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

The authors report the results obtained in 42 patients affected by infantile spasms syndrome during treatment with Sodium Dipropylacetic acid. The subjects were divided into two groups according to the aetiology: idiopathic and secondary. In the first group the use of DPK as determined the disappearance of the seizures in 6 cases (40%), reduction of the crises beyond 50% in 7 cases (46.6%), while in 2 subjects (13.3%) the crises persisted. In the secondary group the crises ceased in 3 cases (11.1%), in 17 (62.9%) there were a reduction of the crises beyond 50%, no response to the drug was observed in 7 subjects (25.9%). In 10 patients the anticonvulsant treatment was progressively diminished and was substituted with hormonal treatment. The long term follow up (1-6 years) gives the following results: the seizures persisted in 2 cases (18.18%) among the idiopathic form and in 6 cases (28.57%) among the secondary group. Mental retardation was found in 4 subjects (36.36%) among the idiopathic group and in 12 patients (57.14%) among the secondary group. The authors shortly report the side effect of the hormonal treatment: they prefer the initiation of treatment of I.S. with anticonvulsant drug and suggest to resort to the ACTH when the initial treatment is unsuccessful.
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PMID:[Therapy of infantile spasms (West syndrome) with sodium dipropylacetate]. 301 74

For a study of the effects of ACTH on established seizures, 16-day-old rats that had been previously kindled in the amygdala were given a high daily dosage of ACTH gel for 15 days and then underwent transfer kindling in the contralateral amygdala. There were no significant differences in the rate of transfer kindling between the controls and ACTH-treated rats. This study indicates that in the immature animal ACTH does not alter the kindled state.
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PMID:Failure of ACTH to alter transfer kindling in the immature brain. 302 58

We investigated the effects and side effects of thyrotropin-releasing hormone (TRH) on severely epileptic children to evaluate the clinical usefulness of TRH in the treatment of epilepsy and compared them with the results of ACTH therapy. The subjects were 64 patients admitted consecutively between 1980 and 1986. Their seizures were frequent, more than one a day or more than one a week. The subjects were divided into two groups; 33 patients treated with ACTH and 31 treated with TRH. The mean follow-up periods in TRH and ACTH therapy were 8 months and 3.0 years, respectively. The daily dose of TRH-t 0.5-1 mg was administered intravenously (i.v.) or intramuscularly (i.m.) for 1-4 weeks. The follow-up periods were 3-12 months (mean 6 months). In the TRH group, complete control of seizures was achieved in 7 of 13 (53.7%) of those with infantile spasms, and marked improvement of EEGs were observed in 8 of 13 (61.5%) of them. In the ACTH group, seizure cessation was observed in 75% of infantile spasms. Of the patients who received ACTH, 66.7% had various side effects, including pneumonia, huge subcutaneous abscess, hypokalemia, cataracts, and brain shrinkage as shown on computed tomography (CT), whereas only 16.7% of the patients treated with TRH had transient reduction of urine volume without other laboratory and physical abnormalities. The results of the study indicated that some patients who received TRH had cessation of infantile spasms and improved EEG findings with no serious side effect. Because of the untoward side effects of ACTH therapy, TRH is considered a possible new treatment for children with infantile spasms.
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PMID:Clinical effects of thyrotropin-releasing hormone for severe epilepsy in childhood: a comparative study with ACTH therapy. 302 59

