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Biomedical subjects

W A Hauser

Publications and source records attributed to W A Hauser.

At least 163 records · Page 9Linked to original sources
PubMed1983

Status epilepticus: frequency, etiology, and neurological sequelae.

Status epilepticus is associated with high mortality and is a predictor of poor neurological outcome; yet the contribution of prolonged seizures to mortality and the causal sequence for neurological damage remain unclear. Many cases of status epilepticus are precipitated by illnesses that themselves are associated with increased mortality and morbidity. In studies of children, status epilepticus appears to be no better a predictor of an adverse outcome than is any seizure disorder starting at a similar age. Status epilepticus is a condition in which fast and definitive medical intervention is warranted. Random assignment to treatment groups is difficult. Evaluation of the effect of duration of seizures is also difficult, because those patients responding promptly to treatment may be quite a different population than those not responding. The study of cases of "nonconvulsive" status may provide information regarding the effect of these continuing ictal brain discharges, which can be evaluated without the confounding effects of concomitant metabolic (e.g., anoxic, pH, electrolyte) disturbances that accompany most cases of generalized status epilepticus. It is possible that appropriately designed prospective studies of status epilepticus and/or case-control studies will assist in evaluating the contribution of a prolonged seizure per se over and above that associated with preexisting or concurrent illness.

Adolescent↗
PubMed1982

Seizure recurrence after a first unprovoked seizure.

We studied 244 patients (of all ages) who presented with a first unprovoked seizure and were followed for a median of 22 months in order to ascertain the risk of subsequent seizures. The cumulative risks of recurrence were 16 per cent at 12 months, 21 per cent at 24 months, and 27 per cent at 36 months after the initial seizure. The risk of recurrence in patients with a history of prior neurologic insult was 34 per cent; all recurrences in this group were observed within the first 20 months. Only 17 per cent of patients without such a history (classified as idiopathic) had a recurrence by 20 months; recurrence in this group was 26 per cent by 36 months. Patients with no recurrence for 36 months did not have a recurrence after that time. Among idiopathic cases the risk of recurrence was increased in patients with generalized spike-wave electroencephalograms (50 per cent at 18 months) and in those who had a sibling with seizures (35 per cent at four months). Age at first seizure, sex, seizure type, onset with status epilepticus, or abnormality on neurologic examination did not affect the risk of recurrence.

Adult↗
PubMed1982

The risks of seizure disorders among relatives of patients with childhood onset epilepsy.

The risk of seizure disorders in relatives of patients with childhood-onset epilepsy was evaluated by a cohort study of the other descendants of parents of probands with epilepsy. The probands comprised 196 cases of idiopathic epilepsy and 60 individuals with isolated idiopathic seizures diagnosed among residents of Rochester, Minnesota, from 1935 to 1974. The risk of epilepsy through age 20 among the siblings and children of probands was 4.1%, three times the rate in the general Rochester population. The risk of any type of seizure (including isolated seizures, febrile convulsions, or seizures due to an acute cerebral insult) through age 20 was 11% in siblings and 13.1% in children of probands. The risks of seizure disorders among the nieces and nephews of probands were not greater than the general population rates.

Adolescent↗
PubMed1980

Neurologic prognosis after cardiopulmonary arrest: II. Level of consciousness.

Sixty-three patients with isolated global anoxic-ischemic injury were prospectively evaluated after cardiopulmonary arrest (CPA); 25 (40%) survived, 16 to an excellent recovery, 8 to a good recovery, and 1 with severe deficits. Forty-six percent of the patients achieved full alertness, and only patients who did so survived. Seventy-five percent of patients arousable or initially alert (level of consciousness [LOC] greater than or equal to 4) survived, all but two with excellent outcomes. Twenty-eight percent of patients initially in deep coma (LOC less than or equal to 3) survived, all with excellent or good outcomes. Ninety percent of patients who became fully alert did so within 72 hours. The likelihood of alerting is correlated with the LOC at given intervals after CPA. Reliable predictions of survival and outcome can often be based upon LOC alone within 2 days after CPA.

Aged↗
PubMed1980

Neurologic prognosis after cardiopulmonary arrest: III. Seizure activity.

