Cases reported "Epilepsy"

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1/34. Psychoneuroendocrine aspects of temporolimbic epilepsy. Part III: case reports.

    Many reproductive steroids have neuroactive effects that can modulate neuronal excitability and influence emotions. Emotional disorders may result when 1) abnormal endocrine states interact with normal brain, 2) normal endocrine states interact with abnormal brain, and 3) abnormal endocrine states interact with abnormal brain. An understanding of these pathogenetic relationships and the potential therapeutic role of reproductive hormones should lead to a more effective and comprehensive management of women and men with anxiety and mood disorders.
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2/34. Photosensitive and nonphotosensitive electronic screen game-induced seizures.

    PURPOSE: To disclose possible epileptologic differences between photosensitive and nonphotosensitive patients with seizures induced by electronic screen games (ESGs). methods: In patients with ESG-induced seizures who showed photo- and pattern sensitivity, magnetoencephalography (MEG) and EEG were performed simultaneously during ESG play, and equivalent current dipoles (ECDs) of the MEG spikes were estimated. In patients without ESG-induced seizures, who were surgical candidates, the intracranial EEG was analyzed for changes in epileptiform spike frequency. RESULTS: Fifteen of 29 patients were photo- or pattern sensitive, and they had a posterior predominance of ECDs of the MEG spikes. In contrast, nonphotosensitive patients had an anterior predominance of ECDs. Other seizure-precipitating factors in the nonphotosensitive patients included hand manipulation or spatial processing. In patients without a history of ESG-induced seizures who underwent intracranial EEG monitoring for surgical evaluation, ESG playing induced changes in spike frequency in the supplementary motor area, perisylvian region, and medial temporal lobe. CONCLUSIONS: In photosensitive patients, interictal MEG spikes arise predominantly from the posterior region of the brain. In nonphotosensitive patients, epileptiform spikes tend to originate in the anterior part of the brain. Thus factors involving functions of the anterior part of the brain other than photo- or pattern sensitivity may play a role in the induction of seizures during ESG play. Furthermore, the changes in spike frequency in specific brain areas may correspond to their involvement in praxic activity and emotional changes during ESG play. A chance occurrence of seizures during ESG play also was observed.
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keywords = motion
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3/34. Emotional outbursts and post-traumatic stress disorder during intracarotid amobarbital procedure.

    Severe emotional outbursts (SEOs) during intracarotid amobarbital procedures (IAP) rarely jeopardize preoperative language and memory testing. Four of four patients (100%) with outbursts had experienced significant emotional trauma (three were raped and one witnessed a decapitation), compared with 26 of 546 patients (4.8%) without outbursts (chi2 = 69.8, p < 0. 0001). Evocative injections were ipsilateral to seizure focus. IAP may disrupt emotional balance in some traumatized patients. counseling may prevent SEOs.
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ranking = 3.5
keywords = motion
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4/34. A transient deficit of motion perception in human.

    We studied the motion perception abilities in a young adult, SF, who had her right occipito-temporal cortices resected to treat epilepsy. Following resection, SF showed transient deficits of both first- and second-order motion perception that recovered to normal within weeks. Previous human studies have shown either first- or second n order motion deficits that have lasted months or years after cerebral damage. SF also showed a transient defect in processing of shape-from-motion with normal perception of shape from non-motion cues. Furthermore, she showed greatly increased reaction times for a mental rotation task, but not for a lexical decision task. The nature and quick recovery of the deficits in SF resembles the transient motion perception deficit observed in monkey following ibotenic acid lesions, and provides additional evidence that humans possess specialized cortical areas subserving similar motion perception functions.
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ranking = 5.5
keywords = motion
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5/34. Transient epileptic amnesia in dementia: a treatable unrecognized cause of episodic amnestic wandering.

    The authors present two patients with dementia who displayed recurrent transient episodes of amnestic wandering and disorientation characterized by getting lost in familiar environments. At other times these patients did not wander or become disoriented. The inability to recall any information during these episodes, and the marked difference of the episodic amnesia exacerbations from the progressive amnesia characteristic of alzheimer disease seen in these patients led to their evaluation. These clinical episodes and the bilateral interictal epileptiform electroencephalographic changes found in both patients led to the diagnosis of transient epileptic amnesia, a syndrome that can be diagnostically elusive. These transient amnestic wandering events subsided after treatment with antiepileptic drugs in both patients. The authors suggest that transient wandering of this type may be caused by ictal events or postictal confusional states. This report emphasizes the importance of recognizing transient epileptic amnesia as an easily treatable cause of episodic behavioral abnormalities responsive to antiepileptic therapy, especially in those patients who have a markedly inconsistent pattern of wandering, disorientation in familiar settings, and amnesia exacerbation manifested by no recall of the emotional stress of getting lost or of any information during these episodes. Recognition of this type of behavioral disruption and its proper treatment can lead to improved quality of life for these patients, maintain these patients in their homes and out of chronic care institutions longer, and facilitate the community's and caretaker's interactive roles with the patient.
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ranking = 0.5
keywords = motion
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6/34. Direction-specific motion blindness induced by focal stimulation of human extrastriate cortex.

