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

In 38 children with partial seizures, the EEG, CT and NMR findings were compared to the results obtained with Tc99m HMPAO single photon emission computed tomography (SPECT) in order to determine whether SPECT is a useful adjunct to EEG, CT and NMR in this age group. In 3 out of 7 patients with a normal EEG, SPECT showed focal abnormalities. Nine patients whose EEGs did not show adequate lateralization had an abnormal SPECT which revealed a focus. In 14 out of 21 patients with a normal CT, SPECT showed focal changes in 13 patients and diffuse changes in the other one. In 7 out of 12 patients with a normal NMR, SPECT showed focal abnormalities. Although clinical history and a careful description of the seizures are the most valuable information in partial seizure disorders, SPECT imagining gives valuable additional information, which might target treatment. SPECT was superior to CT and NMR with respect to the depiction of some kind of abnormality.
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PMID:Single photon emission computed tomography (SPECT) in seizure disorders in childhood. 212 61

A neurologist conducted research efforts for more than 12 years as a step toward the establishment of monotherapy for epilepsy. Of 406 patients with epilepsy, seizures could be controlled for more than one year in 72% and for more than 3 years in 54%. Monotherapy was given to 57% of all the patients with a success rate of 54%. Factors that were found likely to interfere with a reduction in antiepileptic drug therapy to one drug modality included: symptomatic etiology, prolonged duration of illness, low age at onset and secondary generalized epilepsy with a large number of seizures in combination, for generalized epilepsies; symptomatic etiology, prolonged duration of illness, low age at onset, other than occipital lobe origin, complex partial seizure with secondary generalization, temporal lobe epilepsy with associated automatisms, elementary sensorimotor seizure and high frequency of seizures, for partial epilepsies. In addition to these factors relevant to the nature of epilepsies, other factors apparently unrelated to the disease process, e.g., liability of polypharmacy to produce side effects precluding dosage elevation, patient's rejection to reduce drug and the inability of a physician to treat the patient properly for want of information, were also recognized to exist.
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PMID:Factors that preclude the successful use of monopharmacy in the medical treatment of patients with epilepsy. 212 85

All mentally retarded (MR) subjects in a northern Swedish county were assessed for the occurrence of active epilepsy on a prevalence day. Active epilepsy was found in 299 subjects (20.2% of those with MR) corresponding to a crude prevalence rate of 1.2/1000 inhabitants. The age-specific prevalence for 0-9 years was higher for females than for males, while in other age groups it was slightly higher for males or showed no difference between the sexes. Epilepsy and MR were the only disorders in 129 subjects (43.1%). Cerebral palsy was the most common associated disorder and occurred in 100 (33.4%). A presumable etiology for epilepsy and MR was identified in 73.2% and 71.9%, respectively. The presumable etiological factors which caused MR occurred prenatally in 35%, perinatally in 10% and postnatally in 9%. The pathogenetic period was unknown in 31%. In 15%, the etiological events occurred during more than one of the above periods. The presumable causes were responsible for both epilepsy and MR in all except 7 cases. MR individuals with epilepsy were significantly more retarded than those without epilepsy. The first seizure occurred during the neonatal period in 11.6% and before 1 year of age in 27.7%. Generalized tonic-clonic seizures were the most common type and occurred in 204 subjects (68.2%). Seventy-one of these also had partial seizure manifestations. Daily to weekly seizures occurred in 26.8% and 32.0% had been seizure-free for the past year.
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PMID:Epilepsy in a population of mentally retarded children and adults. 214 25

Electrical stimulation of the noradrenergic locus coeruleus (LC) delays the generalization of partial seizures during amygdaloid kindling by increasing the time spent in the earliest stages of seizure development. To determine whether noradrenergic axons projecting to the midbrain and forebrain are involved in this antikindling effect, we examined the effects of lesions of the dorsal noradrenergic bundle, induced by intracerebral infusions of 6-hydroxydopamine (6-OHDA), on kindling and the antikindling action of stimulation of the LC. Stimulation of the LC during amygdaloid kindling increased the number of afterdischarges (ADs) spent in the early stages of partial seizure and decreased the number of ADs spent in later stages of generalized seizure, as has been described previously. LC-stimulated rats also displayed longer durations of AD during early stages of kindling. The antikindling effect of LC stimulation was blocked by lesions of the dorsal bundle, whereas the facilitatory effects of LC stimulation on generalization and on the duration of AD were unaffected by the lesions. These results suggest that the antikindling action of LC stimulation is mediated by the ascending projections of noradrenergic neurons, presumably through enhanced release of noradrenaline. On the other hand, the facilitatory effects of LC stimulation on the development of later stages of seizure and on the duration of AD appear to be independent of the ascending dorsal bundle.
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PMID:Antikindling effects of locus coeruleus stimulation: mediation by ascending noradrenergic projections. 215 8

Clinical applications of experimental models of complex partial seizure were studied using kainic acid-induced limbic seizures and amygdaloid kindling models. The following experiments were done aiming to study the basic approach for the treatment of the intractable complex partial seizures. 1) Degenerative focal lesions were made in bilateral substantia nigra and substantia innominata by a local microinjection of the ibotenic acid and influences upon limbic seizures were studied. Substantia innominata has a facilitatory effect upon secondary generalization of the limbic seizure while substantia nigra has an inhibitory influence. Degenerative lesions of the bilateral hippocampus inhibited development process as well as establishment of the kindling. 2) Resection of the primary epileptic focus in a limbic seizure status resulted in seizure control in cats with a single focus but not in another with multiple foci. 3) An autoradiography was done during limbic seizure status induced by kainic acid microinjection, and local cerebral glucose utilization (LCGU) and local cerebral blood flow were studied in order to study the relationship between cerebral metabolism and cerebral blood flow during limbic seizures. In the pyramidal cell of the hippocampus, an increased ratio of LCGU (x 4.1) is larger than that of LCBF (x 1.6). This uncoupling may be one reason of the neuronal cell damage during the limbic seizure status. 4) Autoradiography of the calcium suggested that one of the causes of hippocampal degeneration in intractable complex partial seizures should be a consequence of calcium influx into pyramidal cells during repeated limbic seizures.
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PMID:[Experimental complex partial seizure and its possible clinical application]. 218 69

