Two patients with prolonged postictal encephalopathy lasting 63 and 72 hours, respectively, following seizures with clozapine are reported. Clozapine alters the EEG in a majority of patients treated, with seizure frequency as high as 5-10% in doses above 600 mg/d. Prolonged postictal encephalopathy following a clozapine-induced seizure has not been ...

Approximately 160,000 United States residents will be evaluated for newly identified unproved seizures in 1990. While the majority will have a favorable prognosis and more than 50% will ultimately be able to discontinue medication, about 10,000 will fall into the category 'intractable'. There are well established predictors for seizure remission ...

The treatment of epilepsy firstly depends upon the correct diagnosis, with emphasis on considerations of etiology, seizure type, and epilepsy syndrome. Following an appropriate diagnostic conclusion, the patient may be started on the medication matched to the seizure type. A full understanding of the pharmacology of antiepileptic drugs will enable ...

Epileptic seizures of focal origin often occur unpredictably as do interictal spikes. It is often assumed that spikes increase prior to seizures of focal origin and that antiepileptic medication affects spikes and seizures in a parallel fashion. We review evidence that this assumption is invalid and that there is a ...

Eighty five civil servants with epilepsy who were referred to the Civil Service Occupational Health Service over an 18 month period formed the study population. The reasons for these referrals and their outcomes have been analysed. The main reasons for referral were prolonged or frequent sickness absence, unsatisfactory work performance, ...

The purpose of this study was to determine if selected cognitive-perceptual variables discriminated between individuals who complied with antiepileptic medication therapy and those who did not. Individuals attending an epilepsy clinic and meeting specified criteria were asked to participate. Data from 64 individuals--39 who were classified as compliant and 25 ...

The superior bioavailability and therapeutic effect of prednisolone acetate over prednisolone sodium phosphate was described about 15 years ago. Review of the original articles and subsequent studies show that in clinical situations the two medications are probably equally effective. Further, patient compliance studies show that prednisolone sodium phosphate may actually ...

Recently, there has been an increase in the research devoted to the study of investigational antiepileptic medications. This has led to extensive clinical trials of several new compounds. This review focuses on four of these antiepileptic medications in development: felbamate, gabapentin, lamotrigine, and vigabatrin. Each has a unique mechanism of ...

The anticonvulsant potency of the trans isomer of 2-en-valproate (trans-2-en-VPA) was determined in standardized models for different seizure types in rodents and dogs. In mice and rats, adverse effects were quantified by the rotarod and chimney tests. Clinically established antiepileptic drugs (valproate, ethosuximide, phenobarbital, carbamazepine, phenytoin, diazepam) were used for ...

Because of case reports suggesting that use of transdermal scopolamine might be associated with the subsequent development of seizures, a retrospective cohort study was performed with computerized Medicaid claims data. Patients receiving transdermal scopolamine were compared with patients receiving diphenhydramine, meclizine, prochlorperazine, and promethazine. A four-fold increased risk of seizures ...

Lithium salts are commonly prescribed psychiatric medications. While they are usually safely used on outpatients, lithium preparations are associated with systemic and ocular side effects with both acute and chronic use. The optometrist should be aware of the ocular side effects so as to participate in the management of these ...

It is evident from the mentioned studies that the medical and psychosocial effects of khat chewing are hazardous both to the individual and the community. The habituation of khat chewing seriously effects the psychoeconomic structure of the subject. Being aware of the increasing prevalence of khat chewing (often together with ...

From the socio-medical points of view, the problem of a driving license for people with epilepsy was discussed. It was concluded that not only seizure but also the presence of side-effects of drugs and of personality change should be assessed to allow them the license. Finally, a medical guideline was ...

In 1983, a new regulation was prepared, based on clinical reports published at that time, redefining the fitness standards for those applicants to the military who had experienced one or more seizures during childhood or early adult life. The most important change admitted those who had been free of seizures ...

Neurologists, like physicians in several other medical specialties, can lay claim to Sherlock Holmes as one of their own. This assertion is validated by the number of neurologic conditions, such as seizures, stroke, syncope, encephalopathies, and head trauma, that are mentioned in the stories and novels. In addition, the article ...

48 patients with medically intractable epilepsy were submitted to a total of 60 series of transcranial magnetic stimulation. Effects of transcranial magnetic stimulation were monitored via subdural electrodes. The aim of the study was to investigate the use and reliability of the method for the localization and delineation of the ...

A case of essential tremor since early adultness is presented, which has been treated successfully with the acetylcholine precursor 2-dimethylaminoethanol (deanol) for 10 years. Development of a marked dyskinesia syndrome affecting predominantly orofacial and respiratory musculature has been noticed with this medication. Partial remission after discontinuation and a favorable response ...

