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

Repeated application of brain stimulation can lead to a progressively augmenting electrical and behavioral response-- a phenomenon termed seizure kindling. In this experiment, stimulation was delivered once per day, and was followed by peripheral (intraperitoneal) administration of ACTH or cortisone. An intermediate or a high dose of either hormone (0.3 IU or 3.0 IU of ACTH/animal, 10 mg or 25 mg cortisone/animal) delayed the completion of kindling if administered shortly after each kindling stimulation. Lower doses (0.03 IU of ACTH or 2 mg of cortisone) had no significant effects. The high dose of ACTH or cortisone was no longer effective if administration was delayed more than 4 h after stimulation. Peripherally administered ACTH and cortisone can influence processes initiated by the brain stimulation which presumably underlie the augmentation of response to successive stimulations. This time-limited action is analogous to the effects of these hormones on memory consolidation.
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PMID:Hormonal influences on seizure kindling: the effects of post-stimulation ACTH or cortisone injections. 627 51

The long-term prognosis of 192 surviving children with the syndrome of infantile spasms was evaluated. The children had been admitted to three paediatric hospitals in Helsinki at the time of initial diagnosis. The aetiological factors of the syndrome were carefully studied in each case. ACTH therapy was employed in 162, usually for about six weeks. The follow-up study 3-19 (mean 10.4) years later was made at the Children's Hospital, University of Helsinki. The rate of mortality was 19.6 per cent. Normal development was seen in 12 per cent and slightly subnormal in 10.4 per cent of the surviving children. Psychiatric disorders were seen in 27.6 per cent of the survivors. Sensory defects were also common. Severe cerebral palsy was seen in 4 per cent. Other seizures after cessation of the infantile spasms were seen in 60 per cent. Serial EEG studies showed that the temporal lobe was the most common site of abnormality. Abnormalities in the temporal lobes were seen frequently in children with symptomatic neonatal hypoglycaemia as a probable cause of the spasms. Prognostically favourable factors were "idiopathic" aetiology, normal development and not other fits prior to the spasms, short treatment lag, good response to ACTH and short duration of the spasms. In this study early treatment seemed to be of great importance even with regard to mental development. The factors connected with a bad outcome were: symptomatic aetiology (especially brain malformations, early infections and tuberous sclerosis), slow development before spasms, other seizures before infantile spasms, early onset of the spasms, long treatment lag, long duration of the spasms and other later occurrence of myoclonic-astatic seizures (Lennox-Gastaut). Large doses of ACTH (120-160 units) were not associated with a better prognosis than the smaller doses (20-40 units). The benefit of long versus short treatment schedules could not be evaluated in this study. The relapse rate here was 32 per cent.
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PMID:A long-term follow-up study of 214 children with the syndrome of infantile spasms. 628 79

We report on two infants (two and six month old) with infantile myoclonic seizures, who developed signs of hypertrophic cardiomyopathy (HCM), while receiving ACTH treatment (Tetracosactid=Synacthen Depot). The diagnosis of HCM was established by echocardiography. The first patient (R.M. female). showed signs of cardiac insufficiency and was treated with a beta-blocking agent (Propranolol=Dociton). This led to resolution of the clinical symptoms and reversal of myocardial muscle thickness as determined by echocardiography. The second patient (R.S. female) did not develop cardiac symptoms. A correlation between cardiomyopathy and ACTH treatment is discussed. Based on the various biological effects of ACTH different hypothetical explanations for this correlation are proposed: increased deposition of glycogen, enhanced protein synthesis, oedema of the myocardial tissue and systemic hypertension. Because of the correlation observed between ACTH treatment and the development of cardiomyopathy we recommend regular physical and echocardiographic examinations to detect cardiac involvement during treatment with ACTH.
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PMID:[Hypertrophic cardiomyopathy during ACTH treatment]. 630 97

We treated 116 children with ACTH or prednisone. Fifty-two had infantile spasms with hypsarhythmia, and 64 had other types of intractable seizures. ACTH completely controlled seizures in all patients with infantile spasms and hypsarhythmia and 74% of those with other types of seizures. Prednisone controlled 51% of patients with infantile spasms and none with other seizures. Serious side effects were minimal for both drugs, and recurrent seizures occurred in 40 to 50% of patients within 4 to 14 months after completion of therapy.
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PMID:ACTH and prednisone in childhood seizure disorders. 630 15

Electroencephalographic and behavioral effects of the following ACTH fragments: 1-4, 4-9, 4-11, 1-10, 4-10, 1-13, 1-17 and 1-24 were studied in rabbits. Sequences 4-9, 1-10 and 4-10 displayed some epileptic properties, i.e., they induced epileptic seizures (only electrographic or also behavioral) or increased hippocampal spiking. The 4-9 sequence seemed to be the common sequence responsible for these proconvulsant effects. The possible involvement of the enkephalinergic system is discussed.
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PMID:Centrally administered N-terminal fragments of ACTH (1-10, 4-10, 4-9) display convulsant properties in rabbits. 631 94

