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

We report the case of a 23-year-old male who presented to the emergency department (ED) with an isolated right-sided pure motor hemiparesis (PMH). An unenhanced computed tomography (CT scan) revealed a hypodensity in the area of the left parasagittal motor strip. The patient then experienced a Jacksonian type of seizure involving his right leg and was treated with intravenous phenytoin and dexamethasone. A second CT scan performed with contrast was thought to be consistent with a cerebral abscess with surrounding white matter edema. Surgical findings were consistent with neurocysticercosis. The patient was treated with praziquantel with nearly full recovery. Worldwide, cysticercosis is the most common CNS parasite. Because of immigration from endemic areas, cysticercosis has become more common in the United States. Patients with neurocysticercosis may arrive in the ED with a wide variety of unusual presentations. In this case, the PMH syndrome was caused by a solitary lesion in the motor strip. This report describes a case of PMH due to neurocysticercosis secondary to local mass affect alone. The literature of neurocysticercosis and PMH is reviewed and the pathogenesis, clinical presentation, and therapy are discussed.
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PMID:Neurocysticercosis presenting to the emergency department as a pure motor hemiparesis. 178 88

Differences in function between the cerebral hemispheres are well documented for normal subjects and, in diseased states, these are used to lateralize and localize a dysfunction. However, the difference in frequency of occurrence of left vs. right hemisphere lesions and the greater likelihood of epilepsy occurring on the left have received scant attention. In the present study patients with a diagnosis of meningioma or cerebral abscess were identified from the EEG computer file. After operation the meningioma patients with predominantly left-sided tumours showed a statistically significant greater chance of developing seizures, similarly those with left-sided cerebral abscess. Considering a larger group of patients with temporal lobe epilepsy from a variety of causes, a left-sided EEG focus occurred more frequently - and was statistically significant - than a right-sided or bilateral disturbance. The full explanation of these results is not clear but they suggest that the hemispheres function differently in patients with a cerebral disorder like epilepsy, as is known to be the case in normal subjects.
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PMID:Left and right cerebral hemisphere differences in the occurrence of epilepsy. 401 23

Two patients with cyanotic congenital heart disease (CHD) and erythremia were seen for abrupt onset of focal neurologic deficits and/or seizure without signs of infection or increased intracranial pressure. Clinical features and initial computed tomography (CT) in both cases suggested stroke. Subsequent CT scans demonstrated cerebral abscess, proved at operation. Review of records of patients with CHD at the University of Rochester (NY) Medical Center from 1965 to 1981 disclosed 12 cases with brain abscess but only two cases with aseptic cerebral infarction. All but one patient with abscess were cyanotic. One third of patients with abscess had a clinical picture suggesting stroke. Clinical or radiologic features of half the cases indicated that cerebral infarction may have led to abscess formation. Diagnosis of brain abscess and immediate antibiotic therapy should be strongly considered in patients with cyanotic CHD who suffer a suspected cerebral infarction.
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PMID:Cyanotic congenital heart disease with suspected stroke. Should all patients receive antibiotics? 683 Apr 69

A previously healthy 9-month-old girl, obese (12,500 gm) with sudden onset of hyperthermia (40 degrees C), generalized tonic-clonic seizures, followed by focal seizures, drowsiness, left facial nerve palsy, left lagophthalmos and mydriasis is presented. CT-scan and MRI suggested temporal-parietal infarction due to Sylvian artery occlusion in a 9-month-old infant with familial hypercholesterolemia (type 2 A dyslipidemia). The possibility of a cerebral abscess or herpetic encephalitis was considered. Negative clinic and serologic results excluded this diagnosis. The management of the symptomatology was made with parenteral antibiotics, anticonvulsive and antioedematous cerebral therapy. Favourable evolution with residual left hemiparesis after 30 days, when the child was discharged. CT-scan reevaluation (after 5 months of evolution) showed a hypodense temporal-parietal area abnormality due to a right ischemic infarction.
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PMID:Acute hemiplegia in one infant. 777 44

Acute encephalitis is mainly of viral origin. Two groups of are considered: i) primary encephalitis, such as Herpes simplex encephalitis with intra-thecal synthesis of antibodies, and ii) post-viral infection encephalitis or acute disseminated encephalitis with immune dysregulation. The most common clinical presentation (fever, consciousness disturbance and seizures) is not specific and may reveal bacterial meningitis or cerebral abscess which require a specific treatment. Acyclovir has allowed consistant advances in the treatment of herpes encephalitis. Vaccination against selected viral infection, such as measle vaccine, is the only way to prevent acute disseminated encephalitis.
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PMID:[Acute encephalitis in children]. 878 67

