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PubMed1998

Characteristics and treatment of temporal lobe epilepsy with a history of complicated febrile convulsion.

This study aimed to examine the close correlation between complicated febrile convulsions (CFC) and medial temporal lobe epilepsy and to delineate characteristics of temporal lobe epilepsy with CFC. Patients with temporal lobe epilepsy were divided into those with a prior episode of CFC (n=52), those with febrile convulsions other than CFC, and those without either (n=345). Clinical constellations, neuroimaging, drug resistance, and effects of temporal lobectomy of the three groups were compared. A close association between CFC and temporal lobe epilepsy was confirmed. The salient features of temporal lobe epilepsy with CFC were early age at onset of habitual seizures (about 10 years), the predominance of autonomic auras, and a high incidence of MRI evidence of unilateral medial temporal sclerosis. Patients with temporal lobe epilepsy with prior CFC had an excellent outcome after surgery, by contrast with an unfavourable response to drug therapy. The surgical results were discouraging in patients with temporal lobe epilepsy without history of any febrile convulsions and without solid brain tumours. These results indicate surgical intervention as the choice of therapy in a substantial number of patients with temporal lobe epilepsy with a history of CFC.

Adult↗
PubMed1982

Synergism of hyperoxia and high helium pressures in the causation of convulsions.

Hyperoxia beyond 1.8 ATA results in a striking reduction of high-pressure neurological syndrome (HPNS) type I convulsion threshold pressures but is without measurable effect on type II convulsions. The synergism is partially or completely reversed by increasing alveolar or tissue CO2 levels. High total pressures (PI) result in striking reductions in the duration of hyperoxic exposure preceding seizure onset (tc). The interaction of hyperoxia and high pressure gives rise to three zones on the PO2-Pt plane. In zone I, Pt less than 30 ATA, the duration of hyperoxia prior to convulsion onset is given by the equation PO2 -- PO2 lim = K/(tc -- tc lim), where PO2 lim and tc lim both decrease with increasing total pressure. Zone II, Pt = 30-50 ATA and PO2 1.8-2.3 ATA, is characterized by a sharp drop in tc, as Pt is increased beyond 30 ATA, to a value near 15 min that is constant within the PO2 limits given. In zone III, Pt greater than 50 ATA and PO2 greater than 0.2 ATA, tc is of the order of 2 min, and the seizures are essentially HPNS seizures only slightly modified by hyperoxia. The data are interpreted as suggesting that zone I represents hyperoxic seizures facilitated by high pressures, whereas zone II represents HPNS type I seizures facilitated by hyperoxia.

Animals↗
PubMed1976

Effect of convulsions and anticonvulsive drugs on cerebrospinal fluid cyclic AMP in rabbits.

Cyclic adenosine 3',5'-monophosphate (cAMP) concentration and aspartate amino transferase (ASAT or GOT) activity were measured from cerebrospinal fluid (CSF) of rabbits before and after electrically induced convulsions. The convulsions caused a significant increase in CSF cAMP concentration. The treatment with phenobarbital, diphenylhydantoin and carbamazepine for 7 days decreased the basal cAMP values in CSF and partly inhibited the rise after the convulsions. The alterations in ASAT activity were parallel, but less striking. The present results suggest the involvement of cAMP in epileptic discharge and in the mechanism of action of anticonvulsants.

Animals↗
PubMed1979

Effects of taurine, glycine and GABA on convulsions produced by strychnine in the rabbit.

The action of intravenously injected taurine, glycine and GABA has been tested on convulsions induced by strychnine using electroencephalographic and electromyographic recordings. The dose of strychnine necessary to produce a generalized tonic-clonic seizure was 0.55 +/- 0.15 mg/kg intravenously for rabbits pretreated with taurine, which was significantly higher than for control animals (0.38 +/- 0.13 mg/kg). After pretreatment with glycine, the strychnine dose required to evoke convulsions (0.51 +/- 0.22 mg/kg) was also higher than the control values, but the difference was statistically not significant. The convulsive dose of strychnine in animals pretreated with GABA was slightly but not significantly lower than in control animals (0.31 +/- 0.13 mg/kg). These results suggest that taurine is the most effective amino acid to protect rabbits from seizures induced by strychnine.

Animals↗
PubMed1984

Effect of prostaglandin synthetase inhibitors on experimentally induced convulsions in rats.

To investigate the relationship of prostaglandins (PGs) to seizure induction, the effects of six PG synthetase inhibitors on convulsions induced by flurothyl, picrotoxin, pentetrazol (PTZ), electroshock or bicuculline were evaluated. Ibuprofen, sulindac, mefenamic acid, and low dose meclofenamic acid increased the latency-to-onset in the flurothyl and/or PTZ models; the electroshock, picrotoxin and bicuculline models were not significantly affected by any of the pretreatment agents. These results suggest that PGs are involved in the mechanism(s) underlying fluorthyl- and PTZ-induced convulsions, but not picrotoxin-, electroshock-, or bicuculline-induced convulsions.

Animals↗
PubMed1986

Recurrence rate of febrile convulsion related to the degree of pyrexia during the first attack.

