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

The unilateral and bilateral therapy differ in psycho-organic effects but have the same antidepressive efficiency. This is due to the facts that the organic effects are mainly caused by the electrical current whereas the antidepressive effect is dependent on the seizure activity. Compared to the bilateral treatment, unilateral gives reduced confusion, anterograde and retrograde amnesia as well as reduced experience of memory impairment. The difference is explained by a lower density of current in the brain. The unilateral treatment should be the treatment to be chosen. The antidepressive action of ECT fits the amine hypothesis, ECT causes a sustained increase of the synthesis of norepinephrine and of the sensitivity of amine receptors and creates conditions for alleviating both "low-output" and "low-sensitivity" depression. The antidepressive action is probably mediated by release of hypothalamic neurohormones.
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PMID:[Unilateral and bilateral shock therapy: mechanism of action (author's transl)]. 4 67

Our study aimed at analysing effects of epileptic foci on memory function in patients with partial epilepsy. Twenty-eight patients with spontaneous memory complaints and psychometrically established memory disorders were assessed by 21-channel electroencephalography recorded both during cognitive testing and during 99mTc-HMPAO single photon emission computed tomography (SPECT). Computed tomography (CT) was performed on the same day. None of the epilepsy-related factors (seizure type, seizure frequency, type of epilepsy, age at onset of the seizures, type of antiepileptic treatment) could be related directly to severity or type of memory impairment (classified into the categories 'global', 'verbal' and 'non-verbal'). Remarkably, this study found no significant relationship between EEG focus localization and severity of measured memory impairment. Most areas with hypoperfusion on the SPECT were found in the group with global (severe) amnesia, typically with a right frontal localization. Abnormalities on CT were predominantly found in the same group, however, with a right-sided parietal localization. An unanticipated finding was that the majority of temporal CT and SPECT lesions were found in the group with relatively better memory performance.
Seizure 1992 Sep
PMID:Memory complaints, memory disorders and focus localization in patients with partial epilepsy. 134 59

Neuropsychological evaluation contributes towards identification of a seizure focus through assessment of function. Tests sample widely among cognitive abilities, usually contrasting language and visuospatial competence. In patients with a temporal-lobe focus, evaluation of memory is crucial and ideally should comprise a variety of tasks tapping different aspects of learning and memory. As a means of predicting and preventing severe postoperative memory impairment, memory is further tested in many cases with the intracarotid sodium amytal (IAP) procedure; hippocampus will be spared in patients who fail IAP memory tests. Performance after temporal lobectomy on three basic memory tests was evaluated in patients who had failed pre-operative IAP memory tests compared to those who had passed. Those who had failed performed significantly worse, confirming fragility of memory function in cases who have been identified as at risk by the IAP procedure.
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PMID:Neuropsychological techniques in the identification of epileptic foci. 141 65

Despite intensive study, the neurobiological basis of epilepsy and persistent memory impairment following traumatic head injury remains unknown. Since abnormalities of the hippocampus are known to be associated with temporal lobe seizures and memory dysfunction, we investigated the effects of experimental traumatic brain injury on hippocampal structure and function in the rat. Using a model of fluid-percussion injury, we have discovered that neurons of the dentate hilus are vulnerable to a brief, unilateral impact to the extradural surface of the brain. One week after trauma, there was a dramatic reduction in hilar neurons ipsilateral to the impact, and a milder but significant decrease in neurons on the contralateral side as well. This neuronal loss was highly selective since adjacent dentate granule and pyramidal neurons appeared relatively unaffected. Immunocytochemistry showed that the hilar cell loss included a loss of somatostatin-immunoreactive neurons, and degeneration stains provided evidence that irreversible hilar injury occurred within 4 hr of impact. To assess the functional effects of the hilar damage, dentate granule cell field potentials were measured in response to perforant path stimulation. This revealed abnormal dentate granule cell hyperexcitability at 2.0 Hz stimulation in many of the injured animals. The presence of abnormal hyperexcitability correlated with the loss of hilar neurons. Thus, a momentary impact to the surface of the brain can cause selective, bilateral hippocampal injury with associated abnormalities in dentate gyrus physiology. Furthermore, the pattern of cell loss is similar to that observed in some patients with temporal lobe epilepsy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Selective vulnerability of dentate hilar neurons following traumatic brain injury: a potential mechanistic link between head trauma and disorders of the hippocampus. 146 70

Thirteen patients with "epileptic amnesic syndrome" (EAS) presented with adult-senile onset of a severe memory complaint that started before or at the same time as seizures. All were diagnosed as temporal lobe epilepsy (TLE). The seizures were stereotyped, with only short loss of contact and oral automatisms, and because they were not obvious or disturbing, they remained underdiagnosed for a long time. Nine cases also presented attacks of transient anteroretrograde amnesia after the seizures--called "epileptic amnesic attacks" (EAA)--during which the patients were able to perform complex actions. EAA are similar to the attacks of transient global amnesia (TGA) but are more frequent, shorter, accompanied by clear-cut clinical and electroencephalographic epileptic manifestations, and respond favorably to antiepileptic therapy. Neuropsychological investigation ruled out global mental deterioration, showing only selective memory impairment in a few long-term tasks and dissociation between formal findings and the relevant memory complaint. These cases have uniform anamnestic, clinical, and neuropsychological characteristics and represent a particular clinical expression of TLE, namely EAS. We suggest that an epileptic origin be entertained in patients presenting repeated amnesic attacks resembling TGA or who complain of persistent memory disturbance, after more common etiologies have been excluded.
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PMID:Epileptic amnesic syndrome. 148 32

