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

A 26-year-old female had her first partial seizure at the age of five years. Further seizures occurred and later became generalised in nature. Control of the seizures became difficult despite the use of nine different anticonvulsants over a period of 20 years. She was not suitable for neurosurgical intervention because of the diffuse nature of her seizures. Cerebellar stimulation had only a marginal effect on seizure frequency. With time she became mentally retarded and was unable to benefit from formal education. Her illness demonstrates many of the long-term clinical features and management problems of intractable epilepsy.
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PMID:Intractable epilepsy. 234 22

For 20 months, an extensive prospective search was made in a Swedish county to identify as many persons as possible aged greater than or equal to 17 years who had their first epileptic seizure or for the first time came to the attention of the medical community because of an epileptic seizure. The rate of initial diagnosis (first attendance rate) of non-provoked seizures was calculated as 34 in 100,000. For both sexes, the lowest age-specific incidences were found in persons aged 30-39 years. For males the highest age-specific incidence was found in the group aged 60-69 years and for females it was found in the group aged 50-59 years. The most common type of seizure was partial seizure, accounting for 60%. If seizures with rapid generalization and a known focal lesion are included, the number increases to 72%. A diagnostic delay greater than or equal to 1 year was found in 16%, mainly a patient delay. A cause for the epileptic seizure was found in 49%. A cerebrovascular disease was most common (21%). Brain tumors were found in 11% and trauma in 7%. A cause was more often identified in the older age groups. There was no significant difference between the sexes in the proportion of identified causes.
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PMID:Prospective incidence study and clinical characterization of seizures in newly referred adults. 234 46

Among 630 patients with human immunodeficiency virus infection, 70 patients with new-onset seizures were studied. Generalized seizures occurred in 66 patients (94%): they occurred as the initial seizure in 56 patients (80%) and during follow-up in another 10 patients (14%). Partial seizures (18 patients), status epilepticus (10 patients), and recurrent seizures (38 patients) were also noted. Identified processes included cerebral toxoplasmosis in 11 patients, cerebral lymphoma in 8, metabolic derangement in 8, cryptococcal meningitis in 7, and vascular infarction in 4. In 32 patients (46%) seizures were not associated with identifiable brain lesions and were believed to result from human immunodeficiency virus cerebral infection. Phenytoin treatment was associated with adverse drug reactions in 16 of 62 patients who received it. Our results suggest that the majority of patients with human immunodeficiency virus and seizures do not have secondary focal brain lesions as the cause of the seizures and that human immunodeficiency virus infection alone can, and often does, cause seizures.
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PMID:Seizures in human immunodeficiency virus infection. 234 90

We reviewed retrospectively a series of 100 inpatients with onset of epileptic seizure after the age of 60. All of them were investigated by EEG and 96 by CT scan. The most frequent cause of seizure was previous stroke, with 25 cerebral infarcts and 5 hemorrhages. Neoplastic lesions were present in 18 cases, with glioma (high grade), meningioma and metastases in the same proportion. Other etiologies included toxico-metabolic (18 cases), post-traumatic (9 cases), cerebral atrophy (4 cases) and miscellaneous (14 cases). The causes of seizure remained unknown in 7 patients, of whom 6 had focal signs in either clinical examination or EEG. Focal seizures (with or without secondary generalization) accounted for 65% of all cases and generalized seizures for 35%. The EEG was normal in 12 patients and abnormal in 88, with diffuse slowing in 55 patients and focal signs in 70 (some patients had both diffuse slowing and focal signs). Fourteen patients presented status epilepticus. Ten died during hospitalization. We conclude that epileptic seizure with onset after age 60 is nearly always symptomatic, and neuroradiologic investigations are necessary in the search for cerebral lesions. In our study, the prevalence of "idiopathic epilepsy" is lower than previously described.
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PMID:[Initial epileptic crisis after the age of 60: etiology, clinical aspects and EEG]. 234 61

Seven patients (five boys, two girls) with video-game epilepsy (VGE) are reported, which reflects the fact that these games have increased in popularity recently among Japanese children. Their ages at onset ranged from four to 13 years. The seizure phenomena were of three types: generalised tonic-clonic, partial seizure and headache. Interictal physical and neurological examinations were within normal limits. EEGs taken while they played video-games confirmed the diagnosis of VGE and revealed three triggers of seizures: flashing lights, special figure patterns and scene-changing. They were recommended to avoid playing video-games, but sodium valproate was effective if seizures persisted even after such avoidance.
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PMID:Electroclinical study of video-game epilepsy. 236 42

