1/2. Hypothalamic hamartoma in adults.epilepsy in adult patients with hypothalamic hamartoma has not been well studied. It is uncommon but merits recognition. In this paper, 14 adult patients with hypothalamic hamartoma and epilepsy, of whom three developed epilepsy only in adult life, are presented. The later onset of epilepsy appears to be associated with a milder epilepsy syndrome, less severe learning difficulties and behaviour problems, and better occupational and social status. Gelastic seizures are less prominent in this age group. Of particular interest, one patient had prominent sleep disturbances characterized by a reduction in total slow wave and REM sleep without daytime sleepiness. The milder epilepsy and preserved cognitive and social functioning have implications for management. A number of patients were controlled by anticonvulsant medication, and were functioning satisfactorily. For such patients minimally invasive surgical procedures, or medical therapy should be considered.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
2/2. The social environment and neurological disease.This chapter has reviewed some of the methodological and theoretical issues in research linking the social environment to medical illnesses. The second part of the chapter has focused on three specific neurological entities to examine evidence for a possible association between neurological illness and life stress. There is some suggestion that certain vulnerable epileptic patients can experience convulsions in response to acute emotional upheaval or certain types of cognitive challenges. More commonly, it is probable that social stress and emotional tension can produce lowering of seizure threshold by increasing levels of fatigue and disrupting sleep. The latter factor, in particular, is known to lower seizure threshold. In the case of stroke, several dramatic cases of intracranial hemorrhage have been related to disastrous life circumstances. A general association between life stress and stroke has yet to be established. The case for a link between life events and onset of exacerbation of multiple sclerosis seems stronger. Events which produce emotional upset seem capable of worsening symptoms in patients with existing disease, and several studies have reported unusual life stresses in the period preceding onset of symptoms in this disorder.- - - - - - - - - - ranking = 5keywords = life (Clic here for more details about this article) |