Ninety-four children consecutively admitted to the hospital between January 1980 and December 1982 with their first febrile convulsion (FC) were studied to assess the influence of the degree of pyrexia on the recurrence rate of FC. Thirty-eight of sixty-three children between 6 and 18 months of age (the peak incidence of FC) with fever above 40 degrees C were almost seven times less likely to have subsequent convulsions with fever, than those whose initial febrile convulsion was associated with a lower degree of pyrexia. It is suggested that the degree of pyrexia is a factor that influences the recurrence of FC. This may explain why some children have a reduced frequency of subsequent FC compared with others who appear to be at comparable risk.

Age Factors↗
PubMedDate not supplied

Alteration of lidocaine-induced convulsions by meperidine and nitrous oxide.

When mice were pretreated with meperidine, the incidence of lidocaine-induced convulsions was increased. Nitrous oxide-oxygen (N2O-02) offered no protection against convulsions caused by lidocaine alone but lowered the incidence of lidocaine-induced convulsions of mice pretreated with meperidine.

Animals↗
PubMed1996

Non-convulsive status epilepticus presenting as a psychiatric condition.

Non-convulsive status epilepticus may present as confusion, behavioural disturbances and psychiatric conditions. We present the case of a 17-year-old man who had episodes of non-convulsive status epilepticus as his only manifestation of epilepsy which was mis-diagnosed as a psychiatric condition for over 10 years. He has had almost complete resolution of his symptoms with the introduction of carbamazepine. Non-convulsive status epilepticus is probably commoner than previously thought, and should be considered as a possible diagnosis in all patients presenting with prolonged episodes of altered consciousness even without other manifestations of epilepsy.

Adolescent↗
PubMed1975

Diazepam prophylaxis for lignocaine induced convulsions.

The effectiveness of intraperitoneal phenobarbitone (4 mg/kg), pentobarbitone (6 mg/kg) and diazepam (2.5, 5 and 7.5 mg/kg) in preventing lignocaine-induced seizures was studied in rats. Although the barbiturates exerted a marked depressant action on wakefulness and gait of the rats, they were still associated with a very high incidence of convulsions and deaths following 100 mg/kg intraperitoneal lignocaine hydrochloride. Diazepam, however, even in doses (2.5 and 5 mg/kg) which did not produce marked sedation was able to completely prevent convulsions. Mortality was not completely prevented as one animal in each of the groups receiving these doses died without convulsing. Diazepam in the dose of 7.5 mg/kg completely prevented the seizures as well as the mortality but exerted a more profound effect on wakefulness and gait of the animals. The effectiveness of diazepam pretreatment in preventing lignocaine-induced seizures in rats is confirmed.

Animals↗
PubMed1977

Methohexitone-induced convulsions in epileptics.

The risk of precipitating a convulsion in epileptic patients with methohexitone has been judged to vary widely. This article reports such complications arising during methohexitone-activated E.E.G. recording in a series of 48 epileptic patients from whom anticonvulsant medication was withheld. Two patients developed grand mal convulsions during induction with methohexitone 1-0%. Two others exhibited status epilepticus of the petit mal type and one of the myoclonic type, after stopping an infusion of 0-09% methohexitone. The specificity for methohexitone-induced convulsions in epileptics or crypto-epileptics is supported by a review of the literature.

Adolescent↗
PubMed1991

Electroconvulsive therapy: electric stimulus variables and the convulsive response.

The ability of an electrical stimulus to induce a grand mal convulsion during electroconvulsive therapy (ECT) was investigated using four clinical treatment protocols during which the stimulus waveform, the electrical energy and/or the electrode placement were varied. The statistically significant results support the view that a pulsatile square wave stimulus is effective in inducing convulsions, provided that the d'Elia and not the Muller unilateral electrode placement is used. Higher stimulus energy may be required for older patients. The results illustrate successive attempts to remedy a previously reported problem with the effectiveness of the pulsatile waveform as a convulsive stimulus. The benefit of maintaining a database of treatment variables in order to monitor the effect of changes in the protocol under conditions of routine clinical practice is also demonstrated.

Adult↗
PubMed1986

Diurnal variation of serum copper and zinc in epileptics receiving anti-convulsants.

Serial measurements of copper and zinc concentrations in serum were made at 06.00, 14.00, 22.00 and again at 06.00 hours in 37 male patients with epilepsy, aged between 9 and 19 years. Anticonvulsant drugs were administered at 08.00 and 20.00 hours, and standard hospital meals were allowed at 07.30, 12.00, 16.00 and 19.00 hours. Similar to our previous results, eight patients (21.6%) had serum copper levels greater than the reference range (11.0-20.5 mumol/l) and this hypercupraemia was associated with carbamazapine and/or phenytoin medication. No diurnal variation in serum copper level was observed. Serum copper concentration had no correlation with either 24 h urinary copper excretion or serum anti-convulsant drug levels. Serum zinc concentrations were within the reference range (10-16.5 mumol/l), confirming our previous report. No relation with anti-convulsant medication or serum copper levels was found. Diurnal variations in serum zinc levels with peak and trough concentrations at 06.00 and 14.00 hours, respectively, were observed. It is proposed that these variations in serum zinc concentrations are a normal physiological process and is unlikely to be related to anti-convulsant drugs or epilepsy.

