Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The patient was a 17-year-old man, who developed Japanese encephalitis in the autumn of 1990 in Japan. He was admitted to our hospital 4 days after onset because of consciousness disturbance. On admission, neurological examination demonstrated left hemiparesis, neck stiffness, and Kernig's sign. He developed generalized tonico-clonic seizure, and required a respirator on the next day of admission. Brain CT 10 days after onset demonstrated hypodensities in the right hippocampus, and the CT obtained 39 days after onset showed whole brain atrophy and hypodensities in the anterior portion of the bilateral thalamus. He died 40 days after onset. Postmortem examination demonstrated perivascular and parenchymal infiltration of lymphocytes and macrophages, proliferation of microglia and astrocytes, and necrosis in the gray matter of the brain. Involvement of the hippocampus and thalamus on CT seemed to reflect the severe lesions characterized by cellular infiltration and necrosis. We discussed for the first time the correlation of CT and neuropathological findings in a patient with Japanese encephalitis.
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PMID:Japanese encephalitis - serial CT findings and neuropathology in an autopsy case. 1991 16

Patients with symptoms and signs of central nervous system dysfunction frequently present to outpatient clinics and emergency departments. Disturbances of consciousness and cognition, headache, vertigo, dizziness or light-headedness, seizures, hemiparesis or hemisensory deficits, and other motor dysfunctions may be due to diseases of internal medicine in up to 50% of cases apart from exclusively neurological diseases. A neurological syndrome oriented analysis of each clinical case allows the exact differential diagnosis of the causes of the disease. A combined approach of internal medicine physicians and neurologists is often warranted.
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PMID:[CNS dysfunction as symptom of internal disease]. 2023 32

We retrospectively investigated prognostic factors of 27 consecutive patients with bacterial meningitis seen at Niigata University Medical and Dental Hospital between 1980 and 2006. Patients were divided into the two categories using the Glasgow outcome scale (GOS) at discharge; the poor outcome group (GOS = 1 to 4; n = 15) and the good outcome group (GOS = 5; n = 12). Poor outcome was significantly associated with the severe consciousness disturbance, and the presence of intracranial (brain swelling, seizure, cerebral hemorrhage) or systemic (pneumonia) complications. The clinical features of patients who died of bacterial meningitis (GOS = 1) were almost identical to those of patients with poor outcome (GOS = 1 to 4); however, the protein and sugar content in the cerebrospinal fluid in the patients who died were significant compared to the patients with good outcome (GOS = 5). Pneumococcal infection was also considered to be a poor prognostic factor. Future prospective studies should be performed on a larger group of patients for establishing the prognostic factors of adult bacterial meningitis.
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PMID:[Clinical features of poor-prognosis patients with adult bacterial meningitis]. 2023 80

We report the case of a 65-year-old man who had encephalitis with a high titer of voltage-gated potassium channel antibodies (VGKC-Abs). His initial symptoms included memory disturbance, confusion, and seizures. Laboratory tests revealed a low plasma sodium concentration and a strong positive result for VGKC-Abs. A diffusion-weighted magnetic resonance imaging (MRI) scan showed a high intensity lesion within the right basal ganglia, which later showed normal intensity. The patient's initial symptoms resolved without any treatment. During the first relapse, the patient experienced consciousness disturbance and an increased number of seizures than that observed initially. A diffusion weighted MRI scan showed a high intensity lesion within the right hippocampus, and a fluid attenuated inversion recovery (FLAIR) weighted MRI scan showed high intensity lesions within the right hippocampus, right thalamus, and pons. The patient's symptoms and the MRI abnormalities resolved with prednisolone therapy. During the second relapse, he again experienced consciousness disturbance and an increased number of seizures than that observed initially. Diffusion-and FLAIR weighted MRI scans showed high intensity lesions within the right thalamus. However, the array of immunosuppressive treatments used during the first relapse was not as effective during the second relapse. The serum VGKC-Ab titers before steroid therapy during the first relapse and after immunosuppressive treatment during the second relapse were 1,252 pmol/L and 22.4 pmol/L, respectively. Brain MRI revealed signal changes in the basal ganglia at the onset of disease, in the limbic area during the first relapse, and in the thalamus during the second relapse. VGKC-Ab-associated encephalopathy is usually considered a benign autoimmune disorder; however, in our case, the encephalitis gradually became intractable to various immunosuppressive treatments, and unique MRI abnormalities were observed.
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PMID:[A recalcitrant case of encephalitis with voltage-gated potassium channel antibodies]. 2106 62

