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

We compared sleep parameters during three-hour postprandial nap recordings in 10 normal controls and 28 seizure patients. Patients had significantly less sleep, longer sleep latency, more wakefulness, less drowsiness and lighter nonREM sleep, and lower sleep efficiency than controls. Generalized seizure patients had longer sleep latency, more arousals, and more (but very little) stage III sleep. Those with partial seizures had more stage II sleep and greater sleep efficiency. Patients on polypharmacy and phenobarbital therapy slept more, phenytoin patients had very short sleep latency but more wakefulness and less sleep efficiency; those taking clonazepam were also awake more and had lower sleep efficiency, while arousals during sleep were more frequent in patients on valproate and carbamazepine. The findings suggest that disturbed sleep, possibly related to aberrant arousal occasioned by generalized epilepsy or epileptogenic foci, is common in seizure patients, and may be related to interictal behavioral and cognitive symptoms. Polypharmacy may have an additive effect on sleep to prolong and disrupt it, while sedative anti-epileptic drugs may increase sleep and other anti-epileptic medications may have alerting effects or interfere with falling asleep. Generalized and partial seizure patients may have sleep disturbances of a different character, possibly reflecting generally altered cerebral excitability by afferent stimuli in the former situation, and the more localized effects of limbic or cortical hyperactivity in the latter.
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PMID:Sleep and waking disturbances in epilepsy. 365 65

Regional cerebral blood flow (rCBF) measurements were determined by the intravenous Xenon 133 technique in 80 patients suffering from temporal lobe epilepsy. All the patients had a normal CT scan. Three subgroups were differentiated, according to EEG and all-night polygraphic recordings: temporal lobe epilepsy with left (N = 25) or right (N = 25) EEG epileptic abnormalities and temporal lobe epilepsy with EEG abnormalities in both temporal regions with asynchronous occurrence (n = 30). In comparison with a control group (n = 20), there was (1) a marked reduction of blood flow in the temporal region corresponding to the site of the epileptic focus and (2) a reduction in blood flow in distant brain areas and the contralateral hemisphere. The rCBF decrease was highly correlated (p less than 0.001) with the disease severity (taking into account the complex partial seizure frequency and the number of secondary generalised seizures). Differences were found in the rCBF decrease between left and right temporal lobe epilepsy.
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PMID:Correlations between cerebral blood flow variations and clinical parameters in temporal lobe epilepsy: an interictal study. 368 8

It is well established that the putative excitatory neurotransmitters, glutamate (Glu) and aspartate (Asp), are neurotoxins that have the potential of destroying central neurons by an excitatory mechanism. Kainic acid (KA), a rigid structural analog of Glu, powerfully reproduces the excitatory neurotoxic (excitotoxic) action of Glu on central neurons and, in addition, causes sustained limbic seizures and a pattern of seizure-linked brain damage in rats that closely resembles that observed in human epilepsy. In the course of studying the seizure-related brain damage syndrome induced by KA, we observed that a similar type of brain damage occurs as a consequence of sustained seizure activity induced by any of a variety of methods. These included intraamygdaloid or supradural administration of known convulsants such as bicuculline, picrotoxin and folic acid, or systemic administration of lithium and cholinergic agonists or cholinesterase inhibitors that have not commonly been viewed as convulsants. We have further observed that this type of brain damage can be reproduced in the hippocampus by persistent electrical stimulation of the perforant path, a major excitatory input to the hippocampus that is thought to use Glu as transmitter. It is a common feature of all such neurotoxic processes that the acute cytopathology resembles the excitotoxic type of damage induced by Glu or Asp, which is acute swelling of dendrites and vacuolar degeneration of neuronal soma, without acute changes in axons or axon terminals. We have found that the seizure-brain damage syndrome induced by cholinergic agents can be prevented by pretreatment with atropine and that the syndrome induced by any of the above methods, cholinergic or noncholinergic, can be either prevented or aborted respectively by either pre-or posttreatment with diazepam. Our findings in experimental animals may be summarized in terms of their potential relevance to human epilepsy as follows. Sustained complex partial seizure activity consistently results in cellular damage if allowed to continue for longer than 1 hr. Hippocampal, or Ammon's horn, sclerosis is the primary pathological result. It may be a priority goal, therefore, in the management of human epilepsy to control such seizure activity within very narrow limits. This proposal is discussed in terms of three major transmitter systems that may be involved; cholinergic, GABAergic, and glutamergic/aspartergic. The cholinergic system may play a role in generating or maintaining this type of seizure activity, and anticholinergics may protect against it provided they are given prior to commencement of behavioral seizures.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Excitotoxic mechanisms of epileptic brain damage. 370 27

Fourteen patients with intractable epilepsy, candidates for surgical treatment, were investigated with intracerebral electrodes because of the presence of multifocal abnormalities in surface recordings. EEG and video monitoring was performed during a period of reduction and/or discontinuation of anticonvulsant medication performed to precipitate seizure occurrence. The clinical and electrical patterns of seizures recorded during the withdrawal of anticonvulsant drugs were compared to those of the patients' habitual seizures observed on full medication. For each patient, we determined a profile of the clinical and electrographic seizure activity observed before the withdrawal of medication or reported by the patient prior to hospitalization. Following the reduction or cessation of medication, an increase in partial seizure frequency was observed in all patients. All but one of these partial seizures had the same clinical pattern as the habitual attacks of the patients, and the EEG manifestations were compatible with the baseline data. Seven of the 14 patients had secondarily generalized seizures; for each patient, these seizures had the same clinical and electrographic onset as their partial seizures. Only one patient had a single partial seizure having an EEG onset different from the other seizures occurring around that time and having a clinical pattern never experienced before. In conclusion, the reduction of anticonvulsant medication extremely rarely causes the appearance of seizures having an electrical onset or a clinical pattern different from those observed on full medication.
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PMID:Effects of drug withdrawal on location of seizure onset. 372 Jul 1

