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Sample records for adult epileptic patients

  1. Factors influencing the population pharmacokinetic parameters of phenytoin in adult epileptic patients in South Africa.

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    Valodia, P; Seymour, M A; Miller, R; McFadyen, M L; Folb, P I

    1999-02-01

    The influence of various covariates (including weight, race, smoking, gender, age, mild-to-moderate alcohol intake, and body surface area) on the population pharmacokinetic parameters of phenytoin in adult epileptic patients in South Africa was investigated. The parameters were the maximum metabolic rate (Vm) and the Michaelis-Menten (MM) constant (Km) of phenytoin. The study population comprised 332 black and colored epileptic patients (note: "black" refers to indigenous people of South Africa, who speak one of the Bantu languages as their native language; "colored" refers to people considered to be of mixed race, classified as such by the apartheid former government of South Africa). The influence of covariates on Vm and Km estimates was determined using nonlinear mixed-effects modeling (NONMEM). Parameter models describing the factors that could potentially influence Vm and Km were tested using the Michaelis-Menten parallel MM and first-order elimination models, to which 853 steady state dose-to-serum concentration pairs were fitted. The results indicated that body weight, smoking, race, and age (65 years or older), in descending order of importance, significantly influenced Vm (p influence of race in Km in the final regression model did not improve the fit of the model to the data, which indicated that the variability in Km was accounted for by Vm. The scaling factors for smoking, colored patients and age (65 years or older) in Vm were 1.16, 1.10, and 0.88, respectively. These factors should be taken into account when adjusting phenytoin dose. PMID:10051055

  2. Effect of antiepileptic drug therapy on thyroid hormones among adult epileptic patients: An analytical cross-sectional study

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    Adhimoolam, Mangaiarkkarasi; Arulmozhi, Ranjitha

    2016-01-01

    Objective: The objective of the study was to evaluate and compare the effect of conventional and newer antiepileptic drugs (AEDs) on thyroid hormone levels in adult epileptic patients. Methods: A hospital-based, analytical cross-sectional study was conducted among the adult epileptic patients receiving conventional AEDs (Group 2) or newer AEDs (Group 3) for more than 6 months. Serum thyroid hormone levels including free triiodothyronine (fT3), free thyroxine (fT4), and thyroid stimulating hormone (TSH) were analyzed and the hormonal status was compared with healthy control subjects (Group 1). Findings: Sodium valproate and phenytoin were commonly used conventional AEDs; levetiracetam and topiramate were common among the newer drugs. There was a statistically significant decrease in serum fT4 and increase in serum TSH levels (P hormone levels (fT3, fT4, and TSH; P = 0.68, 0.37, and 0.90, respectively) was observed with newer antiepileptics-treated patients when compared to control group. One-way analysis of variance followed by post hoc Dunnett's test was performed using SPSS version 17.0 software package. Conclusion: The present study showed that conventional AEDs have significant alteration in the thyroid hormone levels than the newer antiepileptics in adult epileptic patients.

  3. [A national framework for educational programs in epileptic patients, children and adults].

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    Prévos-Morgant, M; Petit, J; Grisoni, F; André-Obadia, N; Auvin, S; Derambure, P

    2014-01-01

    Epilepsy is a chronic disease with a wide range of presentations occurring at any age. It affects the patient's quality of life, implying a need for numerous healthcare services. Therapeutic education programs (TEPs) are designed to match patient age, disease course, and individual learning abilities. In France, these programs are proposed by the national health authorities (Superior Health Authority), and authorized by the Regional Health Agencies. Two years ago, a Therapeutic Education Programs Commission (TEPC), supported by the French League against Epilepsy (FLAE), was created. The goal was to bring together representative healthcare professionals in a working group in order to standardize practices. This led to the creation of a national reference of healthcare skills specific for children and adults with epilepsy. Five tables, for five "life periods", outline the framework of this professional reference tool. Program personalization, an essential part of TEPs, is necessary to develop a creative atmosphere. This slow process is specific to the various stages of life and can be influenced by the occurrence of various handicaps. Family and caregivers make key contributions to the process. The national framework for therapeutic education in epilepsy serves as a central crossroad where professions can find essential information to create or adapt their own TEPs. In the near future, regional experiences will be documented and collected for regular updates. This professional therapeutic education network will help promote therapeutic education programs and facilitate standard practices. Finally, several TEP files and tools will be shared on the FLAE website available for professional access. Today, the group's goal is to achieve national deployment of this "referential" framework. PMID:24947486

  4. Prevalence of Migraine Headache in Epileptic Patients.

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    Sayena Jabbehdari

    2015-06-01

    Full Text Available Epilepsy is one of the most common neurological disorders which a physician might come across in his career life. On the other hand, migraine is common disorders in society chronic headache such as migraine in epileptic patients give ride to difficulties in seizure treatment due to altering the sleeping pattern and calmness disarrangement. Therefore, early diagnosis and suitable treatment in epileptic patients is definitely inevitable, and it will help in a more desirable patients' treatment. So we aimed to evaluate the prevalence of migraine in epileptic patients and relation between these two disorders. Number of 150 epileptic patients attended to neurology clinic of Shohadaye Tajrish Hospital and Iranian Epilepsy Association between June 2010 to May 2011 were fulfilled the questionnaire, and the data has been assessed by SPSS software. In this study, we used MS-Q (migraine screening -questionnaire designed for early diagnosis of migraine in the general population. From all patients filling the questionnaire, the prevalence of migraine (with or without aura was as follows: 23 persons had criteria compatible with migraine with aura; 26 patients had migraine without aura. Migraine was more common in these patients: persons with academic degrees, women, patients who were used 2 antiepileptic drugs, and patients with high BMI. In this study, we showed that migraine in epileptic patients is more prevalent than the general population. Thus, early diagnosis and efficient treatment of migraine headache in these patients is mandatory. More studies are needed for evaluation of this issue.

  5. Epileptic Seizures in Multiple Sclerosis Patients

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    Kamber Zeqiraj

    2013-06-01

    Full Text Available Objective: The presence of epileptic seizures in patients with multiple sclerosis (MS is a well-known phenomenon. The aims of our study, performed in our clinic are to point out the correlation of the mean age/gender and age of MS patients with the onset of seizures, to identify the types of epileptic seizures in MS patients by sex/age, to identify the correlation between relapses and seizures, and to identify the main electrophysiological / imaging changes. Material and Met-hod: The medical records of 300 MS patients observed between January 2000 and December 2009 in the Neurological Clinic of University Clinical Centre of Kosova were reviewed. All patients fulfilled the McDonald MS criteria Epilepsy diagnosis was based on the ILAE (International League against Epilepsy (1983 criteria while epileptic seizures were classified based on the ILAE classification (1981. Results: Out of 300 MS patients enrolled in this study, 49 (16.33% were identified with seizures or epilepsy. In 23 (47% patients out of 49, seizures or epilepsy appeared after the MS diagnosis. In 6 patients (12.2%, epileptic attacks preceded the MS diagnosis, while in 20 patients (40.8%, epilepsy was diagnosed before multiple sclerosis. These patients were treated with antiepileptics. Out of 23 patients (47% in whom the epileptic seizures appeared after the MS diagnosis, 17 (74% had simple partial seizures, and 6 (26% had complex partial seizures. Based to our study, the epileptic seizures in MS patients appeared about 2.2 years after the MS diagnosis. Discussion: Simple partial seizures were 2.8 times more frequent compared to complex partial seizures. In female patients the prevalence of complex partial seizures was higher than in male patients with multiple sclerosis. (Turkish Journal of Neurology 2013; 19: 40-3

  6. Epileptic Seizures in Multiple Sclerosis Patients

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    Kamber Zeqiraj; Nexhat Shatri; Jera Kruja; Afrim Blyta; Enver Isaku; Nazim Dakaj

    2013-01-01

    Objective: The presence of epileptic seizures in patients with multiple sclerosis (MS) is a well-known phenomenon. The aims of our study, performed in our clinic are to point out the correlation of the mean age/gender and age of MS patients with the onset of seizures, to identify the types of epileptic seizures in MS patients by sex/age, to identify the correlation between relapses and seizures, and to identify the main electrophysiological / imaging changes. Material and Met-hod: The medi...

  7. Bone turnover markers in epileptic patients under chronic valproate therapy

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    Mohammad Zare

    2013-01-01

    Full Text Available Background: The effects of chronic valproic acid administration on bone health have been a matter of concern and controversy. In this study, the bone status following valproate intake was assessed by using several bone-related biochemical markers. Materials and Methods: In this case-control study, 62 epileptic patients and 40 age- and gender-matched controls were enrolled. The patients had been under chronic valproate therapy (758 ± 29 mg/day for at least the past 6 months, without any vitamin D/or calcium supplementation. Serum markers of bone turnover (carboxy-terminal telopeptide of type I collagen (CTX and bone-specific alkaline phosphatase [BALP], calcium, phosphorus, total alkaline phosphatase, and parathyroid hormone levels were measured in both groups. Results: The markers of bone turnover as well as other measured bone biochemical parameters did not statistically differ between the two groups. Conclusion: Valproate therapy at the mentioned doses does not seem to change bone turnover in adult epileptic patients.

  8. Expression of Glypican-4 in the brains of epileptic patients and epileptic animals and its effects on epileptic seizures.

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    Xiong, Yan; Zhang, Yanke; Zheng, Fangshuo; Yang, Yong; Xu, Xin; Wang, Wei; Zhu, Binglin; Wang, Xuefeng

    2016-09-01

    Glypican-4 (Gpc4) has been found to play an important role in enhancing miniature excitatory postsynaptic currents (mEPSCs). But, the relationship between Gpc4 and epilepsy is still a mystery. In this study, we investigated the expression patterns of Gpc4 in patients with epilepsy and in a pilocarpine-induced rat model of epilepsy. We also determined if altered Gpc4 expression resulted in increased susceptibility to seizures. Western blotting and immunofluorescent methods were utilized. Gpc4 was significantly increased in patients and epileptic rats induced by pilocarpine injection. According to behavioral studies, downregulation of Gpc4 by Gpc4 siRNA decreased spontaneous seizure frequency, while upregulation of Gpc4 by recombinant Gpc4 overexpression led to a converse result. These findings support the hypothesis that increased expression of Gpc4 in the brain is associated with epileptic seizures. PMID:27425250

  9. Effect Of Cognitive Stimulation On Hippocampal Ripples In Epileptic Patients

    Czech Academy of Sciences Publication Activity Database

    Brázdil, M.; Cimbálník, J.; Roman, R.; Stead, M.; Daniel, P.; Halámek, Josef; Jurák, Pavel

    2013-01-01

    Roč. 54, S3 (2013), s. 268-268. ISSN 0013-9580. [International Epilepsy Congress /30./. 23.06.2013-27.06.2013, Montreal] Institutional support: RVO:68081731 Keywords : Cognitive Stimulation * Epileptic Patients Subject RIV: FH - Neurology

  10. ORAL HEALTH OF EPILEPTIC PATIENTS IN RURAL RAJASTHAN

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    Rakshit

    2015-10-01

    Full Text Available BACKGROUND: Despite the increase in the awareness of Epilepsy, still people are not much aware of the oral health complications related to the intake of antiepileptic drugs. OBJECTIVE: To assess the most common oral health problems that people face while using the Anti-epileptic drugs and hence forth decide its remedy. To make people aware of the potential side effects of using the anti-epileptic drugs. MATERIALS AND METHODS: This study was conducted on 200 epileptic patients who were on anti-epileptic medication for one year or more. The study was conducted at Government Hospital in Ratan nagar dist churu. RESULTS: Gingival hyperplasia was seen as a common side effects of the Anti-epileptic Drug. Lips and cheek biting were the most common soft tissue injury, while tooth fracture was the most common hard tissue dental injury. CONCLUSION: General physicians and dentist should be well aware of the potential side effects of Anti-epileptic Drugs. A dentist should be well versed and trained to manage oro-facial injuries in the emergency department.

  11. Exfoliative Dermatitis Due To Carbamazepine In An Epileptic Patient

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    Ghosh Sadhan Kr

    1995-01-01

    Full Text Available A young epileptic girl of 17 years who was being treated with carbamazepine suddenly developed exanthematous skin eruption all over the body resulting in exfoliative dermatitis within 2 days of onset. The drug was withdrawn and the patient responded well with symptomatic treatment.

  12. FACTORS TRIGGERING EPILEPTIC SEIZURES IN PATIENTS OVER 50 YEARS

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    Demir, Serkan; Rifat Erdem TOGROL; Sonkaya, Ali Riza; Kendirli, Mustafa Tansel; Alay, Semih; Celik, Tugba Yanar; Delil, Sakir; Ozdag, Mehmet Fatih

    2016-01-01

    Objective:In this study the factors that trigger the seizures in epileptic patients over the age of 50 was investigated and the frequency of seizures was analyzed regarding different age, gender, type of seizure and etiological groups. Method:  For this purpose, 387 patients were included in the study who were admitted to neurology outpatient clinic with the diagnosis of epilepsy. The patients are divided into groups based on those characteristics: male / female, generalized seizure / partial...

  13. Studying Network Mechanisms using Intracranial Stimulation in Epileptic Patients

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    Olivier David; Julien Bastin; Stéphan Chabardès; Lorella Minotti; Philippe Kahane

    2010-01-01

    Patients suffering from focal drug-resistant epilepsy who are explored using intracranial electrodes allow to obtain data of exceptional value for studying brain dynamics in correlation with pathophysiological and cognitive processes. Direct electrical stimulation (DES) of cortical regions and axonal tracts in those patients elicits a number of very specific perceptual or behavioural responses, but also abnormal responses due to specific configurations of epileptic networks. Here, we review h...

  14. Cysticercosis in epileptic patients of Mulungu do Morro Northeastern Brazil.

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    Gomes, I; Veiga, M; Correa, D; Meza-Lucas, A; Mata, O; Garcia, R C; Osornio, A; Rabelo, R; Lucena, R; Melo, A

    2000-09-01

    With the aim to study the magnitude of infection by the metacestode of Taenia solium in a population of epileptic patients in the arid region of Bahia, Northeastern Brazil, we examined 200 consecutive cases who attended an ambulatory clinic in the disctrict of Mulungu do Morro. Sixty-six of the patients had a diagnosis of epilepsy. From them 10 (15.2%) presented antibodies against a specific fraction of antigens in Western blot, and 4 (6.0%) had circulating parasite products, as tested by capture ELISA. Only 1 case was positive for antibodies and antigens. We found that the frequency of seropositivity was related to the time without epileptic seizure. We conclude that cysticercosis is endemic in the region of Mulungu do Morro and that it is related to a benign form of epilepsy. PMID:10973100

  15. Cysticercosis in epileptic patients of Mulungu do Morro Northeastern Brazil

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    GOMES IRENIO

    2000-01-01

    Full Text Available With the aim to study the magnitude of infection by the metacestode of Taenia solium in a population of epileptic patients in the arid region of Bahia, Northeastern Brazil, we examined 200 consecutive cases who attended an ambulatory clinic in the disctrict of Mulungu do Morro. Sixty-six of the patients had a diagnosis of epilepsy. From them 10 (15.2% presented antibodies against a specific fraction of antigens in Western blot, and 4 (6.0% had circulating parasite products, as tested by capture ELISA. Only 1 case was positive for antibodies and antigens. We found that the frequency of seropositivity was related to the time without epileptic seizure. We conclude that cysticercosis is endemic in the region of Mulungu do Morro and that it is related to a benign form of epilepsy.

