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

Four siblings aged 12-18 years with progressive myoclonus epilepsy demonstrated a subclinical stage at the age of 9-11 years, with visual blackouts and polyspike electroencephalographic (EEG) activity on photic stimulation, an early myoclonic stage at the age of 12-15 years, with increasing segmental, stimulus-sensitive myoclonus, occasional nocturnal buildup myoclonic "cascade" seizures, slowing of EEG alpha-activity, episodic 4-6 Hz bilateral sharp waves and polyspikes with myoclonias on photic stimulation, and a disabling myoclonic stage at the age of 16-18 years, with periodic generalized myoclonias, nocturnal myoclonic "cascade" seizures, ataxia, dysarthria, mental changes, intermittent wheelchair dependency, and continuous EEG slow waves with polyspikes and intense myoclonias on photic stimulation. One of the siblings died at the age of 18 years with no apparent cause of death. Treatment with antiepileptic drugs other than valproate may have contributed but none of the siblings were ever treated with phenytoin. Extensive clinical and laboratory investigations revealed no abnormalities and excluded other known possible causes of progressive myoclonus epilepsy. The diagnosis was consistent with Unverricht-Lundborg disease and rested on typical age of onset, clinical signs, EEG, and evoked response abnormalities. Buildup myoclonic seizures are typical in advanced stages of Unverricht-Lundborg disease. We have labeled these myoclonic "cascade" seizures. A typical seizure was studied with video-EEG and cardiorespiratory monitoring. Characteristics revealed were onset with continuous arrhythmic myoclonic jerks followed by intense rhythmic myoclonus with increasing muscle tone that successively reduced the amplitude of the jerks. The EEG during the whole seizure showed intense polyspike activity. Obstructive apnea was seen at the peak of the seizure. There were no cardiac dysrhythmias. Consciousness was normal or only slightly impaired. Postictal drowsiness was not observed. Myoclonic "cascade" seizures are easily confused with generalized tonic-clonic seizures.
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PMID:Clinical and neurophysiological development of Unverricht-Lundborg disease in four Swedish siblings. 174 64

This paper examines severity of depressive symptoms, as measured by the Beck Depression Inventory, in chronic alcoholics with and without a history of hallucinations. We found a) alcoholics entering alcohol treatment who have experienced hallucinations during detoxification report higher levels of subjective depression than alcoholics who have never experienced hallucinations, b) the level of subjective depression in alcoholics with a history of hallucinations remains higher at the end of inpatient alcohol treatment than in alcoholics without hallucinations, and c) hallucination is the important variable; alcoholics with blackouts, seizures, and delirium tremens, do not experience higher levels of depression during detoxification. The reporting of a significantly higher level of depressive symptoms by alcoholics with a history of experiencing hallucinations during withdrawal suggests that in some alcoholics, there exists a vulnerability for mood abnormalities which includes a predisposition toward other abnormal mental phenomena such as perceptual distortions.
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PMID:Dysphoria in male alcoholics with a history of hallucinations. 186 70

Clinically it is often very difficult to distinguish rudimentary psychomotor seizures from absence seizures and sudden nonepileptic disturbances, especially from transitory cerebral ischaemia. In contrast to absence seizures during which bifrontally accentuated spike-wave activity is registered in the EEG, absence like psychomotor seizures usually present with unilateral temporal or frontotemporal EEG discharges. Syncopal and psychomotor attacks may overlap in the following context: falls resembling syncope during psychomotor seizures, the so-called "temporal fainting spells"; cardiac arrhythmias during psychomotor attacks; psychomotor symptoms such as automatisms and/or "dreamy states" that occur during syncopal attacks with transient dysfunction of the limbic system; alternating psychomotor and syncopal attacks in the same patient Symptoms of intermittent vertebrobasilar insufficiency: non-systematic vertigo, brief blurring of consciousness and blackouts may all be misinterpreted as rudimentary psychomotor seizures. The further differential diagnosis includes psychogenic attacks as well as states of confusion due to a variety of diseases in internal medicine.
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PMID:[Rudimentary psychomotor seizures and their differential diagnosis]. 236 70

