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Biomedical subjects

E Faught

Publications and source records attributed to E Faught.

At least 91 records · Page 5Linked to original sources
PubMed1991

Cortical dysplasia in temporal lobe epilepsy: magnetic resonance imaging correlations.

Cortical dysplasia has been documented in histological specimens surgically removed for treatment of refractory temporal lobe epilepsy. We studied 10 patients with cortical dysplasia and complex partial seizures who underwent temporal lobectomy. Magnetic resonance imaging revealed abnormalities in 5 of the patients who had microscopically detectable major abnormalities. Magnetic resonance imaging revealed an abnormal cortical-white matter architectonic pattern in 2 patients with moderate cortical dysplasia. In the remaining 3 patients, magnetic resonance imaging findings were unremarkable. These observations suggest that magnetic resonance imaging is sensitive in the detection of certain dysplastic lesions in temporal lobe epilepsy. Preoperative identification of these abnormalities by magnetic resonance imaging may permit early and optimal surgical treatment in patients with refractory epilepsy.

Adolescent↗
PubMed1991

Lateralization of epileptic foci by magnetic resonance imaging in temporal lobe epilepsy.

A retrospective single-blind study was carried out to assess the reliability of magnetic resonance imaging (MRI) for determining lateralization of the electrographic focus in 45 patients with intractable temporal lobe epilepsy. With strictly defined MRI diagnostic criteria, the electroencephalographic (EEG) focus was correctly lateralized in 86% of patients. Excluding patients with structural lesions, the criteria provided for correct lateralization of the epileptogenic focus in 78% and false lateralization in 5%. Hippocampal atrophy on T1-weighted images and increased signal intensity from mesial structures on T2-weighted scans were highly reliable for lateralization. Postoperative outcome did not differ between the patients with normal and those with abnormal findings on MRI, but the group sample was inadequate to assess the issue of surgical outcome. These findings suggest that with appropriate techniques and strictly defined diagnostic criteria, MRI can provide reliable seizure lateralization in patients with intractable temporal lobe epilepsy.

Electroencephalography↗
PubMed1990

Surgical treatment of epilepsy: initial results based upon epidural electroencephalographic recordings.

We describe our initial results in 50 consecutive patients who had investigation for possible surgical treatment of intractable focal epilepsy. Forty-three were investigated using intracranial epidural or foramen ovale electrodes. Forty-five had cortical resection (43 temporal, one frontal, and one parietal). Thirty-two patients who had resection have been followed up for 6 months to 4 years, and 29 (90%) have had good results. Our findings suggest that epidural recordings are valuable in patients with epilepsy who are being considered for surgical resection. They offer an alternative to depth intracerebral investigations in the majority of patients.

Adolescent↗
PubMed1989

Seizures after primary intracerebral hemorrhage.

We followed 123 patients with primary intracerebral hemorrhage (ICH), defined as bleeding without known precipitating cause except hypertension, for an average of 4.6 years or until death in order to determine the incidence, prevalence, and type of epileptic seizures. Twenty-five percent had seizures. In one-half of these, the seizures began within 24 hours of the hemorrhage. Survival table analysis predicted a potential cumulative seizure incidence of 50%, had all patients survived 5 years. Seizure incidence was high with bleeding into lobar cortical structures (54%), low with basal ganglionic hemorrhages (19%), and zero with thalamic hemorrhages. Within the basal ganglia, caudate involvement predicted seizures; within the cortex, temporal or parietal involvement predicted seizures. Although seizure incidence was high, prevalence of chronic epilepsy was much lower: 13% in 30-day to 2-year survivors and 6.5% in 2- to 5-year survivors. Seizure incidence is higher than previously reported after ICH because small lobar hemorrhages are the most epileptogenic and are now easily recognized with computed tomography.

Adult↗
PubMed1988

Patterns of EEG frequency content during experimental transient ischaemia in subhuman primates.

EEGs were recorded with depth electrodes in 8 monkeys undergoing transient middle cerebral artery ligation. Electrodes measured EEG, cerebral blood flow (CBF), and tissue oxygen simultaneously during and after occlusion. An EEG frequency analysis was performed. Electrode sites were examined microscopically, and infarction size, tissue vacuolization index, and neuronal morphology were described quantitatively. Serial neurological examinations were performed. Two patterns of EEG frequency change were delineated, dependent upon degree of ischaemia. Mild ischaemia, as indicated by less severe clinical deficits, higher CBF during occlusion, and minor pathological changes was associated with large increases in slow EEG activity and decreases in fast EEG activity during occlusion, with recovery of slow activities to baseline, but continued suppression of fast activities 24 h later. Severe ischaemia was associated with suppression of both fast and slow frequencies during occlusion, with slow activities returning to baseline and fast activities remaining suppressed 24 h later. The best quantitative EEG indicator of severity of ischaemia was suppression of slow wave activity during occlusion. The best EEG indicator that an ischaemic event had occurred 24 h previously was continued suppression of fast EEG activities. These data may be helpful in the design of EEG frequency analysis studies for monitoring the time course of human cerebral ischaemia and for retrospective diagnosis of transient ischaemic attacks (TIAs).

Animals↗
PubMed1986

Self-induced photosensitive absence seizures with ictal pleasure.

A 32-year-old woman was treated for self-induced photosensitive seizures that included strong subjective feelings of pleasure and masturbatory behavior. Electroencephalograms demonstrated generalized polyphasic spike-wave discharges in response to stroboscopic stimulation. The behavioral sequences leading to seizures and the effects of treatment can be explained in terms of operant conditioning theory. Data from human and animal studies indicate a correlation between ictal pleasure or reinforcement and the subject's ability to induce seizures. Ictal pleasure is rare in spontaneous seizures that are not under the control of the patient.

