Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0149958 (complex partial seizures)
 2,563 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Our analysis of the course of illness in 14 patients, whose common electroencephalographic characteristic was epileptogenic activity in the occipital area, showed very different clinical symptoms. The first group comprised patients who presented bilateral amaurosis. In four of these cases, the occipital hypersynchronous EEG activity was merely a secondary symptom of either ischaemic hypoxia or of a degenerative process in the occipital visual cortex and was not responsible for the genesis of the actual blindness. In two further cases of monosymptomatic temporary loss of vision, it was difficult to make a differential diagnosis between ictal blindness, respectively status epilepticus amauroticus occurring in a occipital lobe epilepsy and a migraine attack involving the basilar territory. The second group comprised five patients with paroxysmal visual hallucinations respectively illusions. Three of them suffered from hallucinations of the elementary type, respectively flickering fits in the hemianopic field, symptoms which are based on discharges in the visual cortex of the occipital lobe. In a case of one patient with complex visual hallucinations as well as in a further case with visual illusions, it was not possible to find out with certainty their place of origin. A study of these cases shows that the cortical or sub-cortical functional disturbance within the visual system causing the various optical deformations and visual hallucinations, form an inhomogeneous group with different etiology. In the only patient belonging to the third group, whose seizures were i.a. characterized through motor phenomena in the field of the ocular organs and the tonic lateral turning movement of the bulbi of the eyes and of the head, an occipital epileptic crisis with spread of discharges from the occipital pole to the frontomesial surface should be assumed. The occurrence of complex partial seizures, respectively generalized tonic-clonic attacks in two patients of the fourth group who have definite epileptogenic EEG-activity in the occipital area, can be explained by a propagation of paroxysmal activity to the temporal lobe or to the motor cortex. Because of the marked tendency to propagation of the hypersynchronous activity originating in the occipital lobe, many combinations of sensory and/or motor symptoms can occur within the frame-work of occipital epileptic seizures. On the basis of one scalp EEG finding, no final localizing conclusions may be drawn here.
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PMID:[Epileptic activity of the occipital lobe. Clinico-electroencephalographic contribution]. 322 Apr 20

Intracarotid injection of 133-Xenon and recording of wash out of radioactivity by 254 external stationary detectors was used to measure rCBF. Initial slope values were calculated by a computer, translated into color code and displayed on a TV-screen. rCBF in patients with epilepsy has been the object of former studies. Those who had a cortical focus showed corresponding high blood flow values during attack and during EEG paroxysms without clinical attacks. On the contrary, all other patients with a cortical focus were normal. Patients with complex partial seizures displayed no abnormalities interictally. During generalized epileptic seizures rCBF and metabolism doubled. Distinction must be made between patients with aura (classic migraine) and patients without aura (common migraine). In the latter CBF was normal or slightly elevated. In the former the aura symptoms are associated with reduced CBF. The reduction usually starts posteriorly and spreads gradually anteriorly. rCBF remains depressed for up to several hours into the headache phase. After 8-12 hours a reactive hyperemia may ensue. In common migraine rCBF remains normal throughout the attack. During classic migraine attacks rCBF is depressed whereas it is increased during epileptic attacks. Thus rCBF studies further strengthen the differences between epilepsy and migraine.
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PMID:Regional cerebral blood flow (rCBF) studies in migraine and epilepsy. 360 67

A retrospective method was used to estimate the incidence of recurring motion-sickness, cyclic vomiting and abdominal pain considered as different manifestations of a so-called periodic syndrome in 100 migraine sufferers, 100 epileptics and 100 control subjects in the pediatric age group. Such recurrent symptoms are significantly more frequent in those suffering from migraine than in the other two groups. Examination of subgroups of patients affected by particular forms of migraine (classical and common) and of epilepsy (generalized seizures, simple partial seizures, complex partial seizures) contributed little new to our understanding of the nature of periodic syndrome. It is concluded that the above symptoms of periodic syndrome should generally be considered as manifestations of a migrainous rather than of an epileptic disorder.
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PMID:Cyclic vomiting and recurrent abdominal pains as migraine or epileptic equivalents. 687 85

