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

The aim of this study was to evaluate the proportion of neurological disorders within the overall number of ailments treated in primary care, as well as to classify them, determine the reason for their referral to specialists, and analyze the appropriateness or justification of such referral in each case. The 553 neurological visits analyzed represented 6.1% of the total (non-bureaucratic-related) number of requests for medical care. The groups cephalea/facial pain, dizziness and partial or complex seizures accounted for 60% of total. One of every three visits was referred to a neuropsychiatrist and/or hospital service. The main cause for the referral was considered clinical in only 28.3% of cases. The referral was judged inappropriate by the specialist in 13.4% of cases. The evidence that neurological disorders are not unusual, in addition to the high rate of referrals and an analysis of the reason and justification for referral, reflect the need to focus on the neurological training of non-neurologists, as well as to evaluate the appropriateness of present specialized outpatient care.
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PMID:[Neurological disorders: a primary care approach]. 210 50

The authors report eight cases of trigeminal neurinoma managed over the past 13 years with radical resection at a single-stage operation. Three patients were male and five were female, ranging in age from 25 to 56 years (mean 41.5 years). One had von Recklinghausen's disease. The tumors were located mainly within the middle fossa in two cases and within the posterior fossa in two, and extended both supra-and infratentorially in four cases. Facial pain and hearing disturbance were the main symptoms, with various other symptoms such as focal seizures, hemiparesis, gait disturbance, increased intracranial pressure, and visual disturbance also being noted. All patients underwent radical tumor resection with either a transpetrosal transtentorial or orbitozygomatic infratemporal surgical approach; the approach depended on the topography of the tumor. Total removal was performed in all cases. Only one patient, treated early in the series, required a second operation to remove the tumor completely. In another case the tumor recurred 5 years after the operation. There has been no operative mortality, but injury or permanent damage to the trigeminal branches was inevitable in many cases. The surgical results were excellent in three patients and good in five.
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PMID:Trigeminal neurinomas: operative approach in eight cases. 279 70

The authors have reviewed a series of 53 patients with unruptured intracranial arterial aneurysm. Out of 50 patients operated upon, 2 died post-operatively, 5 remained with neural deficits that were present before surgery, and 43 were cured without subsequent cerebral or meningeal haemorrhage. None of the 3 unoperated patients developed cerebral vascular accidents. In 25 cases the aneurysm was asymptomatic and was discovered accidentally during angiography; it varied in size from 3 to 6 mm. In 28 cases, the aneurysm gave rise to various symptoms, including headache or facial pain (9 cases), ischaemic vascular accident (7 cases), ocular symptoms (8 cases), seizures (4 cases); its size ranged from 7 to 10 mm. The clinical and post-mortem series available in the literature show the usefulness of surgery in patients presenting with factors that increase the risk of rupture, i.e.: age comprised between 40 and 65 years, history of arterial hypertension, aneurysm located on the anterior segment of Willis' circle and about 10 cm in diameter, which is the critical size for rupture.
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PMID:[Surgical prognosis of unruptured intracranial arterial aneurysms. 50 cases]. 295 Apr 97

Correction of a very high grade carotid stenosis by endarterectomy in a normotensive man was followed by the development of severe unilateral head, eye, and face pain, seizures, and on the 6th day a fatal intracerebral hemorrhage. Autopsy revealed changes in the cerebral hemisphere ipsilateral to the endarterectomy that resembled the changes seen in malignant hypertension, whereas the opposite hemisphere was normal. These changes included hypercellularity and edema of arterial and arteriolar walls, with necrosis, extravasation of erythrocytes, and exudation of fibrin. We propose that the clinical and pathological features in this case were due to relative hyperperfusion of a cerebral hemisphere in which autoregulation had been impaired because of preoperative chronic hypoperfusion with chronic maximal dilatation of its blood vessels. This state of relative hyperperfusion is probably similar to the normal perfusion pressure breakthrough that occasionally occurs after the resection of cerebral arteriovenous malformations. It is similar to the breakthrough perfusion that occurs in severely hypertensive patients and results in hypertensive encephalopathy.
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PMID:Cerebral hyperperfusion after carotid endarterectomy: a cause of cerebral hemorrhage. 647 94

A patient with trigeminal neuralgia experienced a generalized seizure and a prolonged syncopal episode. He was found to be asystolic during the syncopal episode. There was no recurrence of loss of consciousness after implantation of a pacemaker. Mechanical stimulation of the trigeminal nerve during craniotomy for microvascular decompression of the trigeminal nerve resulted in bradycardia. Since vascular decompression of the trigeminal nerve, there has been no recurrent facial pain, and no further syncope, seizures, or bradycardia. Syncope and seizures have not been previously reported in association with trigeminal neuralgia, although they are well described with glossopharyngeal neuralgia.
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PMID:Trigeminal neuralgia associated with seizure and syncope. Case report. 674 98

