1/737. Automatisms during frontal lobe epileptic seizures.Three new cases of automatisms occurring during frontal lobe epileptic seizures are reported. If these cases are added to those already published and adequately described in the literature, a total of 12 cases is obtained. An attempt is made to elucidate the clinical characteristics of automatisms encountered during frontal lobe seizures. This kind of automatism would seem to be clinically distinguishable from other types.- - - - - - - - - - ranking = 1keywords = ms (Clic here for more details about this article) |
2/737. Dilantin jeopardy: avoiding the dangers of phenytoin.phenytoin sodium (Dilantin), is a widely known anticonvulsant medication that can cause serious side effects and interactions with numerous other medications. nurses should thoroughly familiarize themselves with this medication's properties in order to practice safely.- - - - - - - - - - ranking = 0.16666666666667keywords = ms (Clic here for more details about this article) |
3/737. Surgical treatment of a case of early infantile epileptic encephalopathy with suppression-bursts associated with focal cortical dysplasia.We report a surgically treated case of early infantile epileptic encephalopathy (EIEE) with suppression-bursts associated with focal cortical dysplasia. Tonic-clonic seizures followed by a series of spasms occurred about a hundred times a day at a few days of age. Interictal electroencephalogram (EEG) revealed a suppression-burst pattern that was predominant in the left hemisphere. magnetic resonance imaging (MRI) suggested focal cortical dysplasia in the left prefrontal area. Combination therapies with antiepileptic treatments showed only partial efficacy. The patient underwent lesionectomy at age 4 months, after which he gradually showed psychomotor development and a decrease of spasms to 0-2 series daily. In cases of EIEE with focal cortical dysplasia, surgical treatment may have beneficial effects on both psychomotor development and seizure control.- - - - - - - - - - ranking = 0.33333333333333keywords = ms (Clic here for more details about this article) |
4/737. Possibilities of non-pharmacological conservative treatment of epilepsy.This study set out to assess the effect of non-pharmacological conservative (NPC) interventions as alternatives to antiepileptic pharmacotherapy. A prospective follow-up cohort study was conducted in an outpatient seizure clinic of a referral center for epilepsy. Twenty-five patients (nine males, 16 females) aged 16-45, with at least two well-described epileptic seizures, were included who had rejected antiepileptic pharmacotherapy. Twelve had idiopathic generalized epilepsy, 11 had symptomatic or cryptogenic localization-related epilepsy, and two had epilepsy with generalized and focal signs. Twenty-three of the patients were followed for more than 2 years. The patients were treated with arrest after focal seizure onset (2 cases), sensory protection against reflex seizures (3 cases), avoidance of non-specific seizure-precipitating factors ('life hygiene', 16 cases), and/or miscellaneous interventions (8 cases). The main outcome measures were complete seizure control (more than 2 years) or sufficient improvement to continue with NPC treatment alone. Eight of the 23 patients were completely seizure free for more than 4 years, and three were sufficiently improved to continue NPC treatment without drugs. Trends were observed for patients with idiopathic generalized epilepsies with less than seven convulsive seizures, and with only one seizure type to respond better to NPC treatment. The duration of epilepsy, and the finding of generalized epileptiform discharge in the EEG had no influence on the outcome. Rational NPC treatments which are aimed at specific factors in the precipitation and development of epileptic seizures can be useful therapeutic alternatives for patients with milder forms of epilepsy. Apart from photosensitive patients, those most likely to profit are patients with idiopathic generalized epilepsy, a maximum of six generalized tonic-clonic seizures which were precipitated by lack of sleep or excessive alcohol intake, and with no or rare concomitant absences. In such cases, NPC treatment may be as effective as pharmacotherapy and gives the patient a positive experience of regained self-control.- - - - - - - - - - ranking = 0.16666666666667keywords = ms (Clic here for more details about this article) |
5/737. epilepsy in the vibroacoustic disease: a case report.INTRODUCTION: Late-onset epilepsy was one of the first neurological problems identified in patients diagnosed with vibroacoustic disease. Other clinical situations, such as automatisms and rage-like reaction crises were also observed. Some cases of epileptic seizures were triggered by different types of stimuli. CASE REPORT: This study describes the clinical case of a 30-yr-old male metal-worker who had epileptic seizures when he used vibratory tools common to his profession, such as drills and sanders. We performed a 21-channel EEG during a seizure induced in the laboratory by direct contact of a vibratory tool with his right hand. This allowed us to view the electrical discharge of his left hemisphere. The entire procedure was simultaneously videotaped while a partial motor crisis was observed. brain MRI of this subject revealed multiple hyperintense focal lesions in the sub-cortical white matter. echocardiography revealed thickening of the pericardium and valve structures. COMMENTARY: To the authors' knowledge, this is the first documented case of reflex epilepsy due to vibratory stimuli. We briefly discuss the possible pathophysiological mechanisms of this clinical event.- - - - - - - - - - ranking = 0.5keywords = ms (Clic here for more details about this article) |
