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)

Electroencephalogram (EEG) of 524 Tanzanian epileptic patients seen between 1985 and 1988 were reviewed after a description and classification of seizures. Over two thirds were young patients between the age of five and thirty. The majority (86%) had abnormal records. Of these, 89% of abnormal records had focal abnormality and 11% had centrencephalic abnormality. Grand mal seizures did not imply centrencephalic abnormality, only 13% had such abnormality. Absence seizures are rare and 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 epileptic patients in Tanzania. 806 70

Dysembryoplastic neuroepithelial tumor (DNT) is a clinicopathologically unique group of tumors, mostly located in the temporal lobe, associated with intractable complex partial seizure in young patients. We report two unusual cases with multifocal involvement of diverse sites in the central nervous system. Case 1 is that of a 50-year-old man with 9-year history of grand mal seizures, who died of acute myocardial infarction. Case 2 is that of a 10-year-old girl with intractable complex partial seizures and behavioral disorder. Postmortem examination in case 1 showed multifocal tumor in the left temporal lobe, third ventricle, and basal ganglia. Magnetic resonance imaging in case 2 showed tumor in the right temporal lobe, both thalami, right cerebellar hemisphere, and pons. Histologically, both tumors were characterized by a multinodular appearance with a predominant component of alveolar arrangement of oligodendroglial-like cells around delicate capillaries, with mucoid matrix containing floating ganglion cells. There were also astrocytic nodules resembling pilocytic astrocytoma in case 1, and a gangliocytoma-like area merging with surrounding cortical dysplasia in case 2. Ultrastructural examination showed ganglionic differentiation in the oligodendroglial-like cells in case 2. They possessed dense core neurosecretory granules and many slender neuritic processes with microtubules arranged in parallel and terminating in synaptic junctions. The periventricularly located tumor with nodular extension to the periphery suggests an origin from subependymal germinal matrix with nests of primitive neuroblasts arrested in their embryonal migration. DNTs are related to ganglioglioma based on their common location and clinical behavior and on the presence of both ganglionic and astrocytic cells. They are also related to pilocytic astrocytoma by morphological and behavioral similarity. Together with cerebral neuroblastoma and central neurocytoma, they form a spectrum of tumors harboring small neuronal cells. The differentiation of DNT from oligodendroglioma is important so as to avoid unnecessarily aggressive therapy.
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PMID:Dysembryoplastic neuroepithelial tumor. A tumor with small neuronal cells resembling oligodendroglioma. 817 75

The 1981 International Classification of Epileptic Seizures (ICES) was used to study the distribution of seizure types in 1,250 patients attending an Epilepsy Clinic in Sri Lanka. Based on seizure symptomatology 94.6% of the cases could be classified, and by adding the routine interictal EEG findings the percentage of classifiable seizures increased to 97%. Partial seizures (73.8% cases) were three times as common as generalized seizures (23.3% cases). Of the partial seizures, simple partial seizures (SPS) accounted for only 0.4% cases, and complex partial seizures (CPS) for 8.8%, whereas partial seizures secondarily generalized (PSGS) accounted for 64.6%. PSGS had simple onset in 12.5% and complex onset in 34.8% of cases. Myoclonic seizures were the commonest of the generalized seizures, accounting for 14.6% of all cases. Tonic-clonic seizures accounted for 7.4% of cases; absence seizures accounted for only 1.3%. The study showed the 1981 ICES to be relevant and applicable in a clinical setting with limited investigatory facilities. Difficulties encountered with regard to certain subcategories could be overcome with minor modifications which made the classification operative. Routine EEG confirmed the diagnosis in a significant number of cases but changed the diagnosis in only a few, confirming that a good standardized questionnaire is the key instrument for classifying epileptic seizures.
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PMID:Classification of epileptic seizures: a hospital-based study of 1,250 patients in a developing country. 840 30

With the wider availability of magnetic resonance imaging cavernous malformations are being recognised with increasing frequency in those patients presenting with intractable epilepsy. Surgical resection is the treatment of choice. However, because these lesions are usually small and may be located in eloquent areas stereotactic resection should be considered. Stereotactically-guided resection of pathologically verified cavernous angiograms was performed in 10 patients in this series presenting with epilepsy (8 males, 2 females, mean age 32 years). Eight patients presented with medically intractable epilepsy (5 complex partial seizures, 3 grand mal seizures). Of the remaining patients one experienced multiple episodes of haemorrhage and the other headaches (with a non-diagnostic scan) both in association with epilepsy. Pre-operative localisation of the motor strip was determined in one case by functional MRI. Following resection of these lesions all patients experienced improved seizure control with a mean follow-up period of 22 months. The mean postoperative hospital stay was 5.1 days with no surgical complications recorded. We conclude that stereotactically-guided resection offers significant advantages in the management of cavernous malformations. Surgical indications for operative resection would include medically refractory epilepsy, repeated haemorrhage and those cases where there is diagnostic uncertainty.
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PMID:Stereotactically-guided craniotomy for cavernous angiomas presenting wit epilepsy. 874 65

