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

We reported four cases of acute encephalitis, in which MRI abnormalities localized in the limbic system. In the four cases, fever and consciousness disturbance were commonly found and convulsive seizures appeared in three. Within 10 days, their consciousness level became clear, but severe amnestic syndrome remained as sequela. Cerebrospinal fluid (CSF) at the acute stage revealed mild lymphocytic pleocytosis and elevated protein. MRI revealed abnormal signal intensities in both hippocampi and amygdaloid bodies, although CT scans were normal. Herpes simplex encephalitis selectively affects one or both temporal lobes and the limbic system, But our cases spared the temporal lobes. Additionally, serum and CSF antibody titers by CF and ELISA for herpes simplex virus (HSV) were within normal range from the acute to convalescent stages. Neither HSV type 1 and 2 DNA genomes by sensitive PCR-hybridization method were detected in CSF taken from the acute stage of all four cases. On the other hand, paraneoplastic limbic encephalitis is known as a subacute encephalitis predominantly involving the limbic system. MRI shows high signal intensities on T2-weighted in both medial temporal lobes. In our cases, this type of limbic encephalitis was excluded because of the acute onset and lack of malignancy. Accordingly, our four cases are regarded as non-herpetic acute limbic encephalitis. Several Japanese similar cases have been reported. Further etiological studies should be performed.
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PMID:[Non-herpetic acute limbic encephalitis]. 772 85

A 45-year-old man developed generalized convulsion and consciousness disturbance at age 43. An X-ray CT revealed hemorrhagic infarction in the left fronto-parieto-temporal area. A conventional angiography disclosed complete occlusion of the left cortical vein. In the chronic stage of the stroke, he had incomplete right quadrantopsia, a mild right hemiparesis and sensory aphasia. The patient has had partial somatosensory seizures since February 1990. Ictal EEG recordings showed epileptogenic discharges in the left parietal region. The seizures were adequately controlled with clonazepam. Since July 27, 1993, he has become aware of blurred vision in both eyes accompanied with headache and dizziness. On August 6, he was admitted to the hospital with right homonymons hemianopsia, sensory aphsia and tonic seizures in the right hand. Ictal EEG recordings demonstrated theta waves of the left parieto-occipital region and epileptogenic discharges in the left occipital region which consisted of spikes, sharp waves and spike-wave complexes. Single photon emission computed tomography (SEPCT) images obtained during seizures showed considerable hyperperfusion in the left occipital temporal lobes, while there was hypoperfusion in the left temporo-parietal area corresponding to the lesion of the old cerebral infarction. A T2-weighted MRI scan showed an abnormal high-intensity area in the left occipital lobe that suggested brain edema. After the admission, the patient was treated with additional anticonvulsant drugs. The tonic seizures in the right hand disappeared and right homonymous hemianopsia and sensory aphasia showed gradual improvement in the next four weeks.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[An unusual case of status epilepticus of simple partial seizure with an occipital lobe focus]. 799 93

A 62-year-old woman, who frequently had numbness seizures in the right half of her body, is reported. Weakness and consciousness disturbance did not occur during the seizure, and an abnormal electroencephalogram was not observed during the seizure or between seizures. The seizure was completely inhibited by a single-blind administration of phenytoin. It also disappeared on administration of carbamazepine, suggesting that the numbness seizures in this patient were of an epileptic nature.
Seizure 1993 Mar
PMID:Pure sensory seizures. 816 72

We report a 47-year-old woman with SLE, who developed meningeal signs and consciousness disturbance. She noted an onset of fever, and swelling and pain in her face, hands and feet in 1990. She was seen in another hospital and the diagnosis of SLE was made. She was treated with prednisolone with marked improvement in her symptoms. She was well with 5 mg of oral prednisolone daily until January of 1991, when she developed fever, myalgia and weakness in her legs. She was admitted to the medical service of our hospital on August 5. She was receiving 15 mg of prednisolone daily. Gram positive rods were cultured from her blood on August 5. She became incoherent 2 days later, and had a convulsive episode on August 8. After the convulsion, she lost consciousness from which she did not recover. Her CSF contained 304/3 microliters cells, 29 of which were neutrophils, 6 lymphocytes, 90 others, and 179 destructed cells. The CSF protein content was 345 mg/dl, and glucose 23 mg/dl. A neurological consultation was asked on August 9. Physical examination at that time revealed a semicomatous woman. Respiration was 30/min and regular. BP 132/82 mmHg, heart rate 122/min and regular, and BT 39.6 degrees C. General physical examination was unremarkable. Pertinent neurologic findings were positive Kernig sign and spasticity in all four limbs. Brain stem reflexes were retained. Upon painful stimulation, withdrawal response was elicited both lower extremities. She was treated with pipiracillin, latamoxef and phenobarbital, however, she had frequent seizures. She was deeply comatose on December 10. She became flaccid and no more meningeal signs were observed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A 47-year-old woman with meningeal signs and consciousness disturbance]. 821 15

Early antiviral treatment is important for herpes simplex encephalitis. A reliable test for supporting empirical therapy with antiviral agents is urgently needed. Sixty-six children with fever, focal seizures, and consciousness disturbance had their sera examined for anti-herpes simplex viral immunoglobulin M (IgM) antibody with enzyme-linked immunosorbent assay. The result was positive in all seven patients confirmed to have herpes simplex encephalitis. Only two of the other 59 patients were positive on this test. The average period for the development of serologic positivity was 7.3 days from the onset of neurologic symptoms. Although most sera were not tested in the early stage, all were collected on admission day. Our data suggest that before further evidence indicates another diagnosis, this simple, but specific IgM antibody test could be used as a guide for deciding to continue the antiviral treatment for serologically positive cases or to discontinue antiviral treatment for serologically negative ones. Yet, we would not suggest diagnosing herpes simplex encephalitis with this test alone.
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PMID:Value of serum anti-herpes simplex viral IgM antibody testing in empirical antiviral treatment of herpes simplex encephalitis. 822 35