Adult↗
PubMed1986

Methaqualone withdrawal syndrome with photoparoxysmal responses and high-amplitude visual evoked potentials.

Methaqualone is a sedative hypnotic that is often abused. Tolerance and habituation may develop, and the withdrawal syndrome may include seizures. In the patient studied, methaqualone withdrawal was manifested by myoclonic and tonic-clonic seizures, an EEG photoparoxysmal response (PPR), and a high-amplitude visual evoked potential (VEP) to pattern-reversal stimuli. The EEG and VEP returned to normal after resolution of the withdrawal state. Substance withdrawal should be considered in the differential diagnosis of PPR or of an unusually high-amplitude VEP in a person with no previous history of epilepsy. Disappearance of these phenomena may be a useful indicator of the end of the withdrawal state.

Adult↗
PubMed1984

Pattern-reversal visual evoked potentials in photosensitive epilepsy.

VEPs to checkerboard pattern-reversal were recorded from 18 epileptic patients who had EEG photoparoxysmal responses to stroboscopic light. Patients were grouped according to whether seizures were precipitated by environmental light stimuli, or television viewing. Longitudinal studies were conducted on 8 patients treated with valproic acid. We concluded the following: (1) Latency of the major positive peak (P2) of the pattern-reversal VEP was shorter among photosensitive patients than among normal controls. This was especially true of television-sensitive patients. (2) Valproic acid, when effective in controlling seizures, lengthened the P2 latency and decreased VEP amplitude. Studies of drug effects on VEPs may help to elucidate neurochemical mechanisms of the visual cortex. (3) Because of overlap of values with normals, VEP measurements are not at present very sensitive in the diagnosis of photosensitivity. However, longitudinal studies in individuals parallel clinical changes and may be useful as objective measures of improvement.

Adolescent↗
PubMed1983

Late-onset variant of Huntington's chorea.

We identified a large Georgia kinship in which a hereditary autosomal dominant chorea appeared at an average age of 65 years, much later than usual for Huntington's chorea. Progression was slow. Dementia was not an obvious initial feature. Family members denied that affected persons became demented, and those affected cognitively intact with bedside testing. However, deficits of memory were apparent on formal psychologic testing. In the propositus' generation, five of 12 siblings were affected during their 60s. Of 23 persons in a younger generation, aged 30 to 60 years, none was yet affected. A number of variants of Huntington's chorea have been proposed. In elderly patients without obvious dementia, psychologic testing may be of diagnostic importance, revealing characteristic memory deficits. When the disorder consistently occurs at an advanced age and progresses slowly, the implications for the family may be less grave than with Huntington's chorea of earlier onset.

Age Factors↗
PubMed1979

Cerebral complications of angiography for transient ischemia and stroke: prediction of risk.

We examined the records of 147 consecutive patients studied by femoral catheterization to identify factors contributing to angiographic risk in cerebrovascular disease. Cerebral complications occurred in 12.2 percent and were permanent in 5.2 percent. Computer-assisted multivariate analysis of 21 possible risk factors was done. Two of these risk factors correlated strongly with increased risk: number of previous transient ischemic attacks (TIAs) (p less than 0.001), and the presence of arterial stenosis of greater than 90 percent (p less than 0.03). Risk factors of marginal significance were: diabetes, female sex, and number of selective injections. A discriminant function for estimation of risk was derived: D = [8 X number of TIAs] + [6 x number of arteries catheterized] + [14 if diabetic, 0 if not] + [11 if female, 0 if male]. When D was greater than 55, 77 percent of patients had a complication. When D was less than 55, 98 percent of patients had no complication. Unfortunately, patients in whom the study is most indicated tend to be those at greatest risk.

Analysis of Variance↗
PubMedDate not supplied

Electroencephalographic correlations of extracranial and epidural electrodes in temporal lobe epilepsy.

Thirty patients with medically intractable complex partial seizures of temporal lobe origin, but no structural abnormalities on neuroradiologic investigations, had both extracranial (scalp) and epidural EEG recordings. Fifteen patients (50%) had localized, unilateral, ictal, scalp EEGs, but one of these had bilateral independent temporal seizure onset according to epidural recordings. Of the 15 patients in whom scalp EEGs were non-localizing, 12 had well-localized epidural ictal EEGs, and 3 had multifocal or bilateral independent temporal ictal recordings. Epidural recordings provide information for determination of site of onset of temporal lobe seizures in selected patients.

Adult↗
PubMedDate not supplied

Antiepileptic drug treatment after temporal lobe epilepsy surgery: a randomized study comparing carbamazepine and polytherapy.

Temporal lobectomy is an effective treatment in selected patients with medically intractable temporal lobe epilepsy (TLE). Postoperative antiepileptic drug (AED) treatment guidelines have not been established, and patients are often treated with polytherapy postoperatively. We prospectively randomized 40 patients undergoing temporal lobectomy to monotherapy with carbamazepine (CBZ, 20) or to continuation of their presurgical polytherapy (20) to assess the efficacy and safety of each regimen during the first year after operation. No significant differences between groups were noted with respect to seizure recurrence rate and type or time of recurrence. Patients in the polytherapy group had a 30% incidence of drug-related side effects as compared with only 10% in the CBZ group. These results suggest that after temporal lobectomy for intractable epilepsy, patients can be safely treated with CBZ monotherapy and that treatment with multiple AEDs is not necessary.

Adolescent↗