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

In 1965, Feng of the Peking Union Hospital published an article entitled "Innovation in electroencephalography: the use of acupuncture needles as sphenoidal electrodes". It was a preliminary report, but surprisingly EEG records in the figures did not show definite spikes or sharp waves in the sphenoidal leads. In 1983, Feng and his colleagues reported a summary of 2,000 cases studied with acupuncture needle sphenoidal electrodes. This time, spikes or sharp waves were shown in EEG recordings. However, cases studied were several "paroxysmal disorders", including psychomotor seizure (155 cases), generalized seizure (765 cases), epileptic cephalgia (101 cases), syncope (104 cases), abdominal epilepsy (24 cases), encephalopathy (135 cases), brain tumor (32 cases), hemiplegia of unknown cause (43 cases), psychosis (34 cases), and others (607 cases). Therefore, there were many unknown cases and many cases that were not related to temporal lobe epilepsy. Surprisingly, the increase in detection by acupuncture needle electrode was higher for hemiplegia of unknown cause, brain tumors, and encephalopathies than for the temporal lobe epilepsy. Furthermore, the issue of no insulation of the acupuncture needle was not addressed. Therefore, we began in 1988 to reinvestigate the usefulness of uninsulated acupuncture needles as sphenoidal electrodes. We also compared the efficacy of anterior temporal electrodes (T1, T2) with those of acupuncture needle and EMG needle. Our results showed that when compared to the routine EEG recordings, acupuncture needle sphenoidal electrodes increased the yield of detecting anterior temporal spikes from 41% to 70%. Our data further showed that when compared to the EMG needle recordings, acupuncture needle recordings had the same detection rate, but the spike amplitude was slightly smaller (129 microv vs. 135 microv). Interestingly, we also found that anterior temporal surface electrode recordings were nearly as good as those of acupuncture needle and traditional insulated needle electrodes in the detection of anterior temporal spikes. Our data indicate that acupuncture needle sphenoidal electrode is as effective as the traditional insulated needle sphenoidal electrode in the detection of anterior temporal spikes. We agree with Feng that the use of acupuncture needle is easy, safe, and has minimal discomfort and complications. However, when the use of the acupuncture needle is not acceptable to patients or as in the pediatric group, anterior temporal electrode is an ideal alternative to acupuncture needle sphenoidal electrode.
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PMID:[Re-evaluation of using acupuncture needle as sphenoidal electrode in temporal lobe epilepsy]. 1967 69

The goal of antiepileptic therapy is to achieve long-term seizure freedom with minimal or no adverse effects. Current evidence suggests that in many patients who have failed two appropriate antiepileptic drugs (AEDs) because of lack of efficacy, the chance of subsequent seizure freedom with further drug manipulation is low (reports ranging from as little as a few percent to nearly one-fourth of patients). Achieving this may require repeated drug manipulations. Surgery, in appropriately selected candidates, may render up to 70% of patients seizure-free when temporal resection is done, although frontal resection may have only a 25% yield. Both courses of actions (further drug trials and surgery) are associated with a plethora of potential adverse outcomes. Therefore, it is recommended that such patients be promptly referred to an epilepsy center for a comprehensive review of the diagnosis and management, which may include initial evaluation for surgery. Because presurgical evaluation and surgery itself may entail discomfort and risk, the decision to offer surgical treatment requires individual risk-benefit analysis that includes an assessment of possible success with additional trials of medication.
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PMID:Refractory seizures: try additional antiepileptic drugs (after two have failed) or go directly to early surgery evaluation? 1970 35

Major challenge in paediatric palliative home care is to anticipate management of future events. In our opinion, one of major approach is to avoid medical futility especially resuscitation attempts in terminally-ill children especially if home care will be organized. We therefore prospectively discussed with proxi what should be attempted (e.g. treat symptoms of pain or discomfort) and what should be avoided for the sake of the child. A crucial part of the discussion included anticipating non resuscitation of the terminally-ill child. We informed in writing local emergency unit coordinator on results of the discussion with care takers and suggested a procedure in case of an emergency call. To include the local emergency unit is now a standard in our paediatric oncology department since two situations may occur: 1) Parental panic while facing difficult terminal symptoms. We recommend that the local emergency unit coordinator dispatches an emergency team to the child's home in order to manage symptoms (seizures, pain, etc.) but avoid any futile resuscitation attempt. Parental decision to maintain the child at home should be re-evaluated regularly. 2) Parents who wish to stay at home as long as possible, refusing home-based death of their terminally-ill child. We recommend that the family doctor decides whether or not to refer the child to the hospital. Emergency team may be called upon based on the child's status and need for medicalised transport. Even if it should be rather rare that parents contact directly the emergency unit and not as usually the home care coordinator, such situation may occur and should be anticipated. Therefore, the anticipation of non-resuscitation recommendations is a key approach in paediatric palliative home care. This complex discussion should not be avoided as parental/medical panic may induce unrealistic requests for futile medical procedures.
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PMID:[The "do-not-resuscitate order" in paediatric palliative home care: why should the emergency team be involved ?]. 1990 95

