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

Status epilepticus may be resistant to intravenous anticonvulsive drugs. In these cases treatment with the inhalation anaesthetic agent isoflurane may be helpful in the further management. We describe a 35-year-old female patient who suffered from status epilepticus with partial seizures. In spite of therapy with benzodiazepine and phenytoin the status evolved into tonic clonic seizures. Treatment with thiopentone sodium did not stop seizure activity. Anaesthesia with isoflurane (dosage up to 1.5 vol.%) carried out twice within 72 h finally led to a termination of status epilepticus. From our own experience and reports in the literature we conclude that general anaesthesia with isoflurane can and should be used in the treatment of severe status epilepticus that does not respond to intravenous anticonvulsive agents.
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PMID:Isoflurane anaesthesia in the treatment of convulsive status epilepticus. Case report. 157 16

A 79 year old man, with left femoral neck fracture, was scheduled for an elective operation. After admission, severe hyponatremia probably due to diuretics developed. No neurological abnormalities were observed before surgery. He recovered from anesthesia with no problems. But on the 5th postoperative day he showed transient unresponsiveness. Grand mal seizures were also seen after the serum Na level had recovered to around 130 mEq.l-1. This case shows that in the management of severe hyponatremia, the discrimination between acute and chronic hyponatremia seems to be important.
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PMID:[Anesthetic management of a patient with severe hyponatremia]. 157 24

Electrically induced seizures have been used widely to treat psychiatric disease since their introduction in 1938. Seizure activity is the therapeutic aspect of this form of treatment, but it is accompanied by untoward physiologic consequences. Cardiovascular responses consist of generalized autonomic nervous system stimulation with initial parasympathetic outflow, followed immediately by a sympathetic response. In certain patients the sequence described may result in an initial bradycardia or even asystole, followed by tachycardia, dysrhythmia, and hypertension. The cerebrovascular system responds with a marked increase in cerebral blood flow in response to increased cerebral oxygen consumption, and dramatic elevation of intracranial pressure. General anesthesia for electroconvulsive therapy (ECT) must be administered only in locations equipped for support of the unconscious patient and treatment of complications. Intravenous access is mandatory in all patients, as is monitoring of blood pressure, and ECG, as well as pulse oximetry. Appropriate oxygen supplementation and ventilatory support are essential as they are during any procedure necessitating general anesthesia. Methohexital, 0.75 to 1.0 mg/kg intravenously, is the most frequently used agent for induction of anesthesia for ECT; muscle relaxation usually is accomplished with succinylcholine, 0.5 to 1.0 mg/kg. In patients at risk for ill effects from the tachycardia and hypertension that may accompany sympathetic nervous system response to ECT, nitroglycerin, propranolol, hydralazine, or other sympatholytic agents should be used to attenuate the potentially harmful sequelae of ECT. The efficacy of ECT requires a knowledge of anesthetic precepts, an understanding of the interaction between anesthetic drugs and seizure activity, and an awareness of the physiologic effects of ECT as well as the treatment of those effects.
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PMID:Anesthetic considerations for electroconvulsive therapy. 158 98

Enflurane offers few advantages over halothane, and it is more expensive than halothane. It causes greater cardiopulmonary depression and induces seizure activity. When economy and systemic effects are considered, enflurane offers no real benefits for veterinary anesthesia.
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PMID:Precautions when using enflurane. 158 67

Continuous monitoring of regional cerebral blood flow (rCBF) of the hippocampus was made during limbic seizure status in cats by means of a heat clearance method with a calibration method by an electrolytic hydrogen clearance method. A stereotaxic operation was made under Nembutal anesthesia. Local anesthetics were applied to the painful area. Femoral artery and vein were cannulated and served for arterial blood pressure monitoring and drug injection, respectively. Tracheostomy was made and ventilated artificially. A double cannula was inserted to the amygdala and fixed to the skull with a dental cement. Electrodes for heat clearance method, electrolytic hydrogen clearance method and EEG recording were inserted to the dorsal hippocampus. Limbic seizure status was induced by kainic acid microinjection (2 ug) into amygdala via implanted cannula. Baseline rCBF was measured in each cats. Continuous monitoring of rCBF was made before and after intravenous administration of anticonvulsants such as zonisamide (ZNS), valproic acid (VPA), diazepam (DZP), phenobarbital (PB) and phenitoin (PHT). Physiological saline (PHS) was injected for controls. Injection of DZP resulted in strong seizure suppression with decrease of arterial blood pressure and hippocampal rCBF. Intravenous PB demonstrated analogous action with DZP with a mild anticonvulsant effect. Intravenous ZNS or VPA resulted in inhibition of seizure propagation from limbic system to cortex. However, these drugs augmented rCBF of the hippocampus more than 2 hours after administration. PHT and PHS demonstrated no anticonvulsant effect nor rCBF change in the present study.
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PMID:[Effect of anticonvulsants upon experimental limbic seizure status and regional cerebral blood flow in the hippocampus]. 159 Nov

