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

An epidemiologic investigation found a 17.5% prevalence of psychogenic polydipsia in 241 hospitalized psychiatric patients. A randomly selected sample of 10 polydipsic patients revealed such associated disorders as sporadic convulsive seizures, comatose states, hydronephrosis, enuresis/urinary incontinence, projectile type vomiting, malnutrition and, in one case, cardiomegaly and edema. Psychogenic polydipsia is a frequently overlooked disorder, and the somatic consequences of the excessive fluid intake are usually ascribed to other causes.
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PMID:Somatic findings in patients with psychogenic polydipsia. 682 31

We studied 57 patients with poorly controlled or atypical seizures to identify hysterical attacks with a provocative test consisting of initiation and termination of an attack with suggestion and saline injection during electroencephalographic (EEG) monitoring. Using this method, we diagnosed 48 patients as having hysterical attacks. Three additional patients had spontaneous hysterical attacks during routine recordings. Of the 51 patients with hysterical attacks, 78% were female. Two-thirds of the patients were between the ages of 20 and 35 years. Thirty-two patients had taken anticonvulsants before the study. Each patient's hysterical attack, aura, and postictum was stereotyped, and the 6 patients subject to both hysterical and organic seizures described the two types of attacks as different stereotyped behaviors. Tongue laceration, urinary incontinence, and postictal confusion were common. Twelve patients had evidence of past or present neurological disease. Abnormal EEGs were recorded in 37% but only 12% had spike or spike and wave discharges. The provocative EEG test employing saline and suggestion is a useful tool in the diagnosis of hysterical "seizures."
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PMID:Hysterical seizures: suggestion as a provocative EEG test. 710 18

The diagnosis of subcortical arteriosclerotic encephalopathy of Binswanger should be confirmed neuropathologically by postmortem examination. But we expect that it may be possible to diagnose provisionally as Binswanger's disease on the basis of clinical course and findings including computed tomography. Two cases, 57 years old postman (case 1) and 60 years old housewife (case 2) were reported. They had hypertension for over 20 years in their past history and showed a progressive dementia since before one year and 9 years. Transient syncopal attack and epileptiform seizure revealed occasionally. Psychiatrically either of them were apathetic, aspontaneous and autistic. One of them (case 2) showed a striking paranoid-hallucinatory state. Spastic gait disturbance and dysarthria are found neurologically, and moreover in case 1 revealed the incontinence of urine and feces. Arteriosclerotic changes were seen in the fundi. The EEG showed a slow alpha rhythm with scattered theta- and delta-waves. Laboratory data of blood, urine and CSF were normal. On the basis of these clinical course and findings the diagnosis of Binswanger's type of cerebral arteriosclerosis were suspected. The CT-scan of 2 cases proved a symmetrical enlargement of the lateral ventricles and marginated areas of definite abnormal low density in the white matter of the occipital (case 1) and frontal (case 1 and 2) lobes. Conclusively we may provisionally diagnosed our two cases as Binswanger's disease, also supported by the findings of CT.
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PMID:[Two clinical cases diagnosed provisionally as Binswanger type of vascular dementia--on possibility to its clinical recognition from neuropsychiatric findings and computed tomography (author's transl)]. 725 7

Of 62 patients given shunts for normal-pressure hydrocephalus of idiopathic type, 46.8% showed some improvement and 27.4% enjoyed virtually complete recovery. The best clinical predictor of good response was the complete triad of memory difficulty, gait disorder, and urine incontinence; 61.2% of patients with this combination of symptoms improved. Gait disturbance alone was also accompanied by improvement in two of three patients. An "obstructive" cisternographic radioisotope pattern was not significantly different from a "normal" pattern in predicting a response to shunting. Computerized tomography (CT) showing large ventricles and little atrophy predicted improvement in 11 out of 13 patients. There were five deaths within 3 months of shunting. The complication rate was 35.4%; subdural collections, shunt malfunction, and postoperative seizures constituted the most frequent complications. These data suggest that continued investigation for better predictions of shunt response is important, but that in the meantime the clinical pattern and cranial CT pattern are the most satisfactory guides to improvement after shunting.
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PMID:Idiopathic normal-pressure hydrocephalus. Results of shunting in 62 patients. 735 91

Pseudoseizures, clinical events that superficially resemble epileptic attacks but which are not associated with central nervous system paroxysmal activity, are often difficult to differentiate from epileptic seizures. To evaluate the frequency and clinical manifestations of pseudoseizures in children with intractable seizures, children admitted to a Comprehensive Epilepsy Unit received prolonged simultaneous EEG telemetry and video recording. Pseudoseizures occurred in 11 of 53 pediatric patients admitted during the study period. Eight of the 11 patients with pseudoseizures also had documented epileptic seizures. Clinical characteristics of pseudoseizures and epileptic seizures documented by TEEG-VR were compared. Degree and duration of the postictal state, incontinence, combativeness, relationship to stress, and response to anticonvulsant medication were useful differentiating criteria. Pseudoseizures are not unusual in pediatric patients, often occur concurrently with epileptic seizures, and may be difficult to diagnose. However, careful clinical observation may offer clues in differentiating pseudoseizures from epileptic seizures.
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PMID:Evaluation of childhood pseudoseizures using EEG telemetry and video tape monitoring. 742 Feb 17