The relationship between interictal focal hypometabolism determined by 18-fluorodeoxyglucose positron emission tomography (FDG-PET) scans and memory function with the intracarotid amobarbital procedure (IAP) was evaluated in 23 patients with temporal lobe epilepsy. All patients underwent prolonged EEG/video monitoring. The epileptogenic focus was defined by interictal epileptiform discharges and ictal onsets. All 23 patients had recorded seizures arising exclusively from one temporal lobe. PET showed temporal lobe hypometabolism ipsilateral to the epileptogenic focus in 86% (20 of 23) of patients; IAP showed impaired memory of the hemisphere of seizure onset in 65% (15 of 23). Sixty-five percent (13 of 20) of patients with focal hypometabolism had ipsilateral memory impairment. Memory impairment contralateral to the hypometabolic zone was not observed. Ninety-five percent (22 of 23) of patients demonstrated functional impairment by either PET or IAP (or both) on the epileptogenic side.
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PMID:Comparison of the intracarotid amobarbital procedure and interictal cerebral 18-fluorodeoxyglucose positron emission tomography scans in refractory temporal lobe epilepsy. 162 76

Standardized verbal and visuo-spatial memory recognition were obtained on 15 patients with unilateral temporal lobe epilepsy (TLE), using a reference group of 43 (12 males, 31 females) subjects with no previous history of neurological disease. Inter-ictal measures on these two tasks failed to differentiate between those patients with left vs right seizure foci. When eight of these patients were tested post-ictally (within 1 hr of seizure), seven showed the expected selective memory impairment when compared to inter-ictal performance. Left TLE patients showed a relative lowering of verbal memory, whereas patients with right TLE showed a relative visuo-spatial memory impairment. A similar result was also found in the patients when a comparison between pre-operative (inter-ictal) and post-operative performance was made, thereby further substantiating the validity of the tasks. This significant association between side of seizure focus and selective impairment of post-ictal memory performance provides evidence of a more direct method of neuropsychological diagnosis in TLE patients prior to surgery.
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PMID:Post-ictal recognition memory predicts laterality of temporal lobe seizure focus: comparison with post-operative data. 170 63

Domoate, a glutamate analog, is believed to be responsible for a seafood poisoning incident that caused acute neurological disturbances and chronic memory impairment in some victims, with the incidence of mortality and neuropsychological morbidity being highest among the aged. Domoate expresses neurotoxic (excitotoxic) activity in vitro by an action at the kainate subtype of glutamate receptor, and when administered to adult rats, it mimics kainate in causing status epilepticus and a severe seizure-brain damage syndrome. Because domoate is exceedingly expensive, we explored the feasibility of using kainate to study the age-linked features of domoate neurotoxicity. We administered kainate subcutaneously in various doses to young (5-6 months), middle-aged (12-13 months), and old (22-25 months) rats and found the middle-aged and old rats significantly more sensitive than young rats to the neurotoxic actions of kainate. Low doses of kainate, which were nontoxic to young rats, frequently triggered status epilepticus, associated brain damage, and precipitous death in old rats. Middle-aged rats were more sensitive than young rats, but less sensitive than old rats to kainate neurotoxicity. These results suggest that the kainate-treated rat may be a useful model for studying mechanisms underlying age-related aspects of the human domoate neurotoxic syndrome.
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PMID:Age-related sensitivity to kainate neurotoxicity. 174 99

The authors report on the results of clinical investigations, treatment and follow-up of a 9-year old boy with complex partial status epilepticus (CPSE) which occurred after the first onset of partial secondary generalized epileptic seizures. Electroencephalografic recordings during status epilepticus showed a diffuse, generalized, high-voltage delta dysfunction and bilateral epileptiform activity, with local maximum over the posterior right temporal parietal regions. Parenteral administration of diazepam, phenytoin and phenobarbitone as choice anticonvulsant drugs, failed to stop CPSE in the patient. Only by continuous intravenous infusion of chlormethiazole (Heminevrin) status epilepticus was successfully controlled. Paroxysmal discharges on electroencephalogram disappeared and attenuation of slow wave activity was evident. Memory deficits and the elements of nominal dysphasia and tactile dysgnosia were apparent soon after cessation of CPSE and may be related to the signs of maximal local electroencephalographic dysfunction. Later testings after complete seizure control by chlormethiazole and phenytoin given orally, showed almost normal results. No side effects were encountered. A more common chlormethiazole administration as a useful therapeutic agent in the management of CPSE especially in children with refractory and long-time status, would be mandatory. Since chlormethiazole is free from serious side effects, its earlier use in the control of epileptic status may help to preclude some severe cognitive effects and to evade the use of barbiturate anesthesia as the last therapeutic resort.
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PMID:[Chlormethiazole in the treatment of complex partial epileptic status in childhood]. 178 23

Over a 5-year period 17% of admissions to an epilepsy unit in a psychiatric hospital had pseudoseizures; 42% of these patients also had concurrent epilepsy. Memory deficits were common both in those with pseudoseizures along (50%) and in those with concurrent epilepsy (62%). EEG abnormalities were more common in both groups with pseudoseizures than in a control group of patients with anxiety and affective disorders. Of specific EEG abnormalities only paroxysmal events occurred significantly more frequently in those with concurrent epilepsy than in those with pseudoseizures and in complicated cases of seizure disorder, the presence of cerebral pathology cannot be relied on to distinguish between epileptic and pseudo-seizures.
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PMID:Cerebral pathology in pseudoseizures. 190 11


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