Adolescent↗
PubMed2000

Simple febrile convulsions: evidence for best practice.

Febrile convulsions are common in early childhood and may be the first sign of an illness. Witnessing the convulsion and experiencing the subsequent admission is extremely stressful for parents. Children's nurses need to identify the evidence for best practice in the management of febrile convulsions. Parent education is an essential component of the management of care.

Benchmarking↗
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↗
PubMed1981

Homovanillic acid and 5-hydroxyindoleacetic acid in lumbar cerebrospinal fluid in children with afebrile and febrile convulsions.

The concentrations of 5-hydroxyindoleacetic acid (5-HIAA) and homovanillic acid (HVA) were measured in lumbar cerebrospinal fluid (CSF) from five groups of children: (1) afebrile controls (2) febrile controls, (3) children with afebrile convulsions, which included children with established idiopathic epilepsy, (4) children with first febrile convulsions, and (5) children with repeated febrile convulsions. There were no significant differences between the metabolite levels in the five diagnostic groups. The CSF concentrations of 5-HIAA and HVA in these children, with a mean age of 2.5 years, were about twice the levels found in adults.

Child↗
PubMed1990

Prolonged confusion following convulsions due to generalized nonconvulsive status epilepticus.

Among patients with a prolonged confusional state after convulsive seizure, we diagnosed 8 cases as generalized nonconvulsive status epilepticus. Six had a history of seizures, and 2 had new onset. The convulsive seizures were generalized in 6 and focal in two. The postictal confusion lasted up to 36 hours in the most prolonged case, and a delayed response to anticonvulsant medications occurred in all cases. The clinical symptoms ranged from mild confusion to coma. Psychiatric manifestations or automatisms were rare. The presumed etiology was due to diverse causes, but a withdrawal state was the most common. EEG demonstrated continuous or nearly continuous generalized ictal discharges of variable morphology. These cases call attention to the fact that some prolonged confusional states following convulsive seizures are in fact due to persistent seizure activity that can be diagnosed by EEG.

Adolescent↗
PubMed2000

Video analysis of acute motor and convulsive manifestations in sport-related concussion.

OBJECTIVES: To describe the motor and convulsive manifestations in acute sports-related head injury. METHODS: A total of 234 cases of concussive injuries during the 1995 through 1997 football seasons were obtained from the Australian Football League Medical Officers Association injury survey. Of these, 102 cases were recorded adequately on television videotape and were analyzed by two independent observers using a standardized recording form detailing injury mechanics and clinical features of the episodes. Motor and convulsive features were correlated with mechanical variables and with duration of loss of consciousness using linear modeling techniques. RESULTS: Tonic posturing occurred in 25 subjects, clonic movements in 6, righting movement in 40, and gait unsteadiness in 42. In one subject the tonic and clonic features were sufficiently prolonged to be deemed a concussive convulsion. The only risk factor for tonic posturing using logistic regression was the presence of loss of consciousness (p = 0.0001). There was a trend toward facial impact being an independent predictor of tonic posturing but this did not reach significance. No other independent variable predicted the development of clonic movements, righting movements, or gait unsteadiness. CONCLUSIONS: Subtle motor manifestations such as tonic posturing and clonic movements commonly occur in concussion; the main predictive factor for tonic posturing is the presence of loss of consciousness. The authors speculate that these clinical features are due to brainstem dysfunction secondary to biomechanical forces inducing a transient functional decerebration.

Brain Concussion↗
PubMed1978

Anti-convulsant effect of phthalazino-[2,3b]-phthalazine-5(14H), 12(7H)-dione (L-5418). II. Electroencephalographic study.

L-5418 has an anti-convulsant effect which is similar to that of diphenylhydantoin. The effects of L-5418 on EEG activity in rabbits with acute and chronic implantation of electrodes were studied in comparison with those of currently available anti-convulsants. Intravenous administration of L-5418 increased a slow-wave sleep pattern in the spontaneous EEG, which was also induced by diphenylhydantoin. With respect to the focal seizure in the cerebral cortex induced by local application of penicillin, L-5418 showed suppressive effects on the frequency and duration of seizure discharge, and on the spread of seizure discharge to other parts of the brain. The efficacy was about twice that of diphenylhydantoin. L-5418 and dephenylhydantoin did not increase the threshold of seizures induced by bemegride while trimethadione raised the threshold. L-5418 also showed suppressive effects twice as active as diphenylhydantoin on after-discharge induced by electrical stimulation of the hippocampus and amygdala. This suppressive effect on after-discharge of the limbic system may be parallel with the suppressive effect on psychomotor seizure. From these results of L-5418 on an experimental model of epilepsy, it is suggested that L-5418 has suppressive effects similar to that of diphenylhydantoin on convulsion and the efficacy proved to be twice that of diphenylhydantoin in the EEG study.

Animals↗