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

The blood-brain barrier (BBB) in man was studied during various conditions using the indicator dilution method of Crone [8]. Using 113m In-DTPA as reference substance the extraction, E, of the small test substances 24Na+, 36Cl-, 14C-urea and 14C-thiourea was estimated from the areas under the venous outflow curves following intracarotid slug injection of tracers. Interlaminar diffusion and red cell carriage were taken into consideration when calculating E. Cerebral blood flow (CBF) was measured using the intra-arterial 133Xe-injection method. Twenty-two patients receiving electroconvulsive therapy (ECT) were studied before and during seizures and during hypercapnia. Before seizures the extraction values in % were as follows: ENa+ 1.6, ECl- 1.9, Eurea 3.9 and Ethiourea 7.8; the corresponding values for the permeability-surface area products (PS) in ml/100 g x min were 0.5, 0.3, 0.7, 4.1, respectively. During seizure a decrease of Ethiourea and an increase of PSurea were significant. During hypercapnia PSNa and PSthiourea rose significantly. Due to the similarity of the findings in those two high flow situations it is suggested that the changes of CBF and not the epileptic activity are responsible for the changes in permeability. The mechanism of action may be a stretching of endothelial cells in the cerebral vessels or an opening up of new capillaries, or a combination of both.
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PMID:The permeability of the blood-brain barrier during electrically induced seizures in man. 40 64

The effect of electrically induced seizures on the permeability of the rat blood-brain barrier was investigated. The small radioactive tracers sodium (24Na+), chloride (36Cl-) carbon labelled thiourea (14C-thiourea) and glucose (14C-D-glucose) were studied in indicator dilution experiments with indium labelled diethylenetriaminepenta-acetic acid (113mIn-DTPA) as reference substance. This method allows a quantitative estimate of the transcapillary loss of solutes, the extraction (E), during a single passage through the brain. Passage of macromolecules was studied using as marker substance Evans Blue which binds to plasma albumin. In the resting state ENa, ECl, Ethiourea and Eglucose were 2.9, 4.8, 9.3 and 12.5%, respectively. During seizures and during shortlasting hypercapnia E glucose decreased while E for the other tracers was unchanged. As cerebral blood flow increased, there must be an increased transfer of test substances into the brain. This finding is in agreement with recent human studies [15]. When Evans Blue was injected intravenously prior to electroshock, there was no staining of brain tissue after one electroshock but following repeated electroshocks some staining was observed. In an attempt quantify this transcapillary loss of albumin by means of indicator dilution, 51Cr-labelled erythrocytes were used as intravascular reference substance against 113mIn-DTPA (a plasma tracer). However, the albumin loss (by pinocytosis or otherwise) occurring after ten electroshocks could not be detected during a single passage through the brain.
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PMID:Blood-brain barrier during electroshock seizures in the rat. 40 65

CT, MRI and neurological features of 27 children with tuberous sclerosis were prospectively compared. Imaging studies were positive in 92.5% of cases. CT was more useful in detecting subependymal nodules, while MRI showed the number and location of cerebral cortical and subcortical lesions more accurately. Cortical lesions in the cerebellar hemispheres were present in 26% of patients. Gadolinium-DTPA used in 10 patients showed slight enhancement of the subependymal lesions in 80% of cases, probably representing active lesions with alteration of the blood-brain barrier. None of the cortical and subcortical lesions enhanced. Giant-cell astrocytomas were detected in 5 patients, the postcontrast CT and MRI studies improving their assessment. Unlike subependymal nodules, all tumors showed marked enhancement regardless of their size. Seizures were present in 96% of patients, mostly beginning before 1 year of age. There was no clear relationship between the radiological features and the neurological evolution of these patients. Therefore, it is not possible to establish a clinical prognosis based on the radiological findings. MRI is the procedure of choice in the diagnosis of tuberous sclerosis. When pre and postcontrast MRI are negative, CT is used to exclude small calcified subependymal nodules. MRI follow-up is required only when tumoral development is clinically suspected.
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PMID:Neuroimaging in tuberous sclerosis: a clinicoradiological evaluation in pediatric patients. 149 3