There are four lines of evidence for or against a role of neuropeptides in epilepsy: Administration of a variety of opiate agonists into the ventricles or brain of animals produces a constellation of electrical and behavioral changes, seemingly receptor-specific, both sensitive to the specific opiate antagonist naloxone as well as certain anticonvulsant drugs. The primary reservation concerning these data in terms of their relevance to epilepsy regards the fact that the peptides are exogenously administered in relatively high doses. Hence, these data may reflect neurotoxic effects of peptides rather than physiologic function. A variety of opiate agonists are anticonvulsant and naloxone shortens the postictal state in some experimental seizure models. One could attempt to reconcile these data with those in No. 1 by hypothesizing that the spikes and behavioral changes examined in the latter experimental parodynes represented a sort of isolated model of the postictal state. Naloxone has little effect in clinical epilepsy. These data are far from conclusive for two reasons. First, few patients have been studied. Second, because of the issue of opiate receptor heterogeneity and the high doses of naloxone needed experimentally to block non-mu opiate effects, the doses of naloxone used clinically to date are too low to rule out possible delta- or epsilon-mediated effects. The negative clinical data are illustrative of the dangers and difficulties of extrapolating data generated in animal models of seizures to the human condition. ACTH, a peptide that is derived from the same precursor molecule as beta-endorphin, is clearly an effective anticonvulsant in certain childhood seizure states. However, whether this is due to a direct or indirect (that is, cortisol) effect on brain is far from clear. Paradoxically, in contradistinction to other data concerning pro- and anticonvulsant properties of various opioid peptides, there is no animal model of infantile spasms to help resolve this important question.
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PMID:Neuropeptides and seizures. 302 83

Body movements (BMs) during sleep in patients with age dependent epileptic encephalopathy (ADEE) were studied polysomnographically in order to clarify the underlying mechanism of intractability and the age dependent trend. Twenty patients were divided into two groups according to the prognosis of convulsions. In the good prognosis group, BMs were nearly normal except for a low frequency in some cases. In the intractable group with seizures which were uncontrollable by medication and recurred within a year, BMs showed abnormalities as follows: abnormal distribution according to sleep stages, and/or a low frequency; increased BMs on therapy with prednisolone or ACTH. Moreover, a paradoxical increase of BMs with age and recurrence of seizures concomitantly occurred in the course of the disease. Status epilepticus appeared in cases under 1-DOPA administration or with a strikingly high frequency of BMs. Since electrophysiological evidence indicates that BMs during sleep are modulated by the dopaminergic (DA) system, the present data might suggest that prognosis of convulsions in ADEE depend upon, at least in part, the DA system. And denervated supersensitivity of that system might give rise to recurrence of seizures and status epilepticus.
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PMID:Polygraphical study on age dependent epileptic encephalopathy--relationship between body movements during sleep and prognosis. 302 90

We measured ACTH, cortisol, prolactin, and growth hormone concentrations in patients with temporal lobe epilepsy who were having depth electrode studies. During the collection period, electrical stimuli were applied to amygdala and hippocampus to establish after-discharge thresholds. After-discharges that lasted at least 10 seconds or seizures caused secretion of ACTH and prolactin but not growth hormone. Stimuli that did not produce after-discharges of this duration inhibited ACTH secretion, but had no effect on prolactin or growth hormone secretion.
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PMID:The effect of electrical stimulation of medial temporal lobe structures in epileptic patients upon ACTH, prolactin, and growth hormone. 302 12

Patients with temporal lobe epilepsy secrete ACTH at higher rates and in greater amounts than normal subjects. Temporal lobectomy restores ACTH secretion to normal amounts and rates. The ACTH secretion in temporal lobe epilepsy is independent of anticonvulsant drug effect and seizure frequency. Electrical stimulation of medial temporal lobe structures in patients with temporal lobe epilepsy affected ACTH secretion in a manner consistent with the hypothesis that ACTH secretion is regulated by tonic inhibition. A defect in the excitatory and/or inhibitory components of this regulatory process appears to exist in temporal lobe epilepsy.
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PMID:Endocrine abnormalities in human temporal lobe epilepsy. 303 18