Medical records of 66 dogs that had undergone myelography, using iohexol (240 mg of iodine/ml, 0.3 to 0.5 ml/kg of body weight) during a 2-year period, were reviewed. In 3 dogs, myelography was performed twice during different anesthetic procedures. Neurologic abnormalities were more pronounced the day after myelography in dogs with caudal cervical spondylomyelopathy (P less than 0.01), meningitis (P less than 0.01), or extradural tumors (P less than 0.05). Neither anesthetic regimen nor duration of anesthesia significantly affected the frequency of complications. Seizures occurred after myelography in 6 dogs, and 1 dog had seizures after each of 2 myelographic procedures. The frequency of seizures was significantly greater in male Doberman Pinschers afflicted with caudal cervical spondylomyelopathy. Male dogs (P less than 0.01) and Doberman Pinschers (P less than 0.001) had higher prevalence of seizures. Caudal cervical spondylomyelopathy was associated with higher prevalence of seizures, compared with all other diagnoses (P less than 0.001). Seizures were significantly more prevalent when body weight was greater than or equal to 29 kg (P less than 0.001), when greater than or equal to 2 injections of contrast medium were administered (P less than 0.016), or when 2 injections of contrast medium were given at the cisterna magna (P less than 0.015). The 10% prevalence of seizures after myelography with iohexol in the study reported here is greater than in previous reports, but is lower than that reported after myelography using metrizamide.
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PMID:Complications associated with the use of iohexol for myelography of the cervical vertebral column in dogs: 66 cases (1988-1990). 160 29

In an open, prospective clinical trial, midazolam anaesthesia was compared with thiopental (plus suxamethonium chloride as a muscle relaxant) to clinically evaluate the former as an anaesthetic and a muscle relaxant during electroconvulsive therapy (ECT). Twelve depressed patients underwent a course of ECT, receiving midazolam or thiopental anaesthesia alternatively. Significant differences were found in seizure duration between the two anaesthetics. Midazolam shortened the seizures to a duration that was not therapeutically desirable. There were no differences in stimulus parameters between the two groups. The muscle relaxant effect of midazolam failed to provide optimal paralysis. Thus, midazolam anaesthesia offers no advantage over standard anaesthetic agents for ECT.
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PMID:Midazolam shortens seizure duration following electroconvulsive therapy. 161 82

When conventional treatment for status epilepticus fails, general anaesthesia is recommended. We present our experience with isoflurane, an inhalational anaesthetic, in the management of four patients with status epilepticus which occurred soon after surgery for motor area lesion. The seizures were controlled with relatively small concentrations of isoflurane. Hypotension, the only adverse effect of isoflurane, was managed easily with the use of dopamine in physiological saline. Although status epilepticus occurring soon after surgery is transient, it carries a risk of persistent brain damage if active treatment is not instituted promptly. Isoflurane general anaesthesia may be recommended to control it in the intensive neurosurgical care.
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PMID:Isoflurane in the management of status epilepticus after surgery for lesion around the motor area. 161 67

Two elderly women with symptomatic benign intracerebral cysts are reported. Before treatment, they both had developed moderate, but slowly increasing, symptoms from a cyst in the left hemisphere, which included epileptic seizures and right hemiparesis. During local anesthesia, an internal cystosubarachnoid shunt was inserted. After the operation, the cyst size was reduced markedly, with a corresponding improvement in the symptoms. A review of reported cases of benign intracerebral cysts is given. The average age of these patients is surprisingly high for a presumed congenital condition. There is a female preponderance, but the previously reported overrepresentation of left-sided lesions is not found in cases described after the introduction of computerized tomographic imaging.
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PMID:Benign intracerebral cysts treated with internal shunts: review and report of two patients. 162 Mar 11

A retrospective study was performed to evaluate the incidence of seizure and anticonvulsant prophylaxis in 138 patients operated from september 1987 to august 1989 for extra-axial supratentorial tumors. 15 patients (10.9%) developed seizures in the early post-operative period. We have considered the importance of histological type and side of lesions, a previous history of epilepsy and the pre and intraoperative prophylaxis. We can say that there is a statistical significance between sellar and middle cranial fossa tumors and the frequency of post-operative epilepsy and that anticonvulsant prophylaxis can reduce post-operative seizure. There is no statistical significance between the previous history of epilepsy the type of anesthesia and post-operative seizure.
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PMID:[Early epilepsy in surgery of extra-axial supratentorial neoplasms]. 162 Apr 38


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