Vestibular function studies were performed in 20 children with symptoms suggesting basilar artery migraine. Sixteen children had abnormalities on bithermal caloric testing. Labyrinthine preponderance was found in 1 child with labyrinthine concussion and in 6 children with symptoms suggesting ischemia of the territory supplied by the basilar artery and the occipital branches of the posterior cerebral arteries. Directional preponderance was found in 4 children with symptoms suggesting ischemia of the posterior temporal branches of the posterior cerebral arteries. Five children had both labyrinthine and directional preponderance. normal electronystagmographic findings were present in 4 children and correlated clinically with a milder illness. Head trauma was the triggering factor for the migraine in 5 children. Five children developed complex partial seizures and had evidence of directional preponderance (2 children) and combined labyrinthine and directional preponderance (2 children). The presence of abnormalities on electronystagmography in children with basilar artery migraine correlates with the severity of the disease. Directional preponderance or labyrinthine and directional preponderance are more frequently correlated with ischemia in the posterior temporal branches of the posterior cerebral arteries and may suggest a higher risk of developing vertiginous seizures when ischemia is prolonged.
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PMID:Vestibular testing in basilar artery migraine. 723 28

Prior studies have incompletely established a relationship between epilepsy and schizophrenia, primarily because of methodological difficulties. We undertook a two-part retrospective investigation of neurology clinic patients with epilepsy and schizophrenia. Part I: Interictal schizophrenic disorders occurred in 149 (9.25%) of 1,611 epileptic outpatients, compared with only 23 (1.06%) of 2,167 migraine outpatients. Part II: Among age- and sex-matched groups, we compared 62 epilepsy-with-schizophrenia patients with 62 epilepsy patients on six seizure variables, and we compared them with 62 schizophrenia patients on 10 psychosis variables. The epilepsy-with-schizophrenia group had a later epilepsy age of onset with more complex partial seizures, more patients with auras, and fewer patients with generalized epilepsy. Except for increased suicidal behavior, epileptic patients did not differ from controls on psychosis variables; however, psychotic symptoms often emerged with increased seizure activity. Together these results support a distinct association of schizophrenic disorders with epilepsy, particularly with seizures emanating from the temporal limbic system.
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PMID:Schizophrenia in epilepsy: seizure and psychosis variables. 818 35

The ability to study regional cerebral blood flow (rCBF) is available in many institutions, especially with the spread of multi-headed gamma cameras. The use of this technique in paediatrics requires special attention to detail in the manner of data acquisition and handling the child. The interpretation of the rCBF study in a child requires knowledge of normal brain maturation. The major clinical use in paediatrics is epilepsy because of the advances in surgery and the frequency of complex partial seizures. Other indications in paediatric neurology include brain death, acute neurological loss including stroke, language disorders, cerebral palsy, hypertension due to renovascular disease, traumatic brain injury and migraine. There are paediatric psychological conditions in which rCBF assessment has been undertaken, including anorexia nervosa, autism, Gilles de la Tourette Syndrome (GTS) and attention deficit disorder-hyperactivity (ADHD). This article attempts to review all aspects of rCBF studies in paediatrics.
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PMID:Cerebral blood flow imaging in paediatrics: a review. 900 97

Radioisotope brain imaging has focused mainly on regional cerebral blood flow (rCBF). However the use of ligands which go to specific receptor sites is being introduced in paediatrics, mainly psychiatry. rCBF is potentially available in many institutions, especially with the availability of multi-headed gamma cameras. The use of this technique in paediatrics requires special attention to detail in the manner of data acquisition and handling the child. The interpretation of the rCBF study in a child requires knowledge of normal brain maturation. The major clinical use in paediatrics is epilepsy because of the advances in surgery and the frequency of complex partial seizures. Other indications in paediatric neurology include brain death, acute neurological loss including stroke, language disorders, cerebral palsy, hypertension due to renovascular disease, traumatic brain injury and migraine. There are paediatric psychological conditions in which rCBF has been undertaken, these include anorexia nervosa, autism, Gilles de la Tourette syndrome (GTS) and attention deficit disorder-hyperactivity (ADHD). Research using different ligands to specific receptor sites will also be reviewed in paediatrics.
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PMID:Cerebral imaging in paediatrics. 969 65