Gliomatosis Cerebri is an unusual neoplastic entity that affects the central nervous system (C.N.S.); it consists of a marked proliferation of glial cells with variable degrees of differentiation in extensive areas of the brain and/or spinal cord. The process is primarily an infiltrative one rather than destructive. Most of the cases are diagnosed at autopsy. The authors report a new case of Gliomatosis Cerebri in a 46 year old woman, with a long clinical history--15 years--of focal seizures; and during the year prior to her admission: behavioral changes, vertigo, urinary incontinence and frequent falls. C.N.S. imaging revealed extensive involvement of the white matter of both cerebral hemispheres. Stereotactic guided biopsy showed a moderately cellular astrocytic neoplasm. A review of the medical literature led to the conclusion that the present case constitutes one of the very few examples in which the diagnosis of Gliomatosis Cerebri was achieved ante-mortem.
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PMID:[Gliomatosis cerebri. Ante-mortem diagnosis]. 754 7

Two patients who incurred significant injuries during psychogenic seizures prompted us to do a telephone survey of self-injury and incontinence in 102 consecutive patients diagnosed with psychogenic seizures by EEG-closed-circuit TV (EEG-CCTV) monitoring. Seventy-three patients (or a close family member or friend) were reached by telephone and responded to our survey. During typical attacks of psychogenic seizures, 40% reported injuries, 44% reporting tongue biting, and 44% reported urinary incontinence. Suicide attempts were reported by 32% and were more common in those with self-injury and urinary incontinence. We compared the results of patients with psychogenic seizures with those of 30 patients with refractory epilepsy documented by ictal recordings, using a similar telephone survey. Injuries of all types were more commonly reported by epilepsy patients. Burn injuries were reported only by patients with epilepsy. Suicide attempts were more commonly reported by the psychogenic seizure group. Self-injury and incontinence are commonly reported by psychogenic seizure patients. In view of their significant association with suicide attempts, they may indicate an underlying depression.
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PMID:Self-injury and incontinence in psychogenic seizures. 755 72

A female infant had erythematous vesicular skin lesions over the whole body and extremities in the early infancy. These skin lesions then changed to hyperpigmentation in whorls and splashes. Seizure attack was noted at one month old. Skin biopsy showed dyskeratosis, acanthosis, pigmenti incontinence, and massive infiltration of eosinophils. So Incontinentia pigmenti was confirmed. She also had hallmarks of retinal involvement, including peripheral retinal ischemia and neovascularization, which were similar to those seen in retinopathy of prematurity. Cryopexy was performed in her left eye and the lesions regressed.
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PMID:Retinopathy in incontinentia pigmenti: a neonatal case report. 761 73

Ifosfamide, a nitrogen mustard derived alkylating agent commonly used in the treatment of solid tumors, has been associated with neurotoxicity in 5-33% of treated patients. Encephalopathy most often occurs during or shortly following drug administration, with increased drowsiness or irritability, confusion, hallucinations, visual blurring, extrapyramidal dysfunction, cranial nerve abnormalities, incontinence, generalized muscle twitching, seizures, and coma reported in infants, children, and older adults. While most reported neurologic abnormalities associated with ifosfamide have been reversible, encephalopathy resulting in death has occurred. We now report an infant who developed ifosfamide-induced encephalopathy, loss of developmental milestones, progressive brain atrophy, and cessation of cranial growth. This is the first case of cerebral atrophy and loss of developmental milestones that has been reported in a pediatric patient treated with ifosfamide. Given the efficacy of this anti-neoplastic agent and its increasing use in pediatrics, further investigation is indicated, especially in infants where brain growth is ongoing.
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PMID:Cerebral atrophy in an infant following treatment with ifosfamide. 805 12

A 55-year-old mildly hypertensive woman died after having developed a subcortical dementia during the past 9 years, with focal neurological signs. She presented at the age of 46 years with short episodes of dizziness and diplopia, suggesting that transient ischemic attacks involved the posterior fossa structures. Over the next 8 years, she developed difficulty in walking, urinary incontinence and seizures. On examination in 1989, she was severely demented. There was tetraparesis, bilateral arm and leg spasticity with hyperreflexia and bilateral Babinski signs. She showed epilepsia partialis continua involving the eyes, left hemiface and limbs. CT showed hypodensity of the white matter and lacunes in the basal ganglia and centrum semiovale, moderate hydrocephalus with cerebellar and cortical atrophy. Clinical and radiological features were similar to those of Binswanger's disease. Similar cases had occurred in the family affecting the patient's grandfather, father and two brothers, suggesting an autosomal dominant hereditary disease. Postmortem examination disclosed a Binswanger type of leukoencephalopathy caused by a peculiar microangiopathy characterized by a slightly basophilic small arterial granular degeneration of the medial sheath associated with the presence of ballooned smooth muscle cells with clear cytoplasm. Electron microscopic study revealed degenerative changes in the parietal vessels with notable increase of basal-membrane-type material and electron-dense granular deposits. These lesions could correspond to a specific familial pathology of the small arteries of the brain. They are identical to those reported in some patients with autosomal dominant inheritance. For other patients with similar clinical features and the same familial pattern, reported as "hereditary multi-infarct dementia'' and "chronic familial vascular encephalopathy'', there are no sufficient objective pathological facts to consider that they have the same disease.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Small arterial granular degeneration in familial Binswanger's syndrome. 814 Aug 99


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