6/737. Atypical herpes simplex encephalitis presenting as operculum syndrome.This case report demonstrates the course of herpes simplex virus cerebritis in a patient aged 7 years 2 months who presented with non-specific symptoms followed by an epileptic attack. Subcortical, bilateral opercular and bilateral thalamic lesions were detected, but the temporal and inferior frontal lobes were spared. The patient developed anarthria, impairment of mastication and swallowing consistent with operculum syndrome. diagnosis was made by magnetic resonance imaging and elevation of oligoclonal antibodies specific to herpes simplex virus in cerebrospinal fluid after an unexpectedly negative polymerase chain reaction test.- - - - - - - - - - ranking = 0.16666666666667keywords = ms (Clic here for more details about this article) |
7/737. Does the tuberous sclerosis complex include intracranial aneurysms? A case report with a review of the literature.BACKGROUND: tuberous sclerosis is a protean, genetically determined disease that may involve any organ or tissue and lead to a great number of symptoms and clinical features. OBJECTIVE: diagnosis can be very difficult in cases with incomplete manifestations (formes fruste) lacking the classic signs of the disease. MATERIALS AND methods: We report a case fulfilling the diagnostic criteria for tuberous sclerosis (shagreen patches, hypomelanotic macules, renal cysts and angiomyolipomas, and "migration tracts" in the cerebral white matter) in association with a giant intracranial aneurysm, but lacking mental retardation, epilepsy and facial angiofibroma. RESULTS: Fourteen other cases of tuberous sclerosis and intracranial aneurysms, all but one without any clear sign of polycystic kidney disease, were found in the literature. CONCLUSION: We suggest that vascular dysplasias in general and aneurysms (mainly intracranial) in particular can be added to the other non-primary diagnostic features for the clinical diagnosis of tuberous sclerosis.- - - - - - - - - - ranking = 769.31199597536keywords = sclerosis, ms (Clic here for more details about this article) |
8/737. male infertility: possible association with valproate exposure.PURPOSE: To describe a potential association between male infertility and valproate (VPA) exposure. VPA has been implicated in the development of polycystic ovarian disease and subsequent menstrual and infertility problems in women with epilepsy. infertility has been well described in population-based studies of persons with epilepsy. The low marital rates for men with epilepsy have previously been thought to play a major contributing role. methods: We report a case of a 32-year-old man whose wife and he were able to bear a child before the development of his epilepsy. With VPA monotherapy, the family were unable to conceive despite 4 years of unprotected intercourse. An infertility evaluation of the man revealed a very low sperm count of < 50,000/ml, no motile sperm, < 10% viability, and 100% with abnormal structure. Follicle-stimulating hormone, luteinizing hormone, and testosterone levels were normal. RESULTS: Felbamate (FBM) was initiated and VPA discontinued for improved seizure control. Within 4 months, the couple conceived their second child. A seminal analysis revealed a sperm count of > 16 million, 50% motility, 78% viability, and 72% with abnormal structure. CONCLUSIONS: One must be cautious in extrapolating from a case report, but these findings strongly suggest a direct effect of VPA on spermatic structure and function.- - - - - - - - - - ranking = 0.16666666666667keywords = ms (Clic here for more details about this article) |
9/737. Epileptogenic mineralization: pathological variants with good prognosis.Four examples of grossly mineralized lesions of the brain, causing seizures, are described; they include 2 hamartomas, a choristoma (novel associations), and an idiopathic "brain stone." Each was detectable with routine roentgenograms, and the seizures were ameliorated by surgical therapy.- - - - - - - - - - ranking = 0.16666666666667keywords = ms (Clic here for more details about this article) |
10/737. Ictal paraphasia induced by language activity.Four patients with ictal speech disturbance were studied. Their seizures featured isolated, or series of, brief episodes of fluent paraphasia, paragraphia, and comprehension deficit. These episodes were often induced by language activity. Six patients with ictal paraphasia or paragraphia, as a recurrent habitual seizure, are reported in the literature. All ten cases, including the four cases described here and the six cases reported in the literature, featured patients who uttered meaningless speech fluently or displayed paragraphia. The syllables uttered during seizures contained many neologisms and resembled the neologistic jargon of patients with fluent aphasias of the Wernicke type. Nine patients had clusters or status of brief seizures and four patients had auditory hallucination as an ictal event. The seizures in six patients were easily induced by the use of language. Seizure focus was on the left side in all patients mentioned. The possibility of another type of language-induced seizures than those seen in reading epilepsy or language-induced epilepsy is suggested in which myoclonias of the jaw and face, or upper extremities are the main seizure types.- - - - - - - - - - ranking = 0.16666666666667keywords = ms (Clic here for more details about this article) |
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