Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This case of microsporidiosis manifested as mutiple intracranial lesions separated in space and time, and neurological and radiological findings were improved with albendazole administration. A 33-year-old man presented with headache, fever, and dysphasia. His consciousness was clear. Neurological examination revealed acalculia, agraphia, and homonymous hemianopsia. He had a past history of febrile convulsive seizures of unknown cause until 14-years-old, but no history of immunodeficiency. T1-weighted magnetic resonance (MR) imaging showed a hypointense lesion with a hyperintense part, and ring-like enhancement with gadolinium-diethylenetriaminepenta-acetic acid (Gd-DTPA), in the left temporal lobe. T2-weighted and diffusion-weighted MR imaging showed the lesion surrounded by moderate hyperintense areas. He underwent gross total resection of the lesion. Histological examination demonstrated intracellular clusters of small basophilic spore-like bodies in the astrocytes, suggestive of microsporidia-infected astrocytes. However, immunohistochemical, polymerase chain reaction, and serological analyses failed to confirm the definitive diagnosis of microsporidiosis, so that he received no further treatment. Three years later, he presented with sensory disturbance in the left side of his face and left cerebellar ataxia, followed by fever, abnormal sensation in the left side of his face, and aggravated ataxia of the left upper and lower extremities on day 10 after admission. T1-weighted MR imaging with Gd-DTPA showed an enhanced lesion with irregular margin in the left cerebellar peduncle. T2-weighted MR imaging showed a diffuse hyperintense region around the lesion. Cerebrospinal fluid culture, serological analysis for autoimmune disease, and thoracic, abdominal, and pelvic computed tomography and 18F-fluorodeoxyglucose-positron emission tomography detected no abnormalities such as cancers or other lesions in the extracranial organs. No definitive diagnosis was obtained, but recurrence of microsporidiosis was the most probable cause. Administration of albendazole (600 mg/day) was started on day 15, because of rapid neurological and radiological deterioration. This treatment resulted in clinical improvement and disappearance of the lesion on MR imaging after daily administration for 4 weeks. He was discharged on foot with moderate sensory disturbance in the left side of the face and ataxia. Based on the clinical course and negative findings, the final diagnosis was microsporidiosis. This case suggests that microsporidiosis in the central nervous system can persist even in immunocompetent patients without involvement of any other organs, and that albendazole administration is likely to be effective.
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PMID:[Multiple intracerebral enhanced lesions strongly suspected to be microsporidiosis. A case report]. 1863 8

At the Austin Hospital, Melbourne, Australia, 200 consecutive temporal lobectomies were performed for refractorycomplex partial seizures between 1969 and 1991 as part of its Comprehensive Epilepsy Program. The complications of this retrospective series are reported. There were no 30-day postoperative deaths but there were 6 late deaths. Complications are divided into 'major' if permanent and/or severe or 'minor' if temporary or not severe. Complications included hemiparesis (2% major, 1% minor), visual field defect (3% major, 18. 5% minor), dysphasia (96 dominant resections - 0% major, 5. 5% minor), memory impairment (1 % major, 9. 5% minor); intracranial infection (2% major, 0% minor), and miscellaneous (11 % minor). The mechanisms of the complications are discussed. Temporal lobectomy for the treatment of epilepsy can be performed with a low morbidity.
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PMID:Temporal lobectomy for epilepsy - complicationsin 200 patients. 1863 21

Glial tumours associated with subarachnoid haemorrhage are very rare. A 64-year-old woman admitted with a history of 3 weeks seizures and a left sided hemiparesis and dysphasia. The magnetic resonance disclosed heterogeneously enhancing a right temporal mass. During surgery, suddenly an abrupt and extensive swelling had occurred both in tumour and the brain tissue. The surgery was completed with a gross total tumour resection together with a partial temporal lobectomy. Postoperative computerized tomography demonstrated a massive subarachnoid hemorrhage (SAH). A cerebral Magnetic Resonance (MR) angiography showed neither an aneurysm nor arteriovenous malformation. Coincidence of an intracerebral tumour and subarachnoid haemorrhage would be devastating.
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PMID:Intra-operative real time intracranial subarachnoid haemorrhage during glial tumour resection: A case report. 1901 58

Lateral ventricular meningiomas are rare tumours that pose considerable surgical challenge. This study attempts to analyse some of the important clinical features of these tumours and review technical considerations in surgery for lateral ventricular meningiomas. A retrospective analysis of the case records of patients with lateral ventricular meningiomas operated in our institute since 1998 with a minimum of one year follow up was done. The variables analysed included age, sex, clinical presentation, imaging characteristics, histopathology and operative details. Outcome was analysed using the Glasgow outcome score (GOS). Fifteen patients with a mean age of 40.6 years formed the study group. A female preponderance was observed (M:F 5:10). Raised intracranial pressure was the predominant symptom at presentation (10/15; 66%) followed by visual field deficits (6/15; 40%) and contralateral motor deficits (5/15; 33.3%). One patient presented with evidence of intratumoural bleed. The tumour was on the right side in 7 patients and on the left side in 8 patients. The lesion was located in the trigone of the lateral ventricle in 13 patients and in the body of the ventricle in two. The tumours were excised through a parietooccipital approach in 11 (73.33%) patients and through a middle temporal gyrus approach in 4 (26.66%).The tumour recurred in 2 patients, both tumours being histologically fibroblastic variants. Fresh operative complications included motor deficits in 3, contralateral homonymous hemianopia in 2, dysphasia in 1, refractory seizures in 2 and loculated hydrocephalus in one. We had no operative mortality. At last follow-up for 10 patients were in GOS 5, two were in GOS 4 and three in GOS 3. Lateral ventricular meningiomas are difficult tumours to operate. Total surgical excision through a superior parietal lobule or middle temporal gyrus approach is possible in most cases with minimal morbidity.
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PMID:Meningiomas of the lateral ventricle - a report of 15 cases. 1953 63

