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

Temporal lobe syncope (TLS) is a term coined by Landolt. Characteristically, the patient has psychomotor and drop attacks, and the interictal electroencephalogram (EEG) shows temporal lobe epileptic abnormalities. TLS is synonymous with type III complex partial seizures (CPSs) in the Delgado Escueta classification. Several variants of TLS can be recognized including atonic akinetic, simple akinetic, atonic, atonic-tonic complex (automatisms), sexual seizures, stress-induced convulsions, and gelastic atonic seizures. TLS must be distinguished from drop attacks of vertebrobasilar insufficiency and associated EEG abnormalities, and from hereditary tachyarrhythmias mimicking stress-induced convulsions. Epileptic falls and drop attacks are discarded by ictal EEG recordings. Recognition of TLS variants is important in the prospective evaluation of the surgical treatment of epilepsy given the past conflicting reports on the differential outcome of surgically treated CPSs. TLS is an attractive clinical term, easy to remember, and with pathophysiologic relevance to the clinician confronting the patient with a history of syncope and whose EEG discloses temporal lobe paroxysmal activity. The detailed ictal electrophysiology of TLS is unknown.
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PMID:Temporal lobe syncope: clinical variants. 249 8

In 81 depressed children aged 3 to 14 years the nonepileptic attacks could manifest the different psychopathological phenomena: 1, headaches before and after spells, non-systemic++ vertigo with imbalance and oculovestibular events with or without loss of consciousness; 2, orthostatic symptoms, syncope, cataleptoid seizures, Kloos seizures; 3, depersonalization and derealization episodes, deja vu and jamais vu states; 4, attacks with pain in the stomach and other organs, various other autonomic signs; 5, unsteady neurological signs: pareses, sensory, visual and speech disorders; 6, nightmares, oneiroid states, sleep-walking; 7, convulsive states, hyperkinesis; 8, psychomotor excitation and inhibition states; 9, behavioral spells with aggression. These states are differentiated from epileptic and hysterical attacks.
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PMID:[Clinical aspects of paroxysmal states in children with depression]. 258 6

An epileptoid attack induced by orthostatic hypotension seen in a 72-year-old man was reported. The patient had been suffering from progressive autonomic failure with parkinsonism for six years and he had severe orthostatic hypotension, syncope and generalized convulsion when he stood up. The convulsion sometimes associated with urinary incontinence, ceased immediately when he lay down although he remained drowsy for a while. Occasionally the seizure ceased spontaneously and he regained consciousness even while he was kept standing. On lying position his blood pressure was 167/88 mmHg and no abnormality was seen in electroencephalogram. When he was tilted up to 50 degrees his blood pressure fell to 70/46 mmHg, and he became unconscious followed by jaw twitching and generalized clonic seizure. Electroencephalogram during seizure showed sharp wave and rhythmic spikes. Other laboratory examination revealed diffuse and severe autonomic dysfunction and slight cerebral atrophy on brain CT scanning. He was treated with diphenylhydantoin 300 mg/day and the seizure responded partially. The reasons why the patient's seizure was thought to be epileptic rather than the convulsive syncope were as follows: the type of the seizure was similar to an epileptic generalized convulsion, the seizure and unconsciousness ceased spontaneously even during standing position, the seizure and impaired consciousness partially responded to diphenylhydantoin administration. The underlying pathophysiology of the seizure was thought to be transient cerebral hypoperfusion induced by orthostatic hypotension.
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PMID:[Orthostatically induced epileptoid attack]. 262 24

We retrospectively reviewed the emergency department records of 77 children and adolescents seen in an emergency department with the chief complaint of fainting. Upon careful review, 20 patients had not had any type of syncopal or near-syncopal episode. Of the remaining 57 patients, 40 experienced syncope, and 17 patients had near-syncope. The most frequent diagnoses in the syncopal patients were vasovagal syncope (50%), orthostatic hypotension (20%), atypical seizure (7.5%), migraine headache (5%), and minor head trauma (5%). The most frequent diagnoses in the near-syncope group were lightheadedness (29%), seizure (18%), tension headache (12%), and migraine (6%). Seventeen and one half percent of syncopal patients had abnormalities of vital signs, orthostatic vital signs, glucose, hematocrit, or ECG; none of the near-syncopal patients had abnormalities. We conclude that initial evaluation of first-episode syncope should include orthostatic vital signs, glucose, hematocrit, and ECG with further studies performed as clinically indicated.
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PMID:Syncope in children and adolescents. 274 10

Loss of consciousness is rare in the absence of transient or persistent insult to the diencephalon or mesencephalon. We found three patients with severe atherosclerotic stenosis or occlusion of both internal carotid arteries who experienced brief loss of consciousness. Common characteristics were the absence of clinical or electroencephalographic seizure activities, significant cardiovascular disease, or a history suggestive of vasovagal syncope. Angiographically, the patients had widely patent vertebrobasilar circulation and collaterals from vertebrobasilar to carotid circulation. Episodic loss of consciousness disappeared after carotid endarterectomy. We concluded that bilateral hemispheric ischemia caused brief loss of consciousness, but selective focal ischemia in the subcortical structures superimposed on widespread bihemispheric ischemia may have been responsible. Since loss of consciousness is rare in carotid occlusive diseases, systemic and vertebrobasilar causes must be carefully ruled out in each instance.
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PMID:Brief loss of consciousness in bilateral carotid occlusive disease. 275 25

