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

A 38-year-old man experienced severe neck pain while playing badminton. This was followed by symptoms of vertebrobasilar ischaemia, seizure and coma. Autopsy showed bilateral vertebral artery dissection and cystic medial necrosis.
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PMID:Fatal bilateral vertebral artery dissection in a patient with cystic medial necrosis. 168 48

The pathophysiology and treatment of acute subarachnoid hemorrhage (SAH) are reviewed. SAH occurs when blood is released into the subarachnoid space, which surrounds the brain and spinal cord. Symptoms of SAH include severe headache, nausea, vomiting, neck pain, nuchal rigidity, and photophobia. The initial hemorrhage is fatal in 20-30% of patients. Complications of SAH include rebleeding, hydrocephalus, delayed cerebral ischemia associated with cerebral vasospasm, and seizures. The likelihood of rebleeding is increased by measures that rapidly lower intracranial pressure. The risk of developing hydrocephalus is associated with the volume of blood within the subarachnoid space and ventricular system. Cerebral vasospasm develops in 20-40% of patients, and up to 50% of affected patients die or suffer permanent neurological damage. Seizures occur in 5-15% of patients with SAH. Radiologic procedures form the foundation for the diagnosis of SAH. The most commonly used rating scale classifies the severity of SAH based on the clinical presentation of the patient. Surgery is the definitive treatment for the prevention of rebleeding. Hydrocephalus can only be treated surgically, most commonly by insertion of a drain. The only measures proved to be effective for treatment of delayed cerebral ischemia are volume expansion and the induction of hypertension. The calcium-channel blocker nimodipine was recently approved for treatment of arterial spasm in SAH. Intravenous nicardipine is also being studied for the same indication. These agents may improve clinical outcome substantially by limiting fixed neurological deficits. To prevent seizures, prophylactic antiepileptic therapy with phenytoin sodium is generally accepted. The SAH complications of rebleeding, hydrocephalus, delayed cerebral ischemia, and seizures are managed by surgical, drug, and fluid therapy.
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PMID:Pathophysiology and treatment of subarachnoid hemorrhage. 240 1

We have examined 17 patients suffering from recurrent syncope caused by carcinoma of the head and neck. The tumor originated in the mouth in seven, larynx in six, nasopharynx in three and parotid gland in one, and involved cervical lymph nodes at diagnosis in 12. Sixteen patients had previously had radical neck dissections and 12 had had radiation therapy. Recurrent carcinoma was present in 16. Spells resolved spontaneously in four, improved with treatment in 11 and continued in two. The syncope was spontaneous in 15 and induced only by suctioning or carotid sinus massage in two. Suctioning also produced attacks in four others, as did carotid sinus massage in five of ten tested. Acute severe unilateral head or neck pain preceded spontaneous syncope in 11. Sixteen patients had both profound bradycardia and hypotension during most spells, but ten had syncope with hypotension only, either spontaneously or following cardiac pacing or atropine to prevent bradycardia. Seizure activity accompanied syncope in eight. Anticholinergics improved 7/12, carbamazepine 2/5, carotid ligation 1/1 and intracranial sectioning of the glossopharyngeal nerve 1/1. Local radiation may have helped 4/10. Cardiac pacing was ineffective in 3/3 due to the development of pure vasodepressive syncope. Autopsy in 2/2 showed tumor involving the glossopharyngeal and vagus nerves. Syncope in these patients is under-recognized, frequently is due to vasodepression, and suggests recurrent carcinoma.
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PMID:Syncope from head and neck cancer. 608 17

One hundred myelographies with iopamidol and 100 with metrizamide were performed in order to compare the side effects of the two contrast media after injection into the spinal subarachnoid space. All patients were observed for a follow-up period of at least 4 days. The most frequently observed side effect, headache, was more common, of longer duration, and more severe with the use of metrizamide than with iopamidol. Only neck pain was more common with iopamidol. More severe side effects such as meningeal irritation, psychoorganic syndrome, and epileptic seizures occurred only with metrizamide. The results seem to indicate a lower neurotoxicity and better patient tolerance for iopamidol than for metrizamide.
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PMID:Iopamidol vs. metrizamide myelography: clinical comparison of side effects. 641 Jul 28

A 57-year-old epileptic male with an acute central cervical cord injury was reported, who fell down from 2.5 meter height to a dry river bed presumably during a convulsive seizure. Upon physical examination at the time of admission, 4 hours post trauma, there were severe neck pain with limited neck motion, sensory level at C4 bilaterally, no motion at all in the upper extremities, and minimal motion in the lower extremities as well as apparent urinary retention. Plain cervical spine series showed moderate posterior osteophytes at C4--C5 and C5--C6, although the film of lateral view did not visualize a part of C7 well. After 4 days' clinical observation, a myelography was done at lateral cervical approach between C1 and C2, which showed a complete block at C3. Urgent laminectomy C3 through C7 showed a fracture of the C7 spinous process extending to the bilateral lamina and an extradural hematoma from C3 to C7 with thickness of 3 to 5 mm. Neither pial incision nor dorsal myelotomy was performed because of no remarkable swelling of the cord. Post-operative course was uneventful, the patient recovering first the motion in the lower extremities, urinary retention, and motion in the upper extremities. At 10 months' follow-up after the operation, he could take care of himself in dressing, eating and toileting, although he had had residual motor disturbance in his hands and fingers especially in fine finger movements. It was keenly felt important to visualize C7-T1 in roentgenograms of lateral cervical view in cases of acute cervical injury, for which swimmer view and/or tomogram might be necessary. Queckenstedt's test was criticized as a dangerous maneuver in such case but C1--C2 myelography is considered safer and more informative. Literature on the acute central cervical cord injury were reviewed.
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PMID:[Case report of acute central cervical cord injury with C7 laminar fracture and extradural hematoma (author's transl)]. 724 4