The clinical course of patients admitted following minor head injuries (Glasgow Coma Score [GCS] 13-15) has been studied less extensively than in severely head injured patients. Admission criteria, methods and indications for radiological evaluation are controversial. To study this further, a retrospective review of 633 patients admitted following such injuries to King Khalid University Hospital between 1986 and 1993 was undertaken. Their ages ranged from one month to 80 years (average 17 years). The mechanisms of injury were mainly falls in 339 (53.5%) cases and road traffic accidents in 234 (37%). None of the cases resulted from a non-accidental injury. Radiological evaluation was by skull radiography in 616 (97.3%) cases followed by CT scan in 131 (20.7%). These studies revealed a skull fracture in 78 (12.7%) cases. Six of these 78 patients with skull fracture required a neurosurgical procedure during the first week post injury. These represented 0.97% of the cases who had skull radiographs. A base of skull fracture was an ominous sign, since 3 of the 5 cases with such fractures required ventilation of which one resulted in the only mortality of this series, the fourth developed meningitis. Of the cases studied, 3 (0.5%) developed growing skull fractures all had the initial injury during their first year of life. Other complications were as follows: 25 (3.9%) early post-traumatic seizures, 10 (1.6%) chronic subdural haematomas, 9 (1.4%) extradural haematomas, 2 (0.3%) post-traumatic hydrocephalus and one (0.2%) cerebral abscess. We conclude that patients who have an abnormal GCS, a neurological deficit, post-traumatic seizure, signs or suspicion of basal or depressed skull fracture should be admitted for observation because of the risk of deterioration. Patients with a history of loss of consciousness or amnesia without any of the previous may be discharged to be observed at home by a competent observer, otherwise, will need admission for observation. Radiological evaluation once indicated must be by CT scan. There is no benefit from immediate skull radiography in the initial evaluation of minor head injuries. The indications for CT are an abnormal GCS, presence of neurological deficit, signs of basilar or depressed fracture and persistent or progressive headache or vomiting. Infants with minor injuries should be followed up at least once after two to three months for possible growing fractures.
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PMID:Management of minor head injuries: admission criteria, radiological evaluation and treatment of complications. 952 9

A 22 years male patient presented with recurrent seizures, CT and MRI diagnosis of tuberculoma was made and the patient was treated. When seizures persisted, a craniotomy was done and the excised mass revealed an abscess with a segment of broad solid non-cavitory body, wall with no scolex and loose stroma and smooth muscle fibers. A diagnosis of sparganosis cerebral abscess was made. The case is reported in view of the rarity of cerebral sparganosis in India and the need for awareness of the entity in India.
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PMID:Cerebral sparganosis. 1526 Mar 99

In a 10-year-old boy presenting with focal seizures and 6 months later with acute right-sided hemiparesis, the diagnosis of a cerebral abscess due to Actinomyces israelii was established. The immunocompetent child suffered from a complex congenital heart disease with pulmonary arteriovenous shunts and pulmonary hypertension causing mild cyanosis. His parents had been reluctant to agree to neuroimaging investigations resulting in a delayed diagnosis. Despite the long interval between first symptoms and commencement of treatment including neurosurgical excision of the abscess followed by a 4-week course of ceftriaxone, a complete recovery of the hemiparesis was observed. This patient is the first case with cerebral actinomycosis before adolescence reported so far.
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PMID:Cerebral actinomycosis before adolescence. 1532 64

Cerebral abscess is an extremely rare complication of pregnancy. We report a case of a patient at 36 weeks of gestation presenting with severe headache, confusion, and seizures after starting treatment for sinusitis. Imaging revealed a left temporal lobe abscess, which was treated with broad-spectrum antibiotics. Neurologic deterioration in a gravida with sinusitis suggests secondary sinogenic intracranial suppurative complications.
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PMID:Sinogenic brain abscess complicating pregnancy. 1554 46

A 2-year-old boy with underlying congenital cyanotic heart disease presented with seizures and fever and was found to have bilateral parietal cerebral abscesses. Drainage of the pus from the abscesses was done in stages; on the day of admission, four days after admission and 3 weeks after admission. Although the pus from the first drainage did not grow any organisms, the pus from the second drainage on the fourth day of admission yielded a mixed growth of Eikenella corrodens and Streptococcus milleri. Following the second drainage of pus, the child was noted to have mild weakness (grade 3/5) and increased tone in the left upper limb. Three weeks after admission, due to recurring fever, further neurological signs and findings of an enlarging right cerebral abscess on a repeat CT scan, a third drainage was carried out. However no growth was obtained from this specimen. This patient was managed both surgically and with appropriate antibiotics. Over the next four months, serial CT scans revealed gradual resolution of the abscesses with disappearance of the surrounding oedema. The child showed gradual recovery of his left sided weakness with resolution of tone and reflexes to normal.
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PMID:Eikenella corrodens from a brain abscess. 1619 Jan 7


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