1/69. carbamazepine-induced thrombocytopenia defined by a challenge test.carbamazepine (CBZ), a widely used anticonvulsant, occasionally causes serious hematologic disorders. A 12-year-old boy was admitted because of a diffuse petechial rash and profound thrombocytopenia (10 x 10(9) platelets/l), after having been treated for epilepsy with CBZ for 12 days. Seven days following withdrawal of CBZ and initiation of prednisolone therapy, the platelet count recovered. In a subsequent challenge test with CBZ, platelet counts again decreased, and the levels of platelet-associated IgG and serum interleukin-6 increased. No antibodies against platelet glycoprotein IIb/IIIa or Ib were detected in plasma. We believe that this is the first reported occasion when CBZ-induced thrombocytopenia has been defined by a rechallenge test.- - - - - - - - - - ranking = 1keywords = epilepsy (Clic here for more details about this article) |
2/69. scleromyxedema with dermato-neuro syndrome.scleromyxedema is a rare connective tissue disease of unknown cause characterized by a generalized papular eruption, dermal fibroblast proliferation, and monoclonal paraproteinemia. A paroxysmal triad consisting of high fever, seizures, and coma with a flu-like prodrome can rarely occur in patients with scleromyxedema and is termed "dermato-neuro syndrome." We describe a 41-year-old patient with scleromyxedema in whom the dermato-neuro syndrome developed.- - - - - - - - - - ranking = 1.0649298841071keywords = seizure (Clic here for more details about this article) |
3/69. Hemorrhagic shock and encephalopathy syndrome: neurologic features.Hemorrhagic shock and encephalopathy syndrome (HSES) is a severe disease that affects previously healthy infants of less than 1 year of age and is associated with significant mortality and neurologic morbidity. It is characterized by sudden onset of shock, convulsions and coma, bleeding due to severe coagulopathy, fever, diarrhea, metabolic acidosis, and hepatorenal dysfunction. central nervous system involvement with recurrent seizures and brain edema is the most common cause of high mortality and neurological morbidity. In this report, we describe four patients of HSES and review the initial and follow-up neurological features, electroencephalography findings, and the results of neuroradiological examinations of this catastrophic illness.- - - - - - - - - - ranking = 6.3769217751662keywords = convulsion, seizure (Clic here for more details about this article) |
4/69. Deaths of children during an outbreak of hand, foot, and mouth disease in sarawak, malaysia: clinical and pathological characteristics of the disease. For the Outbreak Study Group.From April through June 1997, 29 previously healthy children aged <6 years (median, 1.5 years) in Sarawak, malaysia, died of rapidly progressive cardiorespiratory failure during an outbreak of hand, foot, and mouth disease caused primarily by enterovirus 71 (EV71). The case children were hospitalized after a short illness (median duration, 2 days) that usually included fever (in 100% of case children), oral ulcers (66%), and extremity rashes (62%). The illness rapidly progressed to include seizures (28%), flaccid limb weakness (17%), or cardiopulmonary symptoms (of 24 children, 17 had chest radiographs showing pulmonary edema, and 24 had echocardiograms showing left ventricular dysfunction), resulting in cardiopulmonary arrest soon after hospitalization (median time, 9 h). Cardiac tissue from 10 patients showed normal myocardium, but central nervous system tissue from 5 patients showed inflammatory changes. Brain-stem specimens from 2 patients were available, and both specimens showed extensive neuronal degeneration, inflammation, and necrosis, suggesting that a central nervous system infection was responsible for the disease, with the cardiopulmonary dysfunction being neurogenic in origin. EV71 and possibly an adenovirus, other enteroviruses, or unknown cofactors are likely responsible for this rapidly fatal disease.- - - - - - - - - - ranking = 1.0649298841071keywords = seizure (Clic here for more details about this article) |
5/69. incidence of seizures in pediatric cancer patients treated with imipenem/cilastatin.Proconvulsive tendency of imipenem/cilastatin is one of its well-known side effects. Most studies report incidence rates ranging from 1.5 to 3%. There is no study on the incidence rate among children with systemic malignancies. Eighty-two patients with various malignancies who received imipenem/cilastatin 143 times for neutropenic fever between March 1994 and October 1999 in Department of Pediatric Oncology, Gazi University, were identified. Three of these patients had convulsions attributed to imipenem/cilastatin; 3.6% of the patients had seizure, or 2% of imipenem/cilastatin administrations was followed by a seizure attack.- - - - - - - - - - ranking = 11.701571195702keywords = convulsion, seizure (Clic here for more details about this article) |
6/69. lassa fever encephalopathy: lassa virus in cerebrospinal fluid but not in serum.The pathogenesis of neurologic complications of lassa fever is poorly understood. A Nigerian patient had fever, disorientation, seizures, and blood-brain barrier dysfunction, and lassa virus was found in cerebrospinal fluid (CSF) but not in serum. The concentration of lassa virus rna in CSF corresponded to 1 x 10(3) pfu/mL, as determined by a quantitative real-time polymerase chain reaction assay. To characterize the lassa virus in CSF, the 3.5-kb S rna was sequenced. In the S rna coding sequences, the CSF strain differed between 20% and 24.6% from all known prototype strains. These data suggest that lassa virus or specific lassa virus strains can persist in the central nervous system and thus contribute to neuropathogenesis. lassa virus infection should be considered in West African patients or in travelers returning from this area who present only with fever and neurologic signs.- - - - - - - - - - ranking = 1.0649298841071keywords = seizure (Clic here for more details about this article) |