For as many as 30% of epilepsy patients, seizures are poorly controlled with medication alone. For some of these patients surgery may be an option: the brain region responsible for seizure onset may be removed surgically. However, this requires accurate delineation of the seizure onset region. Currently, the key to making this determination is seizure EEG. Therefore, EEG recordings must continue until enough seizures are obtained to determine the onset region; this may take about 5 days to several weeks. In some cases these recordings must be done using invasive electrodes, a procedure that includes substantial risk, discomfort and cost. In this paper, techniques are developed that use periods of intracranial non-seizure ("rest") EEG to localize epileptogenic networks. Analysis of intracranial EEG (recorded by surface and/or depth electrodes) of 6 epileptic patients shows that certain EEG channels and hence cortical regions are consistently more synchronous ("hypersynchronous") compared to others. It is shown that hypersynchrony seems to strongly correlate with the seizure onset zone; this phenomenon may in the long term allow to determine the seizure onset area(s) from non-seizure EEG, which in turn would enable shorter hospitalizations or even avoidance of semi-chronic implantations all-together.
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PMID:Localization of seizure onset area from intracranial non-seizure EEG by exploiting locally enhanced synchrony. 1996 40

We compared occlusal discomfort in patients with temporomandibular disorders (TMD) between myofascial pain (MFP) and disc displacement (DD) using a database created from Sep, 2003 to Aug, 2005. We selected 71 patients with MFP and 170 patients with DD to construct a null model of structural equation modeling (SEM) in which anxiety influenced depressive mood, depressive mood aggravated occlusal discomfort and sleep complaints, and sleep complaints or an onset event caused by another person aggravated occlusal discomfort. We performed a simultaneous analysis of patients with MFP and DD. The estimated parameter of the path from depressive mood to occlusal discomfort was significant for patients with MFP, but not for patients with DD. The path from an onset event caused by another person, such as dental treatment to occlusal discomfort was significant in patients with MFP and those with DD. The Goodness of Fit Index (=0.909), The Adjusted Goodness of Fit Index (=0.867), and The Root Mean Square Error of Approximation (=0.039) indicated good acceptability. These results suggested that an increase in depressive mood may aggravate occlusal discomfort in patients with MFP, and an onset event caused by another person, such as dental treatment, also may aggravate occlusal discomfort in patients with MFP and those with DD.
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PMID:Comparison of occlusal discomfort in patients with temporomandibular disorders between myofascial pain and disc displacement. 2043 98

We report a 75-year-old, right-handed man, presenting with supplementary motor area (SMA) seizure. The patient had suffered from frequent attacks of transient inability to speak and move without loss of awareness. On admission, he presented with vertical gaze paresis, axial rigidity, paratonia of extremities and gait disturbance. The attacks were preceded by discomfort on the head, followed by inability to move the whole body and arrest of vocalization with tonic posture and exaggerated breathing. Consciousness and cognitive function were preserved throughout the attacks. Electroencephalography recorded intermittently slow theta waves in the bifrontal regions. Brain MRI showed atrophy of the midbrain tegmentum with lacunar state suggesting progressive supranuclear palsy. SPECT with 123I-iomazenil revealed decreased uptake in the medial frontal areas including SMA, bilaterally. The seizures resolved completely following treatment with carbamazepine. Based on clinical features and neuroimagings, we speculated that the negative motor area within SMA was responsible for his seizure. Physicians should keep in mind that SMA seizure comprising negative motor phenomenon can occur in the elderly.
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PMID:[A case of progressive supranuclear palsy with late-onset supplementary motor area seizure]. 2068 Dec 67

