total sleep, and paradoxical sleep bout duration. These correlations are consistent with the view that deficits in paradoxical sleep may be related to deficits in some forms of memory.
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PMID:Amygdala kindling effects on sleep and memory in rats. 339 42

We compared sleep parameters during three-hour postprandial nap recordings in 10 normal controls and 28 seizure patients. Patients had significantly less sleep, longer sleep latency, more wakefulness, less drowsiness and lighter nonREM sleep, and lower sleep efficiency than controls. Generalized seizure patients had longer sleep latency, more arousals, and more (but very little) stage III sleep. Those with partial seizures had more stage II sleep and greater sleep efficiency. Patients on polypharmacy and phenobarbital therapy slept more, phenytoin patients had very short sleep latency but more wakefulness and less sleep efficiency; those taking clonazepam were also awake more and had lower sleep efficiency, while arousals during sleep were more frequent in patients on valproate and carbamazepine. The findings suggest that disturbed sleep, possibly related to aberrant arousal occasioned by generalized epilepsy or epileptogenic foci, is common in seizure patients, and may be related to interictal behavioral and cognitive symptoms. Polypharmacy may have an additive effect on sleep to prolong and disrupt it, while sedative anti-epileptic drugs may increase sleep and other anti-epileptic medications may have alerting effects or interfere with falling asleep. Generalized and partial seizure patients may have sleep disturbances of a different character, possibly reflecting generally altered cerebral excitability by afferent stimuli in the former situation, and the more localized effects of limbic or cortical hyperactivity in the latter.
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PMID:Sleep and waking disturbances in epilepsy. 365 65

One of the main advantages of long-term recording of epileptics is the possibility to monitor these patients during natural sleep. In this chapter, we first describe the reciprocal influence of sleep and epilepsy. On the one hand, sleep and circadian fluctuation of the state of vigilance have a marked influence on the occurrence of generalized and partial seizures as well as on the frequency, morphology and distribution of interictal epileptic discharges. On the other hand, a wide range of sleep disturbances has been documented in epileptics and there is some evidence that sleep disturbance and epilepsy may aggravate and perpetuate one another. Long-term EEG monitoring during sleep is of major importance when investigating epileptics with nocturnal attacks to determine whether these nocturnal episodes represent an ictal manifestation or an independent non-epileptic sleep disorder. In special forms of epilepsy, sleep recording is not only useful but necessary for the diagnosis. Various activation procedures are carried out on patients in whom there is diagnostic uncertainty regarding the presence or the type of epilepsy. Some of these procedures employ sleep: namely sedated sleep, sleep after sleep deprivation and all-night sleep recording. The diagnostic value and the indications of these activation studies are reviewed.
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PMID:Sleep and epilepsy. 392 61


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