Meningioangiomatosis (MA) is a rare hamartomatous lesion of the cerebral cortex; to date only 18 cases with imaging findings have been reported in the English literature. The origin of MA is probably malformative, with possible association with neurofibromatosis. These lesions frequently cause seizures in young patients. We report two new cases seen at our institution and present their CT and MR findings clearly illustrating MA cortex infiltration. Gd-DTPA used in one of the two cases failed to cause enhancement.
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PMID:Meningioangiomatosis: CT and MR findings. 159 16

In 1987, a 69-year-old female suffering from epilepsy and right hemiparesis was admitted to the hospital and given conservative therapy. During the next three weeks she became a stuporous state. Steroids were then prescribed, and she made a complete recovery. Following hormonal and immunological investigations, a diagnosis of Hashimoto's disease with hypothyroidism was made. Following her discharge, thyroxin and anticonvulsant treatments continued. On May 30, 1989, at the age of seventy-one, the patient was found lying unconscious at home, and taken to our hospital. She had signs of a confused state, and seizures of her right arm on admission. Cranial computed tomography (CT) revealed a low density area in the left parieto-occipital lobe, which was heterogeneously enhanced by contrast medium. Magnetic resonance imaging (MRI) showed a lesion of low signal intensity in T1-weighted images and high signal intensity in T2-weighted images, which was homogeneously enhanced by Gd DTPA. Cerebral angiography disclosed no abnormality. Two weeks later, follow-up CT showed that the lesion had become larger and markedly enhanced. A brain tumor, probably malignant lymphoma, was suspected. On June 14, stereotaxic biopsy of the enhanced lesion was performed. Histopathological examination disclosed dense infiltration of the entire walls of many small parenchymal vessels, both arterioles and venules, by lymphocytes. Treatment for angiitis (betamethasone 16 mg daily) was started on June 20, then gradually tapered, and the lesion diminished on CT. Our case has some features of both isolated angiitis of the central nervous system and encephalopathy in compensated Hashimoto's disease. It is suggested that some common base of the autoimmune diseases exists in this case.
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PMID:[Isolated angiitis of the CNS associated with Hashimoto's disease]. 161 79

A 74-year-old woman was admitted because of disturbed consciousness due to iatrogenic hyponatremia. At admission, her serum level of sodium was 88 mEq/l. The hyponatremia was carefully corrected with physiologic saline for three days at a rate of 0.75 mEq/h until the serum sodium concentration of 135 mEq/l was achieved. Her neurologic state gradually improved to respond to painful stimuli with her left hand during the first week of treatment, but further improvement was not noted after that. On the 16th hospital day, seizure developed on her face and left upper extremity. Although abnormal lesions were not detected by MRI of the brain at admission, those performed on the 15th hospital day revealed multiple uncommon lesions with Tl and Gd enhanced images. On Tl images areas of low signal intensity were found in the central pons and left putamen, which were more clearly demonstrated by Gd enhanced MRI images. These lesions were considered to be consistent with central pontine and extra-pontine myelinolysis (CPEM). In addition, a part of the right temporal cortex was enhanced clearly by Gd-DTPA, which was also thought to be an extra-pontine myelinolysis. These lesions were responsible for the development of neurological signs due to CPEM. To our knowledge, this is the first case in which a lesion in the cerebral cortex was revealed as an extra-pontine myelinolysis by Gd enhanced MRI images. Gd enhanced MRI is useful for detecting the extra-pontine myelinolysis as well as central pontine myelinolysis.
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PMID:[A case of central pontine and extra-pontine myelinolysis demonstrated by magnetic resonance imaging]. 181 88

Clinical presentation of a child with port-wine stain and seizures leads to the suspicion of Sturge-Weber disease (SWD). This diagnosis can be confirmed by the detection of a meningeal angiomatosis. In rare cases, early detection of meningeal pathology by ultrasound has been reported. Key findings are brain atrophy, gyriform cortical calcifications demonstrated by skull radiographs after the first year of life or earlier by cranial CT, and dys- or aplasia of the deep cerebral veins on angiography. Radionuclide imaging shows focal or diffuse tracer accumulation over the affected brain regions. MR demonstrates an abnormal appearance of the affected meninges, especially thickening and pathologically increased signal intensity after Gd-DTPA application. This, in association with the demonstration of abnormal enhancement in deep medullary veins, is the most characteristic finding. Contrast-enhanced MR allows early and non-invasive diagnosis of SWD, mainly by revealing leptomeningeal angiomatosis and abnormal venous vessels.
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PMID:[Sturge-Weber syndrome. Diagnostic imaging relative to neuropathology]. 188 71