A six-week-old female borzoi puppy from a brother-sister mating developed a generalised illness characterised by anorexia, temporary intention tremor, episodic pyrexia, tachypnoea, conjunctivitis, otitis and neck pain. Haematological abnormalities included an inflammatory leukogram and regenerative anaemia. Blood cultures remained sterile; clinical chemistry values were unremarkable. The puppy had recurrent seizures and was euthanased when 18 weeks old. Post mortem examination revealed a multisystemic inflammatory disease involving thyroids, lymph nodes, spleen, pancreas, bladder and lung, but no lesions to account for the neurological signs. The cause of this generalised disease was not recognised. The histological features are unusual and resemble those described in other dogs of this breed.
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PMID:Multisystemic inflammatory disease in a borzoi dog. 781 81

The prehospital and emergency department management of the patient with a penetrating cranial injury can be summarized by the following tenets: 1. Assume any alteration in level of consciousness to be a result of the brain injury and not from alcohol or illicit drug intoxication. 2. Have a low threshold to protect the patient's airway with endotracheal intubation and chemical paralysis if a surgical lesion is suspected, there is seizure activity, or the patient is too combative to obtain the necessary studies. 3. Always protect the cervical spine and do not remove the hard collar and spine board until adequate radiographs have been obtained and the patient is lucid enough to complain of any neck pain. 4. Do not delay CT scanning to obtain other studies in the presence of lateralizing neurologic findings. 5. Do not delay in obtaining neurosurgical consultation or in arranging transfer to a facility where definitive care can be provided. 6. Remember, first do no harm. The primary brain injury has already been done. The clinician maximizes preservation of viable brain tissue by preventing secondary injury.
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PMID:The prehospital and emergency department management of penetrating head injuries. 852 15

A 5.5-year-old French bulldog was presented with acute neck pain and a short history of central vestibular syndrome. A marked neutrophilic pleocytosis and numerous gram-positive cocci were evident on cerebrospinal fluid (CSF) cytology. Streptococcus pneumoniae, a pathogen of humans, was isolated upon CSF microbiological culture. Treatment consisted of intravenous antibiotics, supportive care, and anticonvulsants for the generalized seizures which developed shortly after admission. The dog responded to therapy and two years later exhibited only a mild, residual head tilt. The pathogenesis and treatment of bacterial meningoencephalitis in dogs are reviewed.
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PMID:Streptococcal meningoencephalitis in a dog. 1049 18

Studies of patients with psychogenic non-epileptic seizures (NES) typically focus upon the phenomenology and outcome of NES episodes. Little is known, however, about the frequency and nature of other somatic symptoms such as pain, in this population. To assess the frequency, location and severity of symptoms of pain among NES patients, we administered structured interviews to 56 patients, 6 or more months following the diagnosis of psychogenic non-epileptic seizures (NES). Patients were recruited from a tertiary hospital-based epilepsy monitoring unit. Seventy-seven percent of patients suffered from moderate to severe pain, most commonly headache (61%), while neck pain and backache were also common. Twenty-six of 27 patients with persistent NES vs. 17 of 29 patients whose NES resolved experienced moderate to severe pain (P < 0.001). Pain is an under-recognized problem that occurs frequently and with significant severity among NES patients. Pain symptoms are more common among patients with persistent NES than those whose NES resolve.
Seizure 1999 Oct
PMID:Headaches and other pain symptoms among patients with psychogenic non-epileptic seizures. 1060 May 84

A 51-year-old man with a history of hypertension and smoking with an internal carotid artery (ICA) aneurysm was a referral from an outside hospital. He had a history remarkable for headaches for 6 months refractory to conventional therapy, but no stroke, transient ischemic attack, seizure activity, or neck pain. Arteriogram revealed a right ICA aneurysm at the level of the skull base with no accessible cervical ICA distal to the aneurysm. The petrous and intracranial ICA were normal. A team approach to repair was undertaken with a skull base resection and ICA exposure by head and neck surgeons and vascular reconstruction with vein graft from common carotid to petrous portion of ICA by vascular surgeons. A small right parietal infarction was noted in the postoperative period and became a focus of seizure activity. Anti-seizure medication was successful and transient upper-extremity weakness cleared. Transient dysfunction of cranial nerves VII and IX developed. The complex nature of the operation required expertise from different surgical specialties, and the postoperative complication mandated medical specialty and extensive inpatient and outpatient physical, occupational, and speech therapies ICA aneurysms of the skull base are uncommon. Historic treatment involved either ligation with a high risk of stroke or bypass to intracranial artery because direct repair was difficult. With a skilled team approach, direct repair as described is effective. This article focuses on the complexity of the surgical procedure, perioperative care, outcome of surgical intervention, and a multidisciplinary approach to the care of the patient undergoing ICA aneurysm repair requiring skull base resection.
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PMID:Internal carotid artery aneurysm repair requiring skull base resection: a case study. 1060 24


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