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

Disorders or complaints of memory are a frequent cause of consultation in depression, major anxiety and psychiatry disease with personality disorders. We report 3 patients with obsessive compulsive disorder (OCD), without diagnosis and treatment, examined in a specialized memory consultation. They always had OCD with cognitive checking. Diagnosis of transient global amnesia and temporal complex seizure were discussed in 2 cases. Psychometric impairment only was observed in first free recall of a verbal memory task and was no specific. Behavioural during testing seemed to be very important to analyse. First, a 49-year-old man consulted because he had stereotyped transient amnesia lasted one minute, 2 or 3 times a week, since 6 months. He was a teacher. Transient amnesia always occurred during lessons. Suddenly he didn't know where he was or what he was speaking about. Episodes lasted one minute. After them, he had no confusion and no difficulty in concentration but intense anxiety. In an another hand, when he was in his car, after lessons, he could forget where he was during some minutes. CT scan and EEG were normal. Neuropsychological tests only objectived impairment in first free recall of Grober and Buschke's words. Patient explained that he could not prevent to check responses. He told us checking obsessive compulsive disorder during since long time ago. We discussed clear differences which existed between seizure and ruminations or preoccupations. Secondly, a 55-year-old woman was afraid of her memory performances. She was medical secretary and had no problem in her work but she would like a memory consultation to reassure herself. She was neither depressed nor anxious. She presented curious production in fluency task. She had to produce as many animals's names as possible: she could say 35 names which was an excellent performance but only in alphabetic order! Neuropsychological tests objectived impairment in her first free recall of Grober and Buschke's words. She tried in her first free recall to remember words in alphabetic order. She explained how she was bound to range everything in alphabetic order! She had a lot of rituals. She thought that she had an obsessive compulsive disorder but never consulted about this. The observation illustrated suspiscions about memory operations which could be observed in patients group with obsessive compulsive disorders. Finally, a 62-year-old man told us that he had presented a transient global amnesia during 4 hours. He had an important appointment and was upset about that. He didn't go to it and wandered in his flat. He always asked the same questions and forgot everything. He had no neurological deficit. He was anxious, sad and cried several times. He perfectly remembered the episod and thought that he had a panic attack! Verbal memory tests only objectived difficulties in his first free recall of Grober and Buschke words as the two others patients. He had a story of obsessive compulsive disorder with checking and rituals. In this observation, we discussed clear differences which existed between panic attacks and global transient amnesia. We analyzed patterns of neuropsychological performances which illustrated clinical features of obsessive compulsive disorder. These three patients impaired in their first free recall of verbal memory task. It is not a specific result. We observed during psychometric evaluation, strategic processing which impaired episodic memory: patients tried to check their performances. Memory complaints only were observed in checking obsessive compulsive disorder. It is a difficulty or a doubt about memory capacities. Difficulties could be due to particular cognitive processes who pertubate normal memory capacities.
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PMID:[Amnesic presentations of the compulsive obsessional confusions (about 3 patients appearing in a consultation of memory)]. 1197 42

The authors present four patients displaying panic disorder and a history of epileptic seizures to illustrate difficulties regarding differential diagnosis between epileptic seizures and panic attacks. The cases describe the aversive properties of epileptic seizures, the role of visual seizure-triggering stimuli as phobic cues, and the effectiveness and safety of clomipramine treatment of panic attacks as an adjunct to concurrent antiepileptic medication.
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PMID:Panic attacks in the differential diagnosis and treatment of resistant epilepsy. 1211 26

