1/9. Bilateral astrocytoma involving the limbic system precipitating disabling amnesia and seizures.Astrocytomas involving the limbic system are usually unilateral in nature. We report a very unusual case where a low-grade astrocytoma originating in the left temporal lobe spread to the right hippocampus through the hippocampal commissure to cause disabling amnesia and seizures. Some improvement in the memory deficit was facilitated by identification of complex partial status epilepticus. EEG should be performed in all patients with lesions of the limbic system and neuropsychological problems if ongoing seizure activity is not to be missed.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/9. Osteosclerotic metaphyseal dysplasia: a skeletal dysplasia that may mimic lead poisoning in a child with hypotonia and seizures.We report the case of a 23-month-old male with hypotonia, developmental delay, and complex seizures. Radiographs revealed profound sclerosis of the metaphyses and epiphyses of the long and short bones in the extremities, with a unique pattern of distribution. sclerosis also involved the anterior ribs, iliac crests, talus, and calcaneus. The skull and vertebral bodies appeared unaffected. blood lead levels were normal. We believe that this constellation of clinical and radiographic abnormalities closely resembles osteosclerotic metaphyseal dysplasia (OMD) due to an autosomal recessive defect. Characteristic skeletal findings were instrumental in determining the diagnosis. OMD is a very rare sclerosing bone disorder, first described in 1993. The syndrome is characterized clinically by developmental delay of a progressive nature, hypotonia, elevated alkaline phosphatase, and late-onset spastic paraplegia. We encountered a young child with these neurologic symptoms who displayed sclerotic metaphyseal changes on hand radiographs obtained to determine the bone age. lead poisoning, a known cause of metaphyseal sclerosis, was initially suspected. Careful analysis of the metaphyseal bone changes helped to distinguish this bone dysplasia from lead poisoning and other causes of metaphyseal sclerosis.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/9. Group therapy in the management of epilepsy.A pilot project using group therapy with patients from an epilepsy clinic is described. Observations of the group show that members were able to discuss their feelings about having epilepsy, and the difficulties the disorder caused in all areas of their lives, and to tolerate and learn from seizures which took place during group meetings. The greatest benefit was meeting others with epilepsy and sharing experiences in an environment that was not overprotective or overanxious, in contrast to their usual surroundings. The author suggests that groups of a similar nature could be a useful addition to the management of people with epilepsy.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/9. Complete atrio-ventricular conduction block during complex partial seizure.Cardiac arrhythmias are a well known cause of epileptic seizures. Epileptic seizures resulting in cardiac arrhythmias are less well recognised and cardiac arrhythmias are commonly presumed to be of primary cardiac origin. This paper describes a patient with complete AV heart-block during a partial complex seizure. Simultaneous EEG/ECG monitoring was used to show the secondary nature of the bradyarrhythmia.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/9. Vanishing CT lesions in epilepsy.Experience with computed tomography (CT) in patients with epilepsy has drawn attention to specific type of cerebral lesions widely prevalent in this part of the world. The lesions disappear spontaneously while patients receive only anticonvulsant therapy. The exact nature of these lesions is not yet understood. One-hundred and twenty-two such patients (M 77; F 45) were studied. Their age ranged from 3 to 57 (mean 21.8 /- 12.7) years. seizures were partial motor in 86 (70.5%), generalised tonic clonic in 31 (25.4%), complex partial in 4 and atonic in one case. Postictal hemiparesis was seen in 6 patients who completely recovered within 5 min to 7 days. One hundred patients underwent EEG examination. It was abnormal in 84 cases; 40 patients showed localisation which correlated with CT findings. Plain CT showed low attenuation lesions in all cases. Morphology on contrast enhancement was ring lesion in 50 (40.9%), disc lesion in 47 (38.5%), target lesion in 3 (2.5%), mixed lesion in 2 (0.8%), no enhancement in 18 (14.8%) and a speck with oedema in 2 (0.8%) cases. All lesions were cerebral, present at cortical-subcortical junction. The first follow-up scan was performed in 78 (63.9%) patients within 6-12 weeks. It showed complete disappearance of the lesion in 47 (60.3%) cases. Reduction in size of the lesion and surrounding oedema was observed in 24 (30.8%) cases. The follow-up scans in these 24 cases revealed disappearance of lesion in 11 cases and almost complete resolution of the lesion with a remaining speck in 13 cases. cerebrospinal fluid (CSF) was normal in 95 out of 100 cases in which it was performed.(ABSTRACT TRUNCATED AT 250 WORDS)- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/9. Palatal myoclonus occurring during complex partial status epilepticus.Palatal myoclonus is thought to occur after damage to certain brain-stem structures, and with a delay following the causative lesion. A case of palatal myoclonus, probably of epileptic nature, is described.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/9. A case of systemic lupus erythematosus with complex partial status epilepticus.We describe a woman with systemic lupus erythematosus who had complex partial status epilepticus as the sole epileptic manifestation. The patient presented with a confusional state, initially considered to be psychotic in nature, due to SLE. However, the EEG demonstrated the epileptic etiology of her symptoms. In patients with lupus presenting with prolonged episodes of confusion and behavioural disturbance, an EEG should be performed, whenever possible during the episode, even in the absence of a previous history of epilepsy.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/9. Transient global amnesia as a postictal state from recurrent partial seizures.A 60-year-old patient had a 3-year history of recurrent memory disturbances. The video electroencephalographic (EEG) recording of one attack showed that the amnesic state, which clinically resembled transient global amnesia, was characterized by a normal EEG tracing followed by electroclinical complex partial seizures. We suggest that "epileptic" transient global amnesia is postictal in nature.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/9. Epileptic akinetic mutism: following temporal lobectomy for Rasmussen's syndrome.A girl aged 9 years with Rasmussen's encephalitis previously treated by left temporal lobectomy suddenly developed prolonged attacks of extremely rapid respirations associated with poverty of body movements and greatly reduced facial movements with loss of speech. Her comprehension appeared intact and she responded to certain requests. Her eye gaze behaviour suggested a high degree of vigilance. The attacks would last from minutes to hours and were repeated up to a dozen times daily. In the context of the stress generated by the illness and other family problems the attacks had been mistaken for an hysterical elaboration. Their ictal nature was confirmed by EEG/video monitoring. Possible links with other developmental language disorders associated with epilepsy are discussed, including a model of autism.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |