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

A 10-year-old girl with Lennox-Gastaut syndrome who received intravenous lorazepam for atypical absence status seizures is reported. Tonic seizures occurred immediately and appeared to represent a paradoxical seizure exacerbation. We also review other patients with paradoxical seizure exacerbation by benzodiazepines.
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PMID:Paradoxical precipitation of tonic seizures by lorazepam in a child with atypical absence seizures. 314 84

The clinical spectrum and outcome of neonatal convulsions within an obstetric hospital population were reviewed for the 5 years, 1978-82, inclusive. There were 156 convulsing neonates managed at the Mater Mothers Hospital (110 inborn, 46 outborn). The incidence of early neonatal convulsions for inborn babies was 3.0/1000 live births. Antenatal and perinatal risk factors were compared between the 156 convulsing infants and the 36,082 infants born during the same period who did not convulse. The leading risk factors for convulsions were prematurity, intra-uterine growth retardation, low 5 min Apgar score, pre-eclampsia, antepartum haemorrhage, twin pregnancy and breech presentation. The predominant seizure type was tonic in 28.6%, multifocal clonic in 27.2%, subtle in 18.4%, myoclonic in 15.0% and focal clonic in 8.8%. Mortality (31%) and long-term disability (43%) rates were high. Tonic seizures had the highest mortality and morbidity. Throughout the duration of the study period infants received increasingly thorough investigation. Causative factors were determined in 95% of convulsing infants, most frequent being hypoxic-ischaemic encephalopathy (40.3%) and cerebroventricular haemorrhage (30.5%). Follow-up data on 99 of the 107 survivors (93%) revealed severe disability in 25, moderate disability in eight and mild disability in 10. A poor long-term prognosis was associated with prolonged convulsions, tonic and multifocal clonic convulsions, convulsions due to asphyxia and cerebroventricular haemorrhage and an abnormal neurological examination at discharge.
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PMID:Clinical spectrum and outcome of neonatal convulsions. 321 7

The postnatal development of susceptibility to the convulsant effects of Ro5-4864 (4'-chlorodiazepam) was characterized in two inbred mouse strains (DBA/2J and BALB/c ByJ) which as adults differ markedly in their response to this convulsant. Onset of susceptibility to a dose of Ro5-4864 which caused a high frequency of clonic seizures in adults was observed at 10 days of age in DBA/2 mice, but not until 35 days in BALB/c By mice. At 14 days of age an abrupt increase in susceptibility to Ro5-4864-induced tonic seizures was found in DBA/2 but not BALB/c By mice. Both the peak of tonic seizure susceptibility (21 days) and the time course of its subsequent age-dependent decline closely paralleled the change in audiogenic seizure susceptibility in the DBA/2 strain. PK11195 (40 mg/kg) blocked Ro5-4864 (25 mg/kg)-induced, age-dependent tonic seizures but had no effect on clonic seizure induction in the same mice. These observations establish that both the susceptibility to Ro5-4864 in adult mice and the postnatal time course for development of susceptibility to this convulsant are inherently different in these two strains of mice. The lack of coincidence between the developmental onset of susceptibility to Ro5-4864-induced seizures and the onset of supersensitivity to Ro5-4864-induced tonic seizures during the period of peak audiogenic seizure susceptibility in DBA/2 mice implies that more than one neurochemical mechanism is involved in the ability of Ro5-4864 to induce seizures in this strain. However, the blockade of Ro5-4864-induced tonic seizures by PK11195 suggests that peripheral type benzodiazepine receptors may mediate this effect.
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PMID:Ontogeny of susceptibility to the convulsant, Ro 5-4864, and its relationship to audiogenic seizure susceptibility in inbred mice. 356 Nov 51

We examined the inbred mouse strains DBA/2Ibg, C57BL/6Ibg, and C3H/2Ibg for differences in susceptibility to bicuculline-induced seizures, as well as to bicuculline-induced epileptiform activity recorded in the CA1 pyramidal cell layer of hippocampal slices. For susceptibility to seizure onset the strain rank order was (most to least susceptible): C3H = DBA greater than C57. The rank order for sensitivity to effects of bicuculline on tonic seizure latency and on hippocampal epileptiform activity were identical: C3H greater than DBA = C57. It is suggested that mechanisms underlying the development of bicuculline-induced epileptiform events in the hippocampal slice may be similar to those involved in the development of tonic seizures measured in vivo.
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PMID:Differential sensitivity to bicuculline in three inbred mouse strains. 360 31

