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

Grand mal type of sequential spike discharges at 8-12 cps are rare as interseizure phenomena. When the grand mal component is prominent, it usually indicates a greater tendency for major convulsions. The case of a 15 year old girl who developed akinetic seizures along with her menarche and whose electroencephalogram showed recurring sharp waves at 10-11 cps, is reported, and its clinical significance discussed.
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PMID:"Grand mal type" of spike discharge as interseizure phenomenon. 11 38

411 patients with epileptic seizures manifest only after the age of 25 were investigated as to aetiology, seizure type and frequency and age and sex distribution. Neurological, neuro-radiological and EEG findings are reported: There was a clear prevalence of male patients (67%). Manifestation occurred mainly between 30 and 40 years of age (65%). Most seizures were primarily of the generalized grand mal type (68%). Grand mal with focal onset occurred in 13%, partial seizures in 11%, complex partial seizures (psychomotor seizures) in 5%, the latter plus grand mal seizures in 2% and other types in 1% of the cases. Aetiological factors were: chronic alcoholism (31%), vascular diseases (17%), tumours (12%), traumatic brain lesions (8,5%), toxic metabolic lesions (6%) and other factors (6%). Idiopathic epilepsy of late onset was a rare cause (4%). The aetiology remained unknown in 15% of cases. We found that the differences in age distribution, seizure type and the EEG findings are significant factors in the differential diagnosis and we compared them with those found in similar investigations.
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PMID:[So-called late epilepsy (author's transl)]. 56 52

Kainic acid (KA 4-14 mg/kg) administered intraperitoneally (i.p.) produces automatisms (scratching until third postnatal week, "wet dog" shakes thereafter), and clonic and tonic-clonic seizures in rats aged 7, 12, 18, 25, and 90 days. Administration of carbamazepine (CBZ) i.p. (25 or 50 mg/kg), phenobarbital (PB 20-80 mg/kg), clonazepam (CZP 0.2 or 1 mg/kg), or valproate (VPA 200 mg/kg) influenced neither incidence nor latency of automatisms. Clonic seizures that are regularly observed after the third postnatal week in controls were either abolished or substantially suppressed by any of the aforementioned antiepileptic drugs (AEDs). Tonic-clonic seizures observed in the first 3 postnatal weeks were suppressed only by solvent [including propyleneglycol (PEG), ethanol, and water]; the effect of AEDs on tonic-clonic seizures was proconvulsant instead. The automatisms were most resistant to AED therapy. These results induce some doubts about the adequacy of the KA model for identifying AEDs effective against complex partial seizures, but forthcoming AEDs that suppress automatisms in the KA rat model might also be active against human complex partial seizures.
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PMID:Action of antiepileptic drugs against kainic acid-induced seizures and automatisms during ontogenesis in rats. 146 81

We report on 79 pregnancies in 66 female outpatients with epilepsy. An increase of seizure frequency was significantly more frequent in complex partial seizures than in grand mal seizures and in absences. The reason for these disparities are not clear. In most patients a raised frequency of seizures during pregnancy decreased again after delivery. Carbamazepine was the antiepileptic drug prescribed most frequently followed by valproic acid. The course of the blood levels of carbamazepine and valproic acid was nonuniform during pregnancy. Total concentrations of carbamazepine in cord blood were on average 84.5% of those in maternal blood (n = 22). Valproic acid blood levels were on average 183% of those in maternal blood (n = 15). It is still unclear whether these differences are clinically relevant. During the last weeks of pregnancy we found an increase of the free fraction of carbamazepine and valproic acid. Simultaneously the total protein concentration decreased. Until now these findings are without clinical relevance. The course of labor did not differ from normal population concerning the ratios of spontaneous labor, cesarean section and delivery by forceps. Miscarriage and perinatal mortality were 2.7% each and outnumbered the risk in the general population. In 42.8% of the neonates one to three perinatal complications were observed. The ratio of perinatal complications is not different between patients with monotherapy and combined therapy respectively. There was a tendency to lower values of length, weight and head circumference in the male neonates but not in the female neonates. The risk of minor malformations was 26%, the risk of major malformations was 14% (including one case of suspected malformation) without a discernible correlation with a specific antiepileptic drug.
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PMID:[The course of pregnancy and teratogenicity of antiepileptic agents in 66 patients with epilepsy]. 172 Dec 36

We examined the clinical significance of bisynchronous spike-wave complexes which appear in EEGs of some patients with focal spikes in one or both temporal lobes. Few features distinguished patients with bisynchronous spike-waves from those with only focal temporal spikes: a higher incidence of patients with more than two grand mal seizures a year (43 vs. 7%) and a younger age at last recording (22.5 vs. 28.3 years) were the only statistically reliable factors. Proportion of patients with complex partial seizures (CPS) (100%), age of CPS onset, incidence of febrile convulsions, intellectual level, and normal neurologic examination were features common to the two groups. In contrast to other studies which did not exclude influencing variables such as extratemporal spike foci, our group with bisynchronous spike-waves fared equally well after temporal lobectomy as did patients with temporal spikes alone. All 6 patients with spike-waves obtained a reduction of at least 50% in seizure frequency and 5 of the 6 (83%) had a greater than 90% reduction. Sixteen of 17 patients (94%) without spike-waves had a reduction of at least 50% and 14 of the 17 (82%) had a greater than 90% reduction of seizures.
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PMID:Significance of bisynchronous spike-waves in patients with temporal lobe spikes. 249 40