The characteristics and prognostic significance of subclinical seizures and independent auras were studied in 40 patients with partial epilepsy who had long-term electroencephalographic (EEG) monitoring with intracranial electrodes. Focal, restricted subclinical seizures were noted in 23 patients, and 11 patients experienced auras that were accompanied by ictal EEG discharges. Auras and subclinical seizures usually were identical in EEG appearance, but were distributed differently among patients. The subclinical seizures and auras usually had the same origin as complex partial seizures, but did not always reliably indicate complex partial seizure origin. Subclinical seizures and auras were of favorable prognostic significance for patients undergoing temporal lobectomy. A majority (greater than 80%) of individuals with subclinical seizures and auras were free of complex partial seizures after surgery, whereas a minority (29%) of patients without subclinical seizures and auras became free of complex partial seizures.
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PMID:Auras and subclinical seizures: characteristics and prognostic significance. 224 Nov 15

Theoretical issues associated with memory, neurocognitive and noradrenergic mechanisms in posttraumatic migraine and dysautonomic complex-partial seizure disorders are reviewed, compared and discussed. Additionally, pretreatment Contingent Negative Variation (CNV) was recorded in a No-GO/GO reaction-time paradigm for 15 normal, and 18 posttraumatic migraine and seizure patients tested not more than three months postinjury. Normals demonstrated that CNV GO and NO-GO responses significantly differed. In both migraine and seizure patients GO and NO-GO trials did not differ significantly. In uncontrolled trials, it was noted that B-Blocker administration increased the difference between GO and NO-GO trials for both migraine and seizure patients over midline leads.
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PMID:Lateralized effects of migraine and ANS seizures after closed head injury. 226 66

To establish whether transcranial magnetic stimulation is able to activate the primary epileptic focus preferentially, 13 patients who had medically intractable complex partial seizures were examined prior to surgical therapy. Single or a series of magnetic stimuli were applied to various regions of the skull. The effects of transcranial magnetic stimulation were monitored via subdurally implanted electrodes. In the process of presurgical evaluation, the dosage of anticonvulsant medication had been reduced in all patients but one. Transcranial magnetic stimulation was able to activate the epileptic focus (or foci) in 12 of the 13 patients. Distinct patterns of focal activation were observed in 3 patients who had several foci. No epileptiform potentials were induced outside epileptic foci, which had been identified by corticographic recordings. In one patient a complex partial seizure that was induced was identical to her habitual seizures. In another patient, a complete transition from a nonactive theta focus to a self-sustained epileptic focus occurred. A facilitation of epileptiform afterdischarge was seen with sequential stimulation. No adverse effects were either reported by the patients or observed by the investigators. In summary transcranial magnetic stimulation is able to activate the epileptic focus (or foci) and consequently may be an additional tool for the localization of epileptic foci in presurgical evaluation.
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PMID:Activation of the epileptic focus by transcranial magnetic stimulation of the human brain. 230 28

We performed a double-blind, crossover, add-on study of the antitussive agent dextromethorphan (DM 120 mg/d) as therapy for seizures on 9 patients suffering from severe complex partial seizures. DM had no significant influence on key laboratory values, nor on anticonvulsant drug levels. Side effects were negligible. Complex partial seizure frequency increased 25% during the DM arm of the study, although this increase was not clinically significant.
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PMID:Dextromethorphan for treatment of complex partial seizures. 231 1

In a prospective study, 283 children who presented with a first unprovoked seizure were followed for a mean of 30 months from the time of first seizure. Subsequent seizures were experienced by 101 children (36%). The cumulative risk of seizure recurrence for the entire study group was 26% at 12 months, 36% at 24 months, 40% at 36 months, and 42% at 48 months. The cumulative risk of recurrence in the 47 children with a remote symptomatic first seizure was 37%, 53%, and 60% at 12, 24, and 36 months, respectively, compared with a cumulative risk of 24%, 33%, and 36% at 12, 24, and 36 months, respectively, in the 236 children who had had an idiopathic first seizure (P less than .01). In children with an idiopathic first seizure, the electroencephalogram was the most important predictor of recurrence. The cumulative risk of recurrence in the 81 children with abnormal electroencephalograms was 41%, 54%, and 56% at 12, 24 and 36 months, respectively, but only 15%, 23%, and 26% at 12, 24, and 36 months, respectively, in the 138 children with normal electroencephalograms (P less than .001). A history of epilepsy in a first-degree relative was a significant risk factor only in idiopathic cases with abnormal electroencephalograms. In children with a remote symptomatic first seizure, either a history of prior febrile seizures or the occurrence of a partial seizure were significant predictors of recurrence. Age at first seizure and duration of seizure did not affect recurrence risk in either the idiopathic or remote symptomatic group. A total of 84% of the children were not treated with antiepileptic drugs or were treated for less than 2 weeks. Only 9% were treated for longer than 3 months. Treatment did not affect the risk of recurrence. The results suggest that, even without treatment, the majority of children with a first unprovoked seizure will not experiment a recurrence. Children with an idiopathic first seizure and a normal electroencephalogram have a particularly favorable prognosis.
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PMID:Risk of seizure recurrence following a first unprovoked seizure in childhood: a prospective study. 233 31


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