Four elderly patients with epilepsy are described. The seizures took the form of abrupt loss of consciousness without tonic/clonic movements, followed by prolonged loss of consciousness or drowsiness. In three cases, there had been a long history of blackouts before the diagnosis was made. The diagnosis of epilepsy in these cases was made on clinical grounds. In each case, the event was either witnessed by medical observers or an eye-witness account was obtained. In every case, there had been repeated, and apparently precisely similar, transient disturbances of consciousness, with complete recovery in the intervals. All of the patients had abnormal EEGs.
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PMID:Misleading presentation of epilepsy in elderly people. 246 18

Alcoholic blackouts are among the most frequently reported symptoms in the progression of alcoholism. The exact etiology of blackouts remains unknown, but relationships to memory disturbance, seizure disorders, underlying psychiatric conditions, head trauma, and drug use have all been suggested. We studied 72 alcoholics admitted to an alcohol inpatient treatment program. Seventy-five percent of the patients had experienced blackouts. Patients who had had blackouts experienced other alcohol-related symptoms such as a need to drink upon awakening, alcohol cravings, tremors, and hallucinations more frequently and they were more likely to have had a past history of depression and to have been arrested for driving while intoxicated than alcoholics who had never experienced blackouts. No significant differences were observed between patients who had experienced blackouts and those who did not in mild to moderate memory disturbance, seizure disorder, a variety of psychiatric conditions, head trauma, or drug use. No significant differences were found between the two groups in most drinking history variables. The present study does not lend support to most hypotheses made about the etiology of alcoholic blackouts. Blackouts in alcoholics were significantly associated with other symptoms resulting from excessive alcohol use.
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PMID:Variables associated with alcoholic blackouts in men. 409 Nov 63

In 3 decades 1550 patients showed 6/sec spike and wave complexes; 839 were chosen for computer-analyzed electroclinical correlations. Control groups (each 500) included patients (1) randomly selected from EEG files, (2) with normal EEGs, (3) with only slow wave abnormalities, and (4) with only spike abnormalities. In the experimental group more females and Caucasians were found with peak age distribution at 11--15 years. The major symptoms were seizures (53%), neurovegetative (51%) and psychological complaints (24%), all significantly different from control groups, except for seizures in control group 4. Seizures were mainly generalized motor attacks, neurovegetative symptoms included headaches, dizziness and blackouts and psychological symptoms were mainly behavior disorders. As a presumed etiology head injury was noted in over 25% with this complex, which was maximal either on the anterior or occipital areas. Further computer analysis shows that two extreme forms can be identified: (1) the WHAM form, seen mainly in waking records, high amplitude, anterior location, more males, and (2) the FOLD form, seen mainly in females, occipital location, low amplitude, in drowsy states. The WHAM form appears primarily in patients with seizures, and the FOLD form in patients with neurovegetative and psychological complaints.
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PMID:Two forms of the 6/sec spike and wave complex. 615 62

