scholarly journals Alternative psychosis (forced normalisation) in epilepsy

2011 ◽  
Vol 17 (2) ◽  
pp. 4
Author(s):  
Vongani Titi Raymond Ntsanwisi ◽  
Solomon T Rataemane ◽  
Dali S Magazi
Keyword(s):  
Seizure Activity ◽  
Diagnosis And Treatment ◽  
Behavioural Problems ◽  
Valproate Sodium ◽  
Behavioural Changes ◽  
Forced Normalisation ◽  
Forced Normalization ◽  
Refractory Seizures

Abstract Forced normalization is a paradoxical relationship between seizure activity and behavioural problems. A 20 year old male with recurrent refractory tonic clonic epilepsy experienced forced normalization, whilst on medication with multiple anti- epileptic drugs (AEDs).(Valproate Sodium, Carbamazepine, and Topiramate). A reduction in the seizure burden correlated with sudden behavioural changes manifesting with aggressive outbursts and violence.. The present case may help clarify the mechanism of forced normalization whilst providing some helpful hints regarding the diagnosis and treatment of symptoms observed in recurrent refractory seizures.

Seizures following surgery for supratentorial extratemporal low-grade tumors in children: a multicenter retrospective study

2020 ◽  
Vol 26 (1) ◽  
pp. 27-33
Author(s):  
Jonathan Roth ◽  
Or Bercovich ◽  
Ashton Roach ◽  
Francesco T. Mangano ◽  
Arvind C. Mohan ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Brain Tumors ◽  
Seizure Control ◽  
Seizure Activity ◽  
Refractory Epilepsy ◽  
Low Grade ◽  
Refractory Seizures ◽  
Low Rate ◽  
Over Time ◽  
New Onset

OBJECTIVEResection of brain tumors may lead to new-onset seizures but may also reduce seizure rates in patients presenting with seizures. Seizures are seen at presentation in about 24% of patients with brain tumors. For lesional epilepsy in general, early resection is associated with improved seizure control. However, the literature is limited regarding the occurrence of new-onset postoperative seizures, or rates of seizure control in those presenting with seizures, following resections of extratemporal low-grade gliomas (LGGs) in children.METHODSData were collected retrospectively from 4 large tertiary centers for children (< 18 years of age) who underwent resection of a supratentorial extratemporal (STET) LGG. The patients were divided into 4 groups based on preoperative seizure history: no seizures, up to 2 seizures, more than 2 seizures, and uncontrolled or refractory epilepsy. The authors analyzed the postoperative occurrence of seizures and the need for antiepileptic drugs (AEDs) over time for the various subgroups.RESULTSThe study included 98 children. Thirty patients had no preoperative seizures, 18 had up to 2, 16 had more than 2, and 34 had refractory or uncontrolled epilepsy. The risk for future seizures was higher if the patient had seizures within 1 month of surgery. The risk for new-onset seizures among patients with no seizures prior to surgery was low. The rate of seizures decreased over time for children with uncontrolled or refractory seizures. The need for AEDs was higher in the more active preoperative seizure groups; however, it decreased with time.CONCLUSIONSThe resection of STET LGGs in children is associated with a low rate of postoperative new-onset epilepsy. For children with preoperative seizures, even with uncontrolled epilepsy, most have a significant improvement in the seizure activity, and many may be weaned off their AEDs.

Insular epilepsy masquerading as multifocal cortical epilepsy as proven by depth electrode

2010 ◽  
Vol 5 (4) ◽  
pp. 365-367 ◽  
Author(s):  
Michael R. Levitt ◽  
Jeffrey G. Ojemann ◽  
John Kuratani
Keyword(s):  
Seizure Control ◽  
Seizure Activity ◽  
Insular Cortex ◽  
Diagnosis And Treatment ◽  
Precise Localization ◽  
Partial Seizures ◽  
Complex Partial Seizures ◽  
Cortical Areas ◽  
Depth Electrodes ◽  
Depth Electrode

The insular cortex is an uncommon epileptogenic location from which complex partial seizures may arise. Seizure activity in insular epilepsy may mimic temporal, parietal, or other cortical areas. Semiology, electroencephalography, and even surface electrocorticography recordings may falsely localize other cortical foci, leading to inaccurate diagnosis and treatment. The use of insular depth electrodes allows more precise localization of seizure foci. The authors describe the case of a young girl with seizures falsely localized to the cortex, with foci arising from the insula, as proven by depth electrode recordings. Resection of the insula yielded seizure control.

scholarly journals Escalation to Barbiturate-Induced Coma for Refractory Seizures after Liver Transplantation

2022 ◽  
Vol 2022 ◽  
pp. 1-4
Author(s):  
Brittany Miles ◽  
Muhammad Mujtaba ◽  
Shehzad Merwat ◽  
Rupak Kulkarni ◽  
Jeffrey Fair ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Antiepileptic Drugs ◽  
Conventional Treatment ◽  
De Novo ◽  
Seizure Activity ◽  
Burst Suppression ◽  
Full Recovery ◽  
Ventilator Support ◽  
Generalized Seizures ◽  
Refractory Seizures

