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

Acetazolamide (Diamox) (AZM) was evaluated as an adjunct to carbamazepine (CBZ) monotherapy in 48 refractory partial seizure patients at a tertiary care referral center. Patient ages ranged from 6 to 64 years (average 28 years). Seizure frequencies for the pre-AZM baseline period (CBZ monotherapy) were compared with the seizure frequencies at different daily doses of AZM. Patients with a 50% decrease in seizure frequency were considered responders. Twenty-one patients were responders (44%) and three became completely seizure-free. Effective doses ranged from 3.8 to 22.0 mg/kg/day. Effective plasma concentrations ranged from 1 to 22 micrograms/ml in selected patients. Durations of response time to AZM ranged from 3 to 30 months (average 12.9 months). Three patients lost response, one temporarily. Side effects were seen in 10 patients, requiring discontinuation in three.
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PMID:Use of acetazolamide as an adjunct to carbamazepine in refractory partial seizures. 249 25

We describe a reference device that provides accurate correlation between anatomic and functional brain images. The reference device, which generates fiduciary reference points on sequential scan planes, is positioned adjacent to the canthomeatal line of the subject and held in place by a glasses-like framework anchored to the external auditory meatus. The reference system was tested on 17 subjects undergoing 99mTc hexamethylpropylene amine oxime ([99mTc]HMPAO) brain single-photon emission computed tomography (SPECT) and cranial computed tomography (CT) scans. The centers of the caudate nuclei, thalami, brain stem, and cerebellar vermis were identified independently on CT and SPECT. The average difference +/- 1 SD between structure locations (x, y, and z) on SPECT and CT were calculated as 1.86 +/- 1.5, 2.16 +/- 1.4, and 1.83 +/- 1.9 mm, respectively. The clinical application of the method is showed by coregistration of images from SPECT to MRI. An example of sequential [99mTc]HMPAO brain SPECT scan sections precisely coregistered with MRI scan sections oriented parallel to and sequentially above the canthomeatal line illustrates the correlation between regional cerebral blood flow (rCBF) tracer activity on SPECT and normal anatomic structures. Test-retest activation paradigms in brain SPECT requires precise SPECT-to-SPECT image coregistration to evaluate changes in rCBF during activation. Precisely coregistered rest, 48-hour repeat rest [99mTc]HMPAO SPECT studies are shown to illustrate the normal intrasubject variability of tracer uptake. An example of the usefulness of image coregistration for evaluation of viable residual brain tumor and its application to tumor biopsy is presented. An example of developmental abnormalities identified by [99mTc]HMPAO brain SPECT is illustrated by a case of autistic disorder. An example of image coregistration in stroke and evaluation of cerebrovascular disease with Diamox (Lederle Laboratory Division, Pearl River, NY) cerebrovasculature stress testing is presented. The usefulness in epilepsy using a protocol whereby the tracer is injected during the ictal phase of seizure is presented. We conclude that the reference system provides an accurate, rapid, and noninvasive patient-specific method for correlating brain structure with brain function.
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PMID:A reference method for correlation of anatomic and functional brain images: validation and clinical application. 781 99

The main clinical types of epilepsy and their treatment are described. The treatment of choice in petit mal epilepsy is trimethadione (Trimedone) 0.3 g., three to six times a day, or acetazolamide (Diamox) 125-250 mg., three to four times a day. Phenobarbital is usually given as well to prevent grand mal seizures. Diphenylhydantoin sodium (Dilantin Sodium), 100 mg., and/or phenobarbital, 30-100 mg., three to four times a day, is recommended in patients with focal and grand mal epilepsy. Psychomotor automatisms are a form of focal seizure. Primidone (Mysoline), in doses of 125-250 mg. two to three times a day, is a very useful anticonvulsant in patients with myoclonic features, psychomotor automatisms and grand mal seizures. Primidone should be started in small doses. Drug reactions, especially cerebellar ataxia in the case of diphenylhydantoin and blood dyscrasias in the case of some drugs, should be recognized. Excessive drowsiness can be avoided by proper dosage and proper timing of drug administration. Patients should be seen regularly at least two to three times a year. The objective of treatment is to achieve optimum control of seizures by using the appropriate drug in adequate dosage. Social adaptation is good in the majority of patients, who should be encouraged to carry on their life independently, usually free to marry and have children. Attention to special occupational hazards has to be considered. Education of employers and employees is often necessary. Special work arrangements are occasionally indicated for selected patients. Patients should be seizure-free for two to three years before permission is given to drive an automobile.
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PMID:Treatment of epilepsy. 1396 8