The aim of this study was to report the safety and efficacy of tailored cortical resection based on image guided subdural electrode implantations in eight patients with medically refractory epilepsy. The patients were selected for multimodality image guided subdural grid implantation, inpatient invasive electroencephalography video monitoring and surgical resection of epileptogenic foci. All patients had frequent disabling, medically refractory seizures pre-operatively. At a minimum of 10 months post-resection all patients had a worthwhile improvement in seizure frequency, with 7 of the 8 (87.5%) having an excellent outcome (Engel Class I). Short-term complications of grid implantation were: one patient with a post-operative subdural haemorrhage and one patient with a transient fluctuating dysphasia. The only long-term complication was a mild, non-disabling dysarthria following resection near eloquent speech cortex in one patient. We conclude that tailored cortical resection following image-guided insertion of subdural grids is a reliable, safe and highly effective method for the treatment of medically refractory epilepsy in carefully selected patients.
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PMID:Tailored cortical resection following image guided subdural grid implantation for medically refractory epilepsy. 1968 26

We report our experience in treating patients with seizures associated with brain arteriovenous malformations (AVM) without a clinical history of intracranial hemorrhage. Between 2001 and 2003, the neurovascular unit at Beijing Tiantan Hospital treated 109 patients with brain AVM endovascularly. Thirty patients (27.5%) experienced seizures before treatment. We studied the following factors: sex, age, AVM size, AVM location, seizure type, duration of seizure history, endovascular treatment and AVM obliteration. Clinical follow-up was via telephone interview. Thirty patients with seizure disorders due to brain AVMs were endovascularly treated. The age of the patients ranged from eight to 55 years. There were 22 males and eight females. The AVMs were smaller than 3 cm in five patients, between 3 cm and 6 cm in 22, and larger than 6 cm in three. The most frequent location of the AVMs was in the frontal, followed by the parietal, temporal and occipital lobes. Sixty-seven embolization procedures were performed and total obliteration was achieved in four patients. Two patients developed a hemiparesis and three suffered temporary dysphasia after embolization. Two patients had visual field deficits. There were no deaths. The results of post-embolization seizure control during the average follow-up period of 80 months were excellent in 21 patients, good in four, fair in two and poor in three. Successful seizure control can be obtained with endovascular embolization.
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PMID:Brain arteriovenous malformations and endovascular treatment: effect on seizures. 2037 78

For a retrospective observational investigation based on real clinical practice of relative efficacy of valpoic acid (VPA), carbamazepine (CBZ) and topiramate (TPM) we have selected 205 patient with age of seizure onset before 16 years with a undoubted diagnosis of medial temporal lobe epilepsy, who had received treatment according to ILAE recommendations, and observation time since the last treatment change was from 2 to 5 years. The groups of patient receiving CBZ, VPA small i, Cyrillic TPM did not differ significantly in presenting unfavorable prognostic factors and dose regimes that allowed to conduct direct comparison of efficacy of the investigated drugs. Efficacy of VPA in children with medial temporal lobe epilepsy was higher compared with CBZ (79% vs 61%; p< or =0,05) and TPM (79% vs 53%; p< or =0.001). CBZ caused seizure aggravation more frequently than VPA (10% vs 1%; p< or =0,001). In case of presence of clinico-electroencephalografic signs of significant organic brain damage and in patient with seizure onset before age of 1 year CBZ was not effective while TPM showed efficacy of 20%, (p< or =0,05) and VPA was the most effective drug in this case (50%; p< or =0,001). In case of focal cortical dysphasia or the states after periventricular leucomalacia the efficacy of CBZ was lower than VPA (0% for CBZ vs 89% for VPA - p< or =0,01 and 40% for CBZ vs 77% for VPA - p< or =0,05, respectively) and TPM (0% for CBZ vs 100% for TPM - p< or =0,01 and 40% for CBZ vs 100% for TPM - p< or =0,01, respectively). In MRI-negative cases VPA was most effective (90% vs 53% for CBZ; p< or =0,001 and 67% for TPM; p< or =0,05). Efficacy CBZ reduces proportionally the number of previously used antiepileptic drugs (AEDs) (52% as a first AED vs 17% as a second AED; p< or =0,01), this tendency is noted also for TPM but in less extend (80% vs 46%, respectively p< or =0,05), but not for VPA (77% vs 75%; p>0,05, respectively). Adverse effects were more frequent during treatment with CBZ, than VPA (19% vs 5%; p< or =0,001) and TPM (19% vs 9%; p< or =0,05).
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PMID:[Efficacy of carbamazepine, valproate and topiramate in the treatment of medial temporal epilepsy in children]. 2051 9