Reversible posterior leukoencephalopathy syndrome (RPLS) is a recently identified clinical and radiologic entity. The characteristic radiologic findings are bilateral gray and white matter edema in the posterior regions of the cerebral hemispheres. The typical clinical syndrome includes headache, confusion, visual symptoms, and seizures. RPLS most often occurs in the setting of hypertensive crisis, preeclampsia, or with cytotoxic immunosuppressive therapy, but many other clinical settings are described, such as cryoglobulinemia, hemolytic uremic syndrome, systemic lupus erythematosus, and use of erythropoietin. A 24-year-old man, diagnosed as having anaphylactoid purpura nephritis at 12 years of age and who started peritoneal dialysis (PD) at 23 years of age, was admitted to our hospital with a seizure and consciousness disturbance. His blood pressure (BP) and body fluid volume had not been controlled well because of poor compliance with medication and PD. T2-weighted magnetic resonance imaging (MRI) revealed high signal intensity changes restricted to the cortex and subcortical white matter of the cerebellum. On the other hand, diffusion-weighted imaging showed an isointense signal. From these findings, he was diagnosed as having RPLS. With appropriate control of BP and volume control by PD and hemodialysis, his symptoms improved, and a follow-up cranial MRI 1 month later was almost normal. To the best of our knowledge, this is the first report of RPLS in an adult PD patient.
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PMID:A case of reversible posterior leukoencephalopathy syndrome in a patient on peritoneal dialysis. 2107 75

Impaired consciousness requires altered cortical function. This can occur either directly from disorders that impair widespread bilateral regions of the cortex or indirectly through effects on subcortical arousal systems. It has therefore long been puzzling why focal temporal lobe seizures so often impair consciousness. Early work suggested that altered consciousness may occur with bilateral or dominant temporal lobe seizure involvement. However, other bilateral temporal lobe disorders do not impair consciousness. More recent work supports a 'network inhibition hypothesis' in which temporal lobe seizures disrupt brainstem-diencephalic arousal systems, leading indirectly to depressed cortical function and impaired consciousness. Indeed, prior studies show subcortical involvement in temporal lobe seizures and bilateral frontoparietal slow wave activity on intracranial electroencephalography. However, the relationships between frontoparietal slow waves and impaired consciousness and between cortical slowing and fast seizure activity have not been directly investigated. We analysed intracranial electroencephalography recordings during 63 partial seizures in 26 patients with surgically confirmed mesial temporal lobe epilepsy. Behavioural responsiveness was determined based on blinded review of video during seizures and classified as impaired (complex-partial seizures) or unimpaired (simple-partial seizures). We observed significantly increased delta-range 1-2 Hz slow wave activity in the bilateral frontal and parietal neocortices during complex-partial compared with simple-partial seizures. In addition, we confirmed prior work suggesting that propagation of unilateral mesial temporal fast seizure activity to the bilateral temporal lobes was significantly greater in complex-partial than in simple-partial seizures. Interestingly, we found that the signal power of frontoparietal slow wave activity was significantly correlated with the temporal lobe fast seizure activity in each hemisphere. Finally, we observed that complex-partial seizures were somewhat more common with onset in the language-dominant temporal lobe. These findings provide direct evidence for cortical dysfunction in the form of bilateral frontoparietal slow waves associated with impaired consciousness in temporal lobe seizures. We hypothesize that bilateral temporal lobe seizures may exert a powerful inhibitory effect on subcortical arousal systems. Further investigations will be needed to fully determine the role of cortical-subcortical networks in ictal neocortical dysfunction and may reveal treatments to prevent this important negative consequence of temporal lobe epilepsy.
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PMID:Impaired consciousness in temporal lobe seizures: role of cortical slow activity. 2108 51