  16. Quality of life of Epileptic Patients Compared to General

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    Rajabi F; Dabiran S; Hatmi Z.N; Zamani G

    2009-01-01

    Epilepsy is a chronic disease that affects different aspects of life; so we studied the quality of life of epileptic patients and compared it with general population of Tehran. We collected clinical and demographic data and studied quality of life by using the Iranian translation of Short Form 36 questionnaire version 2 (SF-36). The questionnaires were filled out by 200 patients with epilepsy referred to the Epilepsy Institute as outpatients. The mean age of our patients was 32.6 years. 54.5%...

  17. Epileptic seizures in patients with a posterior circulation infarct

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    Yüksel Kaplan

    2014-08-01

    Full Text Available OBJECTIVE: The aim of this study was to investigate the frequency of seizures and the clinical features of patients with seizures related to a posterior circulation infarct (POCI. METHODS: We reviewed all ischemic stroke patients admitted to our clinic between January 2011 and January 2012. The patients’ database information was retrospectively analyzed. Fifty-five patients with a POCI were included in the study. We reviewed all patients with epileptic seizures related to a POCI. Age, gender, recurrent stroke, risk factors, etiology, radiographic localization, the seizure type and onset time, and the electroencephalographic findings of patients were evaluated. We excluded all patients who had precipitating conditions during seizures such as taking drugs, acid-base disturbances, electrolyte imbalance, and history of epilepsy. RESULTS: Seizures were observed in four patients (3 male, 1 female with a POCI related epileptic seizures (7.2%. The etiology of strokes was cardiac-embolic in 3 patients and vertebral artery dissection in 1 patient. Seizures occurred in 2 patients as presenting finding, in 1 patient within 7 days, and 1 patient within 28 days. Primary generalized tonic-clonic seizures occurred in 3 patients and simple partial seizures with secondary generalization in 1 patient. Three patients had cerebellum infarction at the left hemisphere. One patient had lateral medullary infarction at the right side. The electroencephalographic findings of patients were normal. CONCLUSION: Studies involving patients with seizures related to a POCI are novel and few in number. Three patients with seizure had cerebellum infarction. The cerebellum in these patients may contribute via different mechanisms over seizure activity.

  18. Brain spect in the pre-surgical evaluation of epileptic patients preliminary results

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    Carlos A. Buchpiguel

    1992-03-01

    Full Text Available Pre-surgical evaluation of epileptic patients consists of neurological examination, intensive electroencephalographic (EEG monitoring and anatomical studies (CT and MRI. Functional methods such as PET and SPECT imaging are now used more frequently. We have studied pre-operatively 15 adult epileptic patients (8 female, 7 male using a rotational scintillation camera interfaced to a dedicated computer. The tomographic images were obtained 15 minutes after intravenous injection of 99mTc_HMPAO. All had MRI scanning and intensive EEG monitoring which generally included seizure recording. Five patients had progressive lesions (3 meningiomas, 2 astrocytomas. In 10 patients, neuroradiological studies did not show the presence of progressive lesions (2 normal scans and 8 cases with inactive lesions. Two patients with meningioma showed hypoperfusion at the lesion site while the third patient had a marked hyperperfusion which might correlate with the clinical diagnosis of epilepsia partialis continua. In the astrocytoma patients SPECT scans showed hypoperfusion at the lesion site. Data obtained from the 10 patients without progressive CNS lesions showed: (a in 4, SPECT findings correlated well with the anatomical findings; (b in 5 instances, SPECT was able to disclose additional functional deficits; (c in one case, there was no SPECT correlate of a discrete anatomical lesion. In 5 of these cases with no progressive lesions (n=10 SPECT findings were useful as a complementary tool in determining the clinical or surgical management of these patients. Despite the small number and hete-rogenicity of the present sample, SPECT seems to be an useful tool as part of the clinical workup of epileptic patients who are candidates for epilepsy surgery.

  19. Brain SPECT in the pre-surgical evaluation of epileptic patients

    International Nuclear Information System (INIS)

    Fifteen adult epileptic patients were studied pre-operatively using a rotational scintillation camera interfaced to a dedicated computer. The tomographic images were obtained 15 minutes after intravenous injection of 99 m Tc-HMPAO. All had MRI scanning and intensive EEG monitoring which generally included seizure recording. Five patients had progressive lesions (3 meningiomas, 2 astrocytomas). In 10 patients, neuroradiological studies did not show the presence of progressive lesions (2 normal scans and 8 cases with inactive lesions). Two patients with meningioma showed hypoperfusion at the lesion site while the third patient had a marked hypoperfusion which might correlate with the clinical diagnosis of epilepsia partialis continua. In the astrocytoma patients SPECT scans showed hypoperfusion at the lesion site. Data obtained from the 10 patients without progressive CNS lesions showed: in 4, SPECT findings correlated well with the anatomical findings; in 5 instances, SPECT was able to disclose additional functional deficits; in one case, there was no SPECT correlate of a discrete anatomical lesion. In 5 of these cases with no progressive lesions (n=10) SPECT findings were useful as a complementary tool in determining the clinical or surgical management of these patients. Despite the small number and heterogeneity of the present sample, SPECT seems to be an useful tool as part of the clinical workup of epileptic who are candidates for epilepsy surgery. (author)

  20. Comparative study of nonlinear properties of EEG signals of a normal person and an epileptic patient

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    Nurujjaman, Md; Iyengar, A N Sekar

    2007-01-01

    Electroencephalography (EEG) for a normal person is different from an epileptic patient. We have studied EEG of normal men and epileptic patients for different mental conditions using nonlinear techniques like the surrogate analysis and the estimations of the correlation dimensions and Hurst exponents.

  1. Rights of Epileptic Patient According to Turkish Law

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    Saibe Oktay-Özdemir

    2010-12-01

    Full Text Available If epilepsy does not affect the power of judgment, the patient can exercise any of his/her rights, except for obtaining a driver’s license. If the sickness and the medications affect the patient’s power of judgment and require protection over him/her, the patient should be placed under guardianship. In this case, the patient uses his/her capacity to incur liability with the consent of his/her guardian. If the sickness completely eliminates the power of judgment, then the patient, as an incompetent, cannot exercise any rights and cannot operate any transaction. There are some specific characteristics of epilepsy regarding the employer’s liability to employees for equal treatment during recruitment, employment, and dismissal. Epilepsy gives the employer the right to terminate the contract in the following cases: the employee does not comply with his/her obligation to provide the correct information about his/her condition; epilepsy affects performance; epilepsy is incurable and causes endangerment. In the meantime, the employee has the right to give a notice of termination of the contract when it becomes impossible for him/her to perform his/her duties. Regarding the employees who have job security, if epilepsy disturbs the usual conduct at the workplace causing inadequate conditions, the employer can terminate the contract.Under the Turkish law system, epileptic patients cannot obtain a driver’s license. However, the practice around the world does not completely prohibit the right of epileptics to obtain a driver’s license and instead, provides alternatives. These alternatives ensure that the patient does not feel excluded from the society and thus, unnecessary adversities can be avoided. (Archives of Neuropsychiatry 2010; 47: 286-91

  2. The psychological and social profile of epileptic patients in Greece

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    Athanassios Vozikis

    2013-01-01

    Full Text Available Epilepsy is a neurological disorder that leads to occasional epileptic seizures, affecting the quality of life. Aim: The aim of the present study was to explore the current psychological and social profile of epileptic patients in Greece and to identify the main differences as compared to a former similar research. Material and Methods: A sample of 91 questionnaires, from a total of 350 inpatients with epilepsy at a Public Hospital, during the years 2008 to 2009 (response rate 26%. For data analysis, we used simple descriptive statistical analysis (at significance level of α=5% and α=10% and factor analysis, using SPSS 16.0. Results: Our research showed that the quality of life of people with epilepsy in Greece seems to have improved significantly during the last decade, as their crises have been reduced by 15,7% and their employment has increased by 13% . Conclusions: All that mean that these people are no longer been placed in the margin of society and they succeed in living a normal life with the certain limitations of their disease.

  3. Abnormal Vasomotor System Function in Idiopathic Generalized Epileptic Patients

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    Mehdi Maghbooli

    2014-12-01

    Full Text Available OBJECTIVE: Autonomic dysfunction is widely recognized in both partial and generalized epilepsies. The aim of this study was to evaluate the vasomotor response in patients with generalized idiopathic epilepsy by the clinical autonomic function tests. METHODS: 124 consecutive subjects including 62 idiopathic generalized epileptic patients diagnosed for more than 3 months receiving monotherapy and 62 matched for sex and age healthy controls were assessed in this case-control study. The evaluation of the vasomotor system was made using a questionnaire and autonomic function tests including Cold pressor, Valsalva maneuver, mental arithmetic and hand-grip tests. RESULTS: Abnormal score of the Cold pressor test was seen in 59.7%, Valsalva maneuver in 64.5% and 33.9% in mental arithmetic test of epileptic patients. These results were different significantly in comparison to control group. If abnormal hand grip test was defined as an increase less than 11 mmHg in diastolic pressure, there was found no significant difference between two groups of case and control, also a few people in control group was reported normal. While defining abnormal test was interpreted by increase in only one parameter or none of systolic blood pressure, diastolic blood pressure or heart rate, 43.5% in case group versus 14.5% in controls had abnormal results with significantly difference. CONCLUSION: Vasomotor dysfunction evaluated by cardiovascular tests was present commonly in the patients with generalized epilepsy. Further confirmation requires detailed reviewing of central and peripheral limbs to the breakdown of the system to be felt.

  4. Adult epileptic patients’ perception of social support during rational antiepileptic therapy

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    P. N. Vlasov

    2012-01-01

    Full Text Available The problem of stigmatization of a patient with epilepsy is frequently essential in restricting the capacities of his social performance. Society is often unready to recognize an epileptic patient as its equal member. The authors consider the main sources of social support (SS to patients with epilepsy: the patient’s family takes first place; friends and other important persons also play a major role. The perception of SS has been found to be related to the number of used antiepileptic drugs and the hemispheric lateralization of a leading epileptic focus.

  5. Location of Irritative Zone in Epileptic Brains of Schizencephalic Patients.

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    Kim, Do-Hyung; Kwon, Oh-Young; Jung, Suck-Won; Jeong, Heejeong; Son, Seongnam; Kim, Soo-Kyoung; Kang, Heeyoung; Park, Ki-Jong; Choi, Nack-Cheon; Lim, ByeongHoon

    2016-07-01

    Although many schizencephaly patients suffer from epilepsy, the relationship between schizencephalic lesions and epileptic foci remains unclear. Previous studies have shown that schizencephalic lesions may be associated with, rather than contain, epileptogenic zones. Thus, the purpose of this study was to investigate the current source distribution (CSD) of epileptiform discharges in schizencephalic patients and to correlate this activity with existing structural lesions. A consecutive series of 30 schizencephalic patients who were diagnosed using brain magnetic resonance imaging (MRI) were selected retrospectively and prospectively. Of the original 30 subjects selected, 13 had epilepsy, and 6 of these patients exhibited schizencephaly, epilepsy, and interictal spikes on electroencephalograms (EEG) and were enrolled in the present study investigating the current source analysis of interictal spikes. The CSDs of the initial rising phases and the peak points of the interictal spikes were obtained using standardized low-resolution brain electromagnetic tomography (LORETA). Five patients exhibited a single focus of interictal spikes, while 1 patient showed 2 foci. Relative to the structural brain lesions, 5 patients displayed extrinsically localized CSDs, while 1 patient showed a partially intrinsically localized CSD. The present findings demonstrate that the CSDs of interictal spikes in schizencephalic patients are in general anatomically distinct from the cerebral schizencephalic lesions and that these lesions may display an extrinsic epileptogenicity. PMID:25253435

  6. Clinical profile of psychogenic non-epileptic seizures in adults: A study of 63 cases

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    Yogesh Patidar

    2013-01-01

    Full Text Available Aims: To evaluate clinical profile and short-term outcome of psychogenic non-epileptic seizures (PNES in Indian adult population. Setting and Design: A prospective observational study, conducted at tertiary teaching institute at New Delhi. Materials and Methods: Sixty-three patients with confirmed PNES were enrolled. The diagnosis was based on witnessing the event during video-electroencephalography (Video-EEG monitoring. A detailed clinical evaluation was done including evaluation for coexistent anxiety or depressive disorders. Patients were divided into two groups on the basis of excessive or paucity of movements during PNES attacks. Patients were followed-up to 12 months for their PNES frequency. Statistical Analysis: Means and standard deviations were calculated for continuous variables. Chi-square and Students t-test were used to compare categorical and continuous variables respectively. Results: The mean age at onset of PNES was 25.44 years; with F:M ratio of 9.5:1. Coexistent epilepsy was present in 13 (20.63% cases. Twenty-two patients (44% with only PNES ( n = 50 had received antiepileptic drugs. Out of 63 patients of PNES 24 (38.1% had predominant motor phenomenon, whereas 39 (61.9% had limp attacks. The common features observed were pre-ictal headache, ictal eye closure, jaw clenching, resistant behavior, ictal weeping, ictal vocalization, and unresponsiveness during episodes. Comorbid anxiety and depressive disorders was seen in 62.3% and 90.16% patients, respectively. Short-term (6-12 months outcome of 45 patients was good (seizure freedom in 46.66% and >50% improvement in 24.44% cases. Conclusion: PNES is common, but frequently misdiagnosed and treated as epileptic seizures. A high index of suspicion is required for an early diagnosis. Proper disclosure of diagnosis and management of the psychiatric comorbidities can improve their outcome. Limitation: Limited sample size and change in seizures frequency as the only parameter for

  7. Comparison study of SPECT, EEG and CT in 50 epileptic patients during interictal seizures

    International Nuclear Information System (INIS)

    The authors present a comparison study of SPECT, EEG and CT in 50 epileptic patients during interictal. SPECT showed an abnormal rate of 76 per cent. The abnormal findings of EEG conformed to SPECT in 45.6% patients. If CT scan shows a focal abnormality, 85% of local abnormal finding may also be found in SPECT. But not all SPECT abnormal findings were epileptic foci. SPECT, EEG and CT can not be replaced by each other. When using the three examinations at the same time we can know much about epileptic focus from anatomy and physiology

