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

100 all night sleep records in 90 patients with various forms of epilepsy and 10 patients with syncope were analyzed. There were 10 patients with generalized epilepsy, 41-with partial epilepsy with complex symptomatology and temporal foci, 23--with mixed seizures and frontal focal changes and 16 patients with partial epilepsy with simple seizures and various location of EEG foci. Normal sleep pattern was present in 21% of cases. The most frequent changes of sleep pattern were: prolongation of sleep onset and the latency of the first episode of REM, instability of sleep stages and absence of sleep spindles. Interictal discharges appeared mostly in all sleep stages of NREM. 50% of epileptic patients showed focal spikes in REM. Nocturnal seizures occurred in 18 patients, in several of them very frequently.
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PMID:[Physiologic all-night sleep in patients with severe forms of epilepsy]. 358 10

A permanent pacemaker was inserted in eight patients with the long QT syndrome. All had recurrent syncope or seizures, six had documented torsade de pointes and four had aborted sudden death. Among the eight patients, permanent pacing was instituted in three who were unsuccessfully treated with both a beta-adrenergic blocking agent and left cardiothoracic sympathectomy, and in two who proved refractory or intolerant to beta-blockers. Another three patients had pacemaker implantation and long-term beta-blocker therapy because of spontaneous atrioventricular (AV) block in one, aborted sudden death in one and patient preference in one. After pacing (70 to 85 beats/min), there was no significant change in the mean corrected QT interval, but the mean QT interval decreased significantly (534.4 +/- 51.4 to 425.6 +/- 18.9 ms, p less than 0.0001). Over a mean follow-up period of 35.1 +/- 18.9 months, all patients are alive and currently free of syncope. One patient without a history of stress-induced syncope had two syncopal episodes (believed to be due to hyperventilation) while under severe emotional stress, but has been symptom free for the past 5 years. One patient with an atrial demand (AAI) pacemaker developed dizziness due to documented episodes of AV block, but remains asymptomatic after conversion to atrial rate-responsive dual chamber (DDD) pacing. Either atrial or ventricular pacing combined with beta-blocker therapy appears to be effective treatment for a subset of patients with the long QT syndrome, by either preventing episodes of torsade de pointes or alleviating symptoms due to bradycardia from beta-blocker therapy.
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PMID:Permanent cardiac pacing in patients with the long QT syndrome. 362 66

Syncopes due to compulsive respiratory stereotypies were studied in eight patients with autistic features. Most had been referred for episodes thought to be intractable epileptic seizures. Polygraphic recording showed two types of syncope, one induced by prolonged apnea and the other by a prolonged Valsalva maneuver. Fenfluramine, 1.5-3 mg/kg per day, was given in an open trial. In four of five cases with frequent Valsalva maneuvers, respiratory stereotypies and syncopes were suppressed for 2-18 months. Patients with periodic apneas were more severely retarded and had less clear benefit. Side effects consisted of dose-dependent sedation and mild weight loss which stabilized without interrupting treatment. We suggest that these syncopes are volitional and may be associated with pleasant sensations. A double-blind placebo-controlled trial of fenfluramine seems warranted in such patients.
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PMID:Compulsive respiratory stereotypies in children with autistic features: polygraphic recording and treatment with fenfluramine. 365 90

Hyperventilation (HV) is an important activating procedure in clinical EEG. Paroxysmal HV slowing is associated with hypoglycemia and is common in children. Paroxysmal slowing in adults is sometimes interpreted as indicating cerebral instability or paroxysmal tendencies. We investigated the clinical correlates of paroxysmal HV slowing in 100 consecutive EEGs recorded in 1984 and compared these to 100 controls (age-matched normal EEGs recorded since 1982). Twenty-eight percent of patients over 15 with paroxysmal HV slowing not due to hypoglycemia had headaches, 80% of them vascular. Ten percent had syncope, 15% acute behavioral changes possibly representing seizures, 9% psychiatric disorders, 5% assorted complaints of obscure etiology, 20% had clinically definite seizures, 10% assorted neurologic disorders other than epilepsy, and 3% mental retardation. Fewer patients with HV paroxysms had epilepsy than did control individuals (p less than 0.05), while neurologic disorders of other kinds were more often found in those with HV paroxysms (p less than 0.025). Specific psychiatric diagnoses were less frequent in the paroxysmal HV group, but the difference was not significant. Paroxysmal HV responses in non-hypoglycemic adults may identify individuals prone to syncope, vascular headaches, or other autonomic dysfunction. They are not correlated with epilepsy however, and should not be considered abnormal.
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PMID:Paroxysmal hyperventilation responses in the adult electroencephalogram. 373 97

