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

We reviewed the charts of all patients with pathologically proven meningiomas who were admitted to the Montreal General Hospital between 1960 and 1977. Of the 80 patients reviewed, we found approximately one third of them had ophthalmological symptoms of which visual loss, field defect, and diplopia were the most common. Most of these patients also had neurological symptoms, but they were often nonspecific. One half of the patients presented with chronic symptomatology such as headache, mental change, and visual loss. One third of the patients presented acutely with seizures, hemiplegia, or dysphasia. Of the investigations done, the angiogram and brain scan were most often diagnostic, while the skull x-ray and EEG were often normal. Meningioma of the sphenoidal ridge, parasellar area, and occiput most often produced visual deficits. In almost one half of these patients, the visual deficit was initially misdiagnosed.
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PMID:Meningioma and the ophthalmologist. A review of 80 cases. 733 2

After anastomosis of the superficial temporal to the middle cerebral artery, partial motor seizures referable to the left inferior motor strip and Broca's area developed in a 48-year-old man. These seizures were readily induced by attempts to speak, to read silently or aloud, and to write. The seizures were not induced by simple movements of the ocular, facial, jaw, throat, and extremity muscles, primary sensory stimuli, or higher intellectual function such as calculation. The patient had nonfluent dysphasia, but he had no comprehension disorder. A clear focal onset of electrographic seizures was recorded maximally at the left temporal region on reading aloud and at the left central area on writing. The cerebral evoked potentials were mildly abnormal on the affected hemisphere. This case shows cortical onset of language-induced seizure.
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PMID:Language-induced seizure. A case of cortical origin. 738 89

Status epilepticus is usually a straightforward diagnosis when a patient has two or more seizures without regaining consciousness. However, when status is non-convulsive and, in particular, has a temporal lobe flavour the clinical presentation may be misleading. Presentation with automatic or psychic behaviour is well recorded. We report a patient with nonconvulsive status who presented with progressive dysphasia with widespread CT and MRI changes. The dysphasia and imaging changes led to a diagnosis of a probable neoplastic brain process but reversed with anticonvulsant treatment.
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PMID:Status epilepticus presenting as progressive dysphasia. 747 49

Between 1934 and 1988, 34 patients with tumoural parietal lobe epilepsy were treated surgically at the Montreal Neurological Institute (MNI). Fifteen had right-sided and 16 left-sided resections. The remaining three patients had biopsies only. Follow-up ranging from 1 to 40 years (mean 12.3 years) was available for 28 patients. Seventy-five percent (21 out of 28) became seizure free or had rare seizures. Permanent post-operative sensory deficits were described in 12% of patients. An aura was described by 79%. 62% had somatosensory symptoms, contralateral to the epileptogenic region in all but one. Visual illusions (12%), aphasia (9%) and disturbances of body image (6%), were much less common at the beginning of the attacks. Intra-operative cortical stimulation reproduced the habitual aurae in 10 out of 25 (40%) of the patients. The clinical manifestations suggested different spread patterns: 21% had tonic posturing of the extremities, 82% focal clonic activity, 15% head deviation, 9% automatisms and 6% difficulty speaking. Eleven (32%) had Todd's paralysis and 18% postictal dysphasia. Almost half the patients had impaired two-point discrimination in contralateral fingers; two of these also had impaired stereognosis, but only one had astereognosis without coexisting primary cortical sensory deficit. Review of this, now historical, series shows that parietal lobe tumours can be resected with good control of previously intractable seizures. Such an approach is preferable to postponing resection until the lesion is shown to increase in volume.
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PMID:Tumoural parietal lobe epilepsy. Clinical manifestations and outcome in 34 patients treated between 1934 and 1988. 749 87

The introduction of cyclosporine A (CsA) and FK506 significantly improved the outcome of liver transplantation. However, the postoperative course and outcome of liver transplant recipients in still compromised by rejection, over-immunosuppression-induced infection and immunosuppression-associated toxicity. In the present study, we evaluated the reason for conversion between immunosuppressive regimens in 121 patients, 60 treated with FK506 and 61 patients treated with CsA-based immunosuppression. Five patients treated primarily with CsA (8.3%) were converted to FK506 therapy because of refractory acute of chronic rejection within 12 months following liver transplantation (LTX). In 2 patients, conversion was performed after Re-LTX. In 4 of these 5 patients, rejection was successfully treated according to histological and laboratory investigations, while in the remaining patient, graft function improved with persisting histological evidence of chronic rejection. Moderate and severe neurologic symptoms during the early postoperative period, i.e. organic brain syndromes (OBS), seizures, hemiparesis, dysphasia, dysathria and cerebellar symptoms were observed in 21.3% of patients treated with FK506 and in 11.7% of patients treated with CsA (p = n.s.). Five patients treated primarily with FK506 were converted to CsA due to severe neurotoxicity. Early postoperative renal insufficiency was observed to a similar extent with 42.6% of FK506- and 36.7% of CsA-treated patients. 8.3% of FK506-treated patients and 11.7% of CsA-treated patients required hemodialysis (p = n.s.) There patients were converted from FK506 to CsA due to persisting renal insufficiency. Moderate and severe neurologic symptoms were observed more frequently under treatment with FK506 than CsA, and all conversions from FK506 to CsA (13.3%) were performed because of neuro- or nephrotoxicity.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Toxicity versus rejection--or why conversions between cyclosporine A and FK506 were performed after liver transplantation. 754 52

