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At least 847 records · Page 47Linked to original sources
PubMed2002

Partial epilepsy manifesting atonic seizure: report of two cases.

PURPOSE: Atonic seizures are commonly seen in patients with generalized epilepsy but only infrequently in patients with partial epilepsy. Clinically generalized atonic seizures as a partial epilepsy have not been studied in detail with video/EEG monitoring. Here we describe the clinical and physiologic characteristics of atonic seizures due to partial epilepsy and discuss the underlying mechanism. METHODS: Two patients with partial epilepsy manifesting atonic seizures, one with frontal lobe epilepsy (FLE) and the other with parietal lobe epilepsy (PLE), were reported. The long-term video/EEG monitoring, magnetic resonance imaging (MRI), and interictal fluorodeoxyglucose-positron emission tomography (FDG-PET) were investigated in each patient. RESULTS: Paroxysmal diminution of muscle tone mainly involved the axial muscles in both patients. In contrast with the abrupt falls seen in patients with Lennox-Gastaut syndrome, the falls in these patients were slow, taking 2-5 s to fall down. Ictal EEG records showed low-voltage fast activity in the frontocentral area followed by repetitive spikes at the midline frontocentral area in the patient with FLE, and rhythmic spikes in the left central area in the patient with PLE. Interictal FDG-PET disclosed hypometabolic regions consistent with the clinical and EEG findings. CONCLUSIONS: Slow falls might be a feature of atonic seizures in partial epilepsy. Long-lasting atonia in partial epilepsy could be due to either one of the following two possible mechanisms: (a) epileptic activities arising from the negative motor area, of which 50-Hz electric stimulation causes motor inhibition, or (b) sustained atonia with successive electromyogram (EMG) silent periods caused by epileptic discharges arising from the inhibitory area of the primary sensorimotor area.

Adult↗
PubMed2003

Overview: idiopathic generalized epilepsies.

The idiopathic generalized epilepsies (IGEs) are an underemphasized topic. Two reasons for this relative lack of attention are that these epilepsies tend to be more easily controlled than the symptomatic partial and generalized epilepsies, and they are not as common. Because IGE usually arises in childhood or adolescence, these epilepsies may be thought of as a pediatric problem. However, a large number of patients continue to have seizures in adult life. Many exciting developments in understanding the pathophysiology, genetic etiology, and expanded treatment options warrant a reexamination of this important group of the epilepsies. This article reviews the more common IGE syndromes and associated seizure types as the first step in identifying the recent advances in our knowledge of these syndromes.

Adolescent↗
PubMed2001

Clinical correlations of electroencephalographic occipital epileptiform paroxysms in children.

A longitudinal prospective approach was used to investigate clinical correlations of interictal occipital paroxysms with or without fixation-off sensitivity (FOS). Occipital paroxysms were recorded in the electroencephalograms (EEGs) of 76 children with heterogeneous clinical conditions including seizures in 39 patients. Occipital paroxysms with FOS (42 patients ) were only fractionally more frequent than non-FOS (34 patients ) and were not specific of any clinical condition. Although present and FOS-related in all 11 children with benign childhood epilepsies with occipital paroxysms (CEOP), they were also frequently encountered in symptomatic occipital epilepsy. The differentiation of CEOP from other syndromes established on clinical grounds could also be aided by the analysis of background EEG activity that was frequently significantly more abnormal in symptomatic than CEOP. Clinical characteristics and ictal seizure semiology as well as follow-up clearly distinguish two type of idiopathic CEOP syndromes: (1) early onset type or Panayiotopoulos syndrome characterized by excellent prognosis and rare, prolonged nocturnal seizures with tonic deviations of the eyes and vomiting, and (2) late onset or Gastaut type showing a common ictal visual symptomatology, co-occurrence of migraine, diurnal complex partial seizures and less favourable EEG-clinical prognosis.

Adolescent↗
PubMed2003

Positron emission tomography and single photon emission computed tomography in epilepsy care.

Radiopharmaceutical brain imaging is clinically applied in planning resective epilepsy surgery. Cerebral sites of seizure generation-propagation are highly associated with regions of hyperperfusion during seizures, and with glucose hypometabolism interictally. For surgical planning in epilepsy, the functional imaging modalities currently established are ictal single photon emission computed tomography (SPECT) with [(99m)Tc]technetium-hexamethylpropyleneamine oxime (HMPAO) or with [(99m)Tc]technetium-ethylene cysteine dimer (ECD), and interictal positron emission tomography (PET) with 2-[(18)F]fluoro-2-deoxyglucose (FDG). Ictal SPECT and interictal FDG PET can be used in presurgical epilepsy evaluations to reliably: (1) determine the side of anterior temporal lobectomy, and in children the area of multilobar resection, without intracranial electroencephalographic recording of seizures; (2) select high-probability sites of intracranial electrode placement for recording ictal onsets; and, (3) determine the prognosis for complete seizure control following anterior temporal lobe resection. Coregistration of a patient's structural (magnetic resonance) and functional images, and statistical comparison of a patient's data with a normal data set, can increase the sensitivity and specificity of these SPECT and PET applications to the presurgical evaluation.

Brain↗
PubMed2002

Eating epilepsy characterized by periodic spasms.

Seizures induced by eating are generally considered rare. Eating epilepsy is a kind of reflex epilepsy. We report two patients aged 11 and 16, with seizures provoked by eating. The eating-provoked seizures in both patients were a series of tonic spasms. Both ictal EEGs showed a periodic pattern characterized by diffuse high voltage slow wave. These findings were consistent with periodic spasms described by Gobbi et al. The ECD were widely distributed in both patients, although that of Patient 1 was partially clustered in the right frontal region. This is the first report of patients with periodic spasms induced by eating.