The results of clinical, electroencephalographic and repeated computed tomographic examination of 14 children suffering from epileptic seizures in connection with the West and Lennox-Gastaud syndrome are analyzed and compared. Computed tomography yields little information regarding the etiology of such forms of epilepsy. Distinct clinical and electroencephalographic findings were accompanied by normal computed tomographic results in a large proportion of the cases. To avoid misinterpretation of computed tomographic findings and consequent prognostic errors in these epileptic cases it is necessary to take possible side effects of ACTH and corticosteroid treatment into account. At the climax of hormone treatment computed tomography revealed imposing changes in the form of generalized atrophy in 10 of the 14 children examined. These receded completely upon termination of hormone treatment.
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PMID:[Clinical, electroencephalographic and computer tomographic studies of children with West and Lennox-Gastaut syndrome]. 631 17

The mean CSF GABA level in 22 children with infantile spasms was significantly lower than in 35 controls. There was no significant difference between the CSF GABA levels in untreated children and those treated with anticonvulsants, or between uncontrolled and temporarily controlled patients. After treatment with ACTH, CSF GABA levels were lower than before treatment, and seizures disappeared. Brain GABAergic neuronal function may be disturbed in children with infantile spasms, but the decreased CSF GABA level does not directly correlate with the seizures of infantile spasms.
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PMID:Cerebrospinal fluid GABA levels in children with infantile spasms. 632 56

Free amino acid patterns of cerebrospinal fluid in infants and children with various types of convulsive disorders were compared with those in age-matched normal subjects. The total free amino levels in Lennox syndrome were higher than the normal values, and those in infantile spasms controlled by ACTH were higher than those in uncontrolled infantile spasms. Although the levels of only one or two amino acids in tonic-clonic seizure, focal seizure and febrile seizure were higher or lower than those of the controls, the levels of 8 amino acids in infantile spasms were lower and those of 10 amino acids in Lennox syndrome were generally higher compared to the controls. Among amino acids in CSF of children with tonic-clonic seizure, infantile spasms or Lennox syndrome, only the ornithine level was commonly lower than that of the controls. After the treatment, in tonic-clonic seizure, the levels of taurine, asparagine and glycine were increased, and in infantile spasms, those of asparagine, glutamine, glycine, alanine, phenylalanine, lysine and arginine were increased while that of taurine was decreased. These results suggest that each type of convulsive disorder shows the specific amino acid pattern, and the effects of anticonvulsants may be partially understood through the changes of the free amino acid patterns in the brain.
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PMID:Amino acid metabolism in the brain with convulsive disorders. Part 3: Free amino acid patterns in cerebrospinal fluid in infants and children with convulsive disorders. 632 17

Corticotropin releasing factor (CRF) is a 41-residue peptide, capable of stimulating the secretion of corticotropin (ACTH)-like and beta-endorphin-like immunoreactivity from the adenohypophysis. Low doses of CRF (0.0015-0.15 nM) given intracerebroventricularly (i.c.v.) produced changes in electrographic activity suggestive of increased arousal. Higher doses of CRF (1.5-3.75 nM) induced, over a period of 3-7 h, electrographic and behavioral signs of seizure activity indistinguishable from those which occur following electrical 'kindling' of the amygdala.
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PMID:Corticotropin releasing factor produces increases in brain excitability and convulsive seizures in rats. 660 87

The data of 115 children with age-dependent epilepsy in early childhood and treated in the out-patient department of the university clinic for pediatrics in Vienna in the past 20 years were prepared for computerization and subsequently processed. The average observation period was 10,9 years (SD = 6,81 years). At the time of the study 20 out of 35 children with infantile spasms and 61 out of 80 children with myoclonic-astatic seizures were free from seizures. We consider Benzidiazepines to be the optimum treatment for both of the above-mentioned kinds of seizures. If they failed to achieve the desired success, ACTH and steroids proved to be quite effective. In cases of myoclonicastatic seizures with generalized EEG patterns, VPA is indicated. In order to be able to judge the dynamics in psychic development more effectively, we divided our patients into three groups: children with stable development, those with obvious retardation, and those with obvious positive development in the course of therapy. There was no statistically significant correlation between a delayed onset of therapy and the absence of seizures as well as a more satisfactory psychic development (according to the Man-Whitney-Test and the Kruskal-Wallis-Test). In children with infantile spasms we found a statistically significant correlation (p less than 0.05) between relief from seizures and a satisfactory psychic development. In general, the somatic and psychic prognosis of Petit-Mal epilepsies in early childhood seems to depend on pretherapeutical factors.
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PMID:[Treatment result and treatment resistance in early childhood petit mal epilepsy]. 678 88


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