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

Fourteen (74%) of 19 patients obtained a significant reduction in seizures after posterior corticectomy; 6 (32%) were seizure-free over a median follow-up of 3.7 years (range, 1 to 14 years). Surgery included limited resections of the occipital lobe in 16 patients, posterior temporal region in 11, and posterior portion of parietal lobe in 7. Surgical failure related to probable multiple areas of epileptogenesis (4 patients), or limited resections (2 patients) to preserve visual fields (2 patients) and to avoid dyslexia (1 patient). Of 14 patients without a complete hemianopia preoperatively, 6 (43%) developed a new or increased visual field deficit, 2 (14%) of which were hemianopia. Four (36%) of 11 occipital lobe resections resulted in a new or increased visual field deficit: quadrantanopia in 3 and hemianopia in 1. Visual phenomena were the most common initial ictal symptoms, occurring in 13 (68%) of the 19 patients. Twelve patients had complex partial seizures: in 2, always without warning; in 7, always following an aura, usually visual; and in 3 patients, with or without warning. Scalp electroencephalography identified the origin of most recorded seizures in 12 (63%) of the 19 patients. A principal interictal spike focus appeared in 15 patients (79%), and always correlated with the epileptogenic lobe as defined by scalp and/or subdural-recorded seizures (14 patients) or by clinical analysis and computed tomography (1 patient).
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PMID:Epilepsy surgery in the posterior cortex. 189 66

Fifteen patients have been followed for more than one year following callosotomy having presented with long standing epilepsy, no well defined focus amenable to radical excision, and severely incapacitating atonic seizures that were refractory to anticonvulsant therapy. Atonic fits have been reduced by more than 80% in thirteen patients, with two patients suffering long term sequelae (slight dysarthria in one, and dyslexia with mild visuo-spatial disturbances in another). Anticonvulsant therapy was still required post-operatively.
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PMID:Callosotomy for the treatment of drug resistant generalized seizures. 212 84

The results of many studies using quantitative EEG techniques in clinical settings have been published. Those reports are reviewed here, with emphasis on those that used EEG frequency analysis and topographic mapping. In cerebrovascular disease, these methods can confirm the existence of lesions that are too mild to show up on routine EEG or too mild or too early to show up on computed tomography. The results correlate well with cerebral blood flow studies. These EEG tests can be done continuously in an intensive care unit or operating room. However, exact localization ability is inferior to that seen using traditional neuroimaging tests. In epilepsy, quantitative EEG techniques have found subtle degrees of background EEG changes near epileptic foci. Other methods can quantify epileptic spikes in useful ways and can indicate which region is driving other regions during seizures. Quantification is also useful for measuring drug effects when drugs (such as thiopental) are given deliberately to provoke acute EEG changes. Other measurements of drug effects may become useful in the future. In patients with mass lesions and metabolic encephalopathies, quantitative EEG changes do occur, and some of these correlate with the clinical state. However, in the latter settings, the clinical advantages for patient care are not yet clear, especially in comparison to available neuro-imaging studies and other routine medical tests. For dementia, quantitative EEG techniques are being developed. Some of these tests are accurate in moderately or severely demented patients, but there is still poor accuracy for early or borderline cases. For dyslexia, schizophrenia, and depression, there is a considerable volume of research reports but still no consensus about how to use quantitative EEG tests for care of individual patients. These tests require substantial user expertise in EEG. At present, these tests should be viewed as adjunctive to traditional EEG testing: such routine EEG testing should serve as the foundation for any clinical use of quantitative EEG tools.
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PMID:Quantitative EEG: II. Frequency analysis and topographic mapping in clinical settings. 307 70

