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[The Landau-Kleffner syndrome: a special form of acquired childhood aphasia].

The syndrome of "acuqired aphasia with convulsive disorder" occurs in children between 3 and 7 years of age and is characterized by a language disorder with heterogeneous epileptic manifestations. The pathogenesis is unknown. The course can show marked fluctuations. Our study of 6 children shows that the outcome can range from extremely unfavorable to complete recovery. The variables that possibly influence the course are discussed.

Aphasia↗

[Epileptic impaired consciousness in adults].

Alterations of consciousness with impaired perception and drive persisting over hours to days can be due to a nonconvulsive status epilepticus. This possibility has to be considered not only in patients with already known epilepsy, but also in those with a negative history for seizure disorders. The immediately recorded electroencephalogram (EEG) provides decisive clues. In the case of petit mal status most frequently appear tiredness, reduced vigilance and lack of drive. The EEG shows a generalized spike-wave activity. In status psychomotoricus, the clinical symptomatology varies from case to case. It can be characterized by anxiety, dreamy states or productive-psychotic states with agitation, automatisms and hallucinations. In the EEG a temporal or temporally-accentuated epileptic activity will be recorded. Transitional and mixed forms of petit mal status and status psychomotoricus can also be found. I.v. injections of benzodiazepines (clonazepam, diazepam) are an appropriate therapy for any type of nonconvulsive status epilepticus. Phenytoin is indicated in status psychomotoricus, but contra-indicated in the case of petit mal status.

Adult↗

[Barbexaclone in the treatment of cerebral dysrhythmia].

Forty two patients (22 adults and 20 children or adolescents) with cerebral dysrithmia were included in a therapeutic trial using barbexaclone: 28 patients suffered from grand mal crises, 2 had associated GM and petit mal and 12 showed disturbances of behaviour without clinical crises. The patients were observed from 6 to 13 months. Four patients failed to complete the trial due to various side effects; 25 patients with GM and 11 with behaviour disturbances showed a very good response; two patients with associated petit mal failed to show any improvement. Side effects such as insomnia and irritability were seen in 8 patients. The authors concluded that barbexaclone is an excellent therapeutic agent in the treatment of grand mal and in patients with behaviour disturbances without convulsive crises.

Adolescent↗

Looking for epilepsy genes: clinical and molecular genetic studies.

The complexity of the human genome creates special problems in understanding the genetic component of disease processes. An estimated 50,000 genes exist in the human genome, and it is reasonable to assume that mutation in any one of these genes may result in an inherited disorder. Because of the complex pattern of gene expression controlling the development and organization of the central nervous system (CNS), insights into the genetic component, if any, of diseases such as epilepsy are most accessible to analysis by genetic linkage studies. Advances in the manipulation of DNA have made possible more effective acquisition of genotypic information in humans by studying the inheritance of restriction fragment length polymorphisms (RFLPs) using cloned DNA probes. Two approaches exist to utilize this technology in studying inherited disorders. The first approach consists of genotypic determinations in affected families with cloned genes in which a mutation might result in the phenotype observed. Analysis of these data will show whether the inheritance of an allele of the candidate gene is linked to the disease. The second approach relies upon the construction with these probes of a linkage map for the human genome such that disease families can be screened in order to determine with which of these markers the phenotype is linked, indicating the map position of a gene associated with the inherited disorder. The use of these new approaches enables investigators to screen either specific biochemical defects in disease families or to identify the underlying genetic mechanisms in inherited disorders whose phenotype is expressed only in the intact human (84). The first step in localizing the chromosomal site of specific epilepsies is to define their pattern of inheritance. This determination is now being carried out for benign juvenile myoclonic epilepsy; 50 multigenerational families are being studied in three separate epilepsy programs in Los Angeles, Winston-Salem, North Carolina, and Berlin. Concurrent with these studies, investigators are combining the principles of classic linkage analysis, using 30 protein markers, with the use of RFLPs to determine the chromosomal location of juvenile myoclonic epilepsy. Two problems appear formidable, however. First, since the chromosomal location of specific epilepsies is unknown, the entire human genome must be screened.(ABSTRACT TRUNCATED AT 400 WORDS)

Chromosome Mapping↗

[Electroencephalographic value of acoustic stimulation within the scope of the diagnosis of forms of cerebral seizure in childhood and adolescence].

In this report we represent the phone-stimulation as an important method of provocative to activate the bioelectric potentials of brain, if epileptic seizures will be appeared in age of childhood and youth. The method ist able to demonstrate irritations of the reticulothalamic system. The information on the activity of the substantia reticularis will be demonstrated by the bioelectric reaction under phone-stimulation.

Acoustic Stimulation↗

The electroencephalogram in the evaluation of the patient with epilepsy.

The authors describe the use of the electroencephalogram (EEG) in the diagnosis of patients with epilepsy, with specific reference to various seizures types and to commonly seen electrographic abnormalities. Also reviewed are normal variants that are sometimes erroneously thought to be epileptic in nature. The use of special studies, including invasive electrographic recording, is briefly discussed.

Adolescent↗

[The assessment of disability in epileptic patients].

Report is given concerning 16 epileptics in whom annuity could be suspended. Types of seizures did not differ from those analysed in a formerly study of further invalid epileptics. On the contrary, the beginning of treatment was very soon after manifestation of disease, and the treatment was in the hand of neuropsychiatrists with mostly good or very good attention. Improvement could be obtained mainly by decrease of seizure frequency of freedom from seizures, and after few years invalidity could be annulled.

Adult↗