Cases reported "Seizures"

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11/107. Presumed Eales' disease with neurologic involvement: report of three cases.

    PURPOSE: To report three cases of presumed Eales' disease with neurologic lesions. methods: case reports, systemic and neurologic evaluation, and magnetic resonance imaging. RESULTS: All three patients were young men who had seizures in the past; two had migrainous headache. magnetic resonance imaging showed putaminal infarct in two cases and edema in the white matter of temporal cortex was noticed in one case. Clinical features in all these patients were suggestive of Eales' disease. CONCLUSION: Ischemic infarction of the brain can be seen in clinically suspected cases of Eales' disease.
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keywords = cortex
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12/107. Neuropsychological profile of a 9-year-old child with subcortical band heterotopia or 'double cortex'.

    Subcortical band heterotopia (SBH) or 'double cortex', is a congenital brain abnormality that results from aberrant migration of neurons during development of the cortex. MRI shows a continuous band of heterotopic grey matter located between the cortex and ventricular walls, separated from them by a thin layer of white matter. The condition is quite rare, found predominantly in females, and is occasionally familial with an X-linked dominant inheritance. Current research has focused on genetic and neurological correlates, with cognitive assessment restricted to a global measure of general intellectual functioning. This paper describes in detail the results of a neuropsychological assessment of a 9-year-old female recently diagnosed with SBH. Predominant features were a significantly reduced speed of processing for visuomotor and oral output and reduced immediate registration of information. This difficulty has functional implications affecting skill acquisition, learning in the classroom, and social interaction.
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keywords = cortex
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13/107. Subacute fatal aluminum encephalopathy after reconstructive otoneurosurgery: a case report.

    We report a 52-year-old woman who underwent otoneurosurgery to resect acoustic neurinoma. Bone reconstruction was performed with an aluminium (Al)-containing cement. Six weeks later the patient suffered from loss of consciousness, myoclonic jerks, and persistent grand mal seizures, clinical symptoms that resembled those of lethal dialysis encephalopathy of the 1960s and 1970s. She died 6 months later because of septic complications. light- and electron-microscopic investigation of the central nervous system (CNS) showed pathognomonic Al-containing intracytoplasmic argyrophilic inclusions in choroid plexus epithelia, neurons, and cortical glia. These changes are characteristics of dialysis-associated encephalopathy (DAE), induced nowadays by long-term ingestion of Al-containing drugs (and with benign clinical courses). Atomic absorption spectrometry showed an increase of mean bulk Al concentration of the cortex and subcortex up to 9.3 microg/g (normal range <2 microg/g); laser microprobe showed the increase of Al in subcellular structures. This unique case again shows the extraordinary neurotoxicity of Al, which was, in our patient, initiated by an amount of about 30 mg Al and apparently caused by direct Al access to the brain parenchyma via a cerebrospinal fluid leakage.
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keywords = cortex
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14/107. Dysembryoplastic neuroepithelial tumour (DNT). Is the mechanism of seizures related to glutamate? An immunohistochemical study.

    Dysembryoplastic neuroepithelial tumour (DNT) is a rare low-grade, mixed neuronal and glial tumour, usually associated with pharmacologically intractable, complex partial or generalised seizures which date from childhood. The prognosis after surgery is favourable. We present a classic case of DNT occurring in an 18-year-old male, who presented simple partial seizures without signs of raised intracranial pressure. CT and MR demonstrated focal mass located in the right temporal lobe. Histologically there were found the features of a typical DNT architecture with mixed cellular composition. The response to surgery was excellent. The tumour has not recurred, and the control of seizures remained good. Immunostaining for glutamate receptor GluR-2 showed stronger immunopositivity in neurones dispersed within the tumour and especially in margins of lesion as compared with apparently normal cerebral cortex. The expression of both excitatoryamino acid transporterproteins EAAT1 and EAAT2 was weaker then in normal cortex and uneven. This perhaps may explain the mechanism of seizures (elevated glutaminergic stimulation), and may suggest the excitotoxic damage of neurones.
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15/107. The effects of transcranial micropolarization on the severity of convulsive fits in children.

    A total of 18 children with cerebral palsy and organic brain lesions underwent sessions of transcranial micropolarization with the aim of decreasing the frequency of convulsive fits. Transcranial micropolarization of the posterior temporal and parietal areas of the cerebral cortex was found to provide a marked decrease in the frequency of convulsive fits and to normalize the EEG pattern. This effect was due to the targeted effects of direct currents passed through the respective morphofunctional connections of cortical zones to the structures responsible for forming and controlling the convulsive activity of the brain.
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16/107. MR imaging of acute intermittent porphyria mimicking reversible posterior leukoencephalopathy syndrome.

    Reversible posterior leukoencephalopathy syndrome (PLS) is characterized by headache, altered mental function, visual disturbances and seizures. neuroimaging studies suggest a white-matter oedema, predominantly in the posterior parietal-temporal-occipital regions of the brain. We present the case of a 30-year-old woman who had suffered her first attack of acute intermittent porphyria (AIP). Following 1 week of abdominal pain she developed several generalized seizures, and hallucinations, and exhibited a progressive deterioration of the consciousness. T2-weighted images, especially fluid-attenuated inversion recovery (FLAIR) sequences showed bilateral lesions in the posterior frontal, parietal and occipital cortex and subcortical white matter. Following treatment with haematin and a high carbohydrate diet the patient's condition improved. Follow-up magnetic resonance imaging (MRI) revealed complete resolution of the lesions. To our knowledge, this is the first report concerning a completely reversible PLS in AIP.
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17/107. Meningioangiomatosis: MR imaging and pathological correlation in two cases.