Seizures after liver transplantation were previously thought to be a reliable harbinger of catastrophe, but more recent studies have found seizure activity to be relatively common, and most cases do not result in a poor outcome. Generalized seizures are the most common, and they typically occur de novo within the first two weeks after transplantation. The underlying cause for seizure activity in these patients may be complex, with potential etiologies including metabolic, infectious, cerebrovascular, and medication-induced causes. Identification of the underlying cause and the use of antiepileptic drugs (AEDs) is crucial for minimizing risk to the patient’s neurologic and overall health. In this report, we present the case of a patient with refractory seizures unresponsive to conventional treatment, requiring prolonged barbiturate burst suppression with ventilator support. Seizure activity eventually ceased, and the patient made a full recovery.

Problem behaviours and management in cats and dogs.

2021 ◽  
pp. 169-179
Author(s):  
Sagi Denenberg
Keyword(s):  
Clinical Signs ◽  
Diagnosis And Treatment ◽  
Behavioural Problems ◽  
Problem Behaviours

Abstract The clinical signs, diagnosis and treatment of owner-perceived behavioural problems in cats and dogs are described.

Refractory Seizures of Infancy with SCN2A: A Case Review

2019 ◽  
Vol 38 (6) ◽  
pp. 336-340
Author(s):  
Sydney L. Sutton ◽  
Cheryl Carlson ◽  
Cheryl Riley
Keyword(s):  
Seizure Activity ◽  
Neonatal Period ◽  
Sodium Ion ◽  
Genetic Mutations ◽  
Case Review ◽  
Diagnosis And Management ◽  
Exact Etiology ◽  
Refractory Seizures

Neonatal epilepsy occurs for many reasons. Infants may present shortly after birth with seizure activity or seizures may occur later in the neonatal period. Seizures that are refractory to treatment can be difficult to manage and because of different presentations, there may be a delay in diagnosing the exact etiology. Prompt intervention is necessary and developing a plan of care can be done while exploring the etiology. There are several genetic mutations, including the SCN2A sodium ion channelopathy, that can result in a wide array of epileptic conditions, ranging from mild to severe. This case review focuses on diagnosis and management of SCN2A refractory seizures.

Behavioural co-morbidities in epilepsy

2018 ◽  
Author(s):  
Andrea E. Cavanna
Keyword(s):  
Psychiatric Disorders ◽  
Antiepileptic Drugs ◽  
Temporal Relationship ◽  
Psychotic Symptoms ◽  
Behavioural Changes ◽  
Forced Normalization ◽  
Clinical Phenomenon ◽  
Clinically Significant ◽  
Patients With Epilepsy

The association between epilepsy and specific behavioural co-morbidities has long been recognized. The most common and clinically significant psychiatric disorders reported by patients with epilepsy encompass affective, anxiety, and psychotic symptoms. Behavioural co-morbidities in epilepsy can be classified according to the temporal relationship with seizures—inter-ictal, peri-ictal (pre-ictal, ictal, post-ictal), and para-ictal symptomatology. Antiepileptic drugs (AEDs) can modulate behavioural changes in patients with epilepsy through different pathways and are directly responsible for the clinical phenomenon of ‘forced normalization’ (‘alternative psychosis’).

A Case of Refractory Seizures Caused by an Unusual Zoonosis

2013 ◽  
Vol 14 (1) ◽  
pp. 65-66 ◽  
Author(s):  
James Walkington ◽  
Mruthunjaya Hulgur ◽  
David Yates ◽  
C Andy Eynon
Keyword(s):  
Intensive Care ◽  
Seizure Activity ◽  
Refractory Status Epilepticus ◽  
Serological Evidence ◽  
Anaesthetic Agents ◽  
Refractory Status ◽  
Tick Borne Encephalitis ◽  
Louping Ill ◽  
Refractory Seizures ◽  
The Uk

A 29-year-old female presented to the intensive care unit with refractory status epilepticus. Despite treatment with anticonvulsants and sedation, she continued to have EEG evidence of seizure activity that terminated only with volatile anaesthetic agents. There was serological evidence of exposure to a flavivirus. In the UK the only endemic flavivirus is Louping ill, which is closely related to tick-borne encephalitis. It was likely that this was the cause. She remained on intensive care for almost six months and failed to regain consciousness.

Aortic root aneurysm. Diagnosis and treatment

JAMA ◽  
1966 ◽  
Vol 197 (2) ◽  
pp. 133-134 ◽  
Author(s):  
H. Najafi
Keyword(s):  
Aortic Root ◽  
Diagnosis And Treatment ◽  
Aortic Root Aneurysm
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