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

A 59-year-old man was admitted to our hospital with the history of epileptick attack of six years' duration. The seizure was associated with Jacksonian march starting in the right hand and then generalized. Todd's paresis of the right arm followed occasionally to the seizure. He was admitted to neurosurgical unit of other hospital in 1968 and 1971, but on each occasion no tumor or vascular abnormality was detected by extensive examiniations such as brain angiography, pneumoencephalography or brain scanning. He continued his hob as an engineer with anticonvulsant. He once lived in Manchuria in 1930s and had history of pulmonary tuberculosis. He was suffering from diabetes mellitus and chronic otitis media. Recentry he developed headache, forgetfulness, speech disturbance and right hemiparesis and was admitted to our department through psychiatric unit. On examination he was fully conscious but showed typical Gerstmann's syndrome and conduction aphasia. He also revealed bilateral choked disc, right hemiparesis, right hemihypesthesia and right homonymous hemianopsia. The cerebral angiograms and peneumoencephalogram suggested a left parietal cystic tumor. Brain scan with technetium 99m was negative. The spinal fluid was clear but showed slight pleocytosis (99/3/ml). Leucocyte count in the peripheral blood was 6600 per cubic meter with eosinophils of 3%. On craniotomy, small white patches were scattered at the subarachnoidal space suggesting of history of some meningitis. In the left parietooccipital region at Brodmann's area 19, a greyish yellow transparent cystic tumor was found in the subarachnoidal space which was confirmed to be one of the multilocular grape-like cystic tumors extending from area 19, gyrus angularis towards the arcuate fasciculus without continuity with the left lateral ventricle. Microscopic examination showed the racemosal type of cysticercus but no scolex was found. The fluid of the cysts was similar to the spinal fluid. He is totally symptome-free after five months' lapse from the operation except for sporadic spikes on the electroencephalogram. Although some neurosurgeons are against direct operation of the cerebral cysticercosis, we are sure it is possible to cure these patients suffering from chronic cysticercosis with tumor-like symptoms i.e. the tumor type of Stepien. But it is essential not to rupture the cysts during the operative procedure to avoid dissemination of worms which might lead to acute severe cerebral edema. Besides, echinococcus cysts harbouring many worms are often hardly differenciated macroscopically from the cysts of cysticercosis.
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PMID:[A case of brain cysticerosis]. 98 76

Transient postictal hemiparesis or monoparesis is not uncommon after partial (focal) seizures. We report 2 patients who complained of severe bilateral limb weakness after generalized tonic-clonic seizures (GTCS) beginning focally. Bilateral Todd's paralysis was verified and documented in both patients. EEG and clinical evidence indicate the supplementary motor cortex as the most likely source of the seizures in both cases.
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PMID:Bilateral Todd's paralysis after focal seizures. 146 71

We followed 208 patients identified on the day of their 1st unprovoked seizure for a mean duration of 4 years. Seizures recurred in 64. Recurrence risks were estimated to be 14%, 29%, and 34% at 1, 3, and 5 years following the 1st episode. A history of previous neurologic insult (remote symptomatic) was associated with a 2.5-fold increased risk of recurrence. Among idiopathic cases, a sibling with epilepsy, a generalized spike and wave EEG, or a history of acute symptomatic seizure increased risk for recurrence. Among remote symptomatic cases, status epilepticus, a prior acute symptomatic seizure, or Todd's paresis increased risk. Depending upon clinical features, recurrence risk at 5 years following a 1st seizure ranged from 23% to 80%. Treatment with anticonvulsant medication was not associated with a decrease in recurrence risks.
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PMID:Seizure recurrence after a 1st unprovoked seizure: an extended follow-up. 238 23

We studied four patients with focal motor seizures complicating carotid endarterectomy and compared them with 14 other cases reported previously. Seventeen of the 18 patients had high-grade carotid stenoses. A severe unilateral headache usually preceded seizure activity, which was followed by prolonged Todd's paralysis. Eight patients had histories of ipsilateral stroke. There was no association with perioperative hypertension. Two patients who were receiving heparin sodium had intracerebral hemorrhages that caused one of the two postoperative deaths. The patency of all endarterectomized carotid arteries was recorded by arteriography or noninvasive studies. These data suggest that patients who have severe unilateral headaches following ipsilateral carotid endarterectomy for high-grade stenoses are at risk for focal motor seizures. The roles of antithrombotic agents and anti-seizure medication in this setting are unclear.
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PMID:Focal motor seizures complicating carotid endarterectomy. 643 57

Isolated cortical venous thrombosis (CVT) is rare, and the discrepancy between clinical features and neuroradiologic findings has not been adequately emphasized. A thirty-one-year-old woman presented with focal seizures and occasionally secondary generalization. There was no focal neurologic deficit except for Todd's paralysis. Electroencephalography showed intermittent theta waves at the left frontoparietal area. Brain computed tomography (CT) and magnetic resonance imaging (MRI) disclosed a large lesion in the left frontoparietal area. An extensive occlusion of the superior cerebral veins of the left hemisphere with a patency of the dural sinuses was noted in the cerebral angiography. Eight months later, the CT hypodense lesion disappeared. Her neurologic status was stationary, but the seizures, mostly focal, still occurred occasionally. In this report, the authors emphasize the dissociation between minor clinical features and larger CT and MRI lesions in isolated CVT.
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PMID:Isolated cortical venous thrombosis--discrepancy between clinical features and neuroradiologic findings. A case report. 749 19