An increased risk of myocardial ischemic changes was demonstrated in patients suffering from panic disorder (PD). Using classical ECG methods, this risk cannot be evaluated in most patients. We measured the vectocardiogram (VCG) using Frank orthogonal leads and body surface maps (BSM) including 12-lead ECG. In our study of 11 PD patients (2 men, 9 women), without any seizures and pharmacological treatment and without cardiovascular symptoms, we found marked sinus tachycardia (heart rate 90.1 +/- 12.2 min(-1)) and a shorter R-R interval (678 +/- 93.6 ms) than in 27 controls (heart rate 73.6 +/- 7.7min(-1), R-R 822.7 +/- 86.4 ms) (5 men, 22 women) (p<0.001). The VCG measured spatial QRS-STT angle was more opened (70.3 +/- 24.5 degrees) than in the control group (49.5 +/- 19.5 degrees) (p<0.05). The maximum (extremum) in depolarization (DIAM max 30, 40) and repolarization (RIAM max 35) of body surface isoarea and isointegral (RIIM max) maps was less positive (p<0.001) and the minimum (DIAM min 40) was less negative than in the controls (p<0.05) even in the period free of a panic attack. Our results showed the changes in the heart electric field parameters occurred in PD patients when compared to the control group.
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PMID:Electrocardiogram, vectocardiogram and body surface maps in patients with panic disorder. 1244 39

Four hours after having taken 10 ecstasy tablets a Grand Mal seizure occurred in a 19-year-old woman followed by coma, hyperthermia, tachycardia, tachypnea, and renal failure. After awakening she was oriented but presented with helplessness, disconcertion, hallucinations, panic attacks, and amnesic syndrome. Computed tomography and magnetic resonance imaging scans of the brain were normal. [99Tc]-hexamethylpropyleneamine oxime (HMPAO)-single photon emission computed tomography (SPECT), 20 days after intoxication, showed reduced, inhomogeneous, supratentorial tracer uptake bilaterally. Electroencephalography (EEG) disclosed diffuse slowing and occasionally generalized sharp waves. Valproic acid was begun. Except for slight amnesia, neuropsychological deficits had disappeared and [99Tc]-HMPAO-SPECT normalized, 29 days later. Decreased cortical blood flow was explained by vasoconstriction following ecstasy-induced depletion of serotonin.
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PMID:Long lasting impaired cerebral blood flow after ecstasy intoxication. 1266 70

THE EXTENT OF THE PROBLEM: A patient can be misleadingly considered as epileptic although he is not. Conversely an epileptic man not be recognised as such. Moreover, in some patients epilepsy seizures may co-exist with pseudo-seizures. THE PROBLEMS IN DIAGNOSIS: Each stage of the diagnosis of epilepsy is limited, whether regarding anamnesis, electroencephalogram, not only standard but also video, or even the semiological analysis because of the clinical polymorphism of partial epileptic seizures. THE MAJOR DIFFERENTIAL DIAGNOSES: Migraine with aura may be difficult to differentiate from occipital attacks with visual hallucinations. Bilateral tonic or chronic phenomena may occur during syncope. A partial epileptic seizure may simulate a cerebral vascular stroke. Paroxistic anxiety (panic attacks) can resemble that observed during partial seizures with vegetative semiology. In fact the problem is dominated by the pseudo-epileptic seizures, the diagnosis of which is evoked on the clinical aspect, the mode of onset, the past history of the patient and confirmed by simultaneous EEG video recording. FROM A THERAPEUTIC POINT OF VIEW: The best action is preventive. It consists in the earliest possible detection of the pseudo-epileptic seizures and in avoiding so-called 'test' treatments.
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PMID:[True or pseudo epilepsy in the adult]. 1271 21

Anxiety is a medical mimicker that can imitate both cardiac and neurological symptoms. Anxiety disorder research protocols regularly use hyperventilation or i.v. lactate infusion to trigger panic attacks in susceptible subjects. Susceptible patients experience panic attacks with slight decreases in CO2 or increases in lactate production seen in mild exercise such as stair climbing. To the unsuspecting physician this appears to be dyspnea on exertion. Hyperventilation during rapid eye movement (dream) sleep may trigger panic attacks in patients with panic disorder, mimicking paroxysmal nocturnal dyspnea. Syncope from panic-induced hyperventilation can mimic seizures. When panic-like anxiety is discovered in aircrew it necessitates grounding. The prognosis is frequently good after treatment with psychotherapy, with return to full flying status a strong possibility.
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PMID:You're the flight surgeon. Anxiety. 1292 69

