1/69. Transient paralytic attacks of obscure nature: the question of non-convulsive seizure paralysis.Eleven patients with transient paralytic attacks of obscure nature are described. paralysis could involve face or leg alone, face and hand, or face, arm and leg. The duration varied from two minutes to one day. Four patients had brain tumors, six probably had brain infarcts, and one a degenerative process. The differential diagnosis included TIAs, migraine accompaniments, and seizures. In the absence of good evidence for the first two, the cases are discussed from the standpoint of possibly representing nonconvulsive seizure paralysis (ictal paralysis, inhibitory seizure paralysis or somatic inhibitory seizure). Because of the difficulty in defining seizures as well as TIAs and migraine in their atypical variations, a firm conclusion concerning the mechanisms of the spells was not attained. Two cases of the hypertensive amaurosis-seizure syndrome have been added as further examples of ictal deficits.- - - - - - - - - - ranking = 1keywords = seizure (Clic here for more details about this article) |
2/69. A distinctive glioneuronal tumor of the adult cerebrum with neuropil-like (including "rosetted") islands: report of 4 cases.Four examples of a novel glioneuronal neoplasm are presented. All tumors affected adults (including two males and two females aged 25-40 years) as supratentorial, cerebral hemispheric masses with associated seizure activity and, in one case, symptoms of raised intracranial pressure and progressive hemiparesis. CT scans in two cases revealed hypodense masses without calcification. MRI scans at presentation demonstrated, in all cases, solid T1-hypointense and T2-hyperintense tumors with mass effect in one instance but no edema or contrast enhancement. Only one was relatively circumscribed on neuroradiologic study. All were infiltrative in their histologic growth pattern and predominantly glial in appearance, being composed mainly of fibrillary, gemistocytic, or protoplasmic astroglial elements of WHO grade II to III. Their distinguishing feature was their content of sharply delimited, neuropil-like islands of intense synaptophysin reactivity inhabited and rimmed in rosetted fashion by cells demonstrating strong nuclear immunolabeling for the neuronal antigens NeuN and Hu. These cells included small, oligodendrocyte-like ("neurocytic") elements as well as larger, more pleomorphic forms. Two cases contained, in addition, well-differentiated neurons of medium to ganglion-cell size. Proliferative activity was observed principally within the glial compartment; two cases contained mitotic figures and exhibited relatively elevated MIB-1 indices (6.8% and 8.2%). One of the latter progressed and proved fatal at 30 months following subtotal resection and radiotherapy. The three other patients are alive at intervals of 14 to 83 months, two tumor-free and one with extensive disease associated with the appearance of enhancement on MRI. This glioneuronal tumor variant may pursue an unfavorable clinical course.- - - - - - - - - - ranking = 0.1keywords = seizure (Clic here for more details about this article) |
3/69. Periictal diffusion-weighted imaging in a case of lesional epilepsy.PURPOSE: diffusion-weighted MR imaging (DWI) has been used for the early diagnosis of acute ischemic lesions in humans and in animal models of focal status epilepticus. We hypothesized that DWI may be a sensitive, noninvasive tool for the localization of the epileptogenic area during the periictal period. methods: A periictal DWI study was performed on a 35-year-old patient during focal status epilepticus with repetitive prolonged focal motor seizures originating from a lesion in the right frontal lobe. DWI results were analyzed visually and by calculating apparent diffusion coefficient (ADC) maps. RESULTS: On DWI, a single area of signal increase (decrease in ADC) was found in the region of focal electrocorticographic seizures that was mapped intraoperatively. CONCLUSIONS: Ictal/postictal DWI may be a useful technique for seizure localization in patients with lesional epilepsy.- - - - - - - - - - ranking = 0.93436288969954keywords = epilepsy, seizure, epileptic (Clic here for more details about this article) |
4/69. High-grade glioma mimicking acute viral encephalitis--three case reports.The clinical features of viral encephalitis consist of headache, fever, seizures and encephalopathy. We report three patients with high-grade gliomas presenting with encephalitic illnesses. The diagnosis of brain tumour should always be borne in mind if definite evidence for a viral infection is not obtained.- - - - - - - - - - ranking = 0.1keywords = seizure (Clic here for more details about this article) |
5/69. The insular lobe: physiopathological and surgical considerations.OBJECTIVE: Surgery of the insula represents a technical challenge, because of the proximity of the internal capsule to the lenticulostriate arteries and the lack of certainty concerning its functionality. Using intraoperative direct cerebral stimulation, combined with neuronavigation, the authors operated on 12 insular gliomas. On the basis of this experience, the physiopathological and surgical implications are discussed. methods: A low-grade insular glioma, revealed by seizures, was diagnosed in 12 right-handed patients with a normal neurological status. Preoperative magnetic resonance imaging showed that, according to Yasargil's classification system, three patients harbored Type 3 lesions and nine patients had Type 5 lesions (10 tumors on the right side and 2 on the left dominant side). All patients underwent surgery using direct cerebral stimulation, under general anesthesia in nine patients (motor