Between 1934 and 1988, 34 patients with tumoural parietal lobe epilepsy were treated surgically at the Montreal Neurological Institute (MNI). Fifteen had right-sided and 16 left-sided resections. The remaining three patients had biopsies only. Follow-up ranging from 1 to 40 years (mean 12.3 years) was available for 28 patients. Seventy-five percent (21 out of 28) became seizure free or had rare seizures. Permanent post-operative sensory deficits were described in 12% of patients. An aura was described by 79%. 62% had somatosensory symptoms, contralateral to the epileptogenic region in all but one. Visual illusions (12%), aphasia (9%) and disturbances of body image (6%), were much less common at the beginning of the attacks. Intra-operative cortical stimulation reproduced the habitual aurae in 10 out of 25 (40%) of the patients. The clinical manifestations suggested different spread patterns: 21% had tonic posturing of the extremities, 82% focal clonic activity, 15% head deviation, 9% automatisms and 6% difficulty speaking. Eleven (32%) had Todd's paralysis and 18% postictal dysphasia. Almost half the patients had impaired two-point discrimination in contralateral fingers; two of these also had impaired stereognosis, but only one had astereognosis without coexisting primary cortical sensory deficit. Review of this, now historical, series shows that parietal lobe tumours can be resected with good control of previously intractable seizures. Such an approach is preferable to postponing resection until the lesion is shown to increase in volume.
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PMID:Tumoural parietal lobe epilepsy. Clinical manifestations and outcome in 34 patients treated between 1934 and 1988. 749 87

Actual epidemiological studies show a prevalence rate for active epilepsy in 0.5-1%, whereas single seizures occur in up to 5% of the general population. Assessment of the significance of first epileptic reaction requires precise definition and classification of the episode, a careful analysis of the entire context including thorough case history, and indirect anamnesis. The value of EEG-techniques for this issue is part of a controversial discussion. By means of cranial computerized tomography (cCT), brain tumours were detected as structural correlate in 5 to 16% of first-seizure-patients. In recent studies, estimated risk of seizure recurrence after first unprovoked seizure ranged from 27% to 78%: most of the relapses were observed in the first 6 months after the first event. The wide range of relapse rates is due to the divergent methodological designs (retro- versus prospective design, selection of patients, length of time before study entry) in the different studies. There are conflicting results concerning risk factors and predictive value of the following variables: pathology in the neurostatus, focal seizure type or Todd's paresis, history of febrile seizures, symptomatic genesis, and specific epileptic potentials and time of day of seizure event. In an actual metaanalysis of recent studies, seizure etiology and EEG were the strongest predictors of recurrence. The preliminary results of our prospective study with a strict protocol and first-seizure-design are presented: we observed a seizure relapse in 26.7% of 78 adult patients (age range: 17-84 years) after a mean latency of 4.4 months. Until now, there is no evidence for potential predictors of seizure recurrence.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Diagnostic and prognostic implications of the first epileptic seizure in adulthood]. 805 Jul 70

The objective of this study was to determine the frequency of atypical clinical and electrographic features in children with benign rolandic epilepsy. A retrospective case series design was employed in the setting of a tertiary care pediatric hospital. Forty-two children with benign rolandic epilepsy were seen through our neurology department between January 1, 1991, and December 31, 1993. Their charts were reviewed for atypical clinical features, imaging studies and results, total number of seizures at initial presentation and last follow-up, and use of anticonvulsants. Atypical clinical features included status epilepticus, developmental delay, daytime-only seizures, screaming as a seizure component, and postictal Todd's paresis. All children had at least one electroencephalogram, and these records were reviewed for atypical electrographic features such as unusual location, atypical spike morphology, and abnormal background. Atypical clinical features were seen in 50% of patients and atypical electrographic features in 31%. Computed tomographic scans were performed in 15 patients and were consistently normal. Treatment with anticonvulsant medication was initiated in 40%. Although patients with atypical features did not have an increased seizure frequency, they were more likely to undergo imaging studies (P < .01) and to be commenced on anticonvulsant medication (P < .02). Our experience suggests that atypical clinical and electrographic features are the rule rather than the exception in benign rolandic epilepsy. Further work must be done to develop a reliable definition of this common entity.
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PMID:Benign rolandic epilepsy: atypical features are very common. 857 55

After a single seizure, about 40% of patients have recurrence. The main features correlating with recurrence are cause, seizure type, EEG findings, family history of seizures and, possibly, the presence of a prior febrile seizure, Todd's paresis, and other abnormal neurologic findings. A number of medications are available for treatment. Withdrawal from medication is successful in 60% to 70% of patients. Several factors favor successful drug taper. These include a seizure-free status for at least 2 years during drug therapy, a single type of seizure (partial or generalized), young age at seizure onset, and an epilepsy syndrome with a tendency to remit. Surgery can be considered in certain patients with surgically remediable syndromes. Candidates typically have seizures that impair consciousness, that cause falling with injury, that have adverse psychosocial or social effects, and that persist after trials of three appropriate medications. A multidisciplinary evaluation should take place at a surgery center with experience and documented success. Favorable results from surgery can be expected in a large proportion of patients.
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PMID:Epilepsy management. Issues in medical and surgical treatment. 922 82

We performed technetium-99m-hexamethylpropylene- amineoxime (Tc-HMPAO) single photon emission computed tomography in two patients with prolonged hemiconvulsions followed by transient hemiparesis (Todd's paralysis). In both cases, a prolonged post-ictal cerebral hyperperfusion state of approximately 24 h was observed, even after the neurological deficits had resolved. The cerebral hyperperfusion in both cases was of much longer duration than that in previously reported cases of single and uncomplicated focal seizures. The prolonged cerebral hyperperfusion might have been due to impairment of the cerebrovascular autoregulation in seizures followed by Todd's paralysis.
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PMID:Technetium-99m-HMPAO SPECT in patients with hemiconvulsions followed by Todd's paralysis. 947 51


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