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Query: UMLS:C0149958 (complex partial seizures)
 2,563 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Previous interpretations have not adequately explained the presence of focal neurological signs, delirium, and a variety of highly specific disturbances of perception, language, and sensorium in the case of Anna O. Examination of the neurological details suggests that Anna suffered from complex partial seizures exacerbated by drug dependence, and that she developed conversion symptoms patterned after the preexisting organic pathology. Hysterical conversion symptoms that mimic ictal events are not uncommon in psychomotor epilepsy. Recent neuropsychiatric models of hysteria are remarkably similar to the hypnoid states theory Breuer formulated, based on his observation of Anna O. The hypothesis presented here does not conflict with previous psychodynamic interpretations. I submit that it was the development of a conversion disorder patterned on actual organic phenomena, which highlighted for Breuer and Freud the "psychical mechanism" of somatic symptoms, thus paving the way for the important psychodynamic discoveries for which the case is remembered.
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PMID:The case of Anna O.: a neuropsychiatric perspective. 329 85

A chemistry student was acutely exposed to vapors of an organotin compound. Seventy-two hours later, he exhibited delirium, spatial disorientation, perseveration, inappropriate affect, and memory defects. Five months later, he experienced episodes of complex partial seizures, which continue to require anticonvulsant medication after 7 years. Trimethyltin was identified in blood and urine samples taken 17 days after the accident; the blood level of trimethyltin was elevated 35 days after exposure. Serial electroencephalograms showed persistent left temporal paroxysmal epileptogenic potentials. Serial neuropsychological tests revealed persistent memory defects, cognitive dysfunction, and dysphoria 4 years after exposure. We review acute, resolving, and long-term residual neurotoxic effects of trimethyltin in man. We describe detailed clinical observations, serial neuropsychological test results, electroencephalographic findings, and exposure data in this patient, confirming the limbic system effects of trimethyltin and relating them to the known histopathologic pattern of this condition.
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PMID:Trimethyltin encephalopathy. 825 10

The question of whether organic conditions, such as complex partial seizures, can cause dissociative symptoms is controversial. Although a diagnostic category for organic dissociation is included in the tenth edition of International Classification of Disease, it has never been identified in the Diagnostic and Statistical Manual. Its inclusion in the upcoming DSM-IV is currently under debate. This article surveys representative literature regarding the role of organic factors in the causation of dissociative symptoms and considers the differential diagnosis of organic dissociation from current and historic perspectives. Dissociative symptoms and disorders (including amnesia, fugue, depersonalization, multiple personality, automatisms, and certain furors) can be induced by a variety of medications, drugs of abuse, and medical illnesses or conditions affecting cerebral function. Organic dissociation can be distinguished from intoxication, amnestic disorder, and delirium. Psychiatric nosology and our conceptualization of altered mental states and functions would benefit from use of the concept of an organic dissociative syndrome, which has clinical, neurophysiologic, and medicolegal significance. Such a category should be included in DSM-IV.
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PMID:The concept of an organic dissociative syndrome: what is the evidence? 938 42

Dementia is affecting an increasing proportion of the population in the developed world. It is important to reach a correct diagnosis of dementia, because this has implications on the treatment. The electroencephalogram (EEG) is, in general, not a sensitive test for detecting dementia and is not recommended in the standard workup of dementia. In spite of this, however, EEG is useful in patients with deteriorating mental status in whom dementia is suspected mainly to rule out delirium, depression, atypical complex partial seizures, and prion disease. An EEG also provides insight into the physiology of different dementia types. The EEG is most useful when interpreted within a well-defined clinical context, such as knowing the patient's degree of cognitive impairment. It is a noninvasive and inexpensive test, and the threshold should be low for ordering it. This article summarizes EEG findings with aging, different dementia types, and conditions masked as dementia.
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PMID:Electroencephalogram in the dementia workup. 1600 31

This article describes the diary of a man from 19th-century England (1829-1834) that documents the onset and course of his wife's epilepsy after a stroke. Her stroke produced aphasia and right hemiparesis, but her epilepsy was the diary's focus and caused the greatest concern. The diary documents the history of her epilepsy in detail. In addition to tonic-clonic seizures, she experienced frequent bouts of status epilepticus and complex partial seizures. The diary contains some of the earliest recorded descriptions of status epilepticus and its aftermath of delirium, mood disorder, and hysteria. It also offers some of the earliest and most detailed accounts of complex partial seizures. Bleeding by cupping was the only symptomatic or prophylactic treatment recorded. These aspects of the diary are presented, as are the historical perspectives on epilepsy, including early beliefs and stigmas, therapeutic remedies, and early European views of epilepsy.
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PMID:A diary of epilepsy in the early 1800s. 1726 88

A 9-year-old boy was diagnosed as non-herpetic acute limbic encephalitis (NHALE). Four days after the gastrointestinal infection, he developed a generalized seizure accompanied with delirium and psychiatric change, which evolved into intractable seizures. These seizures were complex partial seizures or generalized tonic clonic seizures, and were highly resistant to many anticonvulsants. Magnetic resonance imaging of the brain demonstrated reversible symmetrical high-intensity lesions in the claustra on the diffusion-weighted image. Laboratory findings did not suggest herpes simplex virus infection. Further, the clinical findings were consistent with those in acute encephalitis with refractory repetitive partial seizures (AERRPS). We assume that a part of AERRPS belongs to the category of parainfectious limbic encephalitis with repetitive seizures.
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PMID:[A case of non-herpetic acute limbic encephalitis in childhood--comparison with acute encephalitis with refractory repetitive partial seizures (AERRPS)]. 1751 38

Acute encephalitis with refractory, repetitive partial seizures (AERRPS) is a peculiar form of encephalitis mainly affecting children. Although not usually lethal, we report a case of sudden unexpected death in epilepsy (SUDEP) 3 years after the onset of AERRPS. A 6-year-old boy was admitted to our hospital because of fever and extremely refractory partial and secondary generalized seizures with delirium and psychiatric change. The seizures were highly resistant to anticonvulsants and suppressed only by large dose intravenous administration of midazolam. Seven months after the onset, the seizures were ameliorated by treatment with potassium bromide and clorazepate. After the acute phase, the patient developed complex partial seizures that tended to present with cyanosis. At the age of 10, he was found lying prone in respiratory arrest with facial pallor. Although he regained cardiac function after being taken to our emergency room, the patient died 12 days later. Six SUDEP cases after the onset of AERRPS, including this one, have been reported to date. Since epilepsy following AERRPS is one of the risk factors of SUDEP, clinicians should consider SUDEP to be a rare but high risk syndrome in AERRPS-afflicted children.
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PMID:[A case of sudden unexpected death in epilepsy 3 years after the onset of acute encephalitis with refractory, repetitive partial seizures]. 2180 Jun 98