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

There is much evidence that emotional stess can trigger both neurogenic and hysterical seizures in susceptible patients. We reviewed out experience with 37 patients whose seizures appeared to be precipitated at times by emotional stress and had not been controlled by anticonvulsant medication alone. Approximately 70 per cent of patients demonstrated substantial improvement in seizure control after psychiatric treatment and maintained this improvement during follow-up. The findings of this study suggest that patient characteristics associated with better prognosis include normal intelligence, partial (as opposed to generalized) neurogenic seizures, a diagnosis of hysterical seizures, a less severely abnormal EEG, and being hypnotizable. After psychiatric treatment, 32 per cent of patients had their anticonvulsant medication reduced and another 16 per cent had it discontinued.
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PMID:The impact of psychiatric intervention on patients with uncontrolled seizures. 11 4

This study aims to clarify the role of cholinergic neurons in the occurrence of epileptic seizures when emotional stress is loaded. The effects of stress and drugs on hippocampal interictal discharges were compared among groups of fully kindled male Wistar rats intraperitoneally given atropine, physostigmine and saline with and without immobilization, or pituitary-adrenocortical hormones without immobilization. Hippocampal interictal discharges increased during immobilization, because hippocampal cholinergic neurons were activated by emotional stress. Pituitary-adrenocortical hormones had no effects on the discharges.
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PMID:The role of cholinergic neurons in stress-induced increase of interictal discharges in hippocampal-kindled rats. 133 96

The myoclonic epilepsies constitute an heterogeneous group of entities characterized by primary generalized seizures, whose common critical manifestation is myoclonus. Within this group there is a subset of patients, identified by Janz in 1955 as "Impulsive petit mal" and later named "Janz juvenile myoclonic epilepsy" (JJME) by Delgado-Escueta. Its most important clinical features are myoclonus, expressed as mild to moderate jerks of neck, shoulders and arms. These jerks are more frequent when awakening; they can be caused by sleep deprivation and emotional stress, without consciousness impairment. Usually neurologic examinations and mental status are normal. Response to specific treatment is good, with disappearance of seizures in most patients. We attempted to assess the pathophysiologic mechanisms involved in this kind of epilepsy. The existence of differences or similarities with the findings described in the other forms of myoclonic epilepsy was specially considered. In 14 patients with JJME, we performed C reflex studies with negative results. The mean amplitude of somato sensitive evoked potential (SSEP) was around 5 microV (normal values: 2.5 microV) in its different components. Shibasaki et al. suggested that the amplitude increase could be related to a cortical excitability increase at the somatosensory and motor level, which is the probable site of the epileptogenic area. Within the patient group with myoclonic progressive epilepsy (EMP) and continuous partial epilepsy (CPE), SSPEs amplitude ranged from 8 microV to 40 microV. In our patient group, the increase in SSPEs amplitude was smaller than the one observed in the other two entities. However, it was significantly higher than the mean value for the normal population.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Status of cerebral cortical excitability in juvenile myoclonus epilepsy]. 192 91

A permanent pacemaker was inserted in eight patients with the long QT syndrome. All had recurrent syncope or seizures, six had documented torsade de pointes and four had aborted sudden death. Among the eight patients, permanent pacing was instituted in three who were unsuccessfully treated with both a beta-adrenergic blocking agent and left cardiothoracic sympathectomy, and in two who proved refractory or intolerant to beta-blockers. Another three patients had pacemaker implantation and long-term beta-blocker therapy because of spontaneous atrioventricular (AV) block in one, aborted sudden death in one and patient preference in one. After pacing (70 to 85 beats/min), there was no significant change in the mean corrected QT interval, but the mean QT interval decreased significantly (534.4 +/- 51.4 to 425.6 +/- 18.9 ms, p less than 0.0001). Over a mean follow-up period of 35.1 +/- 18.9 months, all patients are alive and currently free of syncope. One patient without a history of stress-induced syncope had two syncopal episodes (believed to be due to hyperventilation) while under severe emotional stress, but has been symptom free for the past 5 years. One patient with an atrial demand (AAI) pacemaker developed dizziness due to documented episodes of AV block, but remains asymptomatic after conversion to atrial rate-responsive dual chamber (DDD) pacing. Either atrial or ventricular pacing combined with beta-blocker therapy appears to be effective treatment for a subset of patients with the long QT syndrome, by either preventing episodes of torsade de pointes or alleviating symptoms due to bradycardia from beta-blocker therapy.
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PMID:Permanent cardiac pacing in patients with the long QT syndrome. 362 66

Cardiac arrhythmias can present with the signs and symptoms of a seizure disorder. This potentially life-threatening underlying cause of non-febrile seizures should be recognized early, since successful specific treatment is possible. The purpose of this retrospective study was to examine common features in such patients. Over a period of 25 years, eight patients were initially treated for up to 5 years at our institution for a seizure disorder until dysrhythmia as the underlying cause of the seizures was disclosed. The main symptom was drop attacks coinciding with physical activity or emotional stress. Convulsions were only rarely observed. In five of the eight patients the underlying disorder was the long-QT-syndrome (Romano-Ward syndrome). In one patient intermittent complete atrioventricular block was found, another patient showed ventricular tachydysrhythmia of unknown etiology and the last patient suffered from hypertrophic cardiomyopathy.
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PMID:Cardiac arrhythmias mimicking primary neurological disorders: a difficult diagnostic situation. 763 56

