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

Tuberous sclerosis and Klippel-Trenaunay-Weber (KTW) syndromes are phakomatoses which are believed to be inherited separately. A 41 year old woman presented with the classic features of tuberous sclerosis: adenoma sebaceum, mental retardation, and seizures. In addition, the diagnostic triad of KTW involved the left lower limb: cutaneous naevi, a vascular anomaly, and osteohypertrophy. Arteriography documented the presence of visceral tumours and an arteriovenous malformation of the leg. This is the first reported association of the fully-developed symptomatology of tuberous sclerosis and KTW in one person.
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PMID:Tuberous sclerosis and Klippel-Trenaunay-Weber syndromes. Association of two complete phakomatoses in a single individual. 16 20

Two patients with structural lesions had illusions of eye movement as the earliest manifestation of their seizures. One patient had a right occipitoparietal arteriovenous malformation and the other had a tentorial meningioma encroaching on the left occipital lobe. Symptoms were controlled by anticonvulsants and subsequent surgery in both cases. The characteristic feature of this rare form of seizure onset is a unilateral sensation of eye movement in the absence of oscillopsia.
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PMID:Sensations of ocular movement in seizures originating in occipital lobe. 40 25

A case is reported of a former woman astronaut candidate who withstood the rigors of the preliminary physical examinations for this position. Some years later, she sustained a subarachnoid hemorrhage from an arteriovenous malformation in the right parieto-occipital area, which was successfully excised. Postoperatively, she had a marked visual deficit, from which she completely recovered within 3 months. The development of psychomotor seizures 5 months later was due to probable scarring in the right parieto-occipital region of the cerebral cortex, the interpretive area for orientation of body image in space, which had been supplied by the clipped right anterior and posterior cerebral arteries feeding the arteriovenous anomaly. These seizures have been well controlled on anticonvulsants. A lesion in the temporoparieto-occipital region due to a hemorrhage from a ruptured arteriovenous anomaly, resulting in the disabling symptoms of disorientation or loss of body image due to impairment of the interpretive cortex, could be devastating to the pilot and a mission. This case raises the question of an automatic use of the CT brain scan in screening potential space candidates, and even the consideration of a percutaneous femoral four-vessel arteriogram in all, or possibly selected, candidates. Most neurosurgeons and neuroradiologists probably would consider the risks of the latter procedure too great to justify its use for fear of permanent complications to the space candidate.
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PMID:Ruptured arteriovenous anomaly in a former woman astronaut candidate. 44 78

Patients with medically intractable temporal lobe epilepsy (TLE) undergo medial temporal lobectomy with hippocampectomy for one of two reasons. (1) A lesion (tumor or arteriovenous malformation) adjacent to, but not invasive of, the hippocampus, results in the removal of the lesion and adjacent hippocampus in order to ensure a tumor-free margin. This group will be referred to as tumor-related TLE (TTLE) patients. (2) The operation is performed when depth electrode recordings and other evaluative techniques point to the hippocampus as the focus of seizure initiation. This group will be referred to as cryptogenic TLE (CTLE) patients. Analysis of the hippocampi of these two groups of patients reveals that the TTLE hippocampus is quite similar to that of autopsy subjects in its chemical neuroanatomy. However, the dentate gyrus of the CTLE patients shows considerable morphological and cytochemical reorganization. This reorganization is characterized by a number of features. (1) There is a loss of granule cells which occurs either as a patchy loss and/or a thinning of the granule cell layer. (2) Remaining granule cells which contain dynorphin appear to produce recurrent collaterals into the inner molecular layer of the dentate gyrus. (3) In the subgranular region of the hilus (the polymorphic layer) there is a selective loss of interneurons immunoreactive for somatostatin, neuropeptide Y and substance P. (4) There appears to be an increase in fibers immunoreactive for somatostatin and neuropeptide Y which extend throughout the dentate molecular layer. Somatostatin fibers being less numerous than neuropeptide Y fibers (5). The distributions of a number of neurotransmitter receptors also show striking reorganization in the dentate gyrus of the CTLE hippocampus. (6) Second messenger systems protein kinase C and adenylate cyclase, and Na+, K(+)-ATPase activity, as determined by ouabain binding, is increased in the molecular layer of CTLE. This remodeling of the CTLE hippocampus may hold the key to the mechanisms of hyperexcitability of the granule cells in the hippocampus of this group, and consequently the generation of seizures. The removal of the hippocampus in CTLE patients results in good control of seizures, whereas removal of hippocampi that do not show such reorganization, in a group of patients classified as atypical CTLE patients, results in inadequate seizure control. These findings suggest a complex series of processes in converting the properly regulated granule cells into hyperexcitable ones.
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PMID:Neurotransmitters and their receptors in human temporal lobe epilepsy. 136 31