This study investigates the frequency of symptoms of panic attack in a sample of adults (n = 18) and adolescents (n = 21) who were evaluated for intractable seizure disorder and diagnosed with psychogenic nonepileptic seizures (PNES). Medical records were retrospectively reviewed for symptoms associated with their typical seizure events as documented by the attending epileptologist. Adolescents, as a group, reported significantly more symptoms of panic attack than adults. Three adolescents met the full criteria for a panic attack, while no adults met these criteria. In addition, while numerous adults endorsed no panic symptoms associated with their PNES episodes, all adolescents endorsed at least one symptom. Implications of results are discussed in terms of the diagnosis and treatment of PNES in the different age groups.
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PMID:Frequency of panic symptoms in psychogenic nonepileptic seizures. 1571 Mar

Vertigo is an illusion of rotation due to a disorder of the vestibular system, almost always peripheral. In the history it must be distinguished from pre-syncope, seizures and panic attacks. A single attack of acute, isolated spontaneous vertigo lasting a day or more is due either to vestibular neuritis or cerebellar infarction; distinguishing between the two requires mastery of the head impulse test. Recurrent vertigo is mostly due to benign paroxysmal positioning vertigo (BPPV), Meniere's disease or migraine. With a good history, a positional test, an audiogram and a caloric test, it is usually possible to distinguish between these. BPPV is the single most common cause of recurrent vertigo and can usually be cured immediately with a particle repositioning manoeuvre. Posterior circulation ischaemia very rarely causes isolated vertigo attacks and when it does the attacks are brief and frequent and the history is short.
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PMID:Diagnosis and management of vertigo. 1613 4

Ring chromosome 20 (r[20]) syndrome is characterized by mild to moderate learning disability*, behavioural disorders, epilepsy, and various dysmorphic features. Although still considered rare, r (20) syndrome is being increasingly diagnosed. More than 30 cases have been described in the literature since 1976. Here we report an additional case of a 14-year-old male with r (20). He had moderate to severe learning disability and epileptic seizures manifesting at about 18 months of age. During the 13 years' follow-up period he showed intractable epileptic seizures, behavioural disorders, and mild dysmorphological features including microcephaly, strabismus, micrognathia, down-slanting eyelids, and ear abnormalities. Frequent episodes of atypical absence or non-convulsive status associated with electroencephalogram changes were seen in follow-up. He was treated with several classical and new antiepileptic drugs, including intravenous immunoglobulin, corticotropin, and vagal nerve stimulation, with unsuccessful control of seizures. Finally, surgical treatment (corpus callosotomy) was performed at the age of 13 years; severity of tonic seizures was diminished, but frequency was unchanged. Although his behavioural problems, e.g. hyperactivity, were mild in early childhood they became more severe when he was 11 years old. Aggressiveness, compulsiveness with self-injury, and panic attacks developed at the age of 13 years, and were more pronounced after callosotomy. This case report provides the first description of deterioration in psychological situation in patients with r(20) intractable epilepsy. The patient was diagnosed with r(20) syndrome after 13 years of clinical follow-up. Karyotype analysis should, therefore, be performed in every patient with intractable epilepsy of unknown aetiology.
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PMID:Ring chromosome 20 syndrome with intractable epilepsy. 1635 3

Research is presented to support a hypothesis that panic attacks, when they have the same clinical signs as the epileptic consciousness, should be diagnosed as partial seizures with a psychic content. After setting out the four clinical signs defining it (suddenness, automatic nature, great intensity and strangeness), an extensive review of the literature is made in search of scientific information to support the hypothesis, which reveals a wealth of concurring scientific evidence, at both the clinical and preclinical levels, to support the hypothesis presented here. In conclusion, new research is proposed with a view to drawing up interviews and clinical scales in order to quantify the four clinical signs objectively.
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PMID:Panic and epilepsy. 1595 58


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