We report the clinical manifestations and outcome of 82 patients with nontumoural parietal lobe epilepsy treated surgically at the Montreal Neurological Institute between 1929 and 1988. Patients with extensive resections extending outside the parietal lobe were excluded. Ninety-four percent exhibited aurae: the most common were somatosensory, described by 52 patients; 13 of these also described pain. Other aurae included disturbances of body image, visual illusions, vertiginous sensations and aphasia or dysphasia. A few patients exhibited complex visual or auditory hallucinations and elementary visual hallucinations. Intraoperative cortical stimulation reproduced the habitual aurae in 44 patients. Often the clinical manifestations indicated ictal spread to the frontal, supplementary motor area, or temporo-limbic areas: 28% of patients exhibited tonic posturing of the extremities, 57% unilateral clonic activity, 17% oral or gestural automatisms and 4% complex automatisms. Sixty-one percent of patients with tonic posturing had epileptogenic zones which included the superior parietal lobe, and in 79% of patients with automatisms the epileptogenic zones extended to the inferior parietal lobe, suggesting different spread patterns. Forty-three patients underwent right, and 39 left parietal corticectomies. Postoperative sensory deficits were seen only when the corticectomy extended into the post-central gyrus. Early in the series extensive nondominant inferior parietal resections led to disturbances of body image in a few patients. Follow-up ranging from 2 to 50 years was available for 79 patients. Sixty-five percent had a complete or nearly complete cessation of seizures. Those patients with no post-resection electrocorticographic epileptiform discharges had a more favourable outcome.
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PMID:Parietal lobe epilepsy. Clinical manifestations and outcome in 82 patients treated surgically between 1929 and 1988. 760 82

One hundred and sixteen patients with high grade glioma were entered into a prospective phase two study and treated with accelerated radiotherapy from 1988 to 1993. In this cohort of patients we analysed speech deficit as a subdivision of global functional status in terms of incidence, category and prognosis for survival. Forty three patients (37%) had a speech deficit at presentation. Eighty percent of these had a component of expressive dysphasia, associated with considerable degree of awareness and distress. The overall median survival was 9.5 months. On univariate analysis, median survival in patients with speech difficulties (6 months) was worse than patients with normal speech (10.5 months) (log rang p = 0.005). Multivariate analysis established independent significance from age, Karnofsky Performance Status (KPS), gender, histological grade, extent of surgery and seizures. This paper highlights the importance of assessing individual categories of functional disability which in patients with high grade glioma include mobility, cognitive function and communication. Each of these factors may seriously affect an individual's activities of daily living, hence quality of life and separate analysis has a number of clinical implications. Firstly, with over a third of patients suffering speech difficulties, adequate speech therapy facilities should be freely available to score the degree of deficit, devise coping strategies and institute communication therapy. Secondly, an understanding of prognostic factors aids the critical analysis of phase two studies and the design and stratification of future prospective trials which should include an analysis of speech deficit. Thirdly, separating individual patients into good and bad prognostic groups can assist strategic management decisions.
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PMID:Speech and language disorders in patients with high grade glioma and its influence on prognosis. 767 91

A prospective study looking at the prevalence of epilepsy in 246 children with autistic spectrum disorder revealed that 7.6% of children satisfying the criteria of infantile autism and 5% of those with an autistic condition had epilepsy. The majority had onset of seizures before the age of 1 year. Boys predominated in both groups. There was no correlation between the age of onset of seizures, type of seizure, sex, mentality, and the outcome of epilepsy. There is an increased risk of epilepsy in autistic children compared to those with developmental dysphasia or Down syndrome. There might be some underlying defect of the brain in autistic children that causes different degrees of autistic manifestation with which epilepsy is associated, as part of the spectrum complex.
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PMID:Epilepsy in children with autistic spectrum disorder. 769 96

We describe the case of a 46-year-old woman with rheumatoid arthritis who developed a severe reaction to sulfasalazine, characterized by dysphasia, seizures, rash and the development of strongly positive pANCA (perinuclear antineutrophil cytoplasmic antibodies). Her condition improved spontaneously upon withdrawal of sulfasalazine. Dysphasia has not been reported as a side effect of sulfasalazine.
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PMID:Sulfasalazine induced seizures and dysphasia. 791 3

A patient with a remote infarct, seizures, mild hemiparesis, and dysphasia became obtunded over four months and died. Computerized tomography (CT) over 5 years showed a consistent, large, wedge-shaped left hemisphere hypodensity with a central calcification, but without signs of mass effect. This was interpreted as an infarct of the left middle cerebral artery territory. Post-mortem examination of the brain revealed the entire area appearing as infarct on CT was a gliosarcoma. We suspect that the unusual CT appearance of the lesion was likely caused by multiple pathologies: a low grade glioma transforming into a gliosarcoma that was able to spread throughout the area of infarct encephalomalacia without revealing a typical CT appearance of mass effect. The patient's brief period of deterioration probably coincided with transformation of the tumor into a gliosarcoma. The variable CT characteristics of gliosarcomas are reviewed.
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PMID:Unusual evolution and computerized tomographic appearance of a gliosarcoma. 808 41


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