Cases reported "Epilepsy, Temporal Lobe"

Filter by keywords:



Filtering documents. Please wait...

1/434. twins with different temporal lobe malformations: schizencephaly and arachnoid cyst.

    The etiology and relationships between different forms of malformations of cortical development are poorly understood. Schizencephaly is generally regarded as unrelated to arachnoid cysts. As part of a systematic study of epilepsy in twins we observed a monozygotic twin pair discordant for temporal lobe epilepsy where the twin with epilepsy had unilateral temporal schizencephaly and periventricular heterotopia. The twin without epilepsy had an arachnoid cyst in the same temporal lobe. Although an incidental association is possible, this observation, together with occasional reports of schizencephaly and arachnoid cysts within one individual, suggests a shared pathogenic mechanism. Schizencephaly can be caused by both genetic and acquired factors. We propose that our observations in this twin pair are best explained by a genetic factor present in both twins, with an additional environmental insult resulting in schizencephaly in only one of the pair.
- - - - - - - - - -
ranking = 1
keywords = mal
(Clic here for more details about this article)

2/434. research methods in clinical investigation: a case study analysis of medication levels and self-harm.

    This paper uses a case study to illustrate an application of the scientist-practitioner model to clinical practice. Through consultation with a clinical psychologist, a simple method of obtaining an objective overview of the therapeutic use of medication was developed. Focusing on a woman in a Regional Secure Unit, data were gathered from incident forms of self-harm and the corresponding drug charts. Using basic statistical techniques (such as frequencies and measures of central tendency) to summarize these data, useful clinical information was obtained. Actual data from the case study are presented, as an example of a research process that can be applied to understanding the role of extraneous variables when pursuing a course of chemical treatment. Analyses of drug effects suggest that additional variables such as environmental, interpersonal and engagement factors needed to be considered. The paper advocates the ease of applicability of research methods to clinical investigation.
- - - - - - - - - -
ranking = 0.0027377153713592
keywords = simple
(Clic here for more details about this article)

3/434. An angiographically occult arteriovenous malformation in the medial parietal lobe presenting as seizures of medial temporal lobe origin.

    We present an unusual case of a patient who was diagnosed with temporal lobe epilepsy and whose seizures were reduced markedly after excision of an angiographically occult arteriovenous malformation (AVM) located in the left medial parietal lobe. A 38-year-old man had complex partial seizures characterized by motionless staring with oroalimentary and behavioral automatisms since the age of 15 years. magnetic resonance imaging (MRI) demonstrated a small lesion extending from the left posterior cingulate gyrus to the precuneus. There was no MRI evidence of mesial temporal sclerosis. Intracranial EEG recordings showed ictal onset from the left medial parietal lobe propagating to the medial temporal lobes. Clinical signs appeared when these discharges reached the temporal lobes. After excision of the lesion (which was histologically confirmed as an AVM), together with the marginal cortex, seizures were reduced significantly. Careful diagnostic evaluation of lesions such as the this one may reveal an epileptogenic lesion (zone) far from the region where scalp ictal discharges seem to arise. In our case, we hypothesize that false localization was due to propagation of ictal discharges from the parietal focus through the limbic system.
- - - - - - - - - -
ranking = 1.27078993751
keywords = mal, complex
(Clic here for more details about this article)

4/434. Early and delayed MR and PET changes after selective temporomesial radiosurgery in mesial temporal lobe epilepsy.

    We report a patient with medically refractory mesial temporal lobe epilepsy treated by gamma knife radiosurgery. In lieu of a microsurgical procedure, an entorhinoamygdalohippocampectomy was performed with a gamma knife and low marginal doses (25 Gy). The clinical and imaging studies, including CT, MR imaging, 18F-fluorodeoxyglucose positron emission tomography (FDG-PET), and long-term follow-up MR examinations, are reported. The patient has been seizure-free since the day of treatment, with no clinical complications. MR studies accurately depicted the effect on the target structures and the transient secondary changes around them. FDG-PET scans showed decreased metabolism after gamma knife surgery throughout the anteromesial part of the epileptogenic temporal lobe. This metabolic decrease was reversible in the lateral temporal cortex. Our case suggests that gamma knife surgery is a promising tool for use as a minimally invasive approach to the treatment of epilepsy.
- - - - - - - - - -
ranking = 0.2
keywords = mal
(Clic here for more details about this article)

5/434. Removal of catecholamine-secreting chemodectoma. The use of neuroleptanaesthesia, adrenergic blockade and sodium nitroprusside.

    A case of catecholamine-secreting chemodectoma of the neck in a 47-year-old male who also had temporal lobe epilepsy is described. Details of presentation, diagnosis and successful treatment are given. He was fully alpha blocked with phenoxybenzamine and given neuroleptic drugs but his blood pressure rose to dangerous levels when the tumour was handled and did not respond to intravenous phentolamine. sodium nitroprusside was successfully used to achieve blood pressure control.
- - - - - - - - - -
ranking = 0.2
keywords = mal
(Clic here for more details about this article)

6/434. Plasticity of language-related brain function during recovery from stroke.