The epileptogenic action of parenteral penicillin was studied in turtles with electrodes chronically implanted in both cerebral hemispheres. Penicillin was administered intraperitoneally at doses of 200,000 to 1,600,000 IU/kg. Doses higher than 600,000 IU/kg caused the appearance on the electrocorticogram of bilateral sharp waves or biphasic spikes, sometimes more pronounced in one hemisphere. These events were often accompanied by clonic activity of the neck muscles and mouth movements in an epileptic automatism. Intravenous penicillin (200,000 to 1,000,000 IU/kg) also evoked changes of the basic pattern of the electrocorticogram. Doses up to 350,000 IU/kg induced bilateral sharp waves and/or spikes sometimes accompanied by the seizures described in item 2. Doses above 400,000 IU/kg produced bilateral synchronous spike or polyspike discharges with a clonic-tonic seizure pattern. The same dose of penicillin induced more marked changes in the electrocorticogram when injected intravenously than intraperitoneally. Since larger doses of parenteral penicillin were required to evoke epileptic activity in turtles than in cats, the present results are consistent with the concept that the brain of phylogenetically lower animals is less susceptible to epileptogenic agents than the brain of higher animals.
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PMID:Electrocorticographic and behavioral features of turtle parenteral penicillin epilepsy. 380 29

Ten patients, referred to the Austin Hospital for possible surgery to alleviate intractable epilepsy, were found to have large local atrophic lesions on CT head scans. Detailed analysis of seizure patterns showed that tonic seizures constituted the main seizure type. In addition the histories of all 10 patients showed absences, atonic seizures and mental deterioration. In half the subjects there were psychomotor elements in some seizures. The clinical diagnosis of Lennox Gastaut syndrome was made. EEG findings were notable for the appearance of bilateral slow spike-wave activity and also tonic seizure fast activity in all patients. Seemingly focal emphasis of abnormal EEG activity, especially spike and spike-wave elements, prompted the use of long-term videomonitoring with intracerebral electrodes in eight patients. In four of these, marked focal emphasis of tonic fast activity in actual seizure recordings provided the basis for local ablative surgery in the expectation of removal of the epileptic focus. In all four cases this surgery was unsuccessful. It would seem, therefore, that though the focal structural lesion and the seizures probably stemmed from the same source, surgery to the lesion did not effect the removal of an 'epileptic focus'. Tonic seizures would seem to be a generalized form of epilepsy and in these patients their presence and the significance thereof were vital to appropriate management.
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PMID:Adult Lennox Gastaut syndrome: patients with large focal structural lesions. 384 11

A series of 25 adults with Lennox Gastaut syndrome is described, with special reference to the occurrence of clinical features resembling complex partial seizures. The majority of the patients showed seizure patterns that at one time or another had been mistaken for temporal lobe epilepsy. The use of video-monitoring to make the definitive diagnosis in this condition becomes most important when the true inaccuracy of eyewitness descriptions of seizure patterns becomes evident, and the implications for the patient of the refractory nature of the tonic seizure is also revealed. This aspect of Lennox Gastaut syndrome does not seem to have been emphasized in series dealing with younger patients and it may well be that adult patients tend to display these characteristics which render diagnosis more difficult.
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PMID:Adult Lennox Gastaut syndrome: features and diagnostic problems. 384 28

Amantadine HCl was given to 10 children with medically refractory seizures; other anticonvulsant medications were continued unchanged through the 12- to 16-week trial. Several patients noted improvement in control of myoclonic or atypical absence seizures. Tonic seizures were controlled in one patient, but worsened in another. Tonic-clonic and atonic seizures remained unchanged or worsened. Amantadine may be useful as an adjunctive anticonvulsant in some children with refractory atypical absence or myoclonic seizures.
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PMID:Amantadine in the treatment of refractory epilepsy in childhood: an open trial in 10 patients. 392 May 49

The effect of inhibiting endogenous brain thromboxane (TXB2) on pentylenetetrazole-induced seizures was studied using the thromboxane synthetase inhibitors OKY-1581 (20 mg/kg) and UK 38,485 (50 mg/kg). Both compounds selectively decreased (greater than 90%) TXB2 production in brain measured after 2 min of convulsive activity but had no effect on brain PGE2, PGF2 alpha, or 6-keto-PGF1 alpha. No effect of these agents on the tonic seizure threshold was observed, whereas 10 mg/kg ip indomethacin, an agent which inhibits both TXB2 and prostaglandin production, reduced the tonic seizure threshold from 78 +/- 2.6 mg/kg in controls to 62 +/- 3.7 mg/kg. Thus, this study concludes that the availability of TXB2 with convulsant activity is unlikely to be a factor in altering tonic seizure activity observed with indomethacin.
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PMID:The effect of inhibiting brain thromboxane biosynthesis on pentylenetetrazole-induced seizure threshold. 400 45

A retrospective study of neonatal seizures in a tertiary care neonatal intensive care unit determined a 3.2% incidence, and confirmed the relatively poor efficacy of the traditional anticonvulsants phenobarbital and phenytoin. Only 33% responded to an initial adequate loading dose of phenobarbital, while 56% responded to either or both anticonvulsants. Although multifocal clonic seizures were most common (42%), tonic seizures were next in frequency (30%). Tonic seizures which did not respond to phenobarbital responded quite poorly to the addition of phenytoin compared to other seizures types. Tonic seizures may be the result of brainstem release phenomena and require a different strategy for management. Among nonresponders in this study, there was a 56% mortality rate but only 33% of responders died. There is a critical need for studies to find more efficacious agents than phenobarbital and phenytoin to treat seizures in the newborn.
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PMID:Efficacy of phenobarbital in neonatal seizures. 401 97


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