    Motion blindness (MB) or akinetopsia is the selective disturbance of visual motion perception while other features of the visual scene such as colour and shape are normally perceived. Chronic and transient forms of MB are characterized by a global deficit of direction discrimination (pandirectional), which is generally assumed to result from damage to, or interference with, the motion complex MT /V5. However, the most characteristic feature of primate MT-neurons is not their motion specificity, but their preference for one direction of motion (direction specificity). Here, we report that focal electrical stimulation in the human posterior temporal lobe selectively impaired the perception of motion in one direction while the perception of motion in other directions was completely normal (unidirectional MB). In addition, the direction of MB was found to depend on the brain area stimulated. It is argued that direction specificity for visual motion is not only represented at the single neuron level, but also in much larger cortical units.
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ranking = 5.5
keywords = motion
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7/34. epilepsy and ring chromosome 20: case report.

    We present the clinical, electroencephalographic, neuroimaging (brain magnetic resonance image - MRI and spectroscopy by MRI) and cytogenetic findings of a young male patient with a rare cytogenetic anomaly characterised by a de novo 46,XY,r(20)(p13q13.3) karyotype. He presents with mental retardation, emotional liability, and strabismus, without any other significant dysmorphies. There are brain anomalies characterised by corpus callosum, uvula, nodule and cerebellum pyramid hypoplasias, besides arachnoid cysts in the occipital region. He had seizures refractory to pharmacotherapy and long period of confusional status with or without a motor component. The authors recognised that the EEG pattern was not fixed but changed over time, specially for bursts of slow waves with great amplitude accompanied or not by sharp components, and bursts of theta waves sharply contoured. Previously, epilepsy solely has been assigned to region 20q13. However, the important structural cerebral alterations present in our case has not been reported associated to such chromosomal abnormality and may indicate possible new chromosomal sites where such atypical neurological characteristics could be mapped.
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keywords = motion
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8/34. Cognitive retraining in epilepsy.

    epilepsy is the commonest neurological disorder, so there is a need to establish more effective remedial programmes for the deficits in cognitive functioning associated with epilepsy. The present paper studies the relative change in the targeted skill areas as a consequence of cognitive retraining. For this purpose, a pre- and post-multiple baseline design was adopted with the intention of treating specific deficient skill. The measures of neuropsychological functioning adopted were a composite of tests/tasks, with specific emphasis on attention, memory and emotional status. The subject was targeted to a special neuro-rehabilitation programme comprised of cognitive retraining, supportive therapy and a deep breathing relaxation exercise. A regular home intervention programme was conducted simultaneously. Cognitive retraining included both paper and pencil tasks and real life activities. The training programme covered a 6-week period and each weekly session lasted approximately 1 hour. The results showed an overall improvement in cognitive performance across sessions, and the regular home intervention sessions were found to have enhanced the subject's performance. In conclusion, it was noted that by identifying cognitive deficits, effective training programmes can be devised that will be of substantial benefit to patients with epilepsy.
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keywords = motion
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9/34. Amusia after right frontal resection for epilepsy with singing seizures: case report and review of the literature.

    Although many authors consider aprosodia and amusia to be synonymous, they actually represent two distinct communication disorders. Amusia refers to a profound deficit involving musical abilities, whereas aprosodia refers to deficits regarding the emotional content of speech. Many authors have presumed a similar etiology and localization for these conditions and assumed that these disorders would not occur independently. We report the case of a 31-year-old choir director who developed amusia without aprosodia after a right frontal lobe resection for intractable seizures. His ictal onset manifested with rhythmic slapping of his thighs while communicating with melodic speech. Video EEG monitoring documented right hemispheric discharges that occurred simultaneously with this ictal behavior. While a right frontal lobe resection made him seizure-free, his postoperative amusia was so profound that he could no longer continue his occupation as a choir director. This case suggests that the right frontal cortex has different sites for musical ability distinct from the centers regarding prosody. patients scheduled to undergo right frontal lobectomy ought to be counseled regarding the potential loss of musical abilities.
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keywords = motion
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10/34. Bilateral simultaneous hip fractures secondary to an epileptic seizure.

    A 30-year-old man sustained bilateral simultaneous displaced subcapital fractures of neck of femur during an epileptic tonic-clonic seizure. After admission to the hospital approximately 18 hours later, internal fixation of the fractures with dynamic hip screw was undertaken. Post operatively, he was managed by early motion and weight bearing on the second day. Despite the severity of the fractures and delayed surgery, satisfactory union of the fractures was noted at 6 months when bone densitometry was normal. At 3 years follow up, there was no sign of avascular necrosis of the femoral heads.
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keywords = motion
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