    BACKGROUND AND PURPOSE: This study was undertaken to correlate functional recovery from aphasia after acute stroke with the temporal evolution of the anatomic, physiological, and functional changes as measured by MRI. methods: Blood oxygenation level-dependent contrast and echo-planar MRI were used to map language comprehension in 6 normal adults and in 2 adult patients during recovery from acute stroke presenting with aphasia. perfusion, diffusion, sodium, and conventional anatomic MRI were used to follow physiological and structural changes. RESULTS: The normal activation pattern for language comprehension showed activation predominately in left-sided Wernicke's and Broca's areas, with laterality ratios of 0.8 and 0.3, respectively. Recovery of the patient confirmed as having a completed stroke affecting Broca's area occurred rapidly with a shift of activation to the homologous region in the right hemisphere within 3 days, with continued rightward lateralization over 6 months. In the second patient, in whom mapping was performed fortuitously before stroke, recovery of a Wernicke's aphasia showed a similar increasing rightward shift in activation recruitment over 9 months after the event. CONCLUSIONS: Recovery of aphasia in adults can occur rapidly and is concomitant with an activation pattern that changes from left to a homologous right hemispheric pattern. Such recovery occurs even when the stroke evolves to completion. Such plasticity must be considered when evaluating stroke interventions based on behavioral and neurological measurements.
- - - - - - - - - -
ranking = 0.4
keywords = mal
(Clic here for more details about this article)

7/434. Progressive hippocampal atrophy in chronic intractable temporal lobe epilepsy.

    We report on a 28-year-old man with long-standing intractable complex partial and secondary generalized seizures, whose magnetic resonance imaging scans 4 years apart documented progressive decrease in the left hippocampal volume. Left anterior temporal lobectomy with amygdalohippocampectomy rendered the patient seizure free at 12 months' follow-up. The findings demonstrate that patients with uncontrolled temporal lobe seizures may develop progressive atrophy of the hippocampus, in the absence of status epilepticus.
- - - - - - - - - -
ranking = 189.40654589339
keywords = status epilepticus, epilepticus, status, complex
(Clic here for more details about this article)

8/434. Interictal change in cardiac autonomic function associated with EEG abnormalities and clinical symptoms: a longitudinal study following acute deterioration in two patients with temporal lobe epilepsy.

    The purpose of the present study was to investigate the ictal and interictal changes in cardiac autonomic function (CAF), and the relationship between the interictal change in CAF to the electroencephalogram (EEG) and clinical findings. In two patients with temporal lobe epilepsy (TLE) showing acute deterioration, a quantitative evaluation of their interictal CAF based on heart rate variability and their EEG using spectral analysis was conducted, and the findings compared with repeated clinical evaluations during the recovery period. The ictal heart rate changes and their temporal relationship to ictal discharge were investigated using simultaneous EEG/electrocardiogram (ECG) monitoring in one of the patients. Interictal parasympathetic function was decreased during the period of acute deterioration, but was increased in association with improvements in the EEG and clinical findings. In contrast, the sympathetic function showed no specific changes. The ictal discharges were preceded by a brief bradycardia, with a long delay of up to 40s. The results demonstrated that this decrease in parasympathetic function was closely related to the interictal changes in central nervous system function. On the other hand, the ictal discharges in one of the patients were thought to have caused a transient elevation of parasympathetic function. It is strongly suggested that patients with TLE have interictal as well as ictal changes in CAF that are mediated mainly through the parasympathetic nervous system.
- - - - - - - - - -
ranking = 0.8
keywords = mal
(Clic here for more details about this article)

9/434. Topiramate and metabolic acidosis.

    Topiramate (TPM) is a novel antiepileptic medication (AED) with at least three mechanisms of action. A possible fourth mechanism, that of a carbonic anhydrase inhibitor, also may contribute to its antiepileptic properties. We report a patient with intractable epilepsy and normal renal function who developed a normal anion gap metabolic acidosis, which worsened during elective surgery for temporal lobectomy. We believe this side effect of TPM can become clinically significant during surgery, concomitant use of another carbonic anhydrase inhibitor, and potentially with the ketogenic diet.
- - - - - - - - - -
ranking = 0.4
keywords = mal
(Clic here for more details about this article)

10/434. language-related cognitive declines after left temporal lobectomy in children.

    Presented is a case series demonstrating that clinically significant language-related cognitive declines not detected by intelligence quotient (IQ) testing occur after left temporal lobectomy in school-aged children. In this series, comprehensive preoperative and postoperative neuropsychologic evaluations were completed in eight school-aged patients who underwent temporal lobectomy (five left, three right) for temporal lobe epilepsy. Mean age at surgery was 13 years, 11 months /- 2 years, 1 month. Testing included measurement of IQ, verbal learning, naming, visual memory, sight word recognition, reading comprehension, and calculation. All five left temporal lobectomy patients demonstrated significant language-related cognitive declines on postoperative neuropsychologic testing, including deficits in verbal IQ (one patient), verbal learning (four patients), naming (one patient), and reading comprehension (one patient). These deficits were clinically evident in four of the five left temporal lobectomy patients, leading to declines in educational performance. IQ testing alone did not reliably identify these deficits. No significant declines were found after surgery in three right temporal lobectomy patients. Average or high preoperative functioning may have predisposed patients to postoperative deficits in this series, whereas magnetic resonance imaging or pathologic abnormalities did not protect against postoperative deficits. Outcome studies of temporal lobectomy in childhood should use comprehensive neuropsychologic testing to identify cognitive deficits.
- - - - - - - - - -
ranking = 0.2
keywords = mal
(Clic here for more details about this article)
| Next ->


Leave a message about 'Epilepsy, Temporal Lobe'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.