The effects of the ecdysteroids ecdysone and 20-hydroxyecdysone on microfilarial release in Brugia pahangi and on meiotic reinitiation in the oocytes of Dirofilaria immitis were studied. Ecdysone was found to stimulate microfilarial release at 2 x 10(-6) M, but this effect was reduced at higher and lower concentrations. 20-Hydroxyecdysone was ...

The authors propose to correct the historical misimpression that Vincent van Gogh's medical problems resulted from epilepsy. Rather, the authors propose his main medical problem was Meniére's disease. The authors have reviewed the 796 personal letters written by van Gogh. The symptoms of his Vertigo attacks, their presentation and duration ...

We compared the ability of subdural and depth electrodes to detect and localize interictal epileptiform discharges (IEDs) in the temporal lobe. Sixteen patients had simultaneous intraoperative recordings with depth and subdural electrodes while undergoing anterior temporal lobe resections under local anesthesia for medically intractable seizures. IEDs that were focal (detected ...

Upon completion of left amygdaloid kindling, 4 cats underwent long-term phenobarbital administration during the subsequent 5- to 9-month rest period. Plasma phenobarbital levels were maintained above 15 to 20 micrograms/ml and were restimulated following plasma phenobarbital washout. Three cats served as nonmedicated controls. All 7 cats were subjected to repeated ...

Visual potentials evoked by pattern reversal (PRVEPs) were studied in 64 normal subjects (age range 7 to 15 years) and in 15 patients with primary generalized epilepsy (age range 8 to 13 years), 10 of whom were without anticonvulsant medication. Most of them were studied during sodium valproate (VPR) therapy ...

The authors studied the therapeutic effect of acetazolamide on a patient with autosomal dominant retinitis pigmentosa complicated by retinal edema. In addition to reduction of macular edema and some improvement of central vision, they found an unexpected progressive increase in extrafoveal retinal sensitivity with prolonged medication. It is proposed that ...

Over a two year period 108 patients had cranial computerised tomographic (CCT) scans while under the care of a general medical team. Sixty eight scans showed 70 abnormalities. Completed stroke, transient ischaemic attacks (TIA), epilepsy and headache were the most common indications for CTT while infarct, atrophy, haemorrhage and tumour ...

All individuals interviewed wanted to pursue meaningful activities regardless of their age. Use of medication may facilitate positive adaptation to chronic illness by allowing the pursuit of meaningful activities. When side effects occurred, activities were altered by means of substitution, temporary discontinuance, or modified participation, but most individuals struggled to ...

We have previously demonstrated that in pentylenetetrazole (PTZ)-kindled rats, cysteamine causes prolonged depression of the kindled state. We now report that administration of cysteamine before or during the kindling process prevents attainment of the kindled state. This effect lasts long after cysteamine administration has ceased, suggesting that depletion or somatostatin ...

A common assertion about alternative medical technologies is that their results are solely built upon the placebo effect. The reason for this assertion is due to the facts that the placebo effect is perceived as an irrational quantity, and that the placebo effect is considered unspecific. If it is possible ...

The effect of ibotenate lesions of septum and substantia innominata on electrical kindling of the amygdala was investigated in rats. The lesions significantly retarded kindling in the absence of a change in initial seizure sensitivity. This suggests that cholinergic neurotransmission can contribute to, but is not crucial for, amygdala kindling, ...

Psychogenic seizures in 21 nonepileptic children and adolescents, aged 8 to 18 (mean 14.5) years, were recorded by means of video recording and electroencephalography. The episodes included thrashing movements, limb jerking, or staring, with unresponsiveness. Ictal and interictal electroencephalograms showed no abnormalities after antiepileptic medication was discontinued. Fifteen patients had ...

In the female red-sided garter snake (Thamnophis sirtalis parietalis) mating initiates a neuroendocrine reflex that has both a short-term (within hours) effect on circulating estrogen concentrations and a long-term (6-7 weeks) effect on ovarian development. The perception of mating appears at least facultative, if not obligatory, for the initiation and ...

We retrospectively studied the effects of changing antiepileptic drug levels on patterns of seizure discharge in 8 patients investigated with intracerebral electrodes during presurgical evaluation. We compared seizures recorded at high levels of medication to seizures recorded at low levels for changes in seizure duration, duration from unilateral onset to ...

We retrospectively studied 474 patients seen at Hennepin County Medical Center because of medical complications related to acute cocaine intoxication. Of the 474, 403 had no history of seizures. Seizures within 90 minutes of cocaine use was the primary diagnosis in 32 (7.9%) of the 403. The majority of seizures ...

The effect of 4% chlorhexidine detergent and 2% triclosan detergent on the resident flora of the hands was compared on 20 healthy volunteers. The initial and prolonged effects of the agents were assessed by a modification of the Peterson glove rinse test after multiple hand washes. Chlorhexidine detergent was significantly ...

