scholarly journals Etiology of epilepsy a prospective study of 210 cases

1991 ◽  
Vol 49 (3) ◽  
pp. 251-254 ◽  
Author(s):  
Walter Oleschko Arruda

The objective of this study was to establish the etiology of epilepsy in 210 chronic epileptics (110 female, 100 male), aged 14-82 years (34.2±13.3). Patients less than 10 years-old and alcoholism were excluded. All underwent neurological examination, routine blood tests, EEG and CT-scan. Twenty patients (10.5%) were submitted to spinal tap for CSF examination. Neurological examination was abnormal in 26 (12.4%), the EEG in 68 (45.5%), and CT-scan in 93 (44.3%). According to the International Classification of Epileptic Seizures (1981), 101 (48.1%) have generalized seizures, 66 (31.4%) partial seizures secondarily generalized, 25 (11.8%) simple partial and complex partial seizures, and 14 (6.6%) generalized and partial seizures. Four patients (2.0%) could not be classified. In 125 (59.5%) patients the etiology was unknown. Neurocysticercosis accounted for 57 (27.1%) of cases, followed by cerebrovascular disease 8 (3.8%), perinatal damage 5 (2.4%), familial epilepsy 4 (1.9%), head injury 4 (1.9%), infective 1 (0.5%), and miscelanea 6 (2.8%).

Cephalalgia ◽  
1983 ◽  
Vol 3 (2) ◽  
pp. 115-118 ◽  
Author(s):  
G. Lanzi ◽  
U. Balottin ◽  
A. Ottolini ◽  
F. Rosano Burgio ◽  
E. Fazzi ◽  
...  

A retrospective method was used to estimate the incidence of recurring motion-sickness, cyclic vomiting and abdominal pain considered as different manifestations of a so-called periodic syndrome in 100 migraine sufferers, 100 epileptics and 100 control subjects in the pediatric age group. Such recurrent symptoms are significantly more frequent in those suffering from migraine than in the other two groups. Examination of subgroups of patients affected by particular forms of migraine (classical and common) and of epilepsy (generalized seizures, simple partial seizures, complex partial seizures) contributed little new to our understanding of the nature of periodic syndrome. It is concluded that the above symptoms of periodic syndrome should generally be considered as manifestations of a migrainous rather than of an epileptic disorder.


Author(s):  
Andrew McEvoy ◽  
Tim Wehner ◽  
Victoria Wykes

Epileptic seizures are transient neurologic alterations due to abnormal excessive or synchronous neuronal cerebral activity. They may cause subjective symptoms (aura), and objective autonomic, behavioural, or cognitive alterations in any combination. Focal seizures are initially generated in one circumscribed area in the brain, whereas generalized seizures involve bihemispheric neuronal networks from the seizure onset. Epilepsy is a brain disease defined by the occurrence of two unprovoked seizures more than 24 h apart or one unprovoked seizure with underlying pathological or genetic factors resulting in a similar recurrence risk. Focal epilepsy syndromes are best classified by aetiology or anatomical area of origin. A seizure that does not self-terminate results in status epilepticus, and constitutes a medical emergency that requires immediate treatment. Focal cortical dysplasia and hippocampal sclerosis are the commonest aetiologies of epilepsy amenable to surgical treatment and are reviewed here. The limbic pathway may be involved in seizure propagation, and the anatomy is described.


2011 ◽  
Vol 24 (1) ◽  
pp. 35-41 ◽  
Author(s):  
Andrew P. Bagshaw ◽  
Andrea E. Cavanna

Consciousness is a central concept in epileptology, relevant to the understanding of both focal and generalized seizures. Within focal seizures, impairment of consciousness has long been considered as the main criterion differentiating complex partial seizures (CPS) from simple partial seizures With the development of improved tools for investigating human brain function, new insights into the brain mechanisms of altered consciousness in CPS have become available. This paper reviews the existing literature on how the currently available methods can be used to address the fundamental issue of how CPS alter consciousness.


Author(s):  
Dirk Bäumer

Seizures are transient neurological events caused by abnormal excessive or synchronous neuronal activity in the brain. This can arise from a localized brain region, causing focal seizures, or simultaneously from both hemispheres, leading to generalized seizures. Epilepsy is the tendency to develop recurrent seizures and is usually diagnosed after two or more unprovoked seizures. This chapter covers simple partial seizures (sometimes called aura), complex partial seizures, and focal (or partial) seizures, their differential diagnosis, context, approach to diagnosis, key diagnostic tests, therapy, and prognosis, as well as dealing with uncertainty in a diagnosis.


Neurosurgery ◽  
2013 ◽  
Vol 73 (5) ◽  
pp. 838-844 ◽  
Author(s):  
Dario J. Englot ◽  
Anthony T. Lee ◽  
Catherine Tsai ◽  
Cathra Halabi ◽  
Nicholas M. Barbaro ◽  
...  