7/69. Febrile status epilepticus as the first presentation of cortical developmental malformation: report of 2 cases.Cortical developmental malformations are an important cause for epilepsy. The epileptic disorder usually begins with sporadic seizures, followed by gradually increasing seizure frequency and culminating in epilepsia partialis continua. We report the de-novo occurrence of focal status epilepticus accompanying hyperpyrexia in two male children, aged 18 months and 4 years. One child had prior neuro-developmental delay, while in the other, developmental milestones were normal. In both instances, there were no seizures prior to the presenting neurological illness. cerebrospinal fluid examination was normal in both the cases. magnetic resonance imaging revealed extensive pachygyria in one patient and focal cortical thickening in the other. Therefore, cortical developmental malformation may be suspected as an underlying aetiology in children presenting with de-novo status epilepticus and hyperpyrexia.- - - - - - - - - - ranking = 4.1947896523214keywords = seizure, epilepsy (Clic here for more details about this article) |
8/69. hypohidrosis related to the administration of topiramate to children.PURPOSE: Topiramate (TPM) is an antiepileptic agent, first licensed in the United Kingdom in 1994, that is used in the treatment of patients with refractory seizure disorders. TPM is a monosaccharide d-fructose derivate, with sulfamate function, and so far, few adverse side effects have been reported. methods: We describe three patients with epilepsy who were treated with TPM and developed hypohidrosis, heat and exercise intolerance, as well as fever. The sudomotor function was assessed after peripheral stimulation with pilocarpine iontophoresis. RESULTS: sweat response was reduced in all three patients. signs and symptoms ceased after drug suppression. CONCLUSIONS: This side effect associated with TPM, which has not been described previously, can be clinically significant during heat stress and exercise challenge.- - - - - - - - - - ranking = 2.0649298841071keywords = seizure, epilepsy (Clic here for more details about this article) |
9/69. An MRI and neuropathological study of a case of fatal status epilepticus.We report a case of fatal status epilepticus of unknown origin resulting in acute neuropathological changes in the hippocampus and claustrum.The case history, brain magnetic resonance images, and results of neuropathological study of the whole brain were obtained.The subject was a 35 year old male with no significant previous medical history who presented with generalized epileptic seizures progressing to status epilepticus. He died 6 days after developing status epilepticus. magnetic resonance imaging (MRI) brain scans were performed before and four days after developing status epilepticus. The first scan was normal and the second showed high signal lesions on T2 weighted images in the medial aspects of both temporal lobes and in the right claustrum. Neuropathological studies showed severe neuronal loss in the Sommer section of both hippocampi with early glial reactive changes. Similar changes were seen in the claustrum on both sides. There was no evidence of other causes of brain injury such as infectious encephalitis or global hypoxic-ischaemic change.The patient died of status epilepticus for which no underlying cause was found despite extensive investigation. In this case the radiological and pathological changes found bilaterally in the claustrum and hippocampus appear to be the direct result of the status epilepticus.- - - - - - - - - - ranking = 1.0649298841071keywords = seizure (Clic here for more details about this article) |
10/69. Frequent association with neurosurgical conditions in adult proteus mirabilis meningitis: report of five cases.adult Proteus (P.) mirabilis meningitis is relatively rare and has not been examined individually in the English-language literature. During a period of 15 years (January 1986-December 2000), four adult patients with P. mirabilis meningitis and one adult patient with mixed bacterial meningitis involving P. mirabilis were identified at Chang Gung Memorial Hospital, Kaohsiung. These five patients included one man and four women, aged from 19 to 74 years (mean age=55.4). P. mirabilis infection accounted for 1.7% (4/229) of cases of our culture-proven monomicrobial adult bacterial meningitis and was involved in 7.1% (1/14) of cases of our adult mixed bacterial meningitis during this period. Underlying debilitating conditions including diabetes mellitus and neurosurgical disorders were common in these five cases. adult P. mirabilis meningitis had an acute clinical course, with fever and consciousness-disturbance occurring as most prominent clinical manifestations in all patients. Other common manifestations included hydrocephalus, seizure, septic shock and wound infection. Hematogenous spread would appear to be the most likely mechanism. Multi-antibiotic resistant strains of P. mirabilis were not found in our patients. All strains were susceptible to third-generation cephalosporins, imipenem, aztreonam and ciprofloxacin. The results of treatment for adult P. mirabilis meningitis were not satisfactory, most of the patients surviving with severe neurological deficit.- - - - - - - - - - ranking = 1.0649298841071keywords = seizure (Clic here for more details about this article) |
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