Transient elevation of serum levels of prolactin has been observed following several types of epileptic seizures and after electrical stimulation of limbic temporal lobe structures via implanted electrodes. Transcranial magnetic stimulation has been found to selectively induce epileptiform afterdischarges in the epileptic focus of candidates for epilepsy surgery who suffered from temporal lobe epilepsy. Lateralized serial transcranial magnetic stimulation was therefore used and serum levels of prolactin or luteinizing hormone were measured to find if it could be used as a non-invasive diagnostic tool. The investigation was performed on six patients and five healthy volunteers. In the patients the induction of epileptiform potentials was continuously monitored via subdural electrodes. A transient surge of prolactin and luteinizing hormone was found in only one patient, in whom a complex partial seizure was induced. Thus, transcranial magnetic stimulation appeared not to be helpful for the lateralization of the (primary) epileptic focus during presurgical evaluation.
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PMID:Activation of epileptic foci by transcranial magnetic stimulation: effects on secretion of prolactin and luteinizing hormone. 239 46

In this theoretical review, the value of the kindling phenomenon in enhancing our understanding of clinical disorders associated with epilepsy is evaluated. The kindling phenomenon is first described. Kindling is suggested to be a viable model of complex partial seizure (CPS) disorders with secondary generalization. Moreover, it is shown how kindling has been used as a conceptual tool which suggests novel psychiatric therapies. Finally, the value of kindling as a model of psychopathology associated with limbic epilepsy is discussed. It is concluded that studies of the effects of kindling on emotional behavior may offer a model of how limbic seizures in humans increase the vulnerability of patients to external precipitants of psychopathology, including anxiety and depression. Studies of the effects of kindling on dopaminergic function are also reviewed. This line of investigation holds promise for enhancing our understanding of hyperdopaminergic consequences of limbic epilepsy. Furthermore, these studies have created testable hypotheses that may explain the complex relationship between epilepsy and psychosis.
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PMID:Does kindling model anything clinically relevant? 240 14

Six human subjects (5 male, 1 female, age 23.7 + 5.7 years) with incapacitating partial seizure disorders intractable to medical therapy have been treated by ongoing pulsed electrical stimulation of anterior nucleus of the thalamus. Four of the six patients have demonstrated statistically significant clinical control of the seizure disorder. One patient (D.L.) has been seizure-free for the last two years. In two of these six patients, it was possible to study not only electrophysiological activity of the brain, but also regional cerebral glucose metabolism by the (18F) 2-fluoro-2-deoxy-D-glucose method, blood cortisol levels, and blood levels of valproic acid, diphenylhydantoin, and carbamazepine. Significant changes were seen during periods of stimulation compared with control periods without stimulation. These results imply that stimulation of the principal thalamic relay nucleus of the limbic system causes clinical, behavioral, cerebral metabolic, electroencephalographic, endocrinologic, and pharmacokinetic responses.
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PMID:Evoked metabolic responses in the limbic-striate system produced by stimulation of anterior thalamic nucleus in man. 243 82

We studied 59 seizure patients with CT, MR, and EEG to determine the efficacy of each in the detection of an epileptogenic focus. EEG was most sensitive (67%), MR was next (53%), and CT was least sensitive (42%). MR detected an abnormality in five patients (8%) in whom CT was negative. EEG was positive in each of these patients. CT failed to demonstrate any focal lesion not detected by MR. MR and CT detected focal abnormalities in seven patients (12%) who had negative EEGs. Five of the seven patients had brain tumors. Eighteen of the 26 patients who underwent surgery had positive CT and MR; 14 of these patients had tumors. The remaining eight patients who had surgery all had temporal lobectomies for intractable seizures; none had tumors. In the complex partial seizure subgroup of 34 patients, MR was positive in 44%, CT was positive in 29%, and EEG was positive in 80%. We consider MR to be the imaging procedure of choice for the detection of an epileptogenic focus in seizure patients. When indicated, CT may be performed as a second procedure to try to distinguish neoplasm from thrombosed vascular malformations and other lesions.
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PMID:Efficacy of MR vs CT in epilepsy. 266 68

Cortical blindness is rarely an ictal manifestation. We report the case of a man who developed transient cortical blindness followed by permanent visual deficits during repeated partial seizures. Intermittent visual impairment began at age 14 years. After he had the first generalized seizure at age 28 years, neurologic, ophthalmologic, angiographic, and brain computed tomographic (CT) examinations were normal. Several EEGs showed almost continuous biposterior spike-waves. Over the next several years, frequent partial seizures were associated with transient visual loss and left body twitching or paresthesias. When he was 32, transient blindness occurred during several days of repeated occipital seizures. Permanent left homonymous hemianopia, right homonymous central scotoma, dyschromatopsia, and altered stereopsis followed these seizures. Brain CT demonstrated a new right occipital lesion. Partial seizures arising posteriorly may cause transient cortical blindness and result in permanent visual deficits.
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PMID:Ictal cortical blindness with permanent visual loss. 249 21


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