A Caucasian homosexual man with AIDS and cytomegalovirus retinitis presented with facial pain and episodic confusion, had several seizures and became obtunded. An electroencephalogram was suggestive of herpes simplex encephalitis. The diagnosis was confirmed by detection of herpes simplex virus type 2 (HSV 2), but not type 1, DNA in cell-free cerebrospinal fluid (CSF) after amplification by nested polymerase chain reaction. The patient also had evidence of concomitant cytomegalovirus (CMV) infection with detectable CMV DNA in CSF. With high-dose acyclovir the patient recovered. Analysis of a follow up CSF sample taken four months later showed no detectable HSV-2 DNA.
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PMID:Herpes simplex virus type 2 encephalitis and concomitant cytomegalovirus infection in a patient with AIDS: detection of virus-specific DNA in CSF by nested polymerase chain reaction. 759 Jul 23

Seizures can manifest in a variety of different clinical presentations. These include motor signs and symptoms, somatosensory and special sensory, psychic and autonomic signs and symptoms, and loss of impairment of consciousness. However, pain is a very uncommon clinical manifestation of a seizure. We describe a case where paroxysmal, acute-onset, right-sided arm-hand and facial pain was the initial and prominent manifestation of the seizure and was accompanied by interictal and ictal electrographic changes.
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PMID:Pain as a manifestation of seizure disorder. 850 Feb 49

Cholesterol granulomas of the head are relatively rare. Isolated lesions of the cerebellopontine angle are even more uncommon. In this report, 17 cases of petrous apex cholesterol granulomas are presented and management is discussed. Symptoms at presentation included dizziness (14 patients), pressure (nine patients), tinnitus (eight patients), hearing loss (eight patients), otalgia (six patients), headache (six patients), nausea (three patients), drainage from ear (two patients), facial pain (two patients), seizure (two patients), lightheadedness (one patient), hemifacial spasm (one patient), and facial numbness (one patient). Six cases were managed without surgery and 11 patients underwent operative procedures. The approaches used included the infralabyrinthine (eight patients), transcanal-infracochlear (two patients), and translabyrinthine (one patient). The mean follow-up period for all cases was 29.5 months. Of those patients managed without surgery, symptoms improved in all except one, whose tinnitus was slightly worse. Of surgically treated patients, symptoms improved or remained the same except in one with worsened dizziness. There were nine patients with hearing present presurgery and seven whose hearing was preserved postsurgery. The authors present a case that was managed at another center where an attempt at surgical resection through a subtemporal middle fossa approach was unsuccessful. This lesion was successfully treated using an infralabyrinthine approach with drainage into the mastoid cavity. Cholesterol granulomas of the petrous apex can be managed without surgery when symptoms are stable or improve. Otherwise, a transmastoid extradural approach with simple drainage into the mastoid sinus or middle ear produces symptomatic improvement with low morbidity. Resection of petrous apex cholesterol granulomas is not necessary.
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PMID:Cholesterol granulomas of the petrous apex: combined neurosurgical and otological management. 881 66

Individuals with severe injuries were investigated 5 years after the traumatic events, and predictors of anxiety and depression disorders were identified. Trauma victims were selected who had an Injury Severity Score of > or = 16 and were brought to all hospitals in the Mersey region and North Wales over 1 year. The 212 patients aged > or = 15 years who left the hospital alive and lived within an accessible distance of the study hospital in Warrington were contacted 5 years later and 158 (74.5%) received follow-up assessment. Thirty-eight subjects (36.9%) reported "definite" anxiety and/or depression disorders and, of these, only 21.1% reported taking psychotropic medications. Factors associated with anxiety and/or depression disorders at follow-up were: sequelae of head injury (i.e., cognitive problems, posttraumatic seizures, facial pain): writing impairment: disability due to thorax problems; and a new trauma during follow-up. Initial severity or types of injuries and overall residual disability rated by the investigator were not strong predictors of anxiety and/or depression disorders at follow-up.
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PMID:Anxiety and depression disorders 5 years after severe injuries: a prospective follow-up study. 1040 80

Thirty-two patients with refractory central and neuropathic pain of peripheral origin were treated by chronic stimulation of the motor cortex between May 1993 and January 1997. The mean follow-up was 27.3 months. The first 24 patients were operated according to the technique described by Tsubokawa. The last 13 cases (eight new patients and five reinterventions) were operated by a technique including localisation by superficial CT reconstruction of the central region and neuronavigator guidance. The position of the central sulcus was confirmed by the use of intraoperative somatosensory evoked potentials. The somatotopic organisation of the motor cortex was established peroperatively by studying the motor responses at stimulation of the motor cortex through the dura. Ten of the 13 patients with central pain (77%) and ten of the 12 patients with neuropathic facial pain had experienced substantial pain relief (75%). One of the three patients with post-paraplegia pain was clearly improved. A satisfactory result was obtained in one patient with pain related to plexus avulsion and in one patient with pain related to intercostal herpes zooster. None of the patients developed epileptic seizures. The position of the stimulating poles effective on pain corresponded to the somatotopic representation of the motor cortex. The neuronavigator localisation and guidance technique proved to be most useful identifying the appropriate portion of the motor gyrus. It also allowed the establishment of reliable correlations between electrophysiological-clinical and anatomical data which may be used to improve the clinical results and possibly to extend the indications of this technique.
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PMID:Chronic motor cortex stimulation in the treatment of central and neuropathic pain. Correlations between clinical, electrophysiological and anatomical data. 1048 75


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