In 1945, Lennox was the first to describe the epileptic states mainly expressed by various degrees of consciousness disturbance, which have their onset in children who present epileptic absences correlated with ictal EEG patterns of spike-wave complex discharges at about 3 Hz. As the clinical picture seemed to be similar to an uninterrupted series of absences, this led to the definition "Petit Mal Status" (PMS). Many authors have subsequently reported that PMS can occur in epileptic subjects who have never presented absences (and even in subjects without a previous history of epilepsy) and that the related EEG pictures were characterised by paroxysmal generalized activity of various morphology, but hardly ever consisted of the continuous rhythmic spike-wave or polyspike-wave complexes at 3 Hz found in petit mal absences. Finally, in reporting the onset and recurrence of this condition typically in adults and the elderly, some authors have proposed the existence of a particular form of PMS (dependent on different types of pathologic factors and characterising a specific syndrome of this age) that is different from that of the "real PMS" typical of childhood and related to petit mal absences. This paper describes fifteen patients in whom the onset of the condition occurred at different ages, and who seem to exemplify the various possible clinical expressions of PMS, with the aim of making a contribution towards the better nosographic definition of this epileptic condition. On the basis of our study, we sustain that the so-called PMS is a seizure type of Idiopathic Generalized Epilepsy which may appear at nearly all ages, and may occur in isolation or in association with other epileptic manifestations, but cannot itself be considered as characterising one or more age-dependent syndromes.
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PMID:So-called "petit mal status": epileptic syndrome or seizure type? 853 16

The purpose of this project is to investigate the clinical and brain MR characteristics of Epstein-Barr virus (EBV) encephalitis and encephalomyelitis. Clinical and 30 MR findings of 29 patients with EBV encephalitis or encephalomyelitis were retrospectively reviewed. Patients included 24 with encephalitis, 3 with encephalomyelitis, and 2 with brain-stem encephalitis. Altered consciousness, seizures, visual hallucination, and acute psychotic reaction were the common presentations. Eight patients had positive MR findings. These included T2 prolongation over gray and white matter, periventricular leukomalacia, and brain atrophy. Transient T2 prolongation over gray and white matter was found in one patient. Our results indicate that EBV encephalitis and encephalomyelitis have a wide range of both clinical and MR findings. The MR lesions may disappear in a short period, so the timing for the MR scan may be critical.
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PMID:Epstein-Barr virus encephalitis and encephalomyelitis: MR findings. 878 Nov 16

Acute encephalitis is mainly of viral origin. Two groups of are considered: i) primary encephalitis, such as Herpes simplex encephalitis with intra-thecal synthesis of antibodies, and ii) post-viral infection encephalitis or acute disseminated encephalitis with immune dysregulation. The most common clinical presentation (fever, consciousness disturbance and seizures) is not specific and may reveal bacterial meningitis or cerebral abscess which require a specific treatment. Acyclovir has allowed consistant advances in the treatment of herpes encephalitis. Vaccination against selected viral infection, such as measle vaccine, is the only way to prevent acute disseminated encephalitis.
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PMID:[Acute encephalitis in children]. 878 67

We report a case of multiphasic disseminated encephalomyelitis (MDEM) following viral illness presenting as multiple sclerosis (MS) in a 7-year-old boy. The patients had two episodes of alternating hemiparesis and other neurologic symptoms following viral infection, which were separated by 3 years. Neuroimaging studies demonstrated multiple, discrete, small nodules and large globular lesions in the cerebral white matter, basal ganglia, brainstem and cerebellar areas. Based on typical appearance of magnetic resonance imaging (MRI) and clinical manifestations including systemic symptoms such as fever, nausea, vomiting, headache and seizures followed by consciousness disturbance and other multifocal neurologic signs, the diagnosis of MDEM rather than that of MS was made. Because it is difficult to differentiate between MDEM and MS on the basis of the clinical history, the cerebrospinal fluid examination and evoked potential studies, this report emphasizes that the MRI study of the brain may provide an important clue for the diagnosis.
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PMID:Multiphasic disseminated encephalomyelitis mimicking multiple sclerosis. 889 Dec 39

Early seizures represent a major complication in the post operative course of patients operated on for supratentorial tumors or AVMs. The real effectiveness of the AEDs prophylaxis to reduce the occurrence of post operative seizures is controversial. We proposed a prophylactic treatment with endovenous PHT consisting of two infusions of PHT (mean dosage of 18 mg/kg; mean time of 1 hr) perioperatively and during the first postoperative day. The interruption of the previous oral anticonvulsant treatment is not required. The endovenous route should permit a rapid reach of the therapeutical range. Sixty-six patients were treated. Fifty-one patients received two infusions and 15 patients only one infusion. The serum concentration of PHT performed at 24 hrs of operation was in most of patients (more than 80%) in the lower part of the therapeutical range while at 24 hrs of the second infusion was in the higher part or over the range. The overall prevalence of seizures was 10.6%. In the first group the incidence was 7.8%, in the second one was 20%. All the seizures appeared within 48 hrs of the operation. All the patients in the first group had single seizures, 2 patients of the second one experienced two seizures. No status epilepticus was observed. Alteration of consciousness and mild hypotension were the most common side effects. They never required major measurements and were mild, transient and completely reversible. We are starting with a randomized study based on a larger sample of patients which will allow a more reliable statistical analysis.
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PMID:Early postoperative seizures and endovenous phenytoin. Preliminary clinical data. 916 28


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