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

One hundred epileptic patients were included in this study according to the following criteria: intractable partial epilepsy, normal CT scan and focal EEG abnormalities. Eighty-nine patients were suffering from complex partial seizures of temporal or frontal origin, 55 and 34 cases respectively. Eleven patients presented with only simple partial seizures. MRI was abnormal in 31 patients. The abnormalities were: focal T2 increased signal intensity (13 cases) most often temporal (10 cases), cryptic arteriovenous malformation (4 cases), focal T1 and T2 signal abnormality (4 cases), focal atrophy (2 cases) and multiple abnormal T2 signals scattered in the white matter (8 cases). The site of MRI abnormalities was consistent with electroclinical data in 22 patients, of whom 20 had a temporal lobe epilepsy. Thus MRI proved to be more often abnormal in temporal than in frontal lobe epilepsy (36 p. 100 and 5.9 p. 100 respectively) when the CT scan is normal. However MRI data, particularly focal T2 hypersignals should be confronted to electroclinical and metabolic findings whenever functional surgery is considered.
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PMID:[Contribution of magnetic resonance imaging in 100 cases of refractory partial epilepsy with normal CT scans]. 211 95

Twenty-six patients with medically refractory complex partial seizures had temporal lobectomy after evaluation, which included prolonged scalp EEG recordings, positron emission tomography (PET), MRI, and x-ray CT. PET showed a region of focal interictal temporal hypometabolism corresponding to electrographic localization of seizure onset in 21. Five patients had a region of increased MRI signal intensity on the spin echo image in the region of the EEG focus, 2 had an abnormality ipsilateral to but distinct from the EEG focus, and 1 had bilateral findings. CT was abnormal in 3 cases; 2 had tumors. Three patients had low grade tumors (1 with a normal PET). PET can detect metabolic dysfunction associated with mild pathologic changes in epileptic foci, but increased signal intensity on MRI does not necessarily correlate with the degree of pathologic abnormality. Tumors may be less likely when both CT and MRI are normal.
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PMID:Pathology of temporal lobe foci: correlation with CT, MRI, and PET. 233 Jan 7

Frequency analysis (spectral analysis) of both EEG and evoked potentials were studied prospectively in 52 patients with complex partial seizures to see if such tests could help localize the epileptic focus. Results were examined in line, bar and topographic head display formats. Asymmetries of fast and slow frequency components were identified in 26/52 patients. The existence and localization of such frequency alterations agreed with the overall results of other tests including the routine EEG, ictal EEG records, thiopental-activated EEG, CT or MRI, positron computed tomography (PET), and neuropsychometric testing. Changes were present in all 5 temporal lobe epilepsy cases that had a focal CT or MRI change, and in a majority (17/33) of cases in which the baseline EEG showed no focal slowing. These changes agreed with the preponderance of evidence in lateralizing the epileptic focus. Overall, EEG and evoked potential frequency analysis and topographic mapping do appear to offer data which are useful and complementary to other available test results, especially when a suspected lesion does not already show up as a defect on the CT scan or as a well-defined EEG slow focus. Considerable care needs to be taken to identify artifacts and normal EEG variants when interpreting these tests.
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PMID:Frequency analysis and topographic mapping of EEG and evoked potentials in epilepsy. 244 31

Partial seizures are not uncommon in children. They are classified into two types: simple partial, without impairment of consciousness, and complex partial, with impaired consciousness. For both types, the hallmark is onset of the seizure from a portion of one cerebral hemisphere, as indicated by focal spikes or sharp waves on EEG. The symptoms of simple partial seizures may include focal motor or somatosensory phenomena, special sensory phenomena, autonomic symptoms, or psychic symptoms, and these symptoms may occur alone or they may progress into a complex partial seizure with alteration of consciousness. The complex partial phase may include simply an arrest of ongoing activity with altered awareness and a blank empty stare, or there may also be automatisms, including movements which are gestural, alimentary, mimicking, verbal, or ambulatory. Automatisms are predominantly seen in complex partial seizures arising from temporal areas, but they also may be seen in seizures with extratemporal onset. If the epileptic discharge spreads throughout both cerebral hemispheres, the child will have a secondarily generalized tonic-clonic convulsion. EEG should be performed in any child who is suspected of having partial seizures. If there are focal spikes or sharp waves, then there is strong supportive evidence for a diagnosis of partial seizures in the proper clinical setting. It should be remembered, however, that a normal routine EEG cannot be used to "rule out" a diagnosis of epilepsy in patients who have episodes that sound like simple or complex partial seizures. An underlying etiology may be found in a significant percentage of children with partial seizures. Most of these etiologies are static, and the seizures are the result of a previous cerebral insult, but some patients may have slow-growing gliomas or other mass lesions. MRI or CT is indicated in essentially any child with partial seizures. Medical treatment is based on the idea of using single drugs to maximally tolerated doses, if needed, before beginning with two-drug regimens. If the child continues to have seizures despite aggressive trials of medication, then it is important to consider epilepsy surgery, either temporal lobectomy or other cortical resection. When children are identified as candidates for epilepsy surgery, they should be referred to specialized centers for further testing.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Partial seizures in children: clinical features, medical treatment, and surgical considerations. 249 38

One hundred patients suffering from focal epilepsy with complex partial seizures refractory to medical treatment and showing no abnormality at CT were explored by MRI with an 0.5 Tesla magnet. MRI detected an abnormality in 25 patients with, in 17 of them, good correlation between MRI and clinical as well as electroencephalographic findings. Abnormal morphology and signal was found in 5 patients, with positive CT results on reexamination of previous CT images or on new CT scans in 4 of them. There was a diffuse temporal lobe high-intensity signal in 3 cases and a localized high-intensity signal in 9 cases (temporal lobe 4, occipital lobe 3, frontal lobe 1, fronto-parietal and parietal lobes 1). Thus, in 13% of the cases MRI demonstrated a lesion that had not been detected at CT, and the location of the lesion was concordant with clinical and electroencephalographic data.
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PMID:Magnetic resonance imaging in refractory focal epilepsy with normal CT scans. 251 40

Single photon emission computed tomography (SPECT) was performed 30 minutes and 4 hours after injection of 111 MBq (3 mCi) N-isopropyl-p-(123I) iodoamphetamine (IMP) which was injected 5 minutes after the completion of intravenous bemegride loading. A 31-year-old female with simple partial seizures evolving to complex partial seizures evolving to generalized tonic-clonic convulsive seizures with a history of hospitalization, suffering from low-grade fever, generalized convulsive seizures, and impaired consciousness at the age of 27 years was studied. Angiographic examinations, X-CT, MRI, CSF examinations, and interictal neurological examinations were normal. She suffered from clonic convulsions in her right shoulder and arm, and hallucinations and dysmnesia which were characteristic of temporal lobe epilepsy. More recently she suffered from impaired consciousness once or twice a month. While the controlled IMP-SPECT study was normal, the IMP-SPECT study examined after the activation by intravenous bemegride loading showed the pattern of a regional increased uptake of IMP in the epileptic lesions corresponding with the epileptic symptoms, and a surrounding border of decreased uptake which might be the inhibition of surrounding neuronal activity and metabolism. In conclusion, the bemegride loading IMP-SPECT study could be a potential diagnostic method in patients with seizures whose epileptic lesions were not determined by the conventional methods or in whom the surgical interventions were considered, by reason of its capability to demonstrate positively the epileptic lesions.
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PMID:[Visualization of epileptic lesions using single photon emission computed tomography (SPECT) with N-isopropyl-p-(123I) iodoamphetamine after intravenous loading of bemegride--report of a case]. 278 7

A 35-year-old female patient suffering from epilepsy was examined during status epilepticus with simple partial and complex partial seizures by means of EEG, CT, MRI and ictal SPECT. All these examinations showed focal abnormalities with identical location due to oedema and hypervascularisation; these were, however, absent during examinations carried out before and after status epilepticus.
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PMID:CT, MRI and SPECT neuroimaging in status epilepticus with simple partial and complex partial seizures: case report. 278 9

A patient is described who developed complex partial seizures with secondary generalization 3 years after a severe viral encephalitis with a CT and EEG identified lesion in the left insular cortex and its surrounding structures. When the seizures first occurred CT and MRI as well as repeated interictal conventional EEG recordings were entirely normal. Single photon emission computed tomography (SPECT), however, revealed an area of increased 99mTc-hexamethyl propyleneamine oxime (HMPAO) uptake in the left insular cortex. After anticonvulsive therapy the seizures and the SPECT findings disappeared. 99mTc-HMPAO SPECT is a highly sensitive method for the demonstration of functional alterations in brain tissue. It can improve diagnosis of epilepsy and may provide additional information to monitor anticonvulsive therapy.
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PMID:The development of an epileptogenic focus. A case study with 99mTc-HMPAO SPECT. 278 10

We used positron emission tomography (PET) with [18F]2-deoxyglucose to study cerebellar glucose metabolism (LCMRglu) and the effect of phenytoin (PHT) in 42 patients with complex partial seizures (CPS), and 12 normal controls. Mean +/- SD patient LCMRglu was 6.9 +/- 1.8 mg glucose/100 g/min (left = right), significantly lower than control values of 8.5 +/- 1.8 (left, p less than 0.006), and 8.3 +/- 1.6 (right, p less than 0.02). Only four patients had cerebellar atrophy on CT/MRI; cerebellar LCMRglu in these was 5.5 +/- 1.5 (p = 0.054 vs. total patient sample). Patients with unilateral temporal hypometabolism or EEG foci did not have lateralized cerebellar hypometabolism. Patients receiving phenytoin (PHT) at the time of scan and patients with less than 5 years total PHT exposure had lower LCMRglu, but the differences were not significant. There were weak inverse correlations between PHT level and cerebellar LCMRglu in patients receiving PHT (r = -0.36; 0.05 less than p less than 0.1), as well as between length of illness and LCMRglu (r = -0.22; 0.05 less than p less than 0.1). Patients with complex partial seizures have cerebellar hypometabolism that is bilateral and due only in part to the effect of PHT.
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PMID:Complex partial seizures: cerebellar metabolism. 349 1

Ten patients suffering from drug-resistant complex partial seizures, with EEG abnormalities in the temporal region, were studied by means of non-invasive electrophysiological techniques (video-monitored, 16-channel, prolonged surface and sphenoidal EEG) as well as by imaging techniques (CT, MRI, SPECT and PET). Analysis of interictal and ictal EEG indicated the localization of epileptic activity in one side in eight cases. CT demonstrated focal abnormalities in three, SPECT in five unequivocally (in another four questionably, with the same lateralization as indicated by PET), MRI in eight, and PET in all cases. While only EEG provided specific diagnostic information, the focus definition was consistently good on PET images, poor on CT scans, and generally good but less consistent on MRI.
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PMID:Functional and morphological abnormalities in temporal lobe epilepsy: a comparison of interictal and ictal EEG, CT, MRI, SPECT and PET. 349 1


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