The clinical, laboratory, and pathological features of aspergillosis of the central nervous system (CNS) were studied in a series of 17 autopsied patients. Two groups were defined. Group A consisted of 8 patients with diseases commonly associated with CNS aspergillosis: leukemia, lymphoma, aplastic anemia, and renal transplantation. Group B contained 9 patients with various illnesses not generally known to be associated with CNS aspergillosis. CNS aspergillosis was diagnosed and treated before death in only 1 patient. Patients in Group A received cytotoxic drugs, often had granulocytopenia, less commonly had focal neurological deficits, and seldom had seizures. Group B patients were not granulocytopenic, received no cytotoxic agents, underwent nontransplant surgery, and more frequently had focal neurological deficits. Eleven of the 17 patients (65%) had focal deficits, most of them hemiparesis. Meningeal signs were rare, but the cerebrospinal fluid was usually abnormal. The principal neuropathological process was Aspergillus invasion of blood vessels causing hemorrhagic infarction. Focal clinical deficits correlated neuroanatomically with Aspergillus lesions. In 2 patients, such lesions were detected by 99mTc-DTPA or cerebral angiography before computed tomographic scanning. The lungs were the usual portal of entry, but isolated CNS lesions occurred in 2 patients. CNS aspergillosis should be considered as a cause of new onset of focal neurological deficits in patients with illnesses that are more diverse than has generally been appreciated.
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PMID:Aspergillosis of the central nervous system: clinicopathological analysis of 17 patients. 393 42

In spite of great success in the treatment cerebral AVMs with stereotactic radiosurgery, the role of this treatment modality in angiographically occult vascular malformations (AOVMs) is not recognized. Since the installation of the Gamma-knife, we have treated 20 cases of AOVMs by radiosurgery. There were 13 males and 7 females, the age ranged from 3 to 58 years with an average age of 34.0 years. Their clinical presentations at the onset were haemorrhage in 11, convulsive seizure in 7 and progressive neurological deficits in 2. Two cases had multiple lesions. Among 20 symptomatic lesions, 14 were located supratentorially, 4 in the brain stem and 2 in the cerebellar hemispheres. Following localization with MRI and dose planning, the lesions were treated by radiosurgery and the doses ranged from 15 to 20 Gy at the margins. Follow-up studies indicate a significant control of rebleeding as well as of the convulsive seizure. Imaging studies demonstrated the shrinkage of the lesion in 3 and reduced enhancement with Gadolinium-DTPA in some others. Adverse effects, chiefly related to radiation-induced oedema, occurred in 5. But they were generally mild and well controlled by medication. Thus the preliminary results indicate a certain usefulness of radiosurgery in the treatment of symptomatic AOVMs.
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PMID:Treatment of symptomatic AOVMs with radiosurgery. 750 32

We present here magnetic resonance imaging (MRI) and single photon emission computed tomography with 123I-N-isopropyl-p-iodoamphetamine (123I-IMP-SPECT) of a patient suffering from Klinefelter's syndrome with various neuropsychiatric symptoms. He was a 30-year-old male, who showed impaired consciousness seizures, auditory hallucination, delusion of reference, delusion of grandeur, psychomotor excitement and intellectual impairment. Although no focal lesion was detected by computed tomography or T1-weighted MRI, T2-weighted MRI provided a heterogeneous high-signal-intensity lesion of the inferior part of the left temporal lobe, which was not enhanced with Gd-DTPA. In addition 123I-IMP-SPECT exhibited focal hypoperfusion in the left temporal lobe on the early images. We suggest that the neuropsychiatric symptoms of this case are associated with the focal organic brain dysfunction which was revealed by MRI and 123I-IMP-SPECT.
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PMID:MRI and SPECT of Klinefelter's syndrome with various neuropsychiatric symptoms: a case report. 791 Nov 67


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