The patient who presents with new onset seizure is a difficult but common problem in emergency medicine. It is more difficult to make a specific etiologic diagnosis when the seizure patient is without fever, focal neurological deficit, prior medical history, electrolyte or acid-base imbalance. Such a patient with new onset seizures presented to our emergency department. The seizures were induced by a specific right arm position. The patient's initial evaluation included a normal physical examination, screening chemistries, and an unenhanced computed tomography (CT scan) of the head. Subsequent contrast-enhanced head CT scan and eventual magnetic resonance imaging (MRI) of the brain revealed a large arteriovenous malformation (AVM). The differential diagnosis of seizures is long and involved, but a majority of these diagnoses can be ruled in or out by simple and inexpensive screening examinations. Occasionally, more involved studies are indicated than the routine electroencephalogram (EEG) and CT scan. CT scan with contrast, angiography, and magnetic resonance imaging (MRI) may be required to elucidate the cause of the seizure. Of these, angiography and MRI are the most sensitive for AVM, but contrast CT scan is the most readily available with acceptable sensitivity and is therefore potentially more beneficial.
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PMID:An adolescent male with an arteriovenous malformation presenting with reproducible seizures. 140 56

We studied a 24-year-old man who had reading epilepsy after removal of a left frontal arteriovenous malformation. Lesion analysis by means of a neuroanatomic template placed a 2-cm region of encephalomalacia anterior to the left central sulcus in premotor cortex (Brodmann's area 6). Lexical and nonlexical reading activation tests demonstrated seizures during reading and increased discharge rates when the patient was reading aloud or silently articulating. Seizures (perceived or actual jaw clicking) were electrographically characterized by brief left frontocentral epileptiform transients. Grapheme to phoneme transformation, not linguistic complexity, appears to be the critical stimulus in some reading epilepsies. The case adds anatomic relevance to the phonologic component of reading and supports the putative role of dominant premotor cortex in activation of precise sequences of motor linguistic output in reading and writing. Reading epilepsy may be a reflex or action myoclonus syndrome localized to Brodmann's area 6 (Exner's area).
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PMID:The role of dominant premotor cortex and grapheme to phoneme transformation in reading epilepsy. A neuroanatomic, neurophysiologic, and neuropsychological study. 152 84

Despite the great capacity for the pediatric brain to recover from stroke, the morbidity and mortality in children who harbor an arteriovenous malformation (AVM) remains high. This study examines the clinical data and management experience with 132 patients with brain AVM from 1949 to 1989. Although the high tendency for a childhood AVM to present with hemorrhage (79%) remained constant for the forty year study period, the associated morbidity and mortality of hemorrhage changed. The mortality rate from hemorrhage for the entire series was 25%, which was reduced from 39% to 16% after the introduction of computed tomography. The mortality from AVM hemorrhage since 1975 was dependent on location; 8 of 14 patients (57%) with a cerebellar AVM died from hemorrhage while only 2 of 44 patients (4.5%) with a cerebral hemisphere AVM died (p less than 0.0001). Sixteen children (12%) presented with a chronic seizure disorder. Surgical excision of the malformation resulted in complete seizure control off anti-convulsant medication in 73% of patients. Although 21% of patients were treated non-operatively (many with terminal poor-grade hemorrhage), 79% had a surgical procedure with total AVM excision achieved in 70 patients (53.1%). Complete AVM resection was followed by a normal neurological outcome in 47 children (67%). Most partial excisions (n = 9) and clipping of feeding arteries (n = 7) were performed in the early years of this study, and did not provide protection from rehemorrhage. Although conservative management has been advocated for selected non-hemorrhagic AVMs, we conclude that essentially all children with an AVM should be treated in order to eliminate the risk of hemorrhage.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Arteriovenous malformations of the brain in children: a forty year experience. 156 6

