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Biomedical subjects

D Luciano

Publications and source records attributed to D Luciano.

29 records · Page 2Linked to original sources
PubMed1993

Nonepileptic seizures during apparent sleep.

We report 12 patients with nonepileptic seizures (NESs) documented with video-electroencephalographic monitoring during apparent sleep. There were 7 females and 5 males, ages 11 to 67 years (mean, 33 yr). In all patients there was a well-organized posterior alpha rhythm present immediately before onset of clinical changes despite the appearance of sleep. Patients later "confirmed" that these attacks occurred during sleep. Features of these episodes were typical of NESs and none were associated with ictal or postictal electroencephalographic changes other than muscle and movement artifact. Provocative testing with suggestion confirmed the nonepileptic nature of these episodes in 9 patients. Three patients had epileptiform discharges during prolonged interictal recordings and 1 had a documented complex partial seizure. Our findings indicate that reports of seizures during sleep are not uncommon among patients with NESs.

Adolescent↗
PubMed1993

Multiple subpial cortical transections for the control of intractable epilepsy in exquisite cortex.

In 5 cases suffering from intractable seizures and ictal onset in exquisite (primary somatosensory or language related) cortex, surgical therapy has been done consisting wholly or in part of multiple subpial transections. In two cases with involvement of the primary somatosensory cortex, good seizure control without detectable neurological deficit was achieved. In the other three cases with involvement of the language cortex, deficits were minimal and cleared with time. Patients became seizure-free.

Adolescent↗
PubMed1993

Nonepileptic seizures and childhood sexual and physical abuse.

Nonepileptic seizures (NES) must be distinguished from epilepsy to avoid the adverse effects of unnecessary antiepileptic drugs and to initiate appropriate psychiatric treatment. A higher frequency of prior sexual abuse has been suspected in NES, although no prospective controlled study has compared patients with NES and epilepsy. A series of patients with conversion disorder presenting as epilepsy and 140 patients with complex partial epilepsy (CPE) without evidence of conversion were selected from a series of consecutive admissions to a comprehensive epilepsy center. The groups did not differ with respect to age, years of education, race, or marital status, but the percentage of women was greater in the conversion NES group (73.2%) than in the CPE control group (50.7%; p < 0.002). The frequency of a history of sexual or physical abuse was greater in the NES group (32.4%) than in the CPE controls (8.6%; p < 0.000). Severity of sexual but not physical abuse was significantly greater in the NES group relative to controls (p < 0.05). There was a trend for a closer relationship of the perpetrator of sexual abuse to the victim among the NES patients compared with CPE controls (p < 0.1). These results support the impression that childhood abuse is more common among patients with conversion NES than with epilepsy, and suggests that in some cases childhood abuse may be a contributory pathogenetic factor.

Adult↗
PubMed1993

Crying seizures.

We report seven patients with crying during video-EEG-documented simple or complex partial seizures. During simple partial seizures, crying occurred with or without appropriate affect. Crying occurred postictally in two patients and was associated with persistent spiking in one of them. Six patients had ictal activity in the nondominant hemisphere, maximal in the anteromesial temporal region in five and in the mesial frontal region in another. These cases support theories proposing a lateralization of emotion, with right hemisphere dominance for negative affective states.

Adult↗
PubMed1993

Partial seizures of frontal and temporal origin.

The majority of medically refractory partial epilepsies arise in the frontal and temporal lobes and represent a major challenge to the neurologist. The phenomenology of seizures from these regions is diverse and fascinating, at times lying on the border of many medical specialties. An appreciation of the wealth of potential phenomena can lead to more accurate diagnosis and treatment.

Diagnosis, Differential↗
PubMed1975

Aggression and social experience in domesticated rats.

Small colonies of rats were established, using adult animals that had either received continuous social experience or had been isolated since weaning. Unfamiliar "intruder" rats--with or without postweaning social experience--were exposed individually to the colonies for a 21-hr. period. Behavioral observations and an assessment of the intruder's physical condition indicated that serious fighting, physical injuries, and large weight losses occurred only when an isolation-reared intruder was placed into a colony of socially experienced rats. These results demonstrate that aggression is a joint function of the rearing history of both the colony and the intruder and that social experience plays an important role in the behavioral development of this species.

Aggression↗
PubMedDate not supplied

Provocation of nonepileptic seizures by suggestion in a general seizure population.

Nonepileptic seizures (NES) are common and are often diagnosed at epilepsy centers by video-EEG recording of both spontaneous and suggestion-induced episodes, but no study has evaluated provocative testing in a general seizure population. We studied consecutive patients with a tentative diagnosis of epilepsy using saline provocation during video-EEG recording, suggesting that this could produce a typical seizure. Of 52 patients, 40% had no response, 23% had responses unlike their seizures, and 37% had typical episodes (positive test). Patients whose usual episodes resembled complex partial seizures (CPS) were more likely to have NES than were patients with a history of generalized tonic-clonic seizures (GTC). Of patients with positive provocations, the primary physician predicted NES in 68% of cases. This preliminary study suggests that NES are frequent in a general neurology setting, and that saline provocation is a sensitive method of identifying NES.

Adult↗