Studies on dynorphin involvement in epilepsy are summarised in this review. Electrophysiological, biochemical and pharmacological data support the hypothesis that dynorphin is implicated in specific types of seizures. There is clear evidence that this is true for complex partial (limbic) seizures, i.e. those characteristic of temporal lobe epilepsy, because; (1) dynorphin is highly expressed in various parts of the limbic system, and particularly in the granule cells of the hippocampus; (2) dynorphin appears to be released in the hippocampus (and in other brain areas) during complex partial seizures; (3) released dynorphin inhibits excitatory neurotransmission at multiple synapses in the hippocampus via activation of kappa opioid receptors; (4) kappa opioid receptor agonists are highly effective against limbic seizures. Data on generalised tonic-clonic seizures are less straightforward. Dynorphin release appears to occur after ECS seizures and kappa agonists exert a clear anticonvulsant effect in this model. However, more uncertain biochemical data and lack of efficacy of kappa agonists in other generalised tonic-clonic seizure models argue that the involvement of dynorphin in this seizure type may not be paramount. Finally, an involvement of dynorphin in generalised absence seizures appears unlikely on the basis of available data. This may not be surprising, given the presumed origin of absence seizures in alterations of the thalamo-cortical circuit and the low representation of dynorphin in the thalamus. In conclusion, it may be suggested that dynorphin plays a role as an endogenous anticonvulsant in complex partial seizures and in some cases of tonic-clonic seizures, but most likely not in generalised absence. This pattern of effects may coincide with the antiseizure spectrum of selective kappa agonists.
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PMID:Dynorphin and epilepsy. 901 27

A family history of epileptic seizures including febrile convulsions was found in 15 of 103 patients (15%) with localization related epilepsy with partial seizures with and without secondary generalization, who were operated on because of drug resistance. This rate was significantly higher than that of the cumulative incidence in the general population (4%). The localization of the brain damage did not play a role (temporal lobe resection left: 15%, right: 17%, extra-temporal lesion excision: 20%, hemispherectomy: 11%). Various family members were involved. Some patients had more than one relative with seizures. Thus, 21 relatives suffered from seizures. Eleven of them had generalized tonic-clonic seizures (one grand mal on awakening), 7 had febrile convulsions (4 complicated), and in 1 patient the grand mal seizures on awakening were preceded by absences; 1 had generalized tonic-clonic and complex partial seizures; 1 after complicated febrile seizures likewise had complex partial seizures; another mentally retarded patient suffered from generalized tonic-clonic, axial tonic and myoclonic-astatic seizures. The seizure type of 3 remote relatives was not known. The first seizure occurred in 16 family members during childhood, in 3 in adolescence and in only 1 in adulthood (1 unknown). Eight showed mental retardation of slight degree in most. It is interesting that only one-third of the patients with a family history with seizures were seizure-free after the operation; 5 still had seizures, mostly reduced in frequency, 3 had seizures and isolated auras and 2 had only isolated auras. On comparing the findings in patients with and without a family history with seizures, those with family members with epileptic seizures showed a lower rate of an intellectual deficit (7 vs 47%) and brain tumours (13 vs 44%). Our earlier findings with a different group of patients are thus confirmed: that genetics play a role in symptomatic epilepsies.
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PMID:The genetics of localization-related symptomatic epilepsy: risk of a family history with seizures in patients who have undergone surgery. 926 63

The efficacy and safety of vigabatrin (VGB) has been extensively evaluated in preclinical and clinical studies but level of effectiveness in different type of seizures has yet to be established. The aim of our study is the prospective evaluation of anticonvulsant efficacy and toxicity of VGB. This long-term observation mainly focusing on efficacy of VGB in partial vs. secondarily generalized seizures were considered separately. In our study the criterion of drug resistance is occurrence per month of at least 1 tonic-clonic seizure or at least 2 complex partial seizures in 3 following months. The studies are based on 73 patients (39 F and 34 M), with average age of 26 years. After two weeks of treatment with sabril the drug was withdrawn in 5 patients because of side effects. The period of observation was 12 months. In group I--from total of 73 patients with partial seizures (including secondarily generalized)--31 (42%) of patients suffered only from partial seizures. Complex partial seizures occurred in 18 of patients; in this group were also 13 patients with simple partial seizures. Group II consisted of 42 patients (58%) who suffered from secondarily generalized tonic-clonic seizures. Number of seizures in group of patients with tonic-clonic seizures was from 1 to 16 per month (average 3.4) and in group of patients with complex partial seizures was from 1 to 70 per month (average 13.29). After titration period, Vigabatrin was given in doses of 500 to 3500 mg daily. Mean monthly fit frequency was calculated for over 3 months prior to the addition of vigabatrin and 12 months of therapy at the patient's maximum dose. Monthly fit frequency expressed as mean +/- standard error of the mean, and this statistical significance was determined using MANOVA for repeated measurement. Average monthly fit frequency of partial seizures has been reduced from 13.29 to 6.96 (p < 0.0001) and of generalized seizures from 3.38 to 1.38 (p < 0.0001). The percentage of patients achieving an increase of at least 75%--(Ratio < -0.6)--of seizures was greater in generalized seizures (27.3) than in partial ones (21.3). VGB is effective and well tolerated in refractory patients requiring add-on antiepileptic treatment and it has shown efficacy both in therapy of refractory partial seizures as well of secondarily generalized ones.
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PMID:[Clinical analysis of the effectiveness and safety of vigabatrin]. 1076 57