Fifty patients with medically refractory partial seizure disorders have undergone subdural electrode placement for seizure focus localization. Standard scalp telemetry recordings of ictal events had failed to demonstrate accurately the site of seizure onset, and these patients were considered candidates for telemetry with intracerebral depth electrodes. Excellent recordings of interictal and ictal events were obtained, and localization of the epileptogenic focus was derived from recordings made during spontaneously occurring seizures. Electrocorticograms were monitored for up to 21 days. The recordings enabled a surgical decision to be made in 43 of 50 cases (86%). Thirty patients have subsequently undergone cortical excision of their foci with good results. Subdural electrode recordings are a significant addition to the armamentarium of the neurosurgeon attempting to localize surgical seizure foci, offering a low morbidity procedure as an alternative to depth electrode implantation.
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PMID:Subdural electrodes for seizure focus localization. 374 41

In vivo phosphorus 31 nuclear magnetic resonance (31P NMR) spectroscopy was used to evaluate changes in cerebral high-energy phosphate compounds in 8 infants with seizures. During the study 4 babies had seizures that caused a 50% decrease in the phosphocreatine to inorganic phosphate (PCr/Pi) ratio. Focal seizures caused lateralized decreases in the PCr/Pi ratio; generalized seizures caused bilateral decreases. Postictal spectra had increased PCr/Pi ratios, presumably due to postictal inhibition. Interictal 31P NMR spectra were normal. One patient's seizures were successfully treated with intravenously administered phenobarbital during NMR data acquisition, causing an immediate increase in the PCr/Pi ratio from 0.7 to 1.2. These studies indicate that cerebral PCr concentration decreases by approximately 33% and that oxidative metabolism increases by approximately 45% during neonatal seizures. Five babies had PCr/Pi ratios of less than 0.8 during seizures and subsequently developed long-term neurological sequelae, which suggests that neonatal seizures may cause or exacerbate cerebral injury by increasing cerebral metabolic demands above energy supply.
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PMID:Cerebral metabolic effects of neonatal seizures measured with in vivo 31P NMR spectroscopy. 378 67

Regional cerebral blood flow (r CBF) was measured by the I.V. 133 Xenon method and use of 27 detectors in 91 patients with complex partial epilepsy in interictal periods (at least 48 h over a complex partial seizure). Some were also examined less than 48 h before or after seizures. All were studied with ictal and interictal electroencephalography (EEG), polysomnography, computed tomography (CT), some had nuclear magnetic resonance scans (MR). The blood flow values were compared with a group of a 20 normal subjects matching for age. A significant decrease of r CBF ranged from 15% to 25% was found in the temporal region in three groups of epileptic patients: with repeated normal CT scans and lateralized EEG abnormalities (N = 46); with cortical atrophy in CT scan (N = 12); with neurosurgical focal lesions on CT and or MR scans glioma, arteriovenous malformation) (N = 10). r CBF was normal or decreased by less than 15% in the other regions of the brain. Patients with repeated normal CT scans and bilateral EEG abnormalities either asynchronous or alternatively observed in the right side or left side on waking EEG or during NREM sleep and REM sleep, did not show reduction in r CBF. In a previous study, r CBF distribution was also found normal during interictal phase in patients with primary generalized epilepsy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Regional cerebral blood flow in partial complex epilepsy with and without the presence of lesions]. 380 89

202 cases of children with shunted hydrocephalus of congenital or acquired origin were studied and the incidence of seizure disorder was found to be 39%. However in only 17% of cases was the seizure disorder found to be persistent. Focal seizures were rarer than expected. If focal seizures were present they did not appear to be related to shunt site. 9.4% of children suffered an episode of status epilepticus. A large number of incidents of seizures could be shown to have a specific precipitant, usually CSF infection or shunt related problems. No aspect of birth history or development or treatment of the hydrocephalus was related to the occurrence or seizure disorder or type of fit experienced. Children with persistent seizure disorder were found to be more likely to be of low IQ, physically handicapped and at Special School.
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PMID:The incidence of seizure disorder in children with acquired and congenital hydrocephalus. 381 21

We analyzed the histories of 58 patients who had temporal lobectomy for seizure control. A good outcome was more likely if a definite lesion was removed. Unlike other pathologies, including nonspecific hippocampal sclerosis (NSHS), Ammon's horn sclerosis (AHS) was strongly related to a history of a prolonged childhood convulsion as the first epileptic event. Partial seizures developed at a younger age in patients with AHS than with NSHS or nonspecific changes. Epigastric rising sensations were associated with a greater chance of a good outcome than were other forms of simple partial seizure.
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PMID:Seizure characteristics, pathology, and outcome after temporal lobectomy. 382 33

Electro-clinical patterns of seizures were studied in 7 infants with Aicardi Syndrome. In all 7 cases, partial seizure preceded the appearance of asymetrical spasms. Partial seizures and spasms were recorded by polygraphing tracings of long duration. There was a constant correlation between the EEG localization of partial seizures and the side of asymetrical spasms. In 6 cases, a cluster of spasms followed the partial discharge whereas in the 7th case, the partial discharge appeared in the middle of the cluster. Therefore, both partial seizure and cluster of spasms seem to be part of the same critical manifestation. The authors have recorded the same king of seizures in other malformative syndromes (lissencephaly, Bourneville disease) and compare them to those recorded in Aicardi Syndrome. In Aicardi Syndrome, this type of seizures might be in relation with the association of a corpus callosum agenesy and paraventricular heterotopies.
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PMID:[Electroclinical characteristics of seizures in the Aicardi syndrome]. 382 49


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