During a 12-month period, 54 infants with the West syndrome (10 idiopathic, 44 symptomatic) referred to 10 major children's hospitals for initial treatment were evaluated to obtain comprehensive data on clinical findings and current treatment modalities. Prominent features included prevalence of prenatal and perinatal etiologies, severe neurological deficits and disturbed psychomotor development as well as patient-specific spectrum of seizure manifestations. Characteristic behavioural abnormalities before onset of spasms are an early indicator for the West syndrome. Therapeutic management varied considerably. Response to ACTH/steroid regiments was more favourable than to non-ACTH/steroid regimens. The most frequent serious adverse reactions during the initial treatment period were arterial hypertension and infections. Improved therapeutic strategies based on detailed initial patient assessment and systematic monitoring of beneficial effects and adverse reactions are necessary for future trials.
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PMID:Preliminary report of a multi-center study on the West syndrome. 306 26

In a previous study we found depressed ACTH and normal beta-endorphin values in the cerebrospinal fluid of patients with West's syndrome, whereas normal peptide levels were present in infants with secondary Infantile spasms. This prompted us to study the effects of naloxone administration in children with West's syndrome. After informed consent was obtained from the parents, the effects of naloxone administration on clinical and EEG findings were evaluated in five infants 5-9 months old (3 males, 2 females) with cryptogenic infantile spasms and hypsarrhythmia. The infants were studied at the onset of symptomatology before therapy. An average of 5-10 groups of spasms were present per day. Naloxone (12 micrograms/kg body weight) was administered as an intravenous bolus in two cases, as a slow venous drip in another two cases, and intramuscularly in the last case. EEG and polygraphic monitoring were performed for 2 h. Naloxone did not induce any acute behavioral changes and the number of seizures remained unchanged after treatment. These data reject the possibility that endogenous opioids tonically modulate infantile spasms. Further studies are required to ascertain the involvement of POMC peptides in West's syndrome.
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PMID:Lack of clinical-EEG effects of naloxone injection on infantile spasms. 324 47

Corticosteroid release from adrenals of male adult Mongolian gerbils (Meriones unguiculatus) has been studied during continuous and discontinuous in-vitro superfusion. Corticosteroid output from glands of untreated animals with plasma corticosteroid levels below 300 ng/ml was 3.3 +/- 0.3 ng/adrenal pair/min and decreased only slightly with the length of superfusion (60 min: 3.1 +2- 0.3 ng/adrenal pair/min). In-vitro secretion was significantly higher from adrenals of animals which had corticosteroid plasma levels of over 300 ng/ml, underwent clonic-tonic seizures, or were injected with 6 IU/animal (1-24) ACTH. On the other hand, injection of 2 X 50 micrograms dexamethasone markedly decreased corticosteroid plasma levels but had no significant effect on in-vitro secretion of corticosteroids. In contrast to the slow and small, but long-lasting stimulation of corticosteroid secretion elicited by (1-24) ACTH, secretion could be changed within much shorter time periods, either by the addition of plasma proteins to superfusion medium or by stops of superfusion flow. While a significant stimulation of corticosteroid output occurred after the addition of 1% or 10% BSA or rat plasma, stops of superfusion flow for 1.5 or 10 min resulted in a strong inhibition of steroidogenesis, as is evident from corticosteroid amounts found in the first 1-min samples after re-start of superfusion. Within 4-5 min after re-start of superfusion, secretion returned to basal values. Corticosteroid amounts secreted from adrenals superfused in-vitro were significantly higher than those secreted from adrenals incubated in-vitro. In addition, prolonged incubation suppressed corticosteroidogenesis (30 min: 100%, 60 min: 64%, 90 min: 56%, 120 min: 59%). The results demonstrate that superfusion of sliced adrenal tissue gives insights into aspects of adrenal function, including the rapid changes in synthesis and secretion after flow stops which cannot be investigated by incubation of either tissue slices or isolated cells. The possibility that the observed decline in corticosteroidogenesis during flow stops may be due to a feedback inhibition resulting from corticosteroids accumulating within slices is discussed.
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PMID:Rapid and fine adjustment of corticosteroidogenesis operating in the adrenal gland of the Mongolian gerbil (Meriones unguiculatus) superfused in-vitro. 342 59


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