mapping) and under local anesthesia in three patients (sensorimotor and language mapping). ultrasonography and/or neuronavigation was used in all cases. Preoperative angio-computed tomographic scanning showed the lenticulostriate arteries in two patients. RESULTS: The internal capsule was systematically detected, and the language areas were identified within the left insula in the awake patients. The lenticulostriate arteries were seen in two patients. Seven patients presented an immediate postoperative deficit; six of them recovered completely within 3 months. Four resections were total, six were subtotal, and two were partial (left insula). CONCLUSION: The use of intraoperative direct cerebral stimulation and neuronavigation allows surgery of the insula with minimization of the risk of sequelae, but its use is still limited with regard to the dominant hemisphere, owing to the essential role of this structure in language.- - - - - - - - - - ranking = 0.1keywords = seizure (Clic here for more details about this article) |
6/69. eating epilepsy associated with a deep forebrain glioma.seizures associated with deglutition are rare, and previously reported cases of so-called eating epilepsy have not identified specific electrophysiological or anatomical foci. We evaluated a 14-year-old with a deep hemispheric astrocytoma in whom focal seizures were consistently triggered by eating. Electroencephalograms were consistent with a deeply located seizure focus. eating epilepsy should be grouped with reflex epilepsies that may originate with the diencephalon.- - - - - - - - - - ranking = 0.9302458748736keywords = epilepsy, seizure (Clic here for more details about this article) |
7/69. agranulocytosis associated with lamotrigine in a patient with low-grade glioma.PURPOSE: To report agranulocytosis associated with lamotrigine (LTG) in a patient with a brain tumor. methods: A 59-year-old woman with a low-grade glioma and difficult-to-control partial seizures developed agranulocytosis between 9 and 14 weeks after starting LTG. The patient underwent chemotherapy 2 years previously. RESULTS: After stopping LTG, the agranulocytosis persisted for 9 days despite 7 days of granulocyte-colony-stimulating factor (G-CSF), and ultimately resolved. CONCLUSIONS: In this case, the use of LTG was associated with the development of agranulocytosis, and it is likely that this association was causative.- - - - - - - - - - ranking = 0.1keywords = seizure (Clic here for more details about this article) |
8/69. Complete response of a recurrent, multicentric malignant glioma in a patient treated with phenylbutyrate.sodium phenylbutyrate is a biological-response modifier that acts as a dose-dependent inhibitor of glioma cell proliferation, migration, and invasiveness in vitro, possibly by inhibition of urokinase and c-myc pathways. Despite its biological activity in vitro, there have not been any prior reports of efficacy in the treatment of human malignant gliomas. We report a 44-year-old female with a recurrent, multicentric, malignant glioma who experienced a durable remission lasting more than four years. The patient initially presented with seizures caused by a biopsy-proven anaplastic astrocytoma of the frontal lobe. The patient was treated with radiation therapy and procarbazine-CCNU-vincristine (PCV). However, the tumor progressed and extended to the corpus callosum with midline shift, refractory to four cycles of continuous 72-h infusion of BCNU/Cisplatinum. Additional enhancing lesions appeared in the left frontal and left temporal lobes. The patient was started on sodium phenylbutyrate, 18 g daily in three divided oral doses, and reduced to 9 g/day and eventually to 4.5 g/day to eliminate mild, reversible side effects. Four years later, the patient has a KPS functional score of 100%. Phenylbutyrate is a well-tolerated, oral agent that shows potential for the treatment of malignant gliomas. Further studies should be considered to identify a subset of patients that have tumors sensitive to phenylbutyrate, either as a single agent or in combination with radiation therapy or other chemotherapeutic agents.- - - - - - - - - - ranking = 0.1keywords = seizure (Clic here for more details about this article) |
9/69. Ictal vomiting in association with left temporal lobe seizures in a left hemisphere language-dominant patient.Ictal vomiting is considered a localizing sign indicating nondominant lateralization in patients with partial seizures of temporal lobe origin. We report a case of ictal vomiting associated with left temporal seizure activity in a left hemisphere language-dominant patient with a left mesial temporal glioma. Bilateral mesial temporal depth electrodes helped verify seizure lateralization. Surgery consisting of tumor resection and a left anterior temporal lobectomy and amygdalohippocampectomy resulted in freedom from seizures and episodes of vomiting. This case indicates that ictal vomiting can occur as a manifestation of left temporal onset seizures in left hemisphere-dominant patients.- - - - - - - - - - ranking = 0.9keywords = seizure (Clic here for more details about this article) |
10/69. Extensive and dense calcification in the core of a ventrally exophytic brainstem glioma.The first case of a ventrally exophytic pontine glioma with extensive and dense calcification is reported. A 10-year-old boy presented with a generalized seizure. The skull radiogram and CT scan showed a dense area of calcification, revealed by MRI as the core of a ventrally exophytic tumor. The pathologic diagnosis was fibrillary astrocytoma.- - - - - - - - - - ranking = 0.1keywords = seizure (Clic here for more details about this article) |
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