We describe the case of a 22-year-old male affected by NFLE reporting paroxysmal RLS-like symptoms. The patient was referred to our Sleep Center due to nocturnal paresthesias and cramps involving the left leg and leading to sleep fragmentation. At age 4, the patient presented with secondary generalized seizures preceded by left leg discomfort, controlled on CBZ. After successive therapy discontinuation, leg symptoms built up in frequency and duration until a secondary generalized seizure re-occurred. On CBZ prompt resumption no further GM seizures occurred albeit persistence of night-time frequent cramps and paraesthesia. Sleep EEG demonstrated asymmetric interictal sharp theta on the right posterior frontal areas, whereas brain MRI results were consistent with a Taylor type right frontal cortical dysplasia. CBZ augmentation and add on therapy with LEV led to further frequency reduction of sensory symptoms.
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PMID:Nocturnal frontal lobe epilepsy presenting with restless leg syndrome-like symptoms. 2108 77

The prophylactic administration of antibiotics to prevent infection and the prophylactic administration of anticonvulsants to prevent first seizure episodes are common practice in neurosurgery. If prophylactic medication therapy is not indicated, the patient not only incurs the discomfort and the inconvenience resulting from drug treatment but is also unnecessarily exposed to adverse drug reactions, and incurs extra costs. The main situations in which prophylactic anticonvulsants and antibiotics are used are described and those situations we found controversial in the literature and lack further investigation are identified: anticonvulsants for preventing seizures in patients with chronic subdural hematomas, antiepileptic drugs for preventing seizures in those suffering from brain tumors, antibiotic prophylaxis for preventing meningitis in patients with basilar skull fractures, and antibiotic prophylaxis for the surgical introduction of intracranial ventricular shunts.In the following we present systematic reviews of the literature in accordance with the standard protocol of The Cochrane Collaboration to evaluate the effectiveness of the use of these prophylactic medications in the situations mentioned. Our goal was to efficiently integrate valid information and provide a basis for rational decision-making.
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PMID:Prophylactic antibiotics and anticonvulsants in neurosurgery. 2119 10

A 52-year-old woman with rheumatoid arthritis who had been treated with prednisone and hydroxychloroquine for >12 years presented with chest discomfort and a seizure. She was diagnosed with restrictive cardiomyopathy combined with sick sinus syndrome. A myocardial muscle biopsy was performed to identify the underlying cardiomyopathy, which showed marked muscle fiber hypertrophy, fiber dropout, slightly increased interstitial fibrous connective tissue, and extensive cytoplasmic vacuolization of the myocytes under light microscopy. Electron microscopy of the myocytes demonstrated dense, myeloid, and curvilinear bodies. The diagnosis of hydroxychloroquine-induced cardiomyopathy was made based on the clinical, hemodynamic, and pathologic findings. This is the first case report describing chloroquine-induced cardiomyopathy involving the heart conduction system.
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PMID:A case of chloroquine-induced cardiomyopathy that presented as sick sinus syndrome. 2121 40

Gastrointestinal (GI) discomforts are among the most common side effects of antiepileptic drugs (AEDs) that might lead to discontinuation or irregular consumption of the drugs. This study was conducted to evaluate the frequency of GI side effects of different AEDs in intractable epileptic patients treated with single or multiple drugs. GI discomfort of 100 epileptic patients (aged 35-76 years) treated with one or multiple AEDs was assessed. Seventy six patients (76%) were treated with two or more AEDs, and 24 (24%) were on monotherapy. The most common prescribed drug for monotherapy was carbamazepine and the most frequent combination was phenytoin and carbamazepine. Patients were suffering from different GI side effects including heartburn (34.6%), nausea (33.7%), constipation (26%), vomiting (22.1%), diarrhea (21.2%) and dysphagia (19.2%). Nausea and vomiting were significantly higher in patients receiving monotherapy with carbamazepine and valproic acid, respectively. When phenytoin, gabapentine, or valproic acid was added to the other AEDs, the risk of the occurrence of diarrhea, dysphagia, or heartburn was significantly increased, respectively. Addition of gabapentine to the other AEDs in multiple drug therapy was accompanied with the highest frequency of GI complications. This study indicated that GI side effects, which can affect drug absorption and utilization, were common in intractable epileptic patients with long-term AEDs treatment. This may influence the efficacy of the therapy with AEDs and enhance the probability of further attacks.
Seizure 2011 May
PMID:Gastrointestinal adverse effects of antiepileptic drugs in intractable epileptic patients. 2123 3


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