The diagnosis of epilepsy is complicated by various conditions that can mimic an epileptic seizure. Many patients with abnormal seizure activity during loss of consciousness may have cardiovascular syncope with global cerebral hypoxia (convulsive syncope), which may be difficult to differentiate from epilepsy on clinical grounds. The differentiation is, however, important because they need quite different treatment modalities. In addition, long-term anticonvulsant therapy is expensive and can cause serious morbidity. The authors present a case of a patient thought to have treatment-resistant epilepsy for years with recurrent seizure-attacks, who were subsequently found to have a malignant vasovagal reaction of 24s-asystole as a cause for the so called convulsive syncope. A simple, non-invasive evaluation of circulatory responses to acute orthostasis, the head-up tilt table test, can identify cardiovascular reflex abnormalities in patients with recurrent idiopathic seizure-like episodes. The authors could also reproduce the symptoms of the spontaneous attacks in their patient by this way, to confirm an alternative diagnosis of malignant vasovagal reaction and convulsive syncope in this patient with "refractory epilepsy". This rare cardioinhibition can be safely treated by dual-chamber pacemaker implantation, alleviating for the convulsive attacks, this therapeutic option was advised to this patient as well. Orthostatic stress tests should be considered early in the diagnostic workup of patients with convulsive blackouts. Cardiac causes of loss of consciousness should be considered in patients with presumed epilepsy, atypical premonitory symptoms, non-diagnostic electroencephalograms and failure to respond to anticonvulsant therapy.
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PMID:[Malignant vasovagal syncope]. 1290 Nov 79

Vestibular neuronitis was described in 1949 and 1952 by Dix and Hallpike. Two groups of patients were described, those with sudden seizures and sensations of blackout (since identified as having vestibular neuritis) and a second group with symptoms of disequilibrium and feelings of top-heaviness or imbalance. The pathology was believed to be central to the inner ear. Arslan labeled these groups as having nucleoreticular vestibular syndrome. Using a suprathreshold stapedial reflex test, Bosatra localized the pathophysiology in the brainstem, an area rich in serotonergic neurons. This author has used antiserotonergic drugs, with success, in treating patients having the symptoms identified by Dix and Hallpike in their second group (which now should be labeled nucleoreticular vestibular syndrome), properly identified as a brainstem affliction. This study describes the characteristics of this disorder, the methods of diagnosis and treatment, and the outcomes in two groups of patients studied. The study concluded that antiserotonin drugs, specifically affecting 5-hydroxytryptamine2, should be considered in the management of nucleoreticular vestibular syndrome.
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PMID:The use of antiserotonin drugs in the nucleoreticular vestibular syndrome: preliminary observations. 1537 56

An observational study of cases of obstructive sleep apnoea-hypopnoea syndrome (OSAHS), both suspected and established, presenting to general neurology outpatient clinics over a 5-year period was undertaken. Only eight new cases of OSAHS, confirmed by sleep studies, were identified, most with neurological problems (poor seizure control, blackouts and headache) in addition to excessive daytime somnolence. OSAHS appears to be a rare cause of new symptomatic neurological presentations, although cases may have been overlooked as judgement was based on the index of clinical suspicion alone.
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PMID:Obstructive sleep apnoea-hypopnoea syndrome presenting in the neurology clinic: a prospective 5-year study. 1879 71

Objective. To validate NAT (NETER's alcoholic typology), taking into account the differentiated distribution of the measures used as external criteria in alcohol-dependent sub-groups and its relationship with Lesch's alcoholic typology (LAT). Method. A sample of 133 alcohol-dependent patients integrated in the alcoholism unit of the Psychiatric Service of Santa Maria University Hospital were included in the study. Results and Conclusions. Convergent validity was assured by the agreement between the subtypes of the two typologies (NAT and Lesch), considering the same underlying model of alcoholism development: anxiopathic subtype of NAT and Type II (model of anxiety, alcohol as conflict solution) of Lesch and the tymopathic subtype of NAT and type III (model of depression, alcohol as antidepressant) of Lesch. Discriminant analysis (external criteria) showed significant differences between the subtypes in the following variables: gender; tobacco; beer and whisky consumption; daily average of drinks; clinical conditions such as delirium tremens, alcoholic blackouts and seizures; severity of alcohol-related problems; psychological dimensions such as psychological maturity and extroversion; and suicidal ideation during the alcohol consumption period. A more exhaustive description of alcoholic sub-groups may improve genetic studies of alcoholism and provide the alcoholic patient with an adequate specific therapeutic protocol.
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PMID:NETER 1 alcoholic 5 subtypes: Validity with Lesch four evolutionary subtypes. 2491 98


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