Systemic lupus erythematosus (SLE) is a multisystemic disease that predominates in women during the childbearing years. One system frequently affected is the central nervous system. Seizures and psychoses are criteria useful in the diagnosis of SLE. The effects of this disease on disorders of learning and handedness in both patients and first degree relatives are the subject of the present report. Dyslexia and other disorders of learning were present in 45% (24/55) of male offspring of female SLE patients. Ten percent of male siblings of female SLE patients were learning-impaired. Dyslexia and other disorders of learning are also common in women with SLE (dyslexia 12.5%) and men with SLE where the proband is one of two or more cases of SLE in the same family (dyslexia 27.6%). Tests for handedness in the lupus population indicated that there were slightly more patients (mostly women) (p = 0.08) who were lefthanded by the Oldfield laterality test compared to normal volunteers. Handedness did not correlate with the degree of dyslexia in either the patients or their first degree relatives.
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PMID:Systemic lupus erythematosus: learning disability in the male offspring of female patients and relationship to laterality. 320 5

Dyslexia and dysgraphia of various kinds are recognized sequelae of cerebral lesions. Although refusal to read or write may occur in a number of psychiatric disorders, to our knowledge dyslexia and dysgraphia as the sole manifestations of a psychogenic disorder have not previously been reported. Our patient had psychogenic symptoms, initially including seizures but subsequently consisting solely of dyslexia and dysgraphia.
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PMID:Seizures, dyslexia, and dysgraphia of psychogenic origin. 646 66

Developmental dyscalculia (DC) is a primary cognitive disorder of childhood manifested by disturbance of arithmetic ability. As an isolated learning disability (LD), it is usually treated by remedial education and not referred for further medical evaluation. We examined a group of 7 third-grade children with DC attending a mainstream school who had not progressed academically in spite of specific special education intervention. We were able to identify in all 7 children neurological conditions that had direct bearing on the children's cognitive disabilities and remedial programs. One child had petit mal seizures, another developmental Gerstmann syndrome, a third had dyslexia for numbers, and 4 children had attention deficit disorders without hyperactivity. Based on this experience, we suggest that the indications for medical or neurological assessment be broadened to include children who are not improving academically in spite of appropriate professional intervention.
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PMID:Developmental dyscalculia and medical assessment. 768 63

The role of the nondominant hemisphere in reading is controversial. We characterized the reading errors made by 64 right-handed adults with complex partial seizures (half with seizure foci on the right and half on the left), after right hemisphere injection of sodium amobarbital. Subjects were presented with 20 six-word sentences and all were found to have speech associated with the left hemisphere only. A variety of reading errors occurred, most of which fell under the syndrome of "neglect dyslexia" including deletions and substitutions of whole words on the left side of a line of text as well as within-word neglect errors. The nature of these errors indicated that they may have been caused by an interaction between a peripheral processing deficit and more centrally located conceptual knowledge of linguistic structure. Other errors could be attributed to a general decrease in attentional mechanisms. Neglect errors at the level of the sentence occurred in the absence of neglect errors at the level of the word although the converse was not true. This suggests that the latter may represent a more severe deficit in the mechanism that causes the former. A double dissociation existed between single word neglect dyslexia errors and "visual" errors, indicating separate processing mechanisms.
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PMID:Reading errors following right hemisphere injection of sodium amobarbital. 918 96

In order to assess the lateralizing value of several ictal and postictal clinical symptoms in temporal lobe epilepsy (TLE), we analyzed 89 seizures of 20 left dominant patients with intractable left (n = 9) versus right (n = 11) TLE who had undergone successful anterior temporal lobectomy. In left TLE, movement arrest at seizure onset, postictal dysphasia > 120 s and postictal dyslexia > 180 s were the most typical findings and associated with a sensitivity of 94, 94, and 100%, respectively. The highest specificity of 100% each was evident for contralateral versions of eyes and head and dystonic posturing. In right TLE, the highest sensitivity was seen for whole-body movements at seizure onset, postictal dysphasia < 120 s and postictal dyslexia < 180 s with figures of 82, 87, and 93%, respectively. As compared to left TLE, contralateral version and dystonic posturing, ictal speech, and postictal dyslexia < 180 s each had a specificity of 100%. The careful combined analysis of certain ictal clinical signs combined with consistent findings of interictal EEG and neuroimaging studies may be often sufficient to proceed with epilepsy surgery without invasive recordings even if ictal scalp EEG is not unambiguous.
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PMID:The lateralizing value of ictal clinical symptoms in uniregional temporal lobe epilepsy. 952 67