  8. Immunological findings in epileptic and febrile convulsion patients before and under treatment.

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    Tartara, A; Verri, A P; Nespoli, L; Moglia, A; Botta, M G

    1981-01-01

    Serum immunoglobulin levels of 86 epileptic patients have been evaluated in order to investigate the relationship between epilepsy, antiepileptic drugs and humoral immunity. The results confirm a high incidence of immunological disorders in the epileptic and febrile convulsion patients. These abnormalities were not related to clinical type of epilepsy nor to the therapy; the common feature seems the early onset of seizures and antiepileptic treatment. PMID:6791931

  9. Factors influencing serum concentration of zonisamide in epileptic patients.

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    Kimura, M; Tanaka, N; Kimura, Y; Miyake, K; Kitaura, T; Fukuchi, H; Harada, Y

    1992-01-01

    The relationship between daily dose and serum concentration of zonisamide (ZNS) and the effects of patient age on the serum level/dose (L/D) ratio for ZNS were studied in epileptic patients (mean age +/- S.D. = 10.6 +/- 6.2 years) who chronically received ZNS. The influence of phenytoin (PHT), phenobarbital (PB), carbamazepine (CBZ) and valproic acid (VPA) on the serum protein binding of ZNS in vitro and the correlation between total and unbound serum levels of ZNS in patients were also examined. Significant correlations were obtained between daily dose per body weight or per body surface area and serum level of ZNS. The correlation coefficient of the latter was higher than that of the former. There was no effect of age on the L/D ratio on the basis of body surface area, whereas that on the basis of body weight increased significantly with age. No significant increase in the free fraction of ZNS was observed in the presence of PHT, PB and CBZ except VPA in vitro. There were significant correlations between total and unbound serum levels of ZNS in the two patient groups coadministered with and without VPA. Although the free fraction of ZNS in the former was significantly higher than that of the latter, the increase was small. These results suggest that dosage regimens on the basis of body surface area would be more accurate than those on a body weight basis and that there is little effect of other antiepileptics on the serum protein binding of ZNS. PMID:1576673

  10. EPILEPTIC SPASMS

    Directory of Open Access Journals (Sweden)

    K. Yu. Mukhin

    2015-04-01

    Full Text Available Epileptic spasms are epileptic seizures with sudden flexion/extension or of the mixed flexion and extension type, mainly involving the proximal and truncal muscles, that are normally longer than myoclonic seizures but shorter than tonic seizures, and last for about 1 second. For diagnostics of epileptic spasms, it is necessary that they are combined with ictal and interictal epileptiform patterns on electroencephalography (EEG. The first detailed clinical description of seizures of the infantile spasms type was provided by English pediatrician W.J. West in 1841. The term of infantile spasms is limited with age and means epileptic spasms that occur to children in early infancy, usually up to 1 y.o. Infantile spasms cannot be synonymous to the West syndrome. Infantile spasms are a type of epileptic seizures and West syndrome is a form of epilepsy that is usually manifested through hypsarrhythmia on the EEG and mental retardation, apart from infantile spasms. Epileptic spasms is the term broader than infantile spasms. Committee of the International League Against Epilepsy (ILAE recommends exactly the “epileptic spasms” term, as this type of seizures is not a prerogative of the West syndrome and can be observed in children older than 1 y.o. and even in adults. The authors provided a detailed review of modern references devoted to epileptic spasms including the history of the issue, determination of the term, and position of epileptic spasms in modern classification systems, approaches to diagnostics including differential diagnosis, treatment, and prognosis.

  11. Management of a high risk epileptic patient under conscious sedation: A multidisciplinary approach

    Science.gov (United States)

    Chellathurai, Burnice Nalina Kumari; Thiagarajan, Ramakrishnan; Jayakumaran, SelvaKumar; Devadoss, Pradeep; Elavazhagan

    2016-01-01

    Epilepsy, characterized by the risk of recurrent seizures, is a chronic disease that afflicts about 5% of the world's population. The main dental problems associated with epileptic patients include gingival hyperplasia, minor oral injuries, tooth trauma, and prosthodontic problems, which require the dental treatment. Stress and fear are the most common triggering factors for the epilepsy in dental chair. Therefore, a more appropriate method of treating such epileptic patients may be warranted. Conscious sedation is a technique of providing good anesthesia and analgesia to patients, the main advantage of which is the patient's rapid return to presentation levels. Midazolam used as a sedative agent has anticonvulsant properties. This case report highlights a case requiring multiple dental procedures carried out in a high risk epileptic patient under conscious sedation. PMID:27041847

  12. Management of a high risk epileptic patient under conscious sedation: A multidisciplinary approach.

    Science.gov (United States)

    Chellathurai, Burnice Nalina Kumari; Thiagarajan, Ramakrishnan; Jayakumaran, SelvaKumar; Devadoss, Pradeep; Elavazhagan

    2016-01-01

    Epilepsy, characterized by the risk of recurrent seizures, is a chronic disease that afflicts about 5% of the world's population. The main dental problems associated with epileptic patients include gingival hyperplasia, minor oral injuries, tooth trauma, and prosthodontic problems, which require the dental treatment. Stress and fear are the most common triggering factors for the epilepsy in dental chair. Therefore, a more appropriate method of treating such epileptic patients may be warranted. Conscious sedation is a technique of providing good anesthesia and analgesia to patients, the main advantage of which is the patient's rapid return to presentation levels. Midazolam used as a sedative agent has anticonvulsant properties. This case report highlights a case requiring multiple dental procedures carried out in a high risk epileptic patient under conscious sedation. PMID:27041847

  13. Reports on Polysomnograph Combined with Long-term Video Electroencephalogram for Monitoring Nocturnal Sleep-breath Events in 82 Epileptic Patients

    Institute of Scientific and Technical Information of China (English)

    Li Hongliang; Jiang Min; Li Yan; Xu Jianyang; Wang Shouyong; Du Junqiu; Shi Xiangsong

    2013-01-01

    Objective: To investigate the effects of epileptic discharges in sleep of epileptic patients on sleep-breath events. Methods: Polysomnograph (PSG) and long-term video electroencephalogram (LTVEEG) were used to monitor 82 adult epileptic patients. The condition of paroxysmal events in nocturnal sleep was analyzed, and the epileptiform discharge and effects of antiepileptic drugs were explored. Results: In epileptic group, latency to persistent sleep (LPS) and REM sleep latency increased, the proportion of light sleep increased while that of deep sleep decreased, sleep efficiency reduced, nocturnal arousal times increased and apnea hyponea indexes (AHI) improved, which demonstrated significant differences by comparison to control group. Periodic leg movements (PLM) had no conspicuous differences compared with control group. There were no speciifc effects of epileptiform discharge and antiepileptic drugs on AHI and PLM indexes. Conclusion: Epileptic patients have sleep structure disorders and sleep-disordered breathing, and arousal, respiratory and leg movement events inlfuence mutually. Synchronous detection of PSG combined with LTVEEG is in favor of comprehensively analyzing the relationship between sleep structures and epilepsy-breath events.

  14. Reports on Polysomnograph Combined with Long-term Video Electroencephalogram for Monitoring Nocturnal Sleep-breath Events in 82 Epileptic Patients

    Directory of Open Access Journals (Sweden)

    Hongliang Li

    2013-06-01

    Full Text Available Objective: To investigate the effects of epileptic discharges in sleep of epileptic patients on sleepbreath events. Methods: Polysomnograph (PSG and long-term video electroencephalogram (LTVEEG were used to monitor 82 adult epileptic patients. The condition of paroxysmal events in nocturnal sleep was analyzed, and the epileptiform discharge and effects of antiepileptic drugs were explored. Results: In epileptic group, latency to persistent sleep (LPS and REM sleep latency increased, the proportion of light sleep increased while that of deep sleep decreased, sleep efficiency reduced, nocturnal arousal times increased and apnea hyponea indexes (AHI improved, which demonstrated significant differences by comparison to control group. Periodic leg movements (PLM had no conspicuous differences compared with control group. There were no specific effects of epileptiform discharge and antiepileptic drugs on AHI and PLM indexes. Conclusion: Epileptic patients have sleep structure disorders and sleep-disordered breathing, and arousal, respiratory and leg movement events influence mutually. Synchronous detection of PSG combined with LTVEEG is in favor of comprehensively analyzing the relationship between sleep structures and epilepsy-breath events.

  15. Perceived parental rearing behaviour and psychopathology in epileptic patients: a controlled study.

    Science.gov (United States)

    Maj, M; Del Vecchio, M; Tata, M R; Guizzaro, A; Bravaccio, F; Kemali, D

    1987-01-01

    Memories of parental rearing behaviour were assessed by the EMBU in 61 epileptics and 151 healthy controls. The occurrence of the first crisis during the childhood was an inclusion criterion for patients. Epileptics, as compared with controls, rated their fathers and mothers as less stimulating, their fathers as less performance oriented and affectionate, and their mothers as more tolerant. Moreover, the score on the subscale 'favouring subject' for both fathers and mothers was higher in epileptics. As patients with and without interictal psychopathological features were compared, the scores on the subscales 'overprotective' and 'favouring subject' for mothers and 'abusive' and 'depriving' for fathers were higher in the former subgroup, whereas that on the subscale 'performance oriented' for fathers was higher in the latter. No significant difference was observed among patients suffering from the various subtypes of epilepsy. These results are consistent with the idea that parents of epileptics tend to encourage passivity in their children, have low expectations as regards their ability to operate effectively, and treat them in a more indulgent way because of their disability. Furthermore, they are in line with the reported association between maternal overprotectiveness and problem behaviour in epileptics. PMID:3130645

  16. Patients with epilepsy and patients with psychogenic non-epileptic seizures

    DEFF Research Database (Denmark)

    Turner, Katherine; Piazzini, Ada; Chiesa, Valentina;

    2011-01-01

    PURPOSE: The incidence of psychogenic non-epileptic seizures (PNES) is 4.9/100,000/year and it is estimated that about 20-30% of patients referred to tertiary care epilepsy centers for refractory seizures have both epilepsy and PNES. The purpose of our study is to evaluate psychiatric disorders and....... We observed fewer mood and anxiety disorders in patients with PNES compared with those with epilepsy. We did not find statistically significant differences in neuropsychological profiles among the 3 patient groups. CONCLUSION: This study can help to contribute to a better understanding of the impact...

  17. ATHEROSCLEROTIC RISK AMONG EPILEPTIC PATIENTS TAKING CARBAMAZEPINE, PHENYTOIN TREATMENT: BRIEF REVIEW

    Directory of Open Access Journals (Sweden)

    S. S. Khot*, Md. Hanif Shaikh and Lalitkumar Gupta

    2013-03-01

    Full Text Available ABSTRACT: Epilepsy is a common chronic neurological disorder that requires long-term or sometimes lifetime therapy. Anticonvulsant drugs are used in large quantities during long-term antiepileptic therapy and the treatment may be associated with various metabolic abnormalities in connective tissues, endocrine system and the liver. Recent evidence indicates that prolonged use of antiepileptic drugs (AEDs particularly carbamazepine (CBZ, phenytoin (PHT might modify some vascular risk factors; however, the influence of AED therapy on the development of atherosclerosis has been the subject of controversy and pretty unclear. Some epidemiological studies have reported a higher prevalence of ischemic vascular disease among epileptic patients on AEDs, while in other studies the mortality due to atherosclerosis-related cardiovascular disease in treated epileptics has been observed to be lower than in the general population. The etiology of atherosclerosis-related vascular diseases in epileptic patients has not been fully clarified. Atherosclerotic vascular alterations may start early in life, this review focuses on major atherogenic risk, including disordered lipid profiles, and increased lipoprotein (a serum levels among epileptic patients.

  18. Effectiveness of Cognitive– Behavioral Therapy on Dysfunctional Attitudes in Epileptic Patients

    OpenAIRE

    M Salehzadeh; M Najafi; Ebrahimi, A.

    2011-01-01

    Introduction: Epilepsy is a brain disorder that has neurobiological, cognitive, psychological, and social consequences for affected patients. The purpose of this research was to determine the efficacy of cognitive behavioral therapy(CBT) on modification of dysfunctional attitudes in patients with epilepsy. Methods: In the study, 20 epileptic patients were randomly assigned to two experimental and control groups. CBT during 8 weekly sessions was applied for the experimental group with a focus ...

  19. EFFECT OF SEIZURE CONTROL ON IMPROVEMENT OF COGNITIVE FUNCTIONS IN EPILEPTIC PATIENTS

    OpenAIRE

    Nainian, M.R.; Behere, P.B.; Mohanti, S.

    1993-01-01

    SUMMARY A group of fifty epileptic patients were tested with neuropsychological tools for cognitive functions like memory, intelligence, visuomotor coordination, spatial perception and body schema perception. Patients were on carbamazepine and were tested after three months. Seizure improvement was shown to have different effects on different cognitive functions. Memory and intellectual deficits improved, while no difference was observed in visuomotor coordination, spatial and personal percep...

  20. A patient with epileptic psychosis who had rare acute episodic symptoms ☆

    OpenAIRE

    Toru Horinouchi; Yuka Oyanagi; Yuka Umemoto; Yoshiyuki Hosokawa; Hiroshi Honma; Shigehiro Matsubara

    2014-01-01

    This is a case report of a 38-year-old woman with temporal lobe epilepsy and epileptic psychoses. The psychoses consisted of three rare symptoms that were “a distortion in the sense of time,” “what should be there disappears,” and “the next scene is supposed to be in a particular way.” There have been few reports that included these symptoms; therefore, we report the course of this patient in detail.

  1. Locked bilateral posterior fracture-dislocation of the shoulder in an epileptic patient: case report

    OpenAIRE

    CAUTERO, ENRICO; GERVASI, ENRICO

    2014-01-01

    Bilateral posterior dislocation of the shoulder, often secondary to seizures, is uncommon, while bilateral posterior fracture-dislocations is rarer still: 0.6 cases among a population of 100,000 people per year. The scientific literature contains very few published reports of cases of bilateral posterior fracture-dislocation of the shoulder, a condition that tends to be sustained by epileptic patients during seizures. The authors presented a case of bilateral posterior fracture-dislocation of...

  2. Inhibition of epoxide hydrolase by valproic acid in epileptic patients receiving carbamazepine.

    OpenAIRE

    Robbins, D K; Wedlund, P J; Kuhn, R.; Baumann, R J; Levy, R.H.; Chang, S.L.