Adolescent↗
PubMed1989

[Neurophysiologic principles and clinical value of post-convulsive serum prolactin determination in epileptic seizure].

Measurement of postictal serum-prolactin concentrations in epileptic seizures in order to distinguish them from psychogenic seizures is at present used only rarely and non-systematically. Studies of 209 Grand mal seizures, 232 complex-partial seizures, 102 simple-partial seizures and 15 generalized seizures published between 1980 and 1987 differ in their standards of seizure classification as well as in their criteria for evaluating increases in postictal serum-prolactin concentrations. A significant rise was seen in 88% of Grand mal seizures, 78% of complex-partial seizures, 22% of simple-partial seizures and 6% of generalized seizures. The discussion of both these general findings and our own investigations is based on the presentation of neuroanatomical and neurophysiological principles of prolactin secretion.

Adult↗
PubMed1989

[Relation of familial epilepsy predisposition in the etiology of secondary generalized epilepsies in childhood].

Taking into account the familial predisposition with regard to cerebral convulsions and the electroencephalographic and cranial computer-tomographic findings in 307 children and adolescents with epilepsy, the role of genetic factors in the etiology of secondary generalized epilepsy was investigated in the present study. The patients with primary generalized epilepsy displayed a positive family history with regard to cerebral convulsions more frequently than those with secondary generalized and partial epilepsy. However, this difference cannot be statistically verified. One quarter of the 27 patients with secondary generalized epilepsy which display familial predisposition to epilepsy in the history were children with West- and Lennox-Gastaut-Syndrome. It was remarkable that there was no significant difference between the patients with normal and pathological CCT findings with regard to the incidence of familial predisposition. This applied in the same way even in a comparison within the subpopulations of the different epilepsy forms. These results underscore the significance of genetic predisposition not only in manifestation of primary generalized epilepsy, but also with regard to epilepsy forms with demonstrable morphological organic lesions in the brain. They thus support the opinion held hitherto that the manifestation of epileptic attacks results from the interaction of endogenous genetic factors and exogenous damage mechanisms.

Brain Damage, Chronic↗
PubMed1984

[Complex focal seizures: studies based on the cranial computer tomogram, clinical aspects and longitudinal EEG studies].

Investigations were made on 113 patients suffering from CFS. Definite or highly probable diagnosis often was set up by anamnesis, observation and clinical findings. In 93.8% the EEG was abnormal (seizure patterns 35.8%, focal abnormalities 5 8.4%, focal seizure discharges 14.1%). CCT showed pathological findings only in 58.4%. It was unavoidable in the diagnosis of tumors which were rarely found (8.8%). It showed localised brain lesions of various etiology in 31.8%, seldom perinatal brain damage or unspecific hydrocephali (17.7%). It is concluded that anamnesis, observation, clinical findings and EEG are the primary diagnostic steps in suspected CFS. EEG is the best for the patients survey, CCT, even if mostly indispensable because of its high evidence in morphological brain impairment often is of little or no use in he diagnosis of CFS, EEG and CCT are unavoidable in medical certificates.

Brain Diseases↗
PubMedDate not supplied

[Serum prolactin after cerebral and psychogenic seizures in childhood and adolescence--an additional useful method for differentiating the two forms of seizure].

Prolactin levels were measured immediately after the seizure in some, and 15 to 20 minutes later in all of 67 children aged between 6 months and 17 years. Values were determined after grand mal, complex partial and petit mal seizures and psychogen seizures. A more than 2 to 3 fold prolactin increase over the baseline value occurred almost always after grand mal and regularly after complex partial seizures. No hyperprolactinaemia was observed after petit mal seizures. Also after psychogenic seizures a rise in serum prolactin failed. The neurophysiological basis underlying this phenomenon is a decrease of gaba- und dopaminergic systems associated with the seizure. The described method is useful in the differential diagnosis of epileptogenic versus psychogenic seizures.

Adolescent↗
PubMedDate not supplied

[Prolactin--a diagnostic aid in cerebral seizures].

Prolactin concentration was measured 20 minutes after each seizure in 8 patients with grand mal, 2 patients with complex partial seizures and 5 patients with petit mal seizures. In the group of grand mal and complex partial seizures serum prolactin showed markedly increased levels. After petit mal seizures there was no change in serum prolactin concentration. The possible causes for changes in serum prolactin after a seizure in children are discussed.

Adolescent↗
PubMed1985

Morphological aspects of aetiology and the course of infantile spasms (West-syndrome).

The present study using the results of the postmortem examination of twenty-four children, who had infantile spasms (West-Syndrome), gives a view of the aetiology and course of the West-Syndrome. According to the time of occurrence of the lesions three groups could be established: one group of six cases with only embryofetal lesions, one group of ten cases with combined embryofetal and peri/postnatal lesions and one group of eight cases with only peri/postnatal lesions. It is significant, that the time of onset of infantile spasms depends on time of manifestation of lesions. In the groups with combined embryofetal and peri/postnatal lesions the seizures were manifested at the same time as in the cases with isolated embryofetal lesions. Even in the group with combined lesions, microdysgenesis was interpreted as being embryofetal. These embryofetal lesions, as opposed to the peri/postnatal lesions thus appear to dominate and thereby to be pathoplastic. From this correlation two thirds of the cases of infantile spasms can be regarded as fetal epilepsies. The question is open if the infantile spasms which are manifested later on and develop mostly a Lennox-Syndrome indeed should be classified as a separate group together with the isolated peri/postnatal lesions.

Adolescent↗