    Meningioangiomatosis is a rare, benign neoplastic disorder involving the cortex and leptomeninges. The pathological findings are characterised by proliferation of meningothelial cells and leptomeningeal vessels and calcifications within the mass. We experienced two cases of pathologically confirmed meningioangiomatosis, one as a solitary cortical mass with calcification and the other as a cortical lesion manifested as extensive intracranial haemorrhage. On MRI, the first case showed an isointense cortical mass in the left frontal lobe and homogeneous enhancement on the contrast-enhanced study. The second case showed a target-like lesion with a peripheral dark signal rim on T2-weighted images accompanied by extensive haemorrhage in the adjacent frontal lobe and lateral ventricles.
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keywords = cortex
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18/107. Neurological symptoms as the result of enlarged dimensions and non-typical course of inferior superficial temporal vein.

    Neurological symptoms as the result of non-typical course of superficial cerebral veins are described in available literature very rarely. The case described below indicates that in some circumstances the compression symptoms derived from the cerebral cortex may be incredibly more serious than their anatomical reasons. In our observation a young woman was described complaining of paroxysmal numbness of the left upper limb with paraesthesia of the left side of the face, the left eye and left half of the tongue. The patient said that in childhood she used to have paroxysmal itching of the left hand. She also said that CT of the head made a few years ago after a car accident was without pathological changes. Neurological examination, x-ray of the skull and EEG test performed during first visit proved normal. After one year of the disease, Jackson-type epilepsy, combined with loss of sensation of the left half of the face for the first time, was present. Neurological and ophthalmological examination of the bottom of the eye proved normal. skull x-ray was normal. Then disturbances of the vision in the left half of the field appeared. EEG was still in norm. The MRI test showed the asymmetry in the course and dilated superficial vein between the basis of the right temporal lobe and the tentorium of the cerebellum. The diameter of this vein was 2.5 mm, but there were no vascular malformations. Bottom of the eye was normal, but in the field of vision the white and red colours were dominated.
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keywords = cortex
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19/107. Spontaneous thrombosis of a residual arteriovenous malformation in eloquent cortex after surgery: case report.

    OBJECTIVE AND IMPORTANCE: The presence of a residual arteriovenous malformation (AVM) on postoperative angiograms is typically an indication for prompt return to the operating room to complete resection, because of the risk of early hemorrhage. This approach, however, may involve risks of neurological deficits when the residual AVM is in eloquent cortex. We present a case of complete thrombosis of a residual AVM after surgery. This residual AVM tissue was located in eloquent cortex. Complete spontaneous thrombosis of residual AVMs after surgery has only rarely been reported. This phenomenon raises questions regarding the most appropriate management for residual AVMs in eloquent cortex. CLINICAL PRESENTATION: The patient was a 43-year-old, right-handed, male patient with an AVM centered in the left precentral gyrus. The patient presented with medically intractable seizures and progressive right hemiparesis. After AVM resection, angiography revealed a residual AVM with early venous drainage. angiography performed 1 week later demonstrated a persisting AVM nidus without early venous drainage. angiography performed 3 months later demonstrated complete thrombosis of the residual AVM. INTERVENTION: The patient has been monitored for more than 1 year, without additional symptoms or therapy. CONCLUSION: We continue to advocate prompt return to the operating room when postoperative angiography reveals a residual AVM with persistent shunting. When the residual AVM is in eloquent cortex and is small, with a single draining vein, however, observation of the patient (with strict blood pressure control) and repeat angiography after 1 week represent an alternative strategy that is supported by this case report. As this case demonstrates, it is possible for small residual AVMs to thrombose. This may avert the need for reoperation for residual AVMs in eloquent cortex, with the potential for neurological deficits.
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ranking = 9
keywords = cortex
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20/107. A light and electron microscopic study of oedematous human cerebral cortex in two patients with post-traumatic seizures.

    PRIMARY OBJECTIVE: brain cortical biopsies of two patients with clinical diagnosis of complicated brain trauma who had seizures, were studied by means of light and electron microscopes in order to correlate structural alterations with seizure activity. methods AND PROCEDURES: biopsy samples of left frontal cortex and right parietal cortex were processed by current techniques for light and transmission electron microscopy. RESULTS: The tissue showed severe vasogenic oedema with perivascular and intraparenchymatous haemorrhages. At the capillary wall, increased vesicular and vacuolar transendothelial transport, open endothelial junctions, thickened basement membrane and swollen perivascular astrocytic end-feet were observed. Some pyramidal and non-pyramidal nerve cells appeared dense and shrunken and others exhibited marked intraneuronal enlargement of membrane compartment. The myelinated axons displayed signs of degeneration and a process of axonal sprouting. Numerous swollen asymmetrical axo-dendritic synaptic contacts were observed in the neuropil, which exhibited mostly closely aggregated spheroidal synaptic vesicles toward the presynaptic membrane and numerous exocytotic vesicles sites. The perisynaptic astrocytic ensheathment appeared retracted or absent, whereas the extracellular space appeared notably dilated. Synaptic disassembly was also observed. CONCLUSION: The findings demonstrate, in two patients with post-traumatic seizure activity, brain barrier dysfunction, vasogenic oedema, anoxic-ischaemic neurons, axonal sprouting, numerous altered excitatory synapses and synaptic disassembly. Some considerations on clinical and research applications are discussed.
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ranking = 6
keywords = cortex
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