Neurologic consequences of cocaine use frequently present as medical emergencies in the form of stroke, repeated seizures, encephalopathy, acute headache, and unusual transient neurological deficits. The often fatal or disabling neurologic syndromes have only recently been recognized but are now well documented. Cocaine use is a significant cause of stroke ...

123I-Iomazenil SPECT was performed in 17 patients who were considered candidates for surgery of epilepsy because of medically intractable complex partial seizures. In addition to this examination their presurgical evaluation consisted of long term ictal EEG-CCTV monitoring, CT, MRI and 18FDG PET. In eight patients intracranial ictal EEG recordings were ...

The 30-item version of the GHQ was administered to 102 adults with epilepsy, and four sets of variables (neurological, psychosocial, medication, demographic) were used to predict psychiatric distress. Psychopathology was found to be associated with increased perceived stigma, elevated number of stressful life events during the past year, poor adjustment ...

The belief among Nigerians that epilepsy is infectious is widely reported in the relevant professional literature. This belief, however, has not been subjected to scientific investigation and its magnitude has not been assessed, despite the fact that it is one of the most serious obstacles to the care and rehabilitation ...

Seizure patients represent a population that is frequently seen in medical practice. Critical care physicians will encounter chronically epileptic patients as well as patients with isolated seizures that develop in the course of treatment of surgical and other medical disorders. In such circumstances, knowledge of seizure type and common antiepileptic ...

Heterotopia of the cerebral cortex, a disorder of neuronal migration, may be associated with medically intractable seizures. We report on a patient with bihemispheric cortical heterotopia who had medically intractable atonic seizures that were successfully treated by corpus callosotomy. The clinical and radiographic aspects of cortical heterotopia and the surgical ...

A 64-year-old man sustained acute quadriplegia due to a traffic accident, while in the midst of a petit mal seizure. After recovery from the initial medical complications he developed a duplicate limb phenomenon. The patient felt that another pair of upper and lower limbs had grown from his body, parallel ...

William Shakespeare's 37 plays and poetry contain many references of interest for almost all of the medical specialties. To support that the Bard could be considered a Renaissance neurologist, the following important neurological phenomena have been selected from his repertoire for discussion: tremors, paralysis and stroke, sleep disturbances, epilepsy, dementia, ...

The effects of bromocriptine and amantadine in treating cocaine withdrawal were compared. Withdrawal symptoms are thought to be due to central dopamine depletion. Both bromocriptine and amantadine are dopamine agonists previously reported to diminish withdrawal symptoms. Thirty subjects were withdrawn for 30 days with amantadine, bromocriptine, or placebo. Bromocriptine and ...

The cleansing effect of whole-gut irrigation with a balanced electrolyte solution (BES), with or without pretreatment with bisacodyl, was compared, in order to establish whether bisacodyl reduces the duration and side effects of whole-gut irrigation. Bisacodyl at a dose of 20 mg in 2 days reduced the duration of the ...

We randomized 31 children with a 1st afebrile unprovoked seizure to receive carbamazepine (CBZ) or no medication for 1 year or until the time of a 2nd seizure. All seizures had a focal onset or were generalized tonic-clonic. Overall, 2/14 randomized to CBZ and 9/17 with no medication had a ...

This report describes the investigation of a spontaneous grand mal seizure in a 55-year old woman, being treated with drugs and ECT for depression. The spontaneous seizure was due to hyponatremia caused by self-induced water intoxication, although psychotrophic medication may have contributed by lowering the seizure threshold. The diagnosis of ...

Offspring of women with epilepsy who are taking anticonvulsant medications have an increased incidence of clefting abnormalities. However, there is disagreement as to the extent to which this increase is due to a teratogenic effect of anticonvulsant medications or to a familial association of epilepsy and clefting. Some investigators suggested, ...

Fifty patients with developmental disabilities and past history of epilepsy but without reported seizures fo several years underwent trial reductions of an antiepileptic drug. After an 8-year follow-up there was recurrence of seizures in 26 patients. Predictors for a seizure free state off medication were: few documented seizures in lifetime, ...

The psychologic and social aspects of epilepsy have rarely been assessed in community-based samples. We administered the Washington Psychosocial Seizure Inventory in 1985-1986 to 125 nonretarded adults, 18 to 59 years of age, who in 1980 had active epilepsy and resided in Rochester, Minnesota. Individuals having seizures or taking anticonvulsant ...

There is a tendency to call benign focal epilepsy of childhood with centrotemporal origin rolandic epilepsy for the sake of brevity. Martinus Rulandus, a 16th-century medical author, deserves this homage far more than Rolando. Attention is drawn to this 1597 description of the disease, which has become the subject of ...

We describe a case of grand mal generalized tonic-clonic seizure after fluorescein angiography. The patient had a history of seizure disorders and had been controlled with proper medication before the test. We advocate the need to include diazepam and phenytoin in the list of emergency medications needed to control adverse ...