The association of epilepsy and psychosis is studied. Among the 500 patients of epilepsy evaluated, there were 12 patients, 8 males and 4 females with epilepsy-related psychosis. Their average age was 38 years. The interval between the age of onset of epilepsy and psychotic features was 9 years. Complex partial seizures were present in 7 patients and primary generalized tonic-clonic seizure was present in 1 patient. Four patients had post-ictal psychosis, 7 had acute interictal psychosis and 1 patient had chronic psychosis. The inter-ictal and chronic psychoses were schizophreniform whereas the post-ictal psychoses were not. EEG showed a temporal focus in 7 patients with complex partial seizures and an extra-temporal focus was identified in 4 out of the other 5 patients. Imaging (CT scan/MRI) revealed abnormalities in 10 patients. This study attempts to define the characteristics of psychoses occurring in epileptics.
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PMID:A study of epilepsy-related psychosis. 1465 38

Clinical lateralizing signs are the phenomena which can unequivocally refer to the hemispheric onset of epileptic seizures. They can improve the localization of epileptogenic zone during presurgical evaluation, moreover, their presence can predict a success of surgical treatment. Primary sensory phenomena such as visual aura in one half of the field of vision or unilateral ictal somatosensory sensation always appear on the contralateral to the focus. Periictal unilateral headache, although it is an infrequent symptom, is usually an ipsilateral sign. Primary motor phenomena like epileptic clonic, tonic movements, the version of head ubiquitously appear contralateral to the epileptogenic zone. Very useful lateralization sign is the ictal hand-dystonia which lateralizes to the contralateral hemisphere in nearly 100%. The last clonus of the secondarily generalized tonic-clonic seizure lateralizes to the ipsilateral hemisphere in 85%. The fast component of ictal nystagmus appears in nearly 100% on the contralateral side of the epileptic focus. Vegetative symptoms during seizures arising from temporal lobe such as spitting, nausea, vomiting, urinary urge are typical for seizures originating from non-dominant (right) hemisphere. Ictal pallor and cold shivers are dominant hemispheric lateralization signs. Postictal unilateral nose wiping refers to the ipsilateral hemispheric focus compared to the wiping hand. Ictal or postictal aphasia refers to seizure arising from dominant hemisphere. Intelligable speech during complex partial seizures appears in non-dominant seizures. Automatism with preserved consciousness refers to the seizures of non-dominant temporal lobe.
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PMID:[Brain lateralization and seizure semiology: ictal clinical lateralizing signs]. 1876 78

In this study, the authors characterized the clinical and EEG features of adult patients with Down syndrome who were referred, for more than a 10-year period, to the Epilepsy Clinic in the Cork University Hospital. A retrospective audit of the charts of 28 patients with Down syndrome who had an EEG performed in the Cork University Hospital between January 1, 2000, and September 30, 2009, including clinical follow-up, was carried out. Demographics, age at first seizure, seizure types, EEG findings, antiepileptic drugs, psychoactive medications, and seizure control were documented. Seizures most commonly began in the fourth decade of life. Generalized tonic-clonic seizures were the most common type of seizures (15 patients, 54%), followed by complex partial seizures (5 patients, 18%) and generalized myoclonus (4 patients, 15%). A number of patients had more than one type of seizure. Diffuse background slowing was the dominant EEG abnormality seen in 17 patients (60%). Epileptiform activity was present in 5 patients (18%): 2 had focal epileptiform discharges in the frontal regions, 1 in the central region, 1 in the central posterior region bilaterally, and 1 in the temporal regions. The six patients who had poor seizure control were those who had seizure onset from the fourth decade onward and clinically had complex partial seizures in combination with either generalized tonic-clonic or generalized myoclonus; four of them had epileptiform activity on EEG, with two having focal frontal epileptiform discharges: one in the central posterior areas bilaterally and one in the temporal regions. Five of the 28 patients had a normal EEG and 3 of these had a seizure disorder. There was no correlation found between use of psychoactive drugs and increased frequency/poor seizure control in patients in our study. This study documents the variability of clinical and electrophysiologic features in a well-characterized cohort of patients with Down syndrome with adult-onset epilepsy.
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PMID:Clinical and EEG features of seizures in adults with down syndrome. 2194 60


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