Patients with hereditary long QT disorders--Romano-Ward Syndrome and Jervell Lange-Nielsen Syndrome--sometimes present with seizures due to cardiac tachyarrhythmias. Two such patients are presented, emphasizing diagnostic clues--syncope, seizures with onset in early life, precipitation of attacks by emotional or physical stress, positive family history of sudden death and/or seizures, normal EEG and prolonged QT interval on ECG. Treatment is usually with adequate doses of sympathetic betablockers.
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PMID:Cardiac tachyarrhythmias in hereditary long QT syndromes presenting as a seizure disorder. 374 43

Generally patients with epilepsy will not be accepted as blood donors by blood banks. A survey in the Dutch blood banks revealed two blood banks with a total of 13 donors suffering from epilepsy. We also questioned the Chapters of the International League against Epilepsy. The answers on a national and international level differed widely. We believe that the rare convulsion during blood donation is not an epileptic seizure, but in fact an emotive syncope. We advocate the acceptance of patients with epilepsy, free of seizures for 2 years irrespective of their medication, as blood donors.
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PMID:Blood donation, a risk for epileptic patients? 377 38

Twenty-four patients with various manifestations of increased vagal tone were seen between 1975 and 1981. Three distinct groups could be identified by clinical characteristics and to some extent by age. The first group showed evidence of prolonged atrioventricular conduction on their electrocardiograms but were asymptomatic. The others presented with syncope, the etiology of which was determined to be vasovagal. Some patients were older and more athletic. They suffered from syncope associated with exercise or heavy exertion. The youngest patients, however, experienced frequent prolonged episodes of syncope often mistaken for seizures. Treatment for the older patients with syncope consisted mainly of behavior modification, while 5 out of 6 younger patients required the implantation of a ventricular demand pacemaker to prevent repeated and problematic recurrences of syncope.
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PMID:Vagotonia in infants, children, adolescents and young adults. 390 73

Elements relevant to differential diagnosis between epileptic seizure and non-epileptic seizure as a consequence of syncope, cardiac arrhythmia or pseudoepilepsy are reviewed and discussed. Our experience with long-term monitoring of closed circuit TV-EEG of 136 medically refractory seizure patients showed that (a) about 19% have pseudoepileptic seizures, (b) only 36% of those verified pseudoepileptic seizure patients had epileptic seizures as well, and (c) 77% of pseudoepileptic seizures mimicked aspects of complex partial seizures. Pseudoepileptic seizures were not suspected by referring clinicians in the majority of cases, while a small but significant number of patients with verified complex partial seizures were suspected of having pseudoepileptic seizures. Failure to identify these non-epileptic seizures has serious medical and psychosocial implications and, therefore, astute clinical judgment is necessary in the differential diagnosis of epilepsy. Despite some technical limitations inherent in its current practice, the judicious use of long-term monitoring significantly enhances the quality of such judgment upon which the development of a management approach most meaningful to those medically refractory patients and society depends.
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PMID:Differential diagnosis of epilepsy. 392 64

This study was designed to re-examine the question of how sensitive the first EEG is in confirming a definite seizure disorder. Patients (358) with a diagnosis of "epilepsy" were randomly selected and their EEGs reviewed. An abnormal EEG was found in 84% (epileptiform paroxysms in 77-82%), while 16% had a normal tracing. However, after careful review with up to 7 years of follow-up, slightly more than 1/2 of those with a normal EEG did not actually have epilepsy, 1/4 did and in the remaining 1/4 insufficient information was available for a definite diagnosis. The incidence of normal records among patients with definite epilepsy then fell to 4.7%. With the evaluation of additional patients with "epilepsy" and a normal EEG (200), a similar distribution was found. The final diagnosis for the group without seizures was a behavioral-psychiatric condition in 1/4, syncope in 1/5 and pseudoseizure in 1/6.
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PMID:The success of EEG in confirming epilepsy--revisited. 400 31

A case of glossopharyngeal neuralgia associated with episodic cardiac arrest and syncope is presented. Posterior fossa exploration showed that the left glossopharyngeal and vagus nerves were compressed by the posterior inferior cerebellar artery. Microvascular decompression resulted in complete relief of glossopharyngeal neuralgia, cardiac syncope, and seizure. The mechanism of glossopharyngeal neuralgia associated with cardiac syncope is discussed.
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PMID:Glossopharyngeal neuralgia with cardiac syncope. A case successfully treated by microvascular decompression. 402 9


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