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

We reviewed ambulatory cassette EEG (A/EEG) records of 500 patients. Epileptiform abnormalities, seizures, or both were detected in 87 patients (17.4%), including 22 who were not taking anticonvulsant drugs. Epileptiform abnormalities were found in 1.5% of patients with syncope and in none without a clear history of episodic complaints. Abnormalities were found in 5.1% of patients referred by nonneurologic physicians. Some clinical seizures were not accompanied by A/EEG change and some episodes were not seizures, despite detection of epileptiform abnormalities.
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PMID:Ambulatory cassette EEG in clinical practice. 406 69

Three complex partial seizure (CPS) types have been described based upon the behaviors seen at the onset of the ictal event. Type I CPSs are preceded by a motionless stare and have been correlated with a temporal focus, whereas Type II CPSs are not preceded by a motionless stare and have been correlated with an extratemporal focus. A third type of CPS, temporal lobe syncope, has been correlated with bilateral mesial temporal foci. We examined the utility of this CPS classification system in predicting surgical outcomes by reviewing our patients who had undergone surgical excision of their epileptogenic foci for the treatment of medically refractory CPSs. Forty-six consecutive patients were evaluated, with the seizure focus ultimately found to be temporal in 41 and frontal in 5. All 5 patients with frontal foci had Type II CPSs; of the 41 patients with temporal foci, 20 had Type I and 21 had the Type II CPSs. Twenty of 26 patients with Type II CPSs and 18 of 20 patients with Type I CPSs had a good or excellent outcome. Although our data suggest that patients with frontal foci have Type II CPSs, the reverse is not true. Furthermore, CPS type is not correlated with the surgical outcome, since there was no significant difference between the CPS type and the category of surgical outcome.
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PMID:Type I/II complex partial seizures: no correlation with surgical outcome. 407 69

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

Among 821 consecutive patients admitted to an acute stroke unit, the initial diagnosis of stroke proved incorrect in 108 (13%). The commonest causes of misdiagnosis were unwitnessed or unrecognised seizures (39%) and confusional states and syncope (24%), conditions that can be diagnosed only clinically. In a series of 93 cases examined post mortem, the diagnostic accuracy for stroke varied with clinical skill and ranged from 38% to 89%. The frequency (but not the type) of incorrect diagnosis was the same in 244 patients investigated with computerised tomographic (CT) scanning as in 345 patients investigated without it. Although CT and other neurological investigations are useful aids in the diagnosis of stroke, they remain a supplement to, and not a substitute for, correct clinical evaluation.
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PMID:Misdiagnosis of stroke. 612 Mar 23

A previously healthy woman experienced Adams-Stokes attacks ten weeks after the initiation of antithyroid medication for Graves' disease. The patient manifested advanced atrioventricular (A-V) block requiring a temporary transvenous pacemaker. The site of heart block was localized to the A-V node by utilizing a His bundle electrogram. With control of the hyperthyroid state, normal A-V conduction was restored. Review of the literature identified twenty-five additional cases of second or third degree A-V block associated with Graves' disease, ten of whom had Adams-Stokes syncope or convulsive seizures. The A-V nodal block was reversible with cure of the primary endocrine disease. It is postulated that excessive thyroid hormone has a direct effect on the cardiac conduction system, specifically, the region of the A-V node and bundle of His. Recommendations are made regarding the recognition and management of patients at risk for developing heart block associated with Graves' disease.
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PMID:Second and third degree atrioventricular block with Graves' disease: a case report and review of the literature. 616 53

Psychogenic epidemics cover various forms of collective behavior and include mass hysteria, mass psychogenic illness, and hysterical contagion for which no physical explanation can be found. The typical course of a psychogenic epidemic at a workplace progresses from sudden onset, often with dramatic symptoms, to a rapidly attained peak that draws much publicity and is followed by quick disappearance of the symptoms. Over 90% of the affected persons are women, and the symptoms range from dizziness, vomiting, nausea, and fainting to epileptic-type seizures, hyperventilation, and skin disorders. The background mechanisms are thought to be generalized beliefs and triggering events which create a sense of threat that leads to a physiological state of arousal. This state, in turn, creates new beliefs which give meaning to the sense of arousal. The new belief spreads through sociometric channels. Predisposing factors include boredom, pressure to produce, physical stressors, poor labor-management relations, and impaired interpersonal communications, and lack of social support. It is important that a thorough investigation be carried out in all instances. Investigation is not only necessary for diagnosis, but it also reassures the management, the employees, and the press that physical factors are unlikely to be responsible for the disease.
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PMID:Psychogenic epidemics and work. 653 52

A patient with an unusual "compulsion" to induce syncope over a period of years by bilateral compression of the carotid arteries subsequently had recurrent seizures. The EEG showed patterns typical of cerebral ischemia during the syncope and epileptogenic foci in both temporal lobes after sleep deprivation. It is difficult to distinguish between seizure and syncope associated with involuntary movements when making a differential diagnosis. We hypothesize that the frequent self-induced ischemic insult to the brain caused a cicatrix to develop, which in turn caused the frequent seizure disorder; and that because this ischemia functioned as a stimulus to the reward site in the limbic system, the patient repeatedly induced it.
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PMID:Repeated self-induced syncope and subsequent seizures. A case report. 663 12

One hundred seventy patients with syncope presenting to an emergency department were studied prospectively. A checklist was used to supplement the physician's history and physical to ensure adequate recording of potentially useful data. Follow-up data were available in 89% of patients with a mean follow-up period of 6.2 months. Patients were categorized by presumed etiology using specific criteria. Typical vasovagal syncope occurred in 37.1% of patients. Other etiologies included first seizure (8.8%), orthostasis (7.6%), cardiac (4.1%), micturition (2.4%), hypoglycemia (1.8%), and psychogenic (0.6%). Syncope of unknown etiology accounted for 37.6% of the patients. The estimated duration of warning period was significantly shorter in patients with cardiac syncope compared to patients with vasovagal syncope. The yield of laboratory tests was low with the exception of the serum bicarbonate, which was decreased in 70% of our seizure patients. Recommendations regarding initial evaluation and admission are discussed.
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PMID:Prospective evaluation of syncope. 674 51

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 75-year-old man had development of left hemiparesis after a cerebral infarction. Nine months later, he was admitted to the hospital after generalized tonic clonic convulsion. In the hospital, he had clonic movement on the left side of the body. Even after acceptable control of orthostatic hypotension, rising from supine to standing position evoked slow waves over the right hemisphere on the EEG tracing. This example of focal seizures with orthostatic hypotension shows that previously compromised cerebral tissue or vessels may be vulnerable to changes in blood pressure. We suggest that convulsive movements associated with hypotension or syncope result from cortical mechanisms rather than brainstem tonic release mechanisms.
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PMID:Stroke, orthostatic hypotension, and focal seizures. 678 52


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