Nineteen (30%) of 63 adult survivors of cardiopulmonary arrest had seizures after admission to the hospital. Eleven of 19 had more than one type of seizure. Myoclonic seizures began within 12 hours of the arrest in eight patients, and after 3 or more days in four patients. Only two (17%) patients with myoclonic seizures survived. Partial seizures usually began within 12 hours of the arrest and were controllable with anticonvulsants; 4 of 12 patients survived. Two of four patients with generalized tonic-clonic seizures survived; one of four with "shivering" lived. Overall, patients with seizures had a survival rate of 32% (6 of 19), compared with 43% for patients without seizures. None of the survivors had recurrent seizures within 6 months after hospital admission.

Adult↗
PubMed1979

Remission of seizures and relapse in patients with epilepsy.

In a longitudinal study of patients with epilepsy in Rochester, Minnesota, we found that the probability of being in remission (at least 5 consecutive years seizure-free, and continuing) at 20 years after diagnosis was 70%. The rates for remission we encountered were generally higher than those previously reported. We believe that the better prognosis in our series results from inclusion of all incidence cases in a defined population, beginning at the initial diagnosis of epilepsy. Prognosis for remission of epilepsy is poor in patients with associated neurologic dysfunction identified from birth. Patients with idiopathic seizures and survivors of postnatally acquired epilepsy have better prospects for eventual remission. The probability of remission is highest in patients with generalized-onset seizures diagnosed before 10 years of age. Prognosis is less favorable for those with partial complex seizures and adult-onset epilepsy.

Adolescent↗
PubMed1979

The risk of epilepsy following febrile convulsions.

A cohort of 666 children who had convulsions with fever were followed to determine the risks of subsequent epilepsy. High risks were found in children with preexisting cerebral palsy or mental retardation. Other major risk factors were atypical features of the febrile convulsions (such as focal seizures) and duration of febrile seizures for 10 minuts or more. The risk of developing epilepsy by age 20 was about 6 percent for all children who had experienced febrile convulsions. However, this risk figure consisted of a combination of 2.5 percent of children without prior neurologic disorder or atypical or prolonged seizures, and 17 percent of those with such complications.

Age Factors↗
PubMed1978

Neuroanatomical and electroencephalographic correlations in Sanfilippo syndrome, type A.

Waking and all-night-sleeping electroencephalographic recordings were obtained on a boy with Sanfilippo disease, type A. The most striking abnormalities were noted during sleep and included (1) lack of progression through normal sleep stages, (2) absence of vertex waves and normal sleep spindles, (3) inability to stage sleep by the usual criteria, and (4) an unusual alteration of low-amplitude (12 to 15 Hz) activity with generalized delta frequencies. Subsequently, neuropathological examination was performed. The electrophysiological phenomena may be correlated with severe cortical involvement.

Basal Ganglia↗
PubMed1976

Seizure disorders in offspring of parents with a history of seizures - a maternal-paternal difference?

If the patterns of seizure disorders in parents and offspring could be assessed accurately, some insight might be gained into the relative role of genetic and environmental factors in the development of convulsive disorders. In this study 908 children born in a Rochester, Minnesota hospital from 1922 through 1972 whose mother or father had a verified and classified diagnosis of seizure have been followed from birth for evidence of any convulsive episode or seizure disorder. The observed numbers of various types of convulsions in the offspring are compared to the expected the number based on local age-specific incidence rates. The outstanding finding was that a higher than expected number of children whose mothers had epilepsy also suffered from seizures (epilepsy or febrile convulsions), whereas no such increase was detected among the children of affected fathers.

Age Factors↗
PubMed1976

Ischemic heart disease in patients with epilepsy.

It has been suggested that patients with epilepsy and particularly those on long-term anticonvulsant medication may have a lower than expected risk of ischemic heart disease. The records of a cohort of patients with epilepsy in Rochester, Minnesota were reviewed to ascertain their rates of occurrence of ischemic heart disease. The results did not show any relative decrease in the incidence or mortality rates due to ischemic heart disease among men or women with epilepsy. The numbers of ischemic heart disease incidence and mortality cases were 25 and 15, respectively, relative to corresponding expected values of 15.0 and 15.7 new and fatal events. The use of anticonvulsant medications did not appear to influence the rates of ischemic heart disease among the patients with epilepsy. Subgroups of the epilepsy patients, by etiology and types of epilepsy, were not found to account for a disproportionate share of the ischemic heart disease. The survivorship of epilepsy patients after the initial manifestations of ischemic heart disease was comparable to that expected among all ischemic heart disease patients.

Adult↗