A longitudinal prospective approach was used to investigate clinical correlations of interictal occipital paroxysms with or without fixation-off sensitivity (FOS). Occipital paroxysms were recorded in the electroencephalograms (EEGs) of 76 children with heterogeneous clinical conditions including seizures in 39 patients. Occipital paroxysms with FOS (42 patients ) were only fractionally more frequent than non-FOS (34 patients ) and were not specific of any clinical condition. Although present and FOS-related in all 11 children with benign childhood epilepsies with occipital paroxysms (CEOP), they were also frequently encountered in symptomatic occipital epilepsy. The differentiation of CEOP from other syndromes established on clinical grounds could also be aided by the analysis of background EEG activity that was frequently significantly more abnormal in symptomatic than CEOP. Clinical characteristics and ictal seizure semiology as well as follow-up clearly distinguish two type of idiopathic CEOP syndromes: (1) early onset type or Panayiotopoulos syndrome characterized by excellent prognosis and rare, prolonged nocturnal seizures with tonic deviations of the eyes and vomiting, and (2) late onset or Gastaut type showing a common ictal visual symptomatology, co-occurrence of migraine, diurnal complex partial seizures and less favourable EEG-clinical prognosis.
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PMID:Clinical correlations of electroencephalographic occipital epileptiform paroxysms in children. 1148 51

Shire is developing DP-VPA, a prodrug of valproic acid (VPA) licensed from D-Pharm, for the potential treatment of severe forms of epilepsy, including status epilepticus, acute repetitive seizures in children and possibly manic depression and migraine [242649], [385958]; the drug is also being developed for bipolar disorder and migraine prophylaxis [385862]. By March 2000, phase I trials had been completed [359581], [373232] and in October 2000, the compound entered phase II trials for the treatment of epilepsy, bipolar disorder and migraine [385862]; these trials were ongoing in November 2001 [429470]. In October 2001, Shire initiated multicenter, multinational phase II trials of SPD-421 as add-on therapy in the treatment of complex partial seizures [425660]. In February 2002, Shire reported that it planned to make a decision regarding the future of the compound by the second half of 2002 [441819]. DP-VPA is based on D-Pharm's regulation activation of prodrugs (RAP) technology, which designs drugs to be internalized within cells and to be activated only when the tissue becomes diseased. In the case of DP-VPA, the pathological epilepsy process activates it on demand [342433]. RAP-prodrugs are composed of the active drug moiety attached via a chemical linkage to a hydrophobic molecule which allows the agent to penetrate into the cell [182806]. In October 2000, D-Pharrm received patent US-06077837 from the USPTO covering novel 'Prodrugs with enhanced penetration into cells'. This patent claims prodrugs, comprising a pharmacologically active compound covalently linked to an intracellular transporter by a bond which is preferentially cleaved by disease-associated supranormal enzyme activity [385507]. In April 2000, Lehman Brothers predicted the launch of DP-VPA during 2003 [365103]. In December 2001, Lehman Brothers suggested that the product would be approved in 2004. The analysts estimated a 25% probability of the drug reaching the market, and envisaged peak sales of $200 million [434768]. Analysts at Schroder Salomon Smith Barney predicted in March 2002, that sales for Shire of DP-VPA would reach US $9.5 million in 2005, rising to US $31 million in 2006 [449087].
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PMID:DP-VPA D-Pharm. 1213 14

The comorbidity between epilepsy and migraine has been well known for a century, yet it is still not fully understood; the two disorders also share some risk factors, symptoms, and preventive drug therapy. A series of clinical observations and scientific data support the hypothesis of alteration of cortical excitability as a possible mechanism underlying their pathology, with both disorders characterized by transient paroxysmal neurological disturbance. So far, the numerous pathophysiological mechanisms responsible for neuronal hyperexcitability have only been studied in familial hemiplegic migraine (FHM), but they do suggest a link between migraine and epilepsy. Several studies support the hypothesis of a clinical continuum between some types of migraine and some types of epilepsies, with possibly even a complete overlap, representing, in particular cases, headache as the sole ictal manifestation of seizures. Taking into account the data in the literature, we hypothesize that several aetiopathological noxae (either environmental or genetics), such as Na+-K+ ATPase pump impairment, converging on a common final pathway represented by neuronal membrane hyperexcitability, could manifest as either epilepsy or headache/migraine, or both. The potential implications arising from this point of view include (a) a revision of headache/migraine diagnostic criteria as the sole ictal epileptic manifestation in international classifications of both epilepsies and headache disorders; (b) the careful follow-up of patients with headache/migraine as a residual feature, taking into consideration a revised concept of "complete seizure control" to avoid mistakes due to inopportune withdrawal of antiepileptic treatment. In addition, we suggest that headache is associated with other ictal-sensitive and motor features (more than those reported); these may be highly underestimated due to impairment of consciousness during complex partial seizures with or without secondary generalization.
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PMID:Hypothesis on neurophysiopathological mechanisms linking epilepsy and headache. 1819 8


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