    1990-01-01

    The effect of valproic acid (VPA) on the disposition of carbamazepine-10,11-epoxide (epoxide) was studied in five epileptic patients on chronic carbamazepine (CBZ) therapy. The individual pharmacokinetic parameters influencing epoxide disposition were determined in the presence and absence of VPA. VPA significantly decreased the clearance of unbound epoxide (an in vivo index of epoxide hydrolase activity), but did not appear to affect epoxide formation. VPA also increased the free concentrati...

  3. Classifying Normal and Abnormal Status Based on Video Recordings of Epileptic Patients

    Directory of Open Access Journals (Sweden)

    Jing Li

    2014-01-01

    Full Text Available Based on video recordings of the movement of the patients with epilepsy, this paper proposed a human action recognition scheme to detect distinct motion patterns and to distinguish the normal status from the abnormal status of epileptic patients. The scheme first extracts local features and holistic features, which are complementary to each other. Afterwards, a support vector machine is applied to classification. Based on the experimental results, this scheme obtains a satisfactory classification result and provides a fundamental analysis towards the human-robot interaction with socially assistive robots in caring the patients with epilepsy (or other patients with brain disorders in order to protect them from injury.

  4. Experience in using injectable valproic acid (convulex in patients with serial epileptic seizures and status epilepticus at the prehospital stage

    Directory of Open Access Journals (Sweden)

    A. V. Lebedeva

    2014-01-01

    Full Text Available Objective: to evaluate the efficacy of injectable valproate (convulex in patients with serial epileptic seizures and status epilepticus (SE at the prehospital stage.Patients and methods. Thirty-two adult patients, including 17 (53% men and 15 (47% women, were examined. Most patients were aged over 40 years (mean age 54.7±9.4 years. To define the required dose of the drug, the authors estimated the patient's weight that averaged 76.8±1.9 kg, i.e. there was a preponderance of patients who needed convulex, more than 500 mg, to achieve a therapeutic effect.Results. It was impossible to reliably and validly evaluate the type of a seizure as the medical emergency team (MET generally observed the patient with a just evolving seizure and the medical history data were not always valid therefore the type of convulsions and the type of a seizure were evaluated. In most cases, solitary convulsive attacks (tonic and/or clonic convulsions and/or serial seizures were observed in 12 (37.5% and 14 (43.7% patients, respectively; SE was recorded in 6 (8.8% patients. Generalized seizures (without a clear focal onset were prevalent in 24 (75% patients while 8 (25% patients were found to have partial seizures (seizure onset lateralization, a focal onset. According to the pattern of convulsions, seizures may be classified into three types: tonic-clonic, clonic, and tonic in 22 (68.8%, 7 (21.9%, and 3 (9.3% patients, respectively. Analysis of the efficacy of intravenously injectable valproate (convulex in the group of patients with SE and epileptic seizures indicated that complete cessation of seizures could be achieved in 68.8%, their rate decreased in other 9.4% of the patients. Seizures were preserved in 7 (21.8% cases, which required additional administration of drugs. Conclusion. Injectable valproic acid (convulex has a high efficacy and may be preclinically used as the drug of choice to arrest SE and serial seizures caused by both epilepsy and other

  5. 99mTc-HM-PAO SPECT of epileptic patients showing focal paroxysm on electroencephalography

    International Nuclear Information System (INIS)

    The usefulness of 99mTc-HM-PAO SPECT in diagnosing epilepsy was studied. The subjects were 33 epileptic patients, ranging in age from 5 years and 5 months to 28 years and 3 months, who showed focal paroxysm on electroencephalograms. Lowered accumulation site was found on SPECT in 19 patients. Four patients with abnormal findings on X-ray CT or MRI showed lowered accumulation and focal paroxysm at the same site. Of 29 patients with normal X-ray CT or MRI findings, 15 (52%) showed lowered accumulation. Five patients showed a focal paroxysm at the site of lowered accumulation. In 8 patients the focal paroxysm site was partly coincided with the accumulation site. In some patients the focal site predicted by the findings of clinical symptoms and the lowered accumulation site coincided. SPECT is therefore a useful method in diagnosing a focal site in epilepsy and considered to reflect the severity of disease. (Y.S.)

  6. [Diagnosis and certification of the ability of epileptic patients to drive motor vehicles: cases consulted by the author].

    Science.gov (United States)

    Sińczuk-Walczak, Halina; Wagrowska-Koski, Ewa

    2002-01-01

    Epilepsy is a frequent diagnostic problem. It is also difficult to certify whether an epileptic patient is able to drive a motor vehicle. With the advent of efficient anti-epileptic treatment, a general practice of refusing epileptic patients driving license should be seriously reconsidered. However, the matter should be given careful consideration not to jeopardize public safety and patients' rights. The aim of the study was to highlight the problems encountered in rediagnosing and certifying people with diagnosed epilepsy or pseudoepileptic seizures. The authors discuss the diagnosis and certification procedures in persons with epileptic seizures after severe craniocerebral trauma. They also analyze a case of diagnosed epilepsy suggesting the syncope in a patient with cardiac defect; a case of psychogenous pseudoepileptic seizures and the course of the disease in a patient with febrile convulsions in childhood. The problems result from the fact that reliable medical histories are not available and thus the retroassessment of the clinical picture of epileptic seizures is not possible. Missing results of timely laboratory tests (EEG, ECG) and diagnostic errors concerning earlier episodes, especially epilepsy diagnosed inconsiderately, are additional obstacles. PMID:12577810

  7. Effectiveness of Cognitive– Behavioral Therapy on Dysfunctional Attitudes in Epileptic Patients

    Directory of Open Access Journals (Sweden)

    M Salehzadeh

    2011-08-01

    Full Text Available Introduction: Epilepsy is a brain disorder that has neurobiological, cognitive, psychological, and social consequences for affected patients. The purpose of this research was to determine the efficacy of cognitive behavioral therapy(CBT on modification of dysfunctional attitudes in patients with epilepsy. Methods: In the study, 20 epileptic patients were randomly assigned to two experimental and control groups. CBT during 8 weekly sessions was applied for the experimental group with a focus on cognitive restructuring, modification of cognitive distortions and training of behavioral techniques. Dysfunctional attitudes scale(DAS was applied as the pre-test, post- test and in the follow- up for both groups. Analysis of covariance was applied for analysis of data. Results: Data analysis showed that the mean scores of DAS in the experimental group as compared to the control group was significantly increased during post-test and follow-up(p<.05. Conclusion: Cognitive-behavioral therapy is remarkably effective in modifying dysfunctional attitudes in epileptic patients.

  8. Gingival Enlargement In Epileptic Patients On Phenytoin Therapy-An Overview Of Possible Etiologies And Studies

    Directory of Open Access Journals (Sweden)

    Abhishek Singh Nayyar

    2013-01-01

    Full Text Available Epilepsy is a common neurological disorder with recurrent seizures due to a chronic underlying process. Despite tremendous advances in the field of understanding regarding the etio-pathogenesis of epilepsy, phenytoin still remains the drug of choice in its management. Chronic administration of phenytoin has been associated to have a number of adverse effects. Gingival enlargement is one such most often reported adverse drug sequela of long term phenytoin usage with exclusion of local factors contributing towards gingival enlargement. This review gives an overview regarding the association of phenytoin and gingival enlargement seen in epileptic patients being treated with phenytoin.

  9. Thalamocortical relationship in epileptic patients with generalized spike and wave discharges — A multimodal neuroimaging study

    Directory of Open Access Journals (Sweden)

    Clara Huishi Zhang

    2015-01-01

    Full Text Available Unlike focal or partial epilepsy, which has a confined range of influence, idiopathic generalized epilepsy (IGE often affects the whole or a larger portion of the brain without obvious, known cause. It is important to understand the underlying network which generates epileptic activity and through which epileptic activity propagates. The aim of the present study was to investigate the thalamocortical relationship using non-invasive imaging modalities in a group of IGE patients. We specifically investigated the roles of the mediodorsal nuclei in the thalami and the medial frontal cortex in generating and spreading IGE activities. We hypothesized that the connectivity between these two structures is key in understanding the generation and propagation of epileptic activity in brains affected by IGE. Using three imaging techniques of EEG, fMRI and EEG-informed fMRI, we identified important players in generation and propagation of generalized spike-and-wave discharges (GSWDs. EEG-informed fMRI suggested multiple regions including the medial frontal area near to the anterior cingulate cortex, mediodorsal nuclei of the thalamus, caudate nucleus among others that related to the GSWDs. The subsequent seed-based fMRI analysis revealed a reciprocal cortical and bi-thalamic functional connection. Through EEG-based Granger Causality analysis using (DTF and adaptive DTF, within the reciprocal thalamocortical circuitry, thalamus seems to serve as a stronger source in driving cortical activity from initiation to the propagation of a GSWD. Such connectivity change starts before the GSWDs and continues till the end of the slow wave discharge. Thalamus, especially the mediodorsal nuclei, may serve as potential targets for deep brain stimulation to provide more effective treatment options for patients with drug-resistant generalized epilepsy.

  10. Biclustering EEG data from epileptic patients treated with vagus nerve stimulation

    Science.gov (United States)

    Busygin, Stanislav; Boyko, Nikita; Pardalos, Panos M.; Bewernitz, Michael; Ghacibeh, Georges

    2007-11-01

    We present a pilot study of an application of consistent biclustering to analyze scalp EEG data obtained from epileptic patients undergoing treatment with a vagus nerve stimulator (VNS). The ultimate goal of this study is to develop a physiologic marker for optimal VNS parameters (e.g. output current, signal frequency, etc.) using measures of scalp EEG signals. A time series of STLmax values was computed for each scalp EEG channel recorded from two epileptic patients and used as a feature of the two datasets. The averaged samples from stimulation periods were then separated from averaged samples from non-stimulation periods by feature selection performed within the consistent biclustering routine. The obtained biclustering results allow us to assume that signals from certain parts of the brain consistently change their characteristics when VNS is switched on and could provide a basis for desirable VNS stimulation parameters. A physiologic marker of optimal VNS effect could greatly reduce the cost, time, and risk of calibrating VNS stimulation parameters in newly implanted patients compared to the current method of clinical response.

  11. Regression of nodules on cranial computerized tomography (CCT) scans in 4 focal epileptic patients

    International Nuclear Information System (INIS)

    Epilepsy can be defined as a paroxysmal, excessive, neuronal discharge within the brain originating from either cortical or sugcortical regions. The incidence of epilepsy is increasing possibly due to the survival of persons who should have died of brain injuries or other cerebral abnormalities acquired in early life. The use of antibiotics and improvement in the medical care have saved many children who might have died of meningitis, brain abscess, encephalitis, severe head injuries, etc. CCT scan is new radiologic procedure for defining cranial and intracranial structures and also an useful procedure for evaluation and follow-up (FU) of patient with focal seizure disorder. Recently we experienced nodules which were isodense or hypodense on initial non contrasted CT (NECT) and scans became hyperdense of the enhancement in 4 cases of focal epileptic seizure. Nearly complete disappearance or regression of the epileptic foci occurred on the FU CT scans in 2 cases. Operation was performed in 2 cases. The tissue specimen obtained from the CT nodule revealed cerebral edema in one case and localized gliosis and congestion in the other. All the patients showed marked clinical improvement when the CT nodule improved. Review of literature failed to disclose any previous report on such observation

  12. Analysis of Epileptic Discharges from Implanted Subdural Electrodes in Patients with Sturge-Weber Syndrome

    Science.gov (United States)

    2016-01-01

    Objective Almost two-thirds of patients with Sturge-Weber syndrome (SWS) have epilepsy, and half of them require surgery for it. However, it is well known that scalp electroencephalography (EEG) does not demonstrate unequivocal epileptic discharges in patients with SWS. Therefore, we analyzed interictal and ictal discharges from intracranial subdural EEG recordings in patients treated surgically for SWS to elucidate epileptogenicity in this disorder. Methods Five intractable epileptic patients with SWS who were implanted with subdural electrodes for presurgical evaluation were enrolled in this study. We examined the following seizure parameters: seizure onset zone (SOZ), propagation speed of seizure discharges, and seizure duration by visual inspection. Additionally, power spectrogram analysis on some frequency bands at SOZ was performed from 60 s before the visually detected seizure onset using the EEG Complex Demodulation Method (CDM). Results We obtained 21 seizures from five patients for evaluation, and all seizures initiated from the cortex under the leptomeningeal angioma. Most of the patients presented with motionless staring and respiratory distress as seizure symptoms. The average seizure propagation speed and duration were 3.1 ± 3.6 cm/min and 19.4 ± 33.6 min, respectively. Significant power spectrogram changes at the SOZ were detected at 10–30 Hz from 15 s before seizure onset, and at 30–80 Hz from 5 s before seizure onset. Significance In patients with SWS, seizures initiate from the cortex under the leptomeningeal angioma, and seizure propagation is slow and persists for a longer period. CDM indicated beta to low gamma-ranged seizure discharges starting from shortly before the visually detected seizure onset. Our ECoG findings indicate that ischemia is a principal mechanism underlying ictogenesis and epileptogenesis in SWS. PMID:27054715

  13. [The role of the nurse in the patient education of young epileptic patients].

    Science.gov (United States)

    Danse, Marion; Goujon, Estelle

    2015-01-01

    An epileptic seizure in a child is a major source of anxiety and turns the family's everyday life upside down. Through therapeutic education, the nurse guides the families towards the autonomous management of the seizures, antiepileptic treatments, adaptations to daily life and potential comorbidities. PMID:26100481

  14. Serum Leptin Levels in Epileptic Patients Treated with Topiramate and Valproic Acid

    Directory of Open Access Journals (Sweden)

    İrem Fatma Uludağ

    2011-03-01

    Full Text Available OBJECTIVE: Leptin is considered to be a signal factor that regulates body weight and energy expenditure, and there is a strong correlation between serum leptin concentrations, body mass index, and body fat mass in humans. Our aim in this study was to evaluate the role of leptin in valproic acid (VPA and topiramate (TPM related weight changes in epileptic patients. METHODS: Body mass index is calculated and serum leptin and insulin levels are measured in 56 patients with epilepsy (40 patients taking VPA and 16 patients taking VPA and TPM and in 40 healty control subjects. RESULTS: Obesity was seen in 21 patients (52.5% in VPA treated group, in 15 patients (37.5% in the control group and in only one male (6.3% in VPA and TPM treated group. Body mass index was lower in the group treated with VPA and TPM (p<0.001. Serum leptin concentrations were correlated with the body mass index (r=0.49, p<0.001 and were significantly higher in obese subjects (p<0.001 and in women (p<0.001. Serum leptin levels were significantly lower in patients treated with VPA and TPM (p<0.05. CONCLUSION: High levels of serum leptin in patients taking VPA and significantly low levels of serum leptin in patients taking VPA and TPM in our study are in agreement with the hypotheses that weight changes induced with VPA and TPM are related with the alterations in serum leptin levels.

