11/12. Cavernous angioma presenting as pregnancy-related seizures.PURPOSE: To determine the reason that one-quarter to one-third of epileptic women experienced an increased number of seizures during pregnancy. The cause of this increase is not always clearly understood and the principle emphasis of the literature is on the pregnancy-associated changes of anticonvulsant pharmacokinetics. methods: Two patients presented with recurrent seizures occurring only during pregnancy. Both had MRI findings typical of cavernous angiomas of the temporal lobe. RESULTS: In addition to changes in anticonvulsant pharmacokinetics, potential mechanisms underlying the exacerbation of seizures from a vascular malformation during pregnancy include effects of estrogen on temporal structures critically involved in epileptogenesis and changes within the malformation itself secondary to direct actions of estrogen and the hemodynamic changes of pregnancy. CONCLUSIONS: The possibility of an occult lesion such as cavernous angioma should be considered for seizures occurring during pregnancy. Even in the presence of a normal CT scan, an MRI investigation should be pursued, despite the ill-defined fears of MRI in pregnancy.- - - - - - - - - - ranking = 1keywords = fear (Clic here for more details about this article) |
12/12. When one is two.This article is about Karen, who was 20 weeks pregnant when she was involved in a gas explosion. The explosion caused a 35% body surface area deep partial-thickness burn to her legs and arms. This article focuses on the most important concerns and fears Karen expressed while she was in our care. Her statements triggered various clinical memories from several nurses in the burn unit, and thus the stories unfold. These stories reflect nursing practice through the psychological care, clinical signs, and pathophysiology of our patient. The spoken stories, coupled with the reflective stories, provide a total picture of the multidimensional care nurses provide for their patients.- - - - - - - - - - ranking = 1keywords = fear (Clic here for more details about this article) |
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