Patients with hereditary Q-T interval prolongation can present with seizures, syncope, and sudden death. In 2 siblings with autosomal dominant familial long Q-T syndrome, electroencephalographic examinations performed 6 and 2 years before diagnosis included electrocardiographic tracings documenting the cardiac abnormality. A timely diagnosis of this condition may have prevented the death of 1 of these patients. Measurement of the corrected Q-T interval on electrocardiographic tracings obtained in the electroencephalography laboratory should be considered in selected patients.
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PMID:Hereditary long Q-T syndrome presenting as epilepsy: electroencephalography laboratory diagnosis. 277 93

The results of 1,680 consecutive urine and serum toxicologic screens from 1,120 patients, performed in a children's hospital during a 19-month period were surveyed. Among this sample, 52 (4.6%) patients had specimens that contained cocaine and/or metabolite. Fifteen specimens contained ethanol, a benzodiazepine, or a narcotic in addition to cocaine. Four patients were neonates, whereas three were infants from 1 to 7 months of age. The remaining 45 patients were adolescents with a mean age of 19 years. Among the adolescents, 11 had a significant chronic illness. In 19 patients (37%), cocaine exposure was unsuspected until the results of testing for toxic substances were known. The reasons for hospital evaluation included depression/attempted suicide in 19 patients, seizure in five, chest pain in 5, motor vehicle accident in three, syncope in three, abdominal pain in two, pneumomediastinum in two, accidental self-immolation in one, and apnea in one. Twenty patients required medical hospitalization for a total of 268 patient-days. One patient, a neonate, died. There is a striking prevalence of cocaine exposure in the pediatric age group. Among adolescents, this exposure may occur despite the presence of chronic illness. Although the age distribution appears bimodal, infants and young children may also have unsuspected exposure to this toxin. Greater awareness of cocaine exposure in childhood will be needed by primary and tertiary care pediatricians to identify affected children and provide appropriate intervention.
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PMID:Cocaine exposure among children seen at a pediatric hospital. 278 99

In 10 epileptic patients with generalized seizures, plasma levels of ACTH, prolactin, FSH, LH, TSH, were measured first within 60 minutes after the crisis, then 3 to 5 days later without changes in antiepileptic drugs. Within 1 hour after the seizure, a significant rise of ACTH and prolactin 3 - 4 folds the levels observed in the 2nd measure was present. This was compared to measures made within 1 hour after a syncope in which case it was not present. The post-critic rise of ACTH and prolactin would appear to be a characteristic of generalized epileptic seizures.
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PMID:[Neuroendocrine disorders observed in the post-critical phase in epileptic patients]. 282 65

The ability of isoproterenol to induce symptoms and laboratory findings of a vasodepressor reaction was tested in 48 patients, ages 17 to 74, divided into 4 groups according to the reason for their referral. Group 1 comprised 12 patients with vasodepressor syncope, group 2 had 8 patients with syncope of unknown origin, group 3 included 11 patients with syncope due to seizures in 2 and ventricular tachycardia in 9, group 4 had 17 patients with various arrhythmias not associated with syncope. Isoproterenol boluses were administered starting at 2 micrograms and increased in 2-micrograms steps to a maximum of 8 micrograms at 0 degree and +60 degrees. The responses at 0 degrees were all normal. At +60 degrees a vasodepressor reaction consisting of syncope or near syncope, hypotension and bradycardia was produced by isoproterenol (mean dose 6.0 +/- 0.26 micrograms) in 8 patients from group 1 (66.6%), 4 from group 2 (50%), 0 from group 3 and 4 from group 4 (23.5%). Three of the 4 patients in group 4 had a remote history of classic vasodepressor syncope. The overall sensitivity and specificity of the test were 73 and 85%, respectively, while the predictive accuracy of a test with positive or negative outcome were 69 and 89%, respectively. Muscarinic receptor blockade with atropine in 4 patients prevented isoproterenol-induced bradycardia but not hypotension or symptoms of fainting. Beta-adrenergic receptor blockade with propranolol inhibited all aspects of the isoproterenol-induced faint. Thus, the administration of isoproterenol during a passive upright tilt may identify persons who suffer from or are prone to a vasodepressor reaction.
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PMID:Isoproterenol induction of vasodepressor-type reaction in vasodepressor-prone persons. 290 60

We performed a one-year prospective survey of emergency medical responses to travelers at an international airport to observe the frequency and type of emergencies experienced in flight and before and after travel. Emergency personnel evaluated a total of 1107 people; 754 (68%) were travelers, 232 (21%) were employees of the airport or airlines, and 118 (11%) were area residents. Of the 754 travelers, 190 (25%) experienced their problem during flight; the aircraft made an unscheduled landing for seven of these travelers. The frequency of in-flight emergencies was 1 per 753 inbound flights, or 1 per 39,600 inbound passengers. The most common emergency problems among all travelers were abdominal pain, chest pain, shortness of breath, syncope, and seizures; 25% of the emergencies were caused by minor trauma. The majority of emergencies among air travelers (75% [564/754]) happened on the ground within the air terminal. Most problems (84% [633/754]) were effectively handled by personnel trained as emergency medical technicians. The types of problems encountered suggest that the "doctors only" medical kit now required aboard US air carriers contains clinically useful items and should continue to be required on board.
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PMID:Frequency and types of medical emergencies among commercial air travelers. 229 87


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