The clinical outcomes are described for 247 consecutive cases of arteriovenous malformation (AVM) treated with the gamma knife between April, 1970, and December 31, 1983. Headache resolved in 65 (66.3%) of the 98 patients presenting with this symptom and improved in an additional nine (9.2%). Of 59 patients admitted with seizures, 11 (18.6%) became seizure-free without anticonvulsant medication and an additional 30 patients (50.8%) became seizure-free with anticonvulsant medication. Pre-existing neurological deficits improved or totally disappeared following radiosurgery in 56.7% of affected cases. This improvement presumably occurred within the frame of the natural history. The protective effect of the ionizing beams against hemorrhage in incompletely obliterated AVM's is analyzed. To assess the rate of rebleeding, probability estimates were calculated using both the person-year method and the Kaplan-Meier life table. With the person-year method the actual rebleed rate is not too different from the values observed in the natural history of the disease (2% to 3%/yr). Analysis by Kaplan-Meier life-table estimates demonstrated a risk of nearly 3.7%/yr until 60 months after radiosurgery. Five years following treatment, the life table ends in a plateau which could be interpreted as an indication of decrease in the risk of hemorrhage. However, long flat regions at the right end of the life table do not imply that the real risk of rebleeding is negligible unless a large number of patients have been followed well into or beyond the flat region.
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PMID:Clinical outcome of radiosurgery for cerebral arteriovenous malformations. 140 33

The computed tomography findings in 82 children with partial seizures of unknown aetiology were reviewed. All had seizures with predominantly focal motor phenomena and none had abnormality on neurological examination. Findings on computed tomography were normal in 64 children (78%) and abnormal in 18 children (22%). Fourteen children had changes representing static pathology (mainly cerebral atrophy) which did not influence patient management but four had potentially correctable lesions (two tumours and two arteriovenous malformations). There were no correlations between seizure control, seizure duration, intellectual handicap, postictal weakness, electroencephalographic findings, and abnormality on the computed tomogram. In particular, none of these features were useful in predicting the presence of a tumour or arteriovenous malformation. It is concluded that a computed tomogram is indicated in every child with partial seizures.
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PMID:Computed tomography findings in partial seizures. 162 87

A 59-year-old female was hospitalized because of disturbance of consciousness and convulsive seizures. She had taken a hormonal drug for 15 months after breast cancer surgery. A computed tomography scan revealed multiple high-density areas in the left temporal and frontal and the right parietal lobes. Angiography showed a dural arteriovenous malformation (AVM) in the posterior fossa fed by the occipital and the middle meningeal arteries and draining into the transverse sinus. It also demonstrated occlusion of the left sigmoid sinus in the venous phase. She complained of headache in the occipital region and dizziness. On day 13, the left occipital artery was ligated and cut, and then abnormal arterial anastomoses around the lesion were coagulated. After surgery, clinical symptoms disappeared. The etiology of dural AVM is controversial, but in this case it is suspected that sinus thrombosis due to the drug caused the dural AVM. The authors discuss the etiology and treatment of dural AVM in the posterior fossa.
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PMID:[Dural arteriovenous malformation in the posterior fossa presenting with multiple intracerebral hematomas. Case report]. 170 75


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