For a retrospective observational investigation based on real clinical practice of relative efficacy of valpoic acid (VPA), carbamazepine (CBZ) and topiramate (TPM) we have selected 106 patients with age of seizure onset before 17 years with a undoubted diagnosis of symptomatic or cryptogenic occipital lobe epilepsy (OLE), who had received treatment according to ILAE recommendations, and observation time since the last treatment change was from 2 to 10 years. Patients suspicious for idiopathic epilepsies were excluded. The groups of patient receiving CBZ, VPA and TPM did not differ significantly in presenting unfavorable prognostic factors and dose regimes that allowed to conduct direct comparison of efficacy of the investigated drugs. Efficacy of VPA in children with OLE was higher compared with CBZ (69% vs 36%, p < 0.01) and TPM (69% vs 8%, p < 0.001). CBZ and TPM caused seizure aggravation more frequently than VPA (12% and 13% respectively vs 1%, p < 0.001). In case of presence of clinico-electroencephalografic and MRI signs of significant organic brain damage and in patients with seizure onset under 11 years TPM was not effective. In case of focal cortical dysphasia the efficacy of CBZ was lower than VPA (20% vs 63%, p < 0.05). In MRI-negative cases VPA was most effective (79% vs 44% for CBZ, p < 0.001 and 29% for TPM, p < 0.01). Efficacy of CBZ and TPM reduces proportionally the number of previously used antiepileptic drugs (AEDs), this tendency is noted also for VPA but as a second AED it was more effective than CBZ and TPM (56% vs 15%, p < 0.01 and 14%, p < 0.05, respectively); as a first AED VPA was also most effective (82% vs 37%, p < 0.001 for CBZ and 82% vs 33%, p < 0.01 for TPM). Adverse effects were more frequent during treatment with CBZ and TPM, than VPA (21% vs 6%, p < 0.001 and 17% vs 6%, p < 0.05).
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PMID:[Comparative efficacy of carbamazepine, valproic acid and topiramate in symptomatic and cryptogenic occipital lobe epilepsy in children]. 2055 66

For a retrospective observational investigation based on real clinical practice of relative efficacy of valpoic acid (VPA), carbamazepine (CBZ) and topiramate (TPM) we have selected 277 patients with seizure onset before 17 years with a undoubted diagnosis of symptomatic or cryptogenic frontal lobe epilepsy (FLE), who had received treatment according to ILAE recommendations, and observation time since the last treatment change was from 2 to 10 years. Patients suspicious for idiopathic epilepsies were excluded. The groups of patient receiving CBZ, VPA and TPM did not differ significantly in presenting unfavorable prognostic factors that allowed conducting direct comparison of efficacy of the investigated drugs. Efficacy of VPA in children with FLE was higher compared with CBZ (56% vs 22%, p<0,01) and TPM (56% vs 10%, p<0,001). CBZ and TPM caused seizure aggravation rather frequently, but no aggravation was noted while VPA treatment (14% and 17% respectively vs 0%, p<0,001). In case of presence of clinico-electroencephalografic and MRI signs of significant organic brain damage and seizure onset after 1 year of age VPA was most effective and TPM showed minimal effect. TPM was ineffective in case of focal cortical dysphasia and cerebral atrophy; in other lesions its efficacy was comparable with CBZ. In MRI-negative cases VPA was most effective (71% vs 24% for CBZ, p<0,001 and 20% for TPM, p<0,001). Efficacy of VPA, CBZ and TPM does not change with the number of previously used antiepileptic drugs (AEDs). VPA was also most effective as a first AED (63% vs 26%, for CBZ, p<0,001 and 13%, p<0,001 for TPM), as well as a second AED (50% vs 30% for CBZ and 7% for TPM, p<0,05). Adverse effects were more frequent during treatment with CBZ and TPM, than VPA (20% vs 6%, p<0,001 and 31% vs 6%, p<0,05, respectively).
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PMID:[Comparative efficacy of carbamazepine, valproic acid and topiramate in symptomatic and cryptogenic frontal lobe epilepsy in children]. 2055 76

There is relatively little information on the underlying parameters that affect clinical features of the postictal period. Age-related physiological changes, including alterations in cerebral blood flow and metabolism, neurotransmitter function, and responses of the brain to seizure activity may affect postictal clinical phenomena. Some conclusions can be drawn. Elderly adults and children, particularly in the presence of diffuse cerebral dysfunction, may have more prolonged postictal confusion. Postictal dysphasia strongly suggests a dominant hemisphere focus, more often temporal, and Todd's paralysis is always contralateral to the epileptogenic zone. Much additional information could be derived from the vast amount of video/EEG monitoring data available.
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PMID:The postictal state: effects of age and underlying brain dysfunction. 2072 20


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