Stress is commonly believed to precipitate seizures in some patients with epilepsy, but direct examination of this assumption is problematic because of the difficulty in defining vague factors such as 'emotional stress'. Using a questionnaire, we have recorded seizure frequency during the 1991 Persian Gulf war, when Israelis were under stress from the threat of Scud missile attacks, in 100 consecutive adult patients with epilepsy. Increased frequency of seizures was reported by eight patients. These were younger than the other patients, the majority showed generalized epileptic EEG activity and all had generalized seizures (secondarily generalized in four). Only four had seizures directly related to the sounding of an alarm and in the others, non-compliance, being off medication at the time and disturbed sleep were probable contributory factors. We conclude that, in this series, epilepsy control was only weakly affected by an acute external emotional stress factor.
Seizure 1994 Jun
PMID:Stress and epilepsy: the Gulf war experience. 808 40

Long-term intermittent venous access was established in 77 children by means of a central venous catheter (CVC) with a subcutaneous injection port (Port-A-Cath; PAC). Seventy of these children were included in this follow-up study. Sixty-three were treated for different malignant diseases, five for cystic fibrosis, one for severe hemophilia and one for central nervous system disease with seizures as the main problem. As of April, 1992, PACs had been in place for 3/12 to 8 3/12 years (cumulative 175 5/12 years) with 2,206 entries into the system. The PACs were used for blood sampling and administration of chemotherapy, antibiotics, fluids, total parenteral nutrition (TPN) and blood products. Portal infection was observed in four patients of which two patients had their PAC removed. Catheter dislocation was observed in two and catheter breakage in one. Portal occlusion, extravasation, thrombosis leading to removal of the PAC or other technical or psychological complications were not observed. The children continued normal activities, and the easy venous access decreased emotional stress during treatment. Local doctors were trained to use PACs, through which they administered maintenance chemotherapy. We conclude that long-time use of PACs in children is safe and has many advantages compared to traditional CVCs in use. Strict indications, meticulous implantation techniques and adequate handling are, however, mandatory.
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PMID:Central venous catheter with subcutaneous injection port (Port-A-Cath): 8 years clinical follow up with children. 821 38

In December 1997, more than 680 children developed convulsive seizures while watching a notorious audiovisually provocative TV program, "Pocket Monster." Emotional stimulation via hyperventilation may cause respiratory alkalosis, fall of blood ionized calcium (Ca), and sensitization of the nervous system to excessive emotional stress. A study was therefore undertaken to follow the changes of blood ionized Ca in eight healthy volunteers after watching the "Pocket Monster" and also a quiet program, "Classical Music," as a control for 20min from 4 P.M. Although neither marked hyperventilation nor convulsions developed in any of these adult volunteers, blood ionized Ca showed a significantly more pronounced fall during and after watching "Pocket Monster," and their plasma intact parathyroid hormone (iPTH) was significantly higher 120min after the beginning of "Pocket Monster" than the "Classical Music" program. Plasma total Ca, pH, and albumin were free of detectable changes. Ingestion of 600mg Ca as active absorbable algal Ca (AAA Ca) with high bioavailability completely prevented the fall of ionized Ca and suppressed iPTH. Plama osteocalcin was also significantly suppressed after ingestion of AAA Ca. It may be worthwhile to ingest AAA Ca before anticipated emotional stress such as watching a provocative TV program to prevent possible neuromuscular instability.
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PMID:Fall of blood ionized calcium on watching a provocative TV program and its prevention by active absorbable algal calcium (AAA Ca). 1034 Jun 41

Leukocytosis, a common laboratory finding, is most often due to relatively benign conditions (infections or inflammatory processes). Much less common but more serious causes include primary bone marrow disorders. The normal reaction of bone marrow to infection or inflammation leads to an increase in the number of white blood cells, predominantly polymorphonuclear leukocytes and less mature cell forms (the "left shift"). Physical stress (e.g., from seizures, anesthesia or overexertion) and emotional stress can also elevate white blood cell counts. Medications commonly associated with leukocytosis include corticosteroids, lithium and beta agonists. Increased eosinophil or basophil counts, resulting from a variety of infections, allergic reactions and other causes, can lead to leukocytosis in some patients. Primary bone marrow disorders should be suspected in patients who present with extremely elevated white blood cell counts or concurrent abnormalities in red blood cell or platelet counts. Weight loss, bleeding or bruising, liver, spleen or lymph node enlargement, and immunosuppression also increase suspicion for a marrow disorder. The most common bone marrow disorders can be grouped into acute leukemias, chronic leukemias and myeloproliferative disorders. Patients with an acute leukemia are more likely to be ill at presentation, whereas those with a chronic leukemia are often diagnosed incidentally because of abnormal blood cell counts. White blood cell counts above 100,000 per mm3 (100 x 10(9) per L) represent a medical emergency because of the risk of brain infarction and hemorrhage.
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PMID:Leukocytosis: basics of clinical assessment. 1108 87

Catecholamine-induced polymorphic ventricular tachycardia (PVT) is characterized by episodes of syncope, seizures, or sudden death, in response to physical activity or emotional stress. Two modes of inheritance have been described: autosomal dominant and autosomal recessive. Mutations in the ryanodine receptor 2 gene (RYR2), which encodes a cardiac sarcoplasmic reticulum (SR) Ca(2+)-release channel, were recently shown to cause the autosomal dominant form of the disease. In the present report, we describe a missense mutation in a highly conserved region of the calsequestrin 2 gene (CASQ2) as the potential cause of the autosomal recessive form. The CASQ2 protein serves as the major Ca(2+) reservoir within the SR of cardiac myocytes and is part of a protein complex that contains the ryanodine receptor. The mutation, which is in full segregation in seven Bedouin families affected by the disorder, converts a negatively charged aspartic acid into a positively charged histidine, in a highly negatively charged domain, and is likely to exert its deleterious effect by disrupting Ca(2+) binding.
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PMID:A missense mutation in a highly conserved region of CASQ2 is associated with autosomal recessive catecholamine-induced polymorphic ventricular tachycardia in Bedouin families from Israel. 1170 30


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