Five new cases of reading epilepsy (RE) are reported. This is an epilepsy syndrome belonging to the group of idiopathic localization-related epilepsies. They all have some interesting features which contribute to the understanding of the pathomechanism and nosology of this specific type of reflex epilepsy. In our first patient the precipitating effect of texts in unknown languages depended upon phonematic intricacy. With our second case, changes of script within the text (Latin to Greek) increased the precipitating effect. The visual aura experiences reported in vague terms by some patients with RE may represent ictal dyslexia. For case three RE had been misdiagnosed as phobic neurosis. Even if a patient has a history of development dyslexia, and ictal dyslexia is a feature of the seizures, the onset of RE is not during primary school age but at puberty. Our fourth patient's manifestation factor of (late-onset) RE was a change of scriptural environment (Kyrillic to Latin) . Unilateral myocloni were observed with bilateral spike wave discharge in RE, and carbamazepine possibly increased the epileptic response in RE. With the co-occurrence of RE and juvenile myoclonic epilepsy in case five, the clinical features of both syndromes remained separate. All five patients responded well to treatment with valproic acid, and all confirmed that the syndrome has no tendency to deteriorate in long-term follow-up.
Seizure 1998 Aug
PMID:Reading epilepsy: report of five new cases and further considerations on the pathophysiology. 973 1

Children with epilepsy, as a group, have a greater risk for developing learning problems as comorbid disorders. It is unknown which factors contribute to the development of such learning problems; therefore, our current knowledge does not allow the prediction of educational delay in an individual child with epilepsy. This study aimed at excluding as many factors as possible that could interfere with the analysis of the impact of epilepsy on learning. From patients referred to us in 1997 (N = 123), children were included with mild global learning impairment, defined as educational delay between 6 months and 1 year and no other apparent reason for learning impairment except for epilepsy (ie, excluding children with dyslexia, attention-deficit hyperactivity disorder, or mental handicap). A total of 44 patients fulfilled this criterion: 31 also had epilepsy (experimental group); the remaining 13 patients with similar mild learning impairment but without epilepsy were used as controls. In the experimental group two subgroups were distinguished on the basis of onset of learning impairment: in group A (n = 17) the learning problems are not unexpected as they were preceded by mild developmental delay; in group B (n = 14) the problems are unexpected and had a sudden onset. The two experimental groups differed from the control group on a number of variables, such as gender and the incidence of perinatal complications. More differences have been found between the two experimental groups: group B is selected from a larger group: all children with mild global learning impairment with sudden onset. In this group considerably more children with epilepsy have been found compared to the children with developmental delay; moreover the epilepsy is more often characterized in these children as "unexpected," that is, there was no previous established diagnosis of epilepsy, the symptoms were mostly unclear and behavioral in make-up (attentional lapses, etc); the electroencephalogram plays a much greater role in the diagnosis in this group, especially in demonstrating seizures; finally, the children in this group more frequently have neuropsychologic impairment. Children with epilepsy can have mild global learning difficulties, especially in the period after the onset of seizures. This group can be divided in a group with "trait-dependent learning difficulties," that is learning difficulties based on developmental delay, and a group with "state-dependent learning difficulties." The focus in our study was on this latter group, consisting of children with sudden and unexpected decline of results in school. The crucial finding in this group is the relatively frequent demonstration of difficult-to-detect seizures, demonstrating that an uncontrolled epilepsy can cause a decline in school results even when the seizures are of short duration and have subtle symptoms.
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PMID:An open, nonrandomized clinical comparative study evaluating the effect of epilepsy on learning. 1061 66


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