  15. Evaluating therapeutic outcome in epileptic patients using the changes of interval and duration

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: Seizure frequency is in abnormal distribution, and it is not enough to express the trend of concentration using means, and its median loses a lot of information, thus it lacks of a standard for evaluating the therapeutic effects based on seizure frequency.OBJECTIVE: To establish a method for evaluating the therapeutic effects on anti-epileptic drugs using changes of interval and duration of seizure.DESIGN: A prospective cohort study.SETTING: Zhumadian Psychiatric Hospital.PARTICIPANTS: Outpatients and inpatients suffering from epilepsy attending firstly visited Zhumadian Psychiatric Hospital from June 2001 to June 2002 were enrolled. They were diagnosed as epileptic according to the International Classification of Epileptic Seizure by International League Against Epilepsy (1981) based on the clinical history, physical examination, and investigations. The interval time was no more than 6 months. Informed consent was obtained from all the subjects, and the study was approved by the hospital ethical committee.METHODS: ① For the first visit and each follow-up, the following data were recorded, including general demographic information, seizure type, the date and time of ictus, the duration of ictus, and inducement or situation related, according to which the following indexes could be calculated, including seizure styles,interval, duration, cluster frequency and cluster duration. The information from the first review was noted as annals A. The second interview was taken at the end of the evaluating period; the information from the second review was noted as annals B. The third interview was taken within two weeks after the second one;the information from the third review was noted as annals C. The annals B or the annals C were respectively compared with the annals A in the light of the same types or the same styles of the same patient. Summation of the scores of interval change and duration change of the same type or the same style and 5 of basic score

  16. MDR-1 and MRP2 gene polymorphisms in Mexican epileptic pediatric patients with complex partial seizures.

    Directory of Open Access Journals (Sweden)

    David eEscalante-Santiago

    2014-10-01

    Full Text Available Although the Pgp efflux transport protein is overexpressed in resected tissue of patients with epilepsy, the presence of polymorphisms in MDR1 / ABCB1 and MRP2 / ABCC2 in patients with antiepileptic-drugs resistant epilepsy is controversial. The aim of this study was to perform an exploratory study to identify nucleotide changes and search new and reported mutations in patients with antiepileptic-drugs resistant epilepsy (ADR and patients with good response to anti-epileptic drugs (CTR in a rigorously selected population. We analyzed 22 samples from drug-resistant patients with epilepsy and 7 samples from patients with good response to anti-epileptic drugs. Genomic DNA was obtained from leukocytes. Eleven exons in both genes were genotyped. The concentration of drugs in saliva and plasma was determined. The concentration of valproic acid in saliva was lower in ADR than in CRT. In ABCB1, five reported SNPs and five unreported nucleotide changes were identified; rs2229109 (GA and rs2032582 (AT and AG were found only in the ADR. Of six SNPs associated with the ABCC2 that were found in the study population, rs3740066 (TT and 66744T>A (TG were found only in the ADR. The strongest risk factor in the ABCB1 gene was identified as the TA genotype of rs2032582, whereas for the ABCC2 gene the strongest risk factor was the T allele of rs3740066. The screening of SNPs in ACBC1 and ABCC2 indicates that the Mexican patients with epilepsy in this study display frequently reported ABCC1 polymorphisms; however, in the study subjects with a higher risk factor for drug resistance, new nucleotide changes were found in the ABCC2 gene. Thus, the population of Mexican patients with AED-resistant epilepsy used in this study exhibits genetic variability with respect to those reported in other study populations; however, it is necessary to explore this polymorphism in a larger population of patients with AED-resistant epilepsy.

  17. Healthcare-seeking behavior of patients with epileptic seizure disorders attending a tertiary care hospital, Kolkata

    Directory of Open Access Journals (Sweden)

    Abhik Sinha

    2012-01-01

    Full Text Available Introduction : Neurological diseases are very important causes of prolonged morbidity and disability, leading to profound financial loss. Epilepsy is one of the most important neurological disorders Healthcare seeking by epilepsy patients is quite diverse and unique. Aims and Objectives: The study was conducted among the epilepsy patients, to assess their healthcare-seeking behavior and its determinants. Materials and Methods: Three hundred and fifteen epilepsy patients, selected by systematic random sampling, in the neuromedicine outpatient department of a tertiary care hospital were interviewed with a predesigned, pretested, semi-structured proforma. Results and Conclusion: More than 90% sought healthcare just after the onset of a seizure. The majority opted for allopathic medicine and the causes for not seeking initial care from allopaths were ignorance, faith in another system, constraint of money, and so on. A significant association existed between rural residence and low social status of the patients with initial care seeking from someone other than allopaths. No association was found among sex, type of seizure, educational status of the patients, and care seeking. The mean treatment gap was 2.98 ± 10.49 months and the chief motivators were mostly the family members. Patients for anti epileptic drugs preferred neurologists in urban areas and general practitioners in rural areas. District care model of epilepsy was proposed in the recommendation.

  18. "CLINICAL SURVEY OF HYGIENIC CONDITIONS AND CHANGES OF THE GINGIVAL ENLARGEMENT IN EPILEPTIC PATIENTS UNDER PHENYTOIN TREATMENT "

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    F. Mousavi

    1991-12-01

    Full Text Available A clinical study was made on epileptic patients in the diagnostic department of the Tehran School of Dentistry. The results showed that not all of the epileptic patients who are under control with phenytoin develop hyperplasia, and those who do not care about their oral health and hygiene will be afflicted by hyperplasia of gum. On the basis of patients, records gingival hyperplasia in most patients begins to appear 3-4 months after using the drug for the first time, progressing fully after 1.5-2 years. The dosage of the drug may have a role in the extent of the lesion. And it seems that young patients are at a higher risk.

  19. White matter diffusion abnormalities in patients with psychogenic non-epileptic seizures.

    Science.gov (United States)

    Lee, Seongtaek; Allendorfer, Jane B; Gaston, Tyler E; Griffis, Joseph C; Hernando, Kathleen A; Knowlton, Robert C; Szaflarski, Jerzy P; Ver Hoef, Lawrence W

    2015-09-16

    The purpose of this study was to conduct a preliminary investigation of the white matter characteristics in patients with psychogenic non-epileptic seizures (PNES). Diffusion Tensor Imaging (DTI) data were collected at 3T in 16 patients with PNES and 16 age- and sex-matched healthy controls (HC). All patients with PNES had their diagnosis confirmed via video/EEG monitoring; HCs had no comorbid neurological or psychiatric conditions. DTI indices including fractional anisotropy (FA), and mean diffusivity (MD) were calculated and compared between patients with PNES and HCs using Tract-Based Spatial Statistics (TBSS). Significantly higher FA values were observed in patients with PNES in the left corona radiata, left internal and external capsules, left superior temporal gyrus, as well as left uncinate fasciculus (UF) (Psex-matched HCs. These abnormalities are present in left hemispheric regions associated with emotion regulation and motor pathways. While the relationship between the pathophysiology of PNES and these abnormalities is not entirely clear, this work provides an initial basis to guide future prospective studies. PMID:25979311

  20. Cerebral perfusion alterations in epileptic patients during peri-ictal and post-ictal phase: PASL vs DSC-MRI.

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    Pizzini, Francesca B; Farace, Paolo; Manganotti, Paolo; Zoccatelli, Giada; Bongiovanni, Luigi G; Golay, Xavier; Beltramello, Alberto; Osculati, Antonio; Bertini, Giuseppe; Fabene, Paolo F

    2013-07-01

    Non-invasive pulsed arterial spin labeling (PASL) MRI is a method to study brain perfusion that does not require the administration of a contrast agent, which makes it a valuable diagnostic tool as it reduces cost and side effects. The purpose of the present study was to establish the viability of PASL as an alternative to dynamic susceptibility contrast (DSC-MRI) and other perfusion imaging methods in characterizing changes in perfusion patterns caused by seizures in epileptic patients. We evaluated 19 patients with PASL. Of these, the 9 affected by high-frequency seizures were observed during the peri-ictal period (within 5hours since the last seizure), while the 10 patients affected by low-frequency seizures were observed in the post-ictal period. For comparison, 17/19 patients were also evaluated with DSC-MRI and CBF/CBV. PASL imaging showed focal vascular changes, which allowed the classification of patients in three categories: 8 patients characterized by increased perfusion, 4 patients with normal perfusion and 7 patients with decreased perfusion. PASL perfusion imaging findings were comparable to those obtained by DSC-MRI. Since PASL is a) sensitive to vascular alterations induced by epileptic seizures, b) comparable to DSC-MRI for detecting perfusion asymmetries, c) potentially capable of detecting time-related perfusion changes, it can be recommended for repeated evaluations, to identify the epileptic focus, and in follow-up and/or therapy-response assessment. PMID:23623332

  1. Magnetic resonance imaging and computed tomography of epileptic patients with tuberous sclerosis complex

    International Nuclear Information System (INIS)

    Full text: Introduction: Tuberous sclerosis (TS ) is a congenital disease from the group of phacomatoses. It is characterized by multi-organ hamartomas in the skin, central nervous system , lungs, heart and kidneys. The purpose of this study is to present the typical MRI and CT findings in the brain in these patients. Materials and methods: The findings are analyzed in 8 patients who demonstrated TS. Patients were aged 1 to 21 (mean age 10.4 years). Four patients were female, four were male. The clinical data included epileptic seizures and developmental delays. We conducted magnetic resonance tomography of the brain using 1.5 T Philips apparatus and standard protocol for this disease with application of gadolinium containing contrast media. Computed tomography of the brain was done in three patients had a 64- multidetector tomograph Siemens. Results: Cortical tubers and subependymal nodules with the typical features for MR imaging sequences, were observed in all patients. In two patients the findings from MP directed to clinical diagnosis. In one child only one cortical tuber was found, which required differential diagnosis of cortical malformation type II. In three patients the CT images demonstrated calcified subependymal nodules and tuberculosis. Changes in the white matter were visualized in two patients. One patient was diagnosed with subependymal giant cell astrocytoma (SEGA ). Conclusion: The MR findings in TS were typical, but in some cases it was necessary to conduct CT. The imaging characteristics information is important not only in patients with a known diagnosis (establishing the occurrence of SEGA ), but also for clinical studies in children with epilepsy for diagnosing of tuberous sclerosis

  2. Phenytoin influence on human lymphocyte mitogen response: a prospective study of epileptic and nonepileptic patients.

    Science.gov (United States)

    Gabourel, J D; Davies, G H; Bardana, E J; Ratzlaff, N A

    1982-08-01

    The results of this prospective study fail to confirm previously reported phenytoin suppression of lymphocyte responsiveness to mitogens. Our data show a significantly greater than expected percentage (p less than 0.0001) of patients requiring phenytoin treatment have low lymphocyte responsiveness to mitogens prior to phenytoin therapy. Analysis of changes in each individual's response during phenytoin treatment as compared with their pre-phenytoin responses shows a consistent trend to increased responsiveness to concanavalin A, pokeweed mitogen, and to a suboptimal concentration of phytohemagglutinin. This trend was most pronounced for patients whose serum IgA concentration was decreased while taking phenytoin, whereas there was no such trend for individuals whose serum IgA levels were not decreased. This phenomenon was not related to neurological disease classification. Phenytoin added directly to lymphocyte cultures depressed lymphocyte responses to all mitogens in a small (less than 20%) but significant degree, confirming similar in vitro studies by other investigators. Because of limited serum proteins for phenytoin binding in culture medium, these in vitro studies have little application to possible phenytoin effects on lymphocytes of patients taking it to prevent seizures. Thus, the suggestion that phenytoin causes depressed lymphocyte responses to mitogens in epileptic patients appears unwarranted. PMID:7094904

  3. Assessment of compliance-relevant indispensable knowledge to cope with epilepsy in epileptic patients in Xi'an

    Institute of Scientific and Technical Information of China (English)

    DENG Yan-chun; XIA Feng; HUANG Yuan-gui; LI Ning-xiu; ZHENG Shu-ping

    2005-01-01

    Objective: To investigate the knowledge level related to compliance in patients with epilepsy. Methods: Eighty-seven patients with epilepsy were tested in the city of Xi'an with a knowledge questionnaire containing 21 questions related to compliance. Results: Over 39.5% of patients did not know that epilepsy is the result of abnormal firing of neurons, while 29.9% were uncertain or did not realize that epilepsy attacks can bring up accidents such as traffic accidents, drowning and trauma. A total of 36.6% of responders thought that the best therapy for epilepsy could be found in Traditional Chinese Medicine. As many as 36.8% of tested patients were uncertain or did not know that frequent epilepsy attacks can affect their intelligence. Up to 36% were unaware of the possible consequence of sudden withdrawal of anti-epileptic drugs (AED). Among responders, 39.1% did not know the right treatment method of epilepsy. That AED can control seizure attacks were doubted in 57.5% of epileptic patients. Furthermore, 32.2% did not know whether the disease could be cured. Conclusion: In this group of epileptic patients, generally they do not have enough indispensable knowledge to cope with epilepsy. They urgently need for proper health education besides effective AED to control seizure attacks and improve their quality of life.

  4. Correlation between regional cerebral blood flow and degree of brain tissue injury of interictal epileptic activity in patients with epilepsy

    International Nuclear Information System (INIS)

    Objective: To explore the correlation between the change of regional cerebral blood flow (rCBF) and brain tissue injury from interictal epileptic activity in patients with epilepsy. Methods: Forty-eight patients with epilepsy and 30 healthy persons were included in the study from which the serum S100β protein levels were determined by double antibody sandwich ELISA method. SPECT rCBF imaging was performed in all patients. The visual and semi-quantitative analyses were used to analyze the epileptic foci. SPSS 11.0 was applied for variance and linear correlation analyses. Results: Serum S-100β in patients with interictal epileptic activity was significantly higher than that in control group ((0.572±0.163) μg/L vs (0.218±0.134) μg/L, t =9.96, P<0.01). According to epilepsy control criteria, 20 cases achieved complete control (CC), 18 cases achieved partial control (PR). However, 10 cases got no improvement,whose serum S-100β protein ((0.809±0.056) μg/L) and the percentage change of rCBF ((0.337±0.060) %) were significantly higher than those of CC ((0.443±0.083) μg/L, (0.035±0.038) %) and those of PC ((0.585±0.108) μg/L, (0.187±0.075)%), F=56. 740, 92. 316, P<0.01. There were high correlation between serum S-100β and the percentage change of rCBF in epilepsy patients (r =0.887, P<0.01). Conclusion: Serum S-100β protein assay combined with rCBF on SPECT imaging can make semi-quantitative diagnosis of epilepsy and help evaluate the brain damage from interictal epileptic activity. (authors)

  5. Treating Lennox–Gastaut syndrome in epileptic pediatric patients with third-generation rufinamide

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    Jessica Gresham

    2010-09-01

    Full Text Available Jessica Gresham1, Lea S Eiland2,3, Allison M Chung2,41Auburn University, Harrison School of Pharmacy (AUHSOP, 2Department of Pharmacy Practice, AUHSOP, 3University of Alabama, School of Medicine, Huntsville Regional Medical Campus, 4University of South Alabama School of Medicine, Department of Pediatrics, Mobile, Alabama, USAAbstract: Lennox–Gastaut syndrome (LGS is a rare but debilitating pediatric epileptic encephalopathy characterized by multiple intractable seizure types. Treatment of LGS is challenging because of the small number of antiepileptic drugs (AEDs which are effective for this syndrome, as well as the need for polytherapy in the majority of patients. This review focuses on the treatment of LGS with rufinamide, a recently approved third-generation AED with reported efficacy as adjunctive therapy for LGS. All relevant papers identified through a PubMed search on the treatment of LGS with rufinamide were reviewed. To date, the literature suggests improvements in seizure frequency for pediatric patients with LGS on rufinamide. Rufinamide appears to be especially effective for atonic or drop attack seizures. Rufinamide also displays a favorable adverse event profile compared with the older anticonvulsants, as well as a minimal number of drug interactions, making it a promising option for the adjunctive treatment of seizures associated with LGS.Keywords: epilepsy, Lennox-Gastaut syndrome, pediatrics, seizure, rufinamide

  6. Genotoxicity of the anticonvulsant drug phenytoin (PHT): a follow-up study of PHT-untreated epileptic patients. I. Sister chromatid exchange (SCE) analysis.

