Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0599766 (functional recovery)
 13,441 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 29-yr-old writer presented with seizures and left hemiparesis 8 days post-partum. Studies revealed right parietal hemorrhagic infarction secondary to superior sagittal sinus thrombosis. An anticoagulant was given for clot extension associated with increasing cerebral edema and coma. Inpatient rehabilitation was undertaken for residual left hemiparesis, most severe in the leg. Left arm strength rapidly returned to normal. Significant improvement in left leg strength occurred but was delayed for many months. Intracerebral thrombosis is an uncommon but significant cause of stroke in young adults. It frequently occurs in the puerperium and may be associated with unilateral or bilateral neurologic deficits. Treatment with anticoagulants is controversial because of the risk of hemorrhagic cerebral infarction, but may be beneficial in some cases. Recovery may be delayed for several months pending recanalization of the sinus or the development of collateral circulation. The overall prognosis for neurologic and functional recovery in survivors of intracerebral thrombosis is good.
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PMID:Intracerebral thrombosis. Case report and brief clinical review. 155 32

The effects of NC-1100 on the central nervous system were analyzed behaviorally and electroencephalographically in mice, rabbits and mongolian gerbils, using ifenprodil as a control material. NC-1100 showed potentiating effects on spontaneous locomotor activities and excitatory motor activities induced by methamphetamine, but did not affect the rotarod test, traction test, sleeping time induced by pentobarbital, analgesic test, anticonvulsant test (MES and pentetrazol test), body temperature and group toxicity induced by methamphetamine. Following i.v. injection of NC-1100 to rabbits with chronically implanted electrodes, electroencephalographic properties in spontaneous EEGs such as fast waves with low voltages in the neocortex became distinguished slightly. Seizure discharges produced by stimulation of the dorsal hippocampus were slightly inhibited, but arousal responses produced by stimulation of the midbrain reticular formation or the posterior hypothalamic area were not inhibited. Furthermore, the effects of NC-1100 on functional recovery after transient cerebral ischemia in gerbils were not distinct. Based on these results, NC-1100 was considered to be an agent that improves cerebral metabolism and selectively increases cerebrovascular blood flow with few central nervous actions.
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PMID:[Effects of 1-(3,4-dimethoxyphenyl)-2-(4-diphenylmethylpiperazinyl)ethanol dihydrochloride (NC-1100) on the central nervous system]. 181 67

The authors provide a brief review of the indication criteria of callosotomy for the treatment of medically intractable seizures. They report a surgical case with the classical picture of disconnection (split brain) syndrome, following a two-staged complete callosotomy plus anterior commissurotomy. The disconnection syndrome was more severe on the first 5 days post-operatively, improving quickly after the 11th day; there was almost complete functional recovery and a great reduction in seizure frequency.
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PMID:[Interhemispheric disconnection syndrome following total callosotomy associated to anterior commissurotomy for the treatment of intractable epilepsy: a case report]. 226 94

We report our experience using barbiturate anesthesia for the treatment of refractory status epilepticus. Following a retrospective review of eight patients treated with a variety of barbiturates and dosing regimens, we established a specific protocol employing pentobarbital and evaluated it prospectively in six patients. Among the 14 patients, intravenous barbiturates, when administered with a loading dose followed by continuous infusion, were uniformly effective in aborting seizures and producing a burst-suppression EEG pattern. Other than the pupillary light reflex, most patients lost all brainstem reflexes and motor responses during therapy. Barbiturate-induced hypotension was observed in 9 of the 14 patients, and required treatment with pressors in seven cases. Three patients died early as a consequence of their underlying illness, while three others died late for reasons unrelated to the status itself or to anticonvulsant therapy. The time to recovery of function following anesthesia varied highly, spanning hours to days for return of motor function and days to weeks for cognition. Of the eight survivors, four were left with mild cognitive deficits, one returned to his baseline dementia, and three had residual encephalopathies (severe in two). We conclude that barbiturate anesthesia is an extremely effective therapy for refractory seizures. However, its use necessitates recognition of untoward cardiovascular responses and prolonged intensive care.
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PMID:Barbiturate anesthesia in the treatment of status epilepticus: clinical experience with 14 patients. 327 38

Authors report a case of growing skull fracture, unusual complication of linear skull fracture in infancy and childhood. A review of 132 cases reported in literature is done with an analysis of general characteristics of this lesion. The most common localization is parietal (50%); clinical presentation is represented by development of seizures (54 cases), focal neurological deficit (57 cases) or loss of consciousness (50 cases). In 50% of cases interval time between head injury and first symptom varies between 1 day and 1 year. After the first year of age the 34.4% of patients develop seizures and 59% present loss of consciousness. Among patients from 1 day to 6 months of age, 46% develop seizures, 38% focal neurological deficit and 21% loss of consciousness. Asymptomatic presentation is more common in fronto-parietal or fronto-parieto-occipital localizations. In parieto-occipital and occipital localization (30 cases), 13 patients (43.3%) have seizures, 36.7% a focal neurological deficit and 60% loss of consciousness. In parieto-temporal localization there is a higher probability of seizures (62.5%) and loss of consciousness (62.5%). The long-term follow-up and the functional recovery in patients which undergo surgery is linked to the clinical presentation and early diagnosis.
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PMID:Growing skull fractures of childhood. Case report and review of 132 cases. 409 1

Children with well-localized medically resistant seizures are often referred for surgical therapy. In young children, at least three maturational issues play a significant role in the selection process and long-term outcome. First, the early years are a time of exceptionally rapid brain development leading to dynamic changes in the electroencephalogram and the clinical expression of seizures. Many early-onset seizure presentations are also associated with catastrophic outcomes, developmental arrest, or regression. Second, the immature limbic system may be vulnerable to stresses operating in early life, although the consequences may not become apparent for many years. Third, in comparison to the adult, the child's nervous system typically exhibits superior functional recovery after lesioning, but the process of sparing and recovery is often incomplete. An understanding of how these neurobiologic factors influence developmental outcome will ultimately lead to greater selectivity of candidates for early surgery and to improved long-term prognosis.
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PMID:Neurobiologic considerations in early surgery for epilepsy. 780 85

Although preischemic hyperglycemia is known to aggravate damage due to transient ischemia, it is a matter of controversy whether or not this is a result of the exaggerated acidosis. It has recently been reported that although tissue acidosis of a comparable severity could be induced in normoglycemic dogs by an excessive rise in arterial CO2 tension, short-term functional recovery was improved, rather than compromised. In the present experiments we induced excessive hypercapnia (PaCO2, approximately 300 mm Hg) in normoglycemic rats before inducing forebrain ischemia of 10-min duration. This reduced the brain extracellular pH to values normally encountered in hyperglycemic rats subjected to ischemia. The events induced by hypercapnia clearly enhanced ischemic brain damage, as assessed histologically after 7 days of recovery. We hypothesize that the decisive event was an exaggerated decrease in extra- and intracellular pH and that the results thus demonstrate an adverse effect of acidosis. However, since postischemic seizures did not occur in the hypercapnic ischemic rats, the results also demonstrate that changes in intra-extracellular pH and bicarbonate concentrations modulated ischemic damage in an unexpected way.
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PMID:Acidosis induced by hypercapnia exaggerates ischemic brain damage. 811 21

Although most children with epilepsy have a good prognosis, a small but significant minority have seizures that either do not respond to conventional antiepileptic drugs (AEDs) or have significant adverse reactions to AEDs. Many children may benefit from epilepsy surgery. Surgical treatment of epilepsy is becoming a well-established therapy for infants and young children with severe, medically intractable seizures. As in older children and adults, the presurgical evaluations of possible surgical candidates typically consist of a detailed history, neurologic and neuropsychologic examination, and anatomic and functional neuroimaging. The "gold standard" test, however, is the recording of ictal events by using simultaneous EEG and videomonitoring. Although temporal lobe resection is the most commonly performed surgery in older children and adults, nontemporal lobe resection, corpus callosotomy, and hemispherectomy are commonly performed in younger children. Efficacy of surgery in children compares favorably with results from adult patients. In addition, because the immature brain is more plastic than the mature brain, recovery of function is often greater after surgery in children than in adults. Early surgery in children with intractable epilepsy is recommended.
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PMID:Intractable epilepsy in children. 868 6

Injury to the central nervous system initiates a series of signals that control cell survival and rearrangement, leading to some functional recovery. Using a unilateral model of hypoxic-ischemic brain injury, we report strong induction of inhibin beta A and alpha subunit messenger RNA in several regions of the brain and provide evidence for novel roles for the inhibin/activin family of peptides in modulating neural function. Expression was visualized by in situ hybridization and the beta A subunit was observed as early as 1 h after injury in the dentate gyrus of the non-ligated hemisphere. Strong induction was seen in the hippocampus, piriform cortex and amygdala on the non-ligated hemisphere 24 h after injury. The early induction of inhibin beta A was associated with seizure activity, since administration of the anticonvulsant carbamazepine (8 mg/kg) markedly attenuated the signal. Only background expression was observed for the alpha and beta B subunits at these early time points. A bilateral induction of both beta A and alpha subunit messenger RNA was demonstrated in the meningeal membrane from three to seven days after injury. This second wave was not blocked by carbamazepine. Thirdly, beta A and alpha subunit expression was observed in the infarct from days 5 to 7. However, expression was not co-localized with isolectin B4 staining for reactive microglia or astrocytes, but instead the pattern of distribution strongly suggested that inhibin/activin was induced around microvessels. These data demonstrated three distinct waves of beta A subunit expression following hypoxic-ischemic injury, two of which coincided with alpha subunit expression. The early induction of beta A subunit was seizure related, whereas subsequent co-induction of beta A and alpha subunit suggested involvement in vascular and meningeal reactions. These results suggest specific roles for both activin and inhibin in the central nervous system during recovery from injury.
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PMID:Sequential patterns of inhibin subunit gene expression following hypoxic-ischemic injury in the rat brain. 884 64

Damage to the brain triggers a host of reactive responses in neurons and glia which are seen at sites of focal injury as well as at sites that are at a distance from the injury. Although many of these responses have been studied extensively, the signals that initiate the different responses have not been fully characterized, and it is still not understood how focal injury affects neurons and glia in distant sites. The present review summarizes recent findings that suggest that physiological events that occur at the time of the injury or during the early postlesion period can play an important and variable role in modulating neuronal and glial responses to injury. We focus on the events that occur in the hippocampal formation following unilateral lesions of the entorhinal cortex - a model system that has been used extensively for studies of cellular responses following focal brain injury. This lesion destroys the cells of origin of a massive excitatory projection to the dentate gyrus and hippocampus proper. Over time, the denervated neurons in the hippocampal formation are almost completely reinnervated as a result of local sprouting of systems that survive the lesion. Thus, this model system has been useful for studying cellular responses to both denervation and reinnervation. We summarize the information that this injury triggers physiological events that can strongly modulate gene expression in neurons and glia, including episodes of spreading depression that occur at the time of the injury, seizures that occur during the early postlesion period, the loss of afferent drive which leads to decreases in postsynaptic activity, and the restoration of activity that occurs in conjunction with reinnervation. We describe recent studies which suggest that some of these physiological events occur to a variable extent in different animals, especially the episodes of spreading depression and the recurrent seizures. Thus, the spatial pattern and temporal dynamics of altered gene expression following this "model" experimental injury may vary from animal to animal. The fact that physiological events strongly modulate the reactive changes in gene expression that occur following injury has important implications for understanding the sequelae of injury, and offers new opportunities for experimental and therapeutic interventions that may improve cellular repair, regeneration, and recovery of function.
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PMID:Injury-induced physiological events that may modulate gene expression in neurons and glia. 954 30


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