Treatment for seizures during acute encephalopathy and encephalitis is not so different from those for seizures due to other etiologies. However, it is sometimes accompanied with intensive care and we also have to pay attention to consciousness disturbance, because it is difficult to determine whether consciousness disturbance is caused by encephalopathy itself, or effect of anticonvulsant therapy, especially in early stage of acute encephalopathy. In Japanese guideline of treatment for influenza encephalopathy, an intravenous administration of diazepam or midazolam as first-line agent, phenobarbital or phenytoin as second-line agent, and midazolam (continuous) or thiopental as third-line agent, were recommended for therapy for status epilepticus.
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PMID:[Anti-convulsant therapy]. 2140 Aug 50

A 69-year-old woman was admitted to our department for consciousness disturbance with generalized clonic seizure. She had a history of complex partial seizure with automatism 3 years previously, but had not received any antiepileptic drug therapy. On admission, she was unconscious with a Japan Coma Scale of 200. Physical examination demonstrated a blood pressure of 162/90 mm Hg and pulse of 126 beats/min. Neurological examination did not detect any focal findings. Four hours later, she was conscious and antiepileptic drug therapy was initiated. Twenty-six hours post admission, ECG monitoring showed giant T-wave inversion, but cardiac symptoms were absent. Echocardiography showed apical ballooning of the left ventricle. Echocardiography on day 6 demonstrated a thrombus at the apex of the left ventricle. Anticoagulant therapy was started immediately. Echocardiography on day 14 showed that the left ventricular apical asynergy had completely resolved, and the thrombus had disappeared. Takotsubo cardiomyopathy could be a complication of epilepsy. It occurs most often soon after epileptic seizure, rarely occurs with a time lag and is asymptomatic as in the present case. ECG monitoring after epileptic seizure is useful for prompt detection and treatment of takotsubo cardiomyopathy.
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PMID:[A case of asymptomatic takotsubo cardiomyopathy with intraventricular thrombus associated with epileptic seizure]. 2181 82

Paraneoplastic neurological syndrome (PNS) is a rare disorder caused by the remote effects of cancer and is considered as immune-responses to the molecules on cancer which cross-react with self-antigens in the nervous system. Since the 1980s, several specific anti onconeural antibodies have been reported, which are useful diagnostic markers of PNS and occult cancer. Only a few onconeural antibodies have been identified as primary effectors of neurological damage. Recently sophisticated methods for the detection of new or low titer antibodies have been developed. Several new auto-antibodies against receptors or ion channels on the surface of neuronal membrane, such as NMDA receptors, AMPA receptors, GABA(B) receptors and VGKC complexes, have been reported in the patients with encephalopathy including limbic encephalitis. These diseases can be associated with tumor, but they are more often non-paraneoplastic. These antibodies are generally good biomarkers for effective immunomodulatory treatment for immune-mediated encephalitis with not only consciousness disturbance but also dementia, seizures and psychiatric symptoms which sometimes mimic schizophrenia. Further studies are required to clarify the exact mechanisms underlying neuronal damage in immune-mediated neurological diseases including PNS, which may lead to the development of more rational therapies and greater understanding of immunology in the nervous system.
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PMID:[Pareneoplastic neurological syndrome --update]. 2227 85

We report a 16-year-old girl with suspected psychotic mania, who subsequently developed amnesia, catatonia, oro-lingual dyskinesia, consciousness disturbance, seizure and respiratory failure. Repeated studies of the cerebrospinal fluid (CSF), viral culture and serology, brain MRI, single photon emission CT scan, and autoimmune profiles were all normal. She was finally diagnosed with anti-N-methyl D-aspartate receptor (NMDAR) encephalitis based on the positive finding of NMDAR antibodies in CSF. Her abdominal CT scan showed no detectable malignancy and pulse steroid therapy failed to have any effect. After administration of intravenous immunoglobulin her consciousness improved gradually. Anti-NMDAR encephalitis, with a characteristic neuropsychiatric syndrome, predominantly affects females with an ovarian tumor and is frequently misdiagnosed as a psychiatric disorder. Immunotherapy and eradication of associated malignancy are the main treatment strategies. Early recognition and early intervention of the disease should improve the outcome.
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PMID:Anti-NMDA receptor encephalitis with the initial presentation of psychotic mania. 2233 Jun 92


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