The distribution of seizure types was investigated in an epidemiological survey of 1,220 patients over 15 years of age. Classification of clinically dominant seizure type according to the International Classification of Epileptic Seizures (ICES) was possible in 1,005 cases (82.5%). Fifty-six percent of patients had partial seizures and 26.5% had generalized seizures. Subclassification of partial seizures revealed simple partial seizures (SPS) in 7.5% of the cases, complex partial seizures (CPS) in 23%, and partial secondarily generalized seizures (PSGS) in 25.5% of the cases. Simple partial onset was seen in 56% of the patients with CPS, and impairment of consciousness at the onset occurred in the remaining 44%. PSGS started with simple partial onset in 92% of the cases and the remaining 8% started with a complex partial phase. Tonic-clonic seizures were the most common type of generalized seizures, accounting for 23% of all and 88% of generalized seizures. Absence seizures were seen in 1% of the cases. A single seizure type was observed in 737 patients (60%) and the remaining 40% had multiple seizure types. SPS, CPS, and absence seizures were most commonly combined with other seizure types. The study revealed that distribution of seizure type varies as a function of age. Although the present study finds ICES relevant, difficulties in its utilization in epidemiological context are demonstrated.
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PMID:Distribution of seizure types in an epileptic population. 312 10

One hundred sixty-eight children with an initial afebrile, unprovoked seizure were identified from a regional EEG laboratory. This case-finding method seemed justified because 86% of regional physicians indicated they order an EEG after a first seizure. Clinical information and recurrence rate were determined from records and telephone calls. Eighty-one percent had been seen by a pediatric neurologist. Overall, 51.8% recurred, and of those with a recurrence, 79% had additional seizures. Recurrence rates were highest in those with abnormal neurologic examination, focal spikes on EEG, and complex partial seizures. The lowest rates of recurrence followed a generalized tonic-clonic seizure, with normal EEG and normal neurologic examination. Prescription of anticonvulsants did not alter the recurrence rate.
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PMID:Epilepsy after a first unprovoked seizure in childhood. 405 56

The clinical and epidemiological data of 1054 patients with epilepsy between the ages of 16 and 66 years are described. 70% of the patients were treated in neurological departments, 20% by their general practitioners, while 8% received no treatment. The age-specific prevalence was 430 per 100 000 inhabitants, the same for men and women. Hereditary epilepsies (pyknoleptic absences, juvenile myoclonic epilepsy, epilepsy with awakening grand mal) comprised 16% of all the epilepsies; epilepsies with clinical primary generalized grand mal seizures as the only seizure type 32%, epilepsies with complex partial seizures 25% and epilepsies with simple partial seizures 18%. 8% could not be classified.
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PMID:A clinical and epidemiological study of adult patients with epilepsy. 660 33

Electroencephalogram (EEG) of 524 Tanzanian epileptic patients seen between 1985 and 1987 were reviewed. Over two thirds were young patients between the ages of five and thirty. Four hundred and fifty (86%) had abnormal records. Eighty nine per cent of abnormal records had focal abnormality and 11% had centrencephalic abnormality. Grand mal seizures did not imply centrencephalic abnormality, only 13% had such abnormality. Petit mal seizures are rare, over one third of these had temporal focal abnormality. Partial seizures were associated highly with focal abnormality. However, complex partial seizures did not imply temporal focal abnormality. Implications of EEG findings to correlation with epileptic seizures is discussed.
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PMID:Electroencephalographic findings in Tanzanian epileptic patients. 783 7

Five patients with chronic incapacitating seizures averaging 15-5,000/month were selected for study. All patients had more than one seizure type and had received maximal doses of antiepileptic drugs (AEDs). The centromedian thalamic nucleus (CM) was stimulated electrically through bilateral multicontact platinum electrodes stereotaxically placed in CM and connected to internalized pulse generators. Electrophysiologic confirmation of electrode position included thalamically elicited recruiting responses and EEG desynchronization recorded at the scalp. Stimulation parameters were adjusted individually in the range of 450-800-microA intensity, 65 pps, 0.09 ms, in 1-min trains, alternating right and left side stimulation and with 4-min intervals delivered for 2 h/day. Quantitative evaluation included frequency of seizures/month, number of maximal interictal paroxysmal discharges, and frequency of background activities counted in selected scalp EEG samples, taken throughout the observation period (7-33 months). Significance of changes was evaluated by parametric Student's t test. Generalized tonic-clonic seizures (GTC) decreased dramatically, almost disappearing in all cases (p < 0.001), with a significant reduction in interictal paroxysmal discharges (p < 0.01) and a tendency toward an increase in EEG background frequency. Other generalized seizures (atypical absences) decreased significantly, but there was no change in the number of complex partial seizures (CPS). CM stimulation is useful in control of GTC, but its beneficial effect on other seizure types has not been established.
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PMID:Electrical stimulation of the centromedian thalamic nucleus in control of seizures: long-term studies. 800 11


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