Abstract BACKGROUND: Temporal lobectomy can lead to favorable seizure outcomes in medically-refractory temporal lobe epilepsy (TLE). Although most studies focus on seizure freedom after temporal lobectomy, less is known about seizure semiology in patients who “fail” surgery. Morbidity differs between seizure types that impair or spare consciousness. Among TLE patients with seizures after surgery, how does temporal lobectomy influence seizure type and frequency? OBJECTIVE: To characterize seizure types and frequencies before and after temporal lobectomy for TLE, including consciousness-sparing or consciousness-impairing seizures. METHODS: We performed a retrospective longitudinal cohort study examining patients undergoing temporal lobectomy for epilepsy at our institution from January 1995 to August 2010. RESULTS: Among 241 TLE patients who received temporal lobectomy, 174 (72.2%) patients achieved Engel class I outcome (free of disabling seizures), including 141 (58.5%) with complete seizure freedom. Overall seizure frequency in patients with persistent postoperative seizures decreased by 70% (P < .01), with larger reductions in consciousness-impairing seizures. While the number of patients experiencing consciousness-sparing simple partial seizures decreased by only 19% after surgery, the number of individuals having consciousness-impairing complex partial seizures and generalized tonic-clonic seizures diminished by 70% and 68%, respectively (P < .001). Simple partial seizure was the predominant seizure type in 19.1% vs 37.0% of patients preoperatively and postoperatively, respectively (P < .001). Favorable seizure outcome was predicted by a lack of generalized seizures preoperatively (odds ratio 1.74, 95% confidence interval 1.06-2.86, P < .5). CONCLUSION: Given important clinical and mechanistic differences between seizures with or without impairment of consciousness, seizure type and frequency remain important considerations in epilepsy surgery.


PEDIATRICS ◽  
1982 ◽  
Vol 70 (1) ◽  
pp. 87-90
Author(s):  
Kazuyoshi Watanabe ◽  
Kimiko Hara ◽  
Susumu Hakamada ◽  
Tamiko Negoro ◽  
Midori Sugiura ◽  
...  

Five children who had apneic attacks as a manifestation of epileptic seizures are reported. In three children, the apneic attacks were the sole symptom of epileptic fits. The other two children had additional types of seizures. The apneic seizures usually lasted one to two minutes and were characterized by respiratory embarrassment rather than complete arrest. These seizures are usually accompanied by cyanosis which appears early during the course of the attack. Although consciousness seemed to be impaired, this was difficult to assess accurately in infants. The ictal EEGs disclosed paroxysmal discharges of focal onset in all cases, consisting of high amplitude θ-waves, gradually mixed with or replaced by sharp waves or spikes in some and fast waves followed by slower waves in others. These occurred in temporal areas in three patients and in frontal and central areas in one patient each. Interictal EEGs, however, revealed paroxysmal discharges in only one patient. Apneic attacks in these infants are considered to be an integral part of the manifestations of complex partial seizures originating mostly in the limbic system.


2006 ◽  
Vol 6 (3) ◽  
pp. 78-79 ◽  
Author(s):  
Elinor Ben-Menachem

Use of Serum Prolactin in Diagnosing Epileptic Seizures: Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology Chen DK, So YT, Fisher RS Neurology 2005;65(5):668–675 (Review) Objective The purpose of this article is to review the use of serum prolactin assay in epileptic seizure diagnosis. Methods The authors identified relevant studies in multiple databases and reference lists. Studies that met inclusion criteria were summarized and rated for quality of evidence, and the results were analyzed and pooled where appropriate. Results Most studies used a serum prolactin of at least twice baseline value as abnormal. For the differentiation of epileptic seizures from psychogenic nonepileptic seizures, one Class I and seven Class II studies showed that elevated serum prolactin was highly predictive of either generalized tonic–clonic or complex partial seizures. Pooled sensitivity was higher for generalized tonic–clonic seizures (60.0%) than for complex partial seizures (46.1%), while the pooled specificity was similar for both (approximately 96%). Data were insufficient to establish validity for simple partial seizures. Two Class II studies were consistent in showing prolactin elevation after tilt-test–induced syncope. Inconclusive data exist regarding the value of serum prolactin following status epilepticus, repetitive seizures, and neonatal seizures. Recommendations Elevated serum prolactin assay, when measured in the appropriate clinical setting at 10 to 20 minutes after a suspected event, is a useful adjunct for the differentiation of generalized tonic–clonic or complex partial seizure from psychogenic nonepileptic seizure among adults and older children (Level B). Serum prolactin assay does not distinguish epileptic seizures from syncope (Level B). The use of serum PRL assay has not been established in the evaluation of status epilepticus, repetitive seizures, and neonatal seizures (Level U).


2021 ◽  
Author(s):  
Nandini Priyanka Balasubramani ◽  
Elangovan S ◽  
Thangaraj M

Background: Epilepsy is the second most common and frequently encountered neurological disorder which poses huge threat to known healthcare systems worldwide also causing financial, socio economic burden to the community. Complex Partial Seizures are a form of focal epileptic seizures that may impair consciousness. Aim and objectives: Our motivation for the study was to understand the extent of patients with complex partial seizures associated with medial temporal lobe sclerosis. Materials and methods: We performed a cross sectional study about patients with complex partial seizures in Thanjavur medical college and hospital about their clinical profile and neuro-radiological correlation. Statistical analysis and results: Through our multimodal study with EEG, MRI on N=118 (female / male, age range, Most common age group- 10-20 years, mean age of 23 years, SD- 14 years, 66% males), we observed that atypical febrile seizures and fever provoked seizures has more association (18%) to complex partial seizures and to medial temporal lobe sclerosis in comparison to 12% in an earlier study. Conclusion: We believe this study summarizes the complex partial seizure features, origin, and their link to Medial Temporal lobe Sclerosis in our subject pool from Thajavur, India. Limitation: There are some limitations to our study, especially with no video EEG monitoring and no invasive EEG recording. We aim to improve them in our future studies.


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