    Science.gov (United States)

    Kaul, A; Goyle, S

    1999-01-01

    Phenytoin (PHT) is a widely prescribed antiepileptic drug. Its potential to interact with genetic material was investigated in a set of 30 epileptic patients (age 10-30 years) prior to and following the administration of PHT over a period of 9 months (grouped in a multiple of 3 months) and 40 control subjects in relation to age, sex, duration of drug therapy, and plasma concentration of PHT, using the sister chromatid exchange (SCE) frequency assay. Plasma levels of the phenytoin were measured by biochemical assay in epileptic patients before and after the PHT therapy. The peripheral blood lymphocytes were cultured and harvested at 72 h. The frequency of SCE was significantly higher (P genotoxic effect as expressed by the induction of increased SCE rates in treated epileptics, while disease does not play any role in inducing genetic damage as shown by no difference in SCE frequencies between control subjects and PHT-untreated epileptic patients. PMID:10321411

  7. Factors influencing plasma concentrations of carbamazepine and carbamazepine-10,11-epoxide in epileptic children and adults.

    Science.gov (United States)

    Lanchote, V L; Bonato, P S; Campos, G M; Rodrigues, I

    1995-02-01

    Plasma carbamazepine (CBZ) and carbamazepine-10,11-epoxide (CBZ-E) concentrations were measured in 160 epileptic patients in order to determine the effect of factors such as age, daily dosing schedule, formulation, and combination with other antiepileptic drugs on these concentrations in relation to the daily dose. The results showed that the CBZ plasma level/dose ratio was affected by all factors studied, whereas the CBZ-E plasma level/dose ratio was affected only by formulation and age. The ratio of CBZ-E to CBZ plasma levels (CBZ-E/CBZ) was affected by daily dosing schedule, age, and combination with other antiepileptic drugs. The present study demonstrated that many factors affect plasma CBZ/dose ratios, explaining the discrepancies observed in the literature. PMID:7725376

  8. Clinical analysis of 32 patients with non- epileptic seizures passed for epileptic seizures%非癫痫发作误诊为癫痫发作32例临床分析

    Institute of Scientific and Technical Information of China (English)

    李玉生; 黄圣明; 黄希顺

    2011-01-01

    Objective To investigate the causes and clinical characteristics of non - epileptic seizures misdiagnosed as epileptic seizures. Methods Clinical data of 32 patients with non - epileptic seizures misdiagnosed as epileptic seizures were analyzed retrospectively. Results Among 32 patients , 7 were syncope, 6 were psychic seizure, 4 were paroxysmal kinesigenic choreoathetosis, 4 were migraine, 4 were sleep disorder, 3 were acute anxiety attack, 2 were tourette syndrome, and hypopara-thyroidism, hypoglycemia attack was 1 case respectively. Conclusions Clinical doctors should attach much importance to epileptic discrimination; Diagnosis of epilepsy must be prudent, otherwise, it not only delayed treatment, but also brought about psychological and economic burden for the patients themselves and their relatives.%目的 分析非癫痫发作误诊为癫痫发作的原因及特点,以提高癫痫的诊断水平,减少误诊误治.方法 回顾性分析32例非癫痫发作性疾病被误诊为癫痫的临床资料.结果 32例中,7例为晕厥,6例为精神性发作,4例为阵发性运动诱发性运动障碍,4例为偏头痛,4例为睡眠障碍,3例为急性焦虑发作,2例为抽动-秽语综合症,甲状旁腺功能减退症、低血糖发作各l例.结论 临床医生对于癫痫的鉴别应该有足够的认识,诊断一定要慎重,否则不但耽误治疗,还将给患者及其亲属带来不必要的心理和经济负担.

  9. Effects of Vitamin E on seizure frequency, electroencephalogram findings, and oxidative stress status of refractory epileptic patients

    Science.gov (United States)

    Mehvari, Jafar; Motlagh, Fataneh Gholami; Najafi, Mohamad; Ghazvini, Mohammad Reza Aghaye; Naeini, Amirmansour Alavi; Zare, Mohamad

    2016-01-01

    Background: Oxidative stress has been a frequent finding in epileptic patients receiving antiepileptic drugs (AEDs). In this study, the influence of Vitamin E on the antiseizure activity and redox state of patients treated with carbamazepine, sodium valproate, and levetiracetam has been investigated. Materials and Methods: This double-blind, placebo-controlled trial was carried out on 65 epileptic patients with chronic antiepileptic intake. The subjects received 400 IU/day of Vitamin E or placebo for 6 months. Seizure frequency, electroencephalogram (EEG), and redox state markers were measured monthly through the study. Results: Total antioxidant capacity, catalase and glutathione were significantly higher in Vitamin E received group compared with controls (P < 0.05) whereas malodialdehyde levels did not differ between two groups (P < 0.07). Vitamin E administration also caused a significant decrease in the frequency of seizures (P < 0.001) and improved EEG findings (P = 0.001). Of 32 patients in case group, the positive EEG decreased in 16 patients (50%) whereas among 33 patients in control group only 4 patients (12.1%) showed decreased positive EEG. Conclusion: The results of this preliminary study indicate that coadministration of antioxidant Vitamin E with AEDs improves seizure control and reduces oxidative stress. PMID:27099849

  10. Evaluating the efficacy of memantine on improving cognitive functions in epileptic patients receiving anti-epileptic drugs: A double-blind placebo-controlled clinical trial (Phase IIIb pilot study

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    Priya Marimuthu

    2016-01-01

    Full Text Available Objectives: People with epilepsy have greater cognitive and behavioral dysfunction than the general population. There is no specific treatment available for cognitive impairment of these patients. We aimed to evaluate the effects of memantine, an N-methyl-D-aspartate-type glutamate receptor noncompetitive antagonist, on improving cognition and memory functions in epileptic patients with cognitive and memory impairment, who received anti-epileptic drugs (AEDs. Methods: We did a randomized, double-blind, placebo-controlled parallel group trial, in SRM Medical College Hospital and Research Centre, Kattankulathur, Kancheepuram, Tamil Nadu, India between April 2013 and September 2013. Fifty-nine epileptic patients taking AEDs with subjective memory complaints were recruited and randomized to either Group 1 to receive 16 weeks of once-daily memantine, (5 mg for first 8 weeks, followed by memantine 10 mg for next 8 weeks or Group 2 to receive once daily placebo. This trial is registered with Clinical Trial Registry of India CTRI/2013/04/003573. Results: Of 59 randomized patients, 55 patients completed the study (26 memantine and 29 placebo. Memantine group showed statistically significant improvement in total mini mental state examination score from baseline (P = 0.765 to 16 th week (P < 0.001 in comparison with the placebo. The Weshler′s Memory Scale total score in memantine group improved significantly after 8 weeks (P = 0.002 compared with baseline (P = 0.873 and highly significant at the end of 16 th week (P < 0.001. The self-rated quality of life and memory in memantine group also significantly improved at the study end. Conclusion: We conclude that once-daily memantine (10 mg treatment significantly improved cognition, memory and quality of life in epileptic patients with mild to moderate cognitive impairment and was found to have a favorable safety profile.

  11. Altered regional homogeneity in epileptic patients with infantile spasm: A resting-state fMRI study.

    Science.gov (United States)

    Tan, Zhen; Li, Yongxin; Zang, Dongdong; Zhang, Heye; Zhao, Cailei; Jiang, Haibo; Chen, Yan; Cao, Dezhi; Chen, Li; Liao, Jianxiang; Chen, Qian; Luan, Guoming

    2016-09-14

    Infantile spasm (IS) syndrome is an age-related epileptic encephalopathy that occurs in children. The purpose of this study was to investigate regional homogeneity (ReHo) changes in IS patients. Resting-state fMRI was performed on 11 patients with IS, along with 35 age- and sex-matched healthy subjects. Group comparisons between the two groups demonstrate that the pattern of regional synchronization synchronization in IS patients is changed. Decreased ReHo values were found in default mode network, bilateral motor-related areas and left occipital gyrus of the patient group. Increased ReHo was found in regions of cingulum, cerebellum, supplementary motor area and brain deep nucleus, such as hippocampus, caudate, thalamus and insula. The significant differences might indicate that epileptic action have some injurious effects on the motor, executive and cognitive related regions. In addition, ReHo values of left precuneus and right superior frontal gyrus were associated with the epilepsy duration in the IS group. The correlation results indicate that the involvement of these regions may be related to the seizure generation. Our results suggest that IS may have an injurious effect on the brain activation. The findings may shed new light on the understanding the neural mechanism of IS epilepsy. PMID:27002912

  12. Investigation of Anti-Toxocara Antibodies in Epileptic Patients and Comparison of Two Methods: ELISA and Western Blotting

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    Mohammad Zibaei

    2013-01-01

    Full Text Available The relationship between Toxocara infection and epilepsy was previously demonstrated by several case-control studies and case reports. These previous studies were often based on the enzyme-linked immunosorbent assay (ELISA using Toxocara excretory-secretory antigens, which are not specific due to cross-reactivity with other parasitic infections such as ascariasis, trichuriasis, and anisakiasis. An immunoblot analysis is highly specific and can detect low levels of Toxocara antibodies. Therefore, this assay may be useful in the identification of toxocariasis in epileptic patients. We examined patients who had epilepsy and healthy subjects for seropositivity for Toxocara infection by ELISA and Western blotting. Out of 85 epileptic patients, 10 (11.8% and 3 (3.5% persons exhibited Toxocara immunoglobulin G (IgG antibodies responses by ELISA and by both techniques, respectively. Moreover, in the healthy group (, 3 (3.5% persons were positive by ELISA, but none was detected by Western blotting. This study indicates that Toxocara infection is a risk factor for epilepsy in Iran. These findings strongly suggest the need to perform Western blotting immunodiagnosis, as well as the ELISA using Toxocara excretory-secretory antigens, to improve diagnosis of human toxocariasis in patients with epilepsy.

  13. Examinations with computerized cranial axial tomography carried out on patients with epileptic seizures, taking into consideration the EEG and the clinical picture

    International Nuclear Information System (INIS)

    204 patients suffering from epileptic seizures were examined with the help of computerized cranial X-ray tomography; the results were compared with anamnestic, clinical, and EEC-findings. In good agreement with results published in literature, in 54% of the patients pathologic CT's such as tumours, attack scars, changes in ventricles and arachnoid spaces etc. were found. A pathological CT is very likely to appear in male patients who are 30 or even 50 years of age, having partial attacks with elementary symptoms, focal diagnosis in the EEG and a neurological unilateral finding. Especially noteworthy is the tumour detecting rate achieved by CT and the fact that in nearly 5% of the cases CT detected a cerebral lesion which has not been suspected, neither clinically nor in the EEG (4 tumours). This shows clearly that CT represents a heighly valuable diagnostic help, especially for patients with epileptic seizures. (orig./MG)

  14. Preoperative MR imaging-based volume measurements of the hippocampal formation and anterior temporal lobe in epileptic patients

    International Nuclear Information System (INIS)

    MR-based volume measurements of the anterior temporal lobe and hippocampal formation were performed in 36 patients who subsequently underwent surgery for medically refractory temporal lobe epilepsy. Seizure lateralization was based on standard clinical and electroencephalographic criteria. No surgical pathologic specimens contained structural lesions; epilepsy in these patients was therefore presumably due to mesial sclerosis. The right-minus-left hippocampal formation volume difference was greater than 0 in all 20 patients operated on the left side and less than 0 in all 16 patients operated on the right side. This difference completely separated the two surgical groups, while the same measurement in a group of 35 normal controls fell between the two surgical groups. Measurements of the anterior temporal to be showed a similar trend but incompletely separated controls, right- and left-sided epileptics. These results suggest that in a significant percentage of cases, MR-based volume measurements correctly identify the unilateral hippocampal atrophy that is known to occur in cases of mesial temporal sclerosis

  15. Novel CDKL5 Mutations in Czech Patients with Phenotypes of Atypical Rett Syndrome and Early-Onset Epileptic Encephalopathy.

    Science.gov (United States)

    Záhoráková, D; Langová, M; Brožová, K; Laštůvková, J; Kalina, Z; Rennerová, L; Martásek, P

    2016-01-01

    The X-linked CDKL5 gene, which encodes cyclin-dependent kinase-like 5 protein, has been implicated in early-onset encephalopathy and atypical Rett syndrome with early-onset seizures. The CDKL5 protein is a kinase required for neuronal development and morphogenesis, but its precise functions are still largely unexplored. Individuals with CDKL5 mutations present with severe global developmental delay, intractable epilepsy, and Rett-like features. A clear genotype-phenotype correlation has not been established due to an insufficient number of reported cases. The aim of this study was to analyse the CDKL5 gene in Czech patients with early-onset seizures and Rett-like features. We performed mutation screening in a cohort of 83 individuals using high-resolution melting analysis, DNA sequencing and multiplex ligation- dependent probe amplification. Molecular analyses revealed heterozygous pathogenic mutations in three girls with severe intellectual disability and intractable epilepsy starting at the age of two months. All three identified mutations, c.637G>A, c.902_977+29del105, and c.1757_1758delCT, are novel, thus significantly extending the growing spectrum of known pathogenic CDKL5 sequence variants. Our results support the importance of genetic testing of the CDKL5 gene in patients with early-onset epileptic encephalopathy and Rett-like features with early-onset seizures. This is the first study referring to molecular defects of CDKL5 in Czech cases. PMID:27187038

  16. Clonazepam serum levels in epileptic patients determined simply and rapidly by high-performance liquid chromatography using a solid-phase extraction column.

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    Furuno,Katsushi

    1991-04-01

    Full Text Available We studied the use of high-performance liquid chromatography (HPLC, using a solid phase extraction column (Bond Elut cartridge column, for the simple, rapid and sensitive determination of serum clonazepam levels in epileptic patients. Extracted aliquots were analyzed by HPLC, using a reverse phase ODS column (mu-Bondapak C18. The analytical mean recovery of clonazepam added to the blank serum averaged 99.9%. The detection limit was as high as approximately 2 ng/ml in the serum. The reproducibilities were 2.3-8.6 CV % in the within-day assay and 6.5 CV % in the between-day assay, indicating that the analysis method was effective in the determination of clonazepam serum levels. Accordingly, we suggest that the present method, using a solid phase extraction column, may be useful for the routine monitoring of clonazepam serum levels in epileptic patients.

  17. Influence of coadministered antiepileptic drugs on serum zonisamide concentrations in epileptic patients: quantitative analysis based on suitable transforming factor.

    Science.gov (United States)

    Fukuoka, Noriyasu; Tsukamoto, Toyohisa; Uno, Junji; Kimura, Michio; Morita, Shushi

    2003-12-01

    We conducted a study to clarify the most suitable transforming factor related to the daily zonisamide dose (D) providing a steady-state serum concentration (C(t)) and analyzed the influences of the concomitant use of antiepileptic drugs on C(t) quantitatively. Data obtained by routine therapeutic drug monitoring from a total of 175 epileptic patients treated with the multiple oral administrations of zonisamide (ZNS) as a powder/tablets, were used for the analysis. Employing the extracellular water volume (V(ECW)) as a transforming factor, led the level/dose (L/D) ratio (:C(t)/(D/V(ECW))) to be independent of the patient's age and sex for the administration of ZNS alone. C(t) was revealed to be dependent on only one variable regarding D/V(ECW) and expressed as C(t)=0.604x(D/V(ECW)). Phenytoin (PHT) significantly lowered (pratio to 0.76 of the value for ZNS alone. For a more detailed analysis, we defined the parameter R(i) (i=1, 2, em leader, 6) as an alteration ratio, representing the influence of each antiepileptic drug on the L/D ratio of ZNS alone. A model based on the assumption that each R(i) value was independent from one another and multiplicative, was adopted. The analysis clarified that phenobarbital, valproic acid, carbamazepine, and PHT significantly lowered (pratio of ZNS to 0.849, 0.865, 0.846, and 0.804, respectively. In the case of the addition or discontinuance of concomitant treatment with antiepileptic drugs in the same patient, the estimated L/D ratios were calculated using the value of each R(i) and compared with the measured ones. The mean of prediction error was calculated as 22.9%. Our results appear valid and R(i) should be available for clinical use. PMID:14646181

  18. Determining the disease management process for epileptic patients: A qualitative study

    OpenAIRE

    Hosseini, Nazafarin; Sharif, Farkhondeh; Ahmadi, Fazlollah; Zare, Mohammad

    2016-01-01

    Background: Epilepsy exposes patients to many physical, social, and emotional challenges. Thus, it seems to portray a complex picture and needs holistic care. Medical treatment and psychosocial part of epilepsy remain central to managing and improving the patient's qualify of life through team efforts. Some studies have shown the dimensions of self-management, but its management process of epilepsy patients, especially in Iran, is not clear. This study aimed to determine the disease managemen...

  19. A STUDY OF EPILEPTIC PSYCHOSES - 150 CASES

    OpenAIRE

    Swamy, H. Satyanarayana; Mallikarjunaiah, M.; Bhatti, Ranbir S.; Kaliaperumal, V.G.

    1986-01-01

    SUMMARY One hundred and fifty patients of epileptic psychosis, registered over a period of five years in neuropsychiatry clinics at NIMHANS were studied. Patients with organic causes which may produce both epilepsy and psychosis were excluded. The epileptic psychosis ratio to epilepsy was 1:23 and the epileptic psychosis ratio to psychosis was 1:75. The mean age at the onset of epilepsy was 19.4 years, while the mean age at the onset of psychosis was 29 years and thus the mean duration of epi...

  20. Ambroxol-induced focal epileptic seizure.

    Science.gov (United States)

    Lapenta, Leonardo; Morano, Alessandra; Fattouch, Jinane; Casciato, Sara; Fanella, Martina; Giallonardo, Anna Teresa; Di Bonaventura, Carlo

    2014-01-01

    It is well known that in epileptic patients some compounds and different drugs used for the treatment of comorbidities can facilitate or provoke seizures, this evidence regarding a wide spectrum of pharmacological categories. The potential facilitating factors usually include direct toxic effects or pharmacological interactions of either active ingredients or excipients. We report the case of a patient with drug-resistant epilepsy who experienced focal epileptic seizures, easily and constantly reproducible, after each administration of a cough syrup. This is, to our knowledge, the first electroencephalogram-documented case of focal epileptic seizures induced by cough syrup containing ambroxol as active ingredient. PMID:24824664

  1. Ictal brain SPET during seizures pharmacologically provoked with pentylenetetrazol: a new diagnostic procedure in drug-resistant epileptic patients

    Energy Technology Data Exchange (ETDEWEB)

    Calcagni, Maria Lucia; Giordano, Alessandro; Bruno, Isabella; Di Giuda, Daniela; De Rossi, Giuseppe; Troncone, Luigi [Department of Nuclear Medicine, Universita Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168 Roma (Italy); Parbonetti, Giovanni; Colicchio, Gabriella [Department of Neurosurgery, Universita Cattolica del Sacro Cuore, Roma (Italy)

    2002-10-01

    Functional brain imaging plays an important role in seizure focus localisation. However, truly ictal single-photon emission tomography (SPET) studies are not routinely performed owing to technical problems associated with the use of tracers and methodological and logistical difficulties. In this study we tried to resolve both of these issues by means of a new procedure: technetium-99m ethyl cysteinate dimer (ECD) brain SPET performed during seizures pharmacologically provoked with pentylenetetrazol, a well-known central and respiratory stimulant. We studied 33 drug-resistant epileptic patients. All patients underwent anamnestic evaluation, neuropsychological and psychodynamic assessment, magnetic resonance imaging, interictal and ictal video-EEG monitoring, and interictal and ictal SPET with {sup 99m}Tc-ECD. In order to obtain truly ictal SPET, 65 mg of pentylenetetrazol was injected every 2 minutes and, immediately the seizure began, 740 MBq of {sup 99m}Tc-ECD was injected. The scintigraphic findings were considered abnormal if a single area of hyperperfusion was present and corresponded to the site of a single area of hypoperfusion at interictal SPET: the ''hypo-hyperperfusion'' SPET pattern. In 27 of the 33 patients (82%), interictal-ictal SPET showed the hypo-hyperperfusion SPET pattern. Video-EEG showed a single epileptogenic zone in 21/33 patients (64%), and MRI showed anatomical lesions in 19/33 patients (57%). Twenty-two of the 27 patients with hypo-hyperperfusion SPET pattern underwent ablative or palliative surgery and were seizure-free at 3 years of follow-up. No adverse effects were noted during pharmacologically provoked seizure. It is concluded that ictal brain SPET performed during pharmacologically provoked seizure provides truly ictal images because {sup 99m}Tc-ECD is injected immediately upon seizure onset. Using this feasible procedure it is possible to localise the focus, to avoid the limitations due to the unpredictability

  2. The Causes of Secondary Epilepsy in Epileptic Patients Referred to Neurology Clinics of Mashhad Hospitals

    OpenAIRE

    Mehran Homam; Ghazi Hosseini; Badriahmadi; Shamsi

    2015-01-01

    Background Epilepsy is a group of disorders characterized by recurrent unprovoked seizures. It is recognized as one of the most common neurological diseases affecting different age groups. Objectives This study aimed to determine the causes of secondary epilepsy in patients with epilepsy at Mashhad hospitals in 2011 - 2012. Patients and Methods In this cross-sectional, descriptive ...

  3. Time-variant coherence between heart rate variability and EEG activity in epileptic patients: an advanced coupling analysis between physiological networks

    International Nuclear Information System (INIS)

    Time-variant coherence analysis between the heart rate variability (HRV) and the channel-related envelopes of adaptively selected EEG components was used as an indicator for the occurrence of (correlative) couplings between the central autonomic network (CAN) and the epileptic network before, during and after epileptic seizures. Two groups of patients were investigated, a group with left and a group with right hemispheric temporal lobe epilepsy. The individual EEG components were extracted by a signal-adaptive approach, the multivariate empirical mode decomposition, and the envelopes of each resulting intrinsic mode function (IMF) were computed by using Hilbert transform. Two IMFs, whose envelopes were strongly correlated with the HRV’s low-frequency oscillation (HRV-LF; ≈0.1 Hz) before and after the seizure were identified. The frequency ranges of these IMFs correspond to the EEG delta-band. The time-variant coherence was statistically quantified and tensor decomposition of the time-frequency coherence maps was applied to explore the topography-time-frequency characteristics of the coherence analysis. Results allow the hypothesis that couplings between the CAN, which controls the cardiovascular-cardiorespiratory system, and the ‘epileptic neural network’ exist. Additionally, our results confirm the hypothesis of a right hemispheric lateralization of sympathetic cardiac control of the HRV-LF. (paper)

  4. SM-10ANTI-EPILEPTIC DRUGS AND CORTICAL IRRITABILITY IN PATIENTS WITH TUMORAL EPILEPSIES

    OpenAIRE

    Warren, Paula; Szaflarski, Jerzy; Nabors, Louis

    2014-01-01

    Tumor-associated seizures and epilepsy in patients with primary malignant brain tumors constitute a major healthcare challenge. Seizures and antiepileptic drugs (AEDs) used in their management significantly impact patients' quality of life; there is a dearth of information regarding the actual effects of AEDs on cortical irritability, as measured by electroencephalograms (EEGs). Herein, we investigated the effects of various AEDs on the presence or absence of epileptiform discharges (EDs) in ...

  5. Influence of coadministered antiepileptic drugs on serum phenobarbital concentrations in epileptic patients: quantitative analysis based on a suitable transforming factor.

    Science.gov (United States)

    Fukuoka, Noriyasu; Tsukamoto, Toyohisa; Uno, Junji; Kimura, Michio; Morita, Shushi

    2004-12-01

    This study investigated most suitable transforming factor related to the daily Phenobarbital dose (D) providing a steady-state serum concentration (Ct) and analyzed the influences of concomitant antiepileptic drugs on Ct quantitatively. Data obtained by routine therapeutic drug monitoring from a total of 326 epileptic patients treated with multiple oral administrations of phenobarbital (PB) as a powder, were used for the analysis. A total of 156 patients were administered PB alone, and 92, 57, and 21 patients were coadministered one, two, and three different antiepileptic drugs, respectively. Valproic acid (VPA), carbamazepine (CBZ), phenytoin (PHT), zonisamide (ZNS), clonazepam, and ethosuximide were coadministered with PB. For administration of PB alone, four types of transforming factor corresponding to clearance, i.e., total body weight, total body water volume, body surface area and extracellular water volume (VECW) were proposed. With VECW as a transforming factor, the level/dose (L/D) ratio (:Ct/(D/VECW)) was independent of the patient's age and gender. Ct was dependent on only one variable regarding D/VECW and expressed as Ct=0.989 x (D/VECW). The coadministration of one drug caused a difference in the gradient of the regression line of PB alone, and the influence of each drug was detected by dividing each mean L/D ratio of PB plus one other drug by that of PB alone. VPA, CBZ, and PHT significantly increased (pratio to 1.48, 1.35, and 1.23 of the value for PB alone, respectively. With coadministration of multiple drugs, the L/D ratio rose significantly (pratio Ri, representing the influence of each antiepileptic drug on the L/D ratio of PB alone. A model based on the assumption that each coadministered drug competitively inhibited PB-metabolizing enzyme, was adopted. The analysis clarified that VPA, CBZ, and PHT significantly increased (pratio of PB to 1.466, 1.177, and 1.186, respectively. In the case of the addition or discontinuance of concomitant

  6. Automated differentiation between epileptic and non-epileptic convulsive seizures

    DEFF Research Database (Denmark)

    Beniczky, Sándor; Conradsen, Isa; Moldovan, Mihai;

    2015-01-01

    algorithm: 25 generalized tonic-clonic seizures (GTCSs) from 11 patients, and 19 episodes of convulsive PNES from 13 patients. The gold standard was the interpretation of the video-electroencephalographic recordings by experts blinded to the EMG results. The algorithm correctly classified 24 GTCSs (96%) and...... 18 PNESs (95%). The overall diagnostic accuracy was 95%. This algorithm is useful for distinguishing between epileptic and psychogenic convulsive seizures....

  7. Real-Time Management of Multimodal Streaming Data for Monitoring of Epileptic Patients.

    Science.gov (United States)

    Triantafyllopoulos, Dimitrios; Korvesis, Panagiotis; Mporas, Iosif; Megalooikonomou, Vasileios

    2016-03-01

    New generation of healthcare is represented by wearable health monitoring systems, which provide real-time monitoring of patient's physiological parameters. It is expected that continuous ambulatory monitoring of vital signals will improve treatment of patients and enable proactive personal health management. In this paper, we present the implementation of a multimodal real-time system for epilepsy management. The proposed methodology is based on a data streaming architecture and efficient management of a big flow of physiological parameters. The performance of this architecture is examined for varying spatial resolution of the recorded data. PMID:26643075

  8. ANALYSIS OF MAIN REASONS FOR MISTAKES IN DIAGNOSTICS OF EPILEPTIC SEIZURES AND EPILEPTIC SYNDROMES (CLINICAL PECULIARITIES OF EPILEPTIC SEIZURES

    Directory of Open Access Journals (Sweden)

    M. B. Mironov

    2015-04-01

    Full Text Available Epilepsy is a chronic brain disease that requires long therapy and continuous careful supervision of the status of the patient. In connection with this, both overdiagnosis and underdiagnosis of this disease is extremely dangerous. Overdiagnosis causes ungrounded social "label", limitation in rights, significant decreasing quality of life of the patient, family problems, prescription of long-term anti-epileptic therapy that may cause potential side effects. Underdiagnosis of epilepsy frequently causes further resistance of seizures to therapy, they become more frequent, there appears the possibility of development of epileptic status, life threatening situations, possibility of development of cognitive disorders associated with the disease. A significant progress in epileptology and medical technologies (video electroencephalographic (EEG monitoring, neuroimaging methods, genetic studies that has been marked in recent decades has allowed minimizing errors of physicians. Despite this, certain difficulties still remain in diagnostics of epilepsy. In the author's opinion, there is a range of epileptic seizures visual assessment of which is extremely difficult and is literally impossible without video EEG monitoring. Short, phantom, atypical absences, absences on the outside, epileptic myoclonus of the eyelids with or without absences, myoclonic, tonic, gelastic, focal hyperkinetic seizures, epileptic aura, reversing focal seizures, epileptic spasms, ictal syncopes, negative myoclonus, focal epileptic myoclonus, epileptic seizures arising when closing the eyes, and self-induced seizures can be attributed to such seizures with difficulties in diagnosis. The author reviews each of these types epileptic seizures in details focusing the attention on their diagnostic criteria and characteristics of the clinical and the EEF features that are of utmost importance in the course of performance of differential diagnostics. Own experience of the

  9. Influence of anti-epileptic drugs on hematological and biochemical parameters in patients with epilepsy

    Directory of Open Access Journals (Sweden)

    S. Dwajani

    2014-08-01

    Conclusions: The results of this study showed significant alterations in the levels of Hb and ALP with the use of AED polytherapy in PWE. Routine hematological and biochemical investigations may be considered during AED treatment in those patients receiving AED polytherapy. [Int J Basic Clin Pharmacol 2014; 3(4.000: 692-695

  10. [Influence of coadministered antiepileptic drugs on serum antiepileptic drug concentrations in epileptic patients -quantitative analysis based on suitable transforming factor].

    Science.gov (United States)

    Fukuoka, Noriyasu

    2004-07-01

    We conducted a study to clarify the most suitable transforming factor related to the daily dose of antiepileptic drugs (D) providing a steady-state serum concentration (C(t)) and analyzed the influences of the concomitant use of antiepileptic drugs on C(t) quantitatively. Data obtained by routine therapeutic drug monitoring from epileptic patients treated with the multiple oral administration of valproic acid (VPA), carbamazepine (CBZ), zonisamide (ZNS), phenobarbital (PB), and phenytoin (PHT) were used for the analysis. Employing the ideal body weight or the extracellular water volume as a transforming factor, allowed the level/dose (L/D) ratio to be independent of the patient's age and gender for monotherapy with VPA or CBZ, ZNS, PB, and PHT, respectively. Each C(t) was revealed to be dependent on only one variable in terms of the transformed daily dose (D'). C(t) was proportional to the power function of D' for VPA and CBZ and was linearly proportional to D' for ZNS and PB. The L/D ratio is expressed as a linear function of C(t) for PHT. For a detailed analysis of the influences of the coadministered antiepileptic drugs, we defined the parameter as an alteration ratio, representing the influence of each antiepileptic drug on the C(t) of VPA and CBZ alone, and on the L/D ratio of ZNS and PB alone, respectively. A model based on the assumption that each value of an alteration ratio was independent from one other and multiplicative for VPA, CBZ, and ZNS, and that the coadministered drug inhibited the drug-metabolizing enzyme competitively for PB, was adopted. The Michaelis-Menten kinetic model was adopted for PHT. The analysis clarified that CBZ, PB, and PHT significantly lowered (Pratio of ZNS alone to 0.87, 0.85, 0.85, and 0.80, respectively. VPA, CBZ, and PHT significantly increased (Pratio of PB to 1.47, 1.18, and 1.19, respectively. The daily PHT dose was decreased to 0.89, 0.91, 0.90, and 0.84 the dose of PHT alone to maintain C(t) in the therapeutic range

  11. Risk of epileptic seizures onset during acute period of stroke

    OpenAIRE

    I. G. Rudakova; E. Yu. Djachkova; I. G. Kolchu

    2013-01-01

    Stroke is one of the chief cause adults epilepsy. Screening study was performed. Risk factors of early and late after stroke epileptic seizures was studied. It were included 300 patient with different types of stroke, et the age of 41–94. Data of medical history and brain imaging were studied. Results of research were showed: risk of early seizures increase by patients with hemorrhagic stroke, with heart embolic type of ischemic stroke, with combination of cardiac fibrillation and arterial hy...

  12. Clonazepam serum levels in epileptic patients determined simply and rapidly by high-performance liquid chromatography using a solid-phase extraction column.

    OpenAIRE

    Furuno,Katsushi; Gomita,Yutaka; Araki,Yasunori; Fukuda,Tamotu

    1991-01-01

    We studied the use of high-performance liquid chromatography (HPLC), using a solid phase extraction column (Bond Elut cartridge column), for the simple, rapid and sensitive determination of serum clonazepam levels in epileptic patients. Extracted aliquots were analyzed by HPLC, using a reverse phase ODS column (mu-Bondapak C18). The analytical mean recovery of clonazepam added to the blank serum averaged 99.9%. The detection limit was as high as approximately 2 ng/ml in the serum. The reprodu...

  13. Synchronization analysis of cultured epileptic human astrocytes

    Science.gov (United States)

    Balazsi, Gabor; Cornell-Bell, Ann; Neiman, Alexander; Moss, Frank

    2001-03-01

    Astrocyte cultures from severely epileptic patients were cultured, and the fluctuations of the intracellular calcium ion concentration were visualized using the fluorescent dye Fluo-3. The resulting image sequences were analyzed by methods of stochastic synchronization. Increased synchronization was observed in the epileptic tissues, when compared to normal tissues from rats. The more pathological the tissue, the more synchronized the calcium oscillations. The results might lead to a better understanding of intracellular calcium dynamics and could help drug development.

  14. Ictal technetium-99m ethyl cysteinate dimer single-photon emission tomographic findings and propagation of epileptic seizure activity in patients with extratemporal epilepsies

    International Nuclear Information System (INIS)

    We investigated the influence of the propagation of extratemporal epileptic seizure activity on the regional increase in cerebral blood flow, which is usually associated with epileptic seizure activity. Forty-two consecutive patients with extratemporal epilepsies were prospectively evaluated. All patients underwent ictal SPET studies with simultaneous electroencephalography (EEG) and video recordings of habitual seizures and imaging studies including cranial magnetic resonance imaging and positron emission tomography with 2-[18F]-fluoro-2 deoxy-d-glucose. Propagation of epilptic seizure activity (PESA) was defined as the absence of hyperperfusion on ictal ECD SPET in the lobe of seizure onset, but its presence in another ipsilateral or contralateral lobe. Observers analysing the SPET images were not informed of the other results. PESA was observed in 8 of the 42 patients (19%) and was ipsilateral to the seizure onset in five (63%) of these eight patients. The time between clinical seizure onset and injection of the ECD tracer ranged from 14 to 61 s (mean 34 s). Seven patients (88%) with PESA had parieto-occipital epilepsy and one patient had a frontal epilepsy. PESA was statistically more frequent in patients with parieto-occipital lobe epilepsies (58%) than in the remaining extratemporal epilepsy syndromes (3%) (P<0.0002). These findings indicate that ictal SPET studies require simultaneous EEG-video recordings in patients with extratemporal epilepsies. PESA should be considered when interpreting ictal SPET studies in these patients. Patients with PESA are more likely to have parieto-occipital lobe epilepsy than seizure onset in other extratemporal regions. (orig./MG) (orig.)

  15. Epilepsy in patients with psychogenic non-epileptic seizures Epilepsia em pacientes com crises não epilépticas psicogênicas

    Directory of Open Access Journals (Sweden)

    Renato Luiz Marchetti

    2010-04-01

    Full Text Available The aim of this study was to evaluate the frequency of epilepsy in patients who presented psychogenic non-epileptic seizures (PNES. The evaluation was carried out during intensive VEEG monitoring in a diagnostic center for epilepsy in a university hospital. The difficulties involved in reaching this diagnosis are discussed. Ninety-eight patients underwent intensive and prolonged video-electroencephalographic (VEEG monitoring; out of these, a total of 28 patients presented PNES during monitoring. Epilepsy was defined as present when the patient presented epileptic seizures during VEEG monitoring or when, although not presenting epileptic seizures during monitoring, the patient presented unequivocal interictal epileptiform discharges. The frequency of epilepsy in patients with PNES was 50% (14 patients. Our findings suggest that the frequency of epilepsy in patients with PNES is much higher than that of previous studies, and point out the need, at least in some cases, for prolonging the evaluation of patients with PNES who have clinical histories indicating epilepsy.O objetivo deste estudo foi avaliar a frequência de epilepsia em pacientes que apresentaram crises não epilépticas psicogênicas (CNEP. Isto foi realizado durante monitoração intensiva por video-EEG num centro diagnóstico de epilepsia em um hospital universitário. As dificuldades envolvidas para se chegar a este diagnóstico são discutidas. Noventa e oito pacientes foram submetidos a monitoração intensiva por video-EEG; 28 destes pacientes apresentaram CNEP durante a monitoração. Epilepsia foi considerada presente quando o paciente apresentou crises epilépticas durante a avaliação pelo video-EEG ou quando, apesar da não ocorrência de crises epilépticas durante a avaliação, descargas epilépticas interictais inequívocas estavam presentes. A frequência de epilepsia em pacientes com CNEP foi 50% (14 pacientes. Nossos achados sugerem que a frequência de epilepsia em

  16. Distortion of time interval reproduction in an epileptic patient with a focal lesion in the right anterior insular/inferior frontal cortices.

    Science.gov (United States)

    Monfort, Vincent; Pfeuty, Micha; Klein, Madelyne; Collé, Steffie; Brissart, Hélène; Jonas, Jacques; Maillard, Louis

    2014-11-01

    This case report on an epileptic patient suffering from a focal lesion at the junction of the right anterior insular cortex (AIC) and the adjacent inferior frontal cortex (IFC) provides the first evidence that damage to this brain region impairs temporal performance in a visual time reproduction task in which participants had to reproduce the presentation duration (3, 5 and 7s) of emotionally-neutral and -negative pictures. Strikingly, as compared to a group of healthy subjects, the AIC/IFC case considerably overestimated reproduction times despite normal variability. The effect was obtained in all duration and emotion conditions. Such a distortion in time reproduction was not observed in four other epileptic patients without insular or inferior frontal damage. Importantly, the absolute extent of temporal over-reproduction increased in proportion to the magnitude of the target durations, which concurs with the scalar property of interval timing, and points to an impairment of time-specific rather than of non temporal (such as motor) mechanisms. Our data suggest that the disability in temporal reproduction of the AIC/IFC case would result from a distorted memory representation of the encoded duration, occurring during the process of storage and/or of recovery from memory and leading to a deviation of the temporal judgment during the reproduction task. These findings support the recent proposal that the anterior insular/inferior frontal cortices would be involved in time interval representation. PMID:25223467

  17. Mortality predictors of epilepsy and epileptic seizures among hospitalized elderly

    OpenAIRE

    Telma M.R. de Assis; Aroldo Bacellar; Gersonita Costa; Nascimento, Osvaldo J.M.

    2015-01-01

    Epilepsy and epileptic seizures are common brain disorders in the elderly and are associated with increased mortality that may be ascribed to the underlying disease or epilepsy-related causes. Objective To describe mortality predictors of epilepsy and epileptic seizures in elderly inpatients.Method Retrospective analysis was performed on hospitalized elderly who had epilepsy or epileptic seizures, from January 2009 to December 2010. One hundred and twenty patients were enrolled.Results The mo...

  18. Wavelet analysis of epileptic spikes

    CERN Document Server

    Latka, M; Kozik, A; West, B J; Latka, Miroslaw; Was, Ziemowit; Kozik, Andrzej; West, Bruce J.

    2003-01-01

    Interictal spikes and sharp waves in human EEG are characteristic signatures of epilepsy. These potentials originate as a result of synchronous, pathological discharge of many neurons. The reliable detection of such potentials has been the long standing problem in EEG analysis, especially after long-term monitoring became common in investigation of epileptic patients. The traditional definition of a spike is based on its amplitude, duration, sharpness, and emergence from its background. However, spike detection systems built solely around this definition are not reliable due to the presence of numerous transients and artifacts. We use wavelet transform to analyze the properties of EEG manifestations of epilepsy. We demonstrate that the behavior of wavelet transform of epileptic spikes across scales can constitute the foundation of a relatively simple yet effective detection algorithm.

  19. Cerebrospinal fluid findings after epileptic seizures.

    Science.gov (United States)

    Chatzikonstantinou, Anastasios; Ebert, Anne D; Hennerici, Michael G

    2015-12-01

    We aimed to evaluate ictally-induced CSF parameter changes after seizures in adult patients without acute inflammatory diseases or infectious diseases associated with the central nervous system. In total, 151 patients were included in the study. All patients were admitted to our department of neurology following acute seizures and received an extensive work-up including EEG, cerebral imaging, and CSF examinations. CSF protein elevation was found in most patients (92; 60.9%) and was significantly associated with older age, male sex, and generalized seizures. Abnormal CSF-to-serum glucose ratio was found in only nine patients (5.9%) and did not show any significant associations. CSF lactate was elevated in 34 patients (22.5%) and showed a significant association with focal seizures with impaired consciousness, status epilepticus, the presence of EEG abnormalities in general and epileptiform potentials in particular, as well as epileptogenic lesions on cerebral imaging. Our results indicate that non-inflammatory CSF elevation of protein and lactate after epileptic seizures is relatively common, in contrast to changes in CSF-to-serum glucose ratio, and further suggest that these changes are caused by ictal activity and are related to seizure type and intensity. We found no indication that these changes may have further-reaching pathological implications besides their postictal character. PMID:26575850

  20. Domoic Acid Epileptic Disease

    Directory of Open Access Journals (Sweden)

    John S. Ramsdell

    2014-03-01

    Full Text Available Domoic acid epileptic disease is characterized by spontaneous recurrent seizures weeks to months after domoic acid exposure. The potential for this disease was first recognized in a human case study of temporal lobe epilepsy after the 1987 amnesic shellfish-poisoning event in Quebec, and was characterized as a chronic epileptic syndrome in California sea lions through investigation of a series of domoic acid poisoning cases between 1998 and 2006. The sea lion study provided a breadth of insight into clinical presentations, unusual behaviors, brain pathology, and epidemiology. A rat model that replicates key observations of the chronic epileptic syndrome in sea lions has been applied to identify the progression of the epileptic disease state, its relationship to behavioral manifestations, and to define the neural systems involved in these behavioral disorders. Here, we present the concept of domoic acid epileptic disease as a delayed manifestation of domoic acid poisoning and review the state of knowledge for this disease state in affected humans and sea lions. We discuss causative mechanisms and neural underpinnings of disease maturation revealed by the rat model to present the concept for olfactory origin of an epileptic disease; triggered in dendodendritic synapases of the olfactory bulb and maturing in the olfactory cortex. We conclude with updated information on populations at risk, medical diagnosis, treatment, and prognosis.

  1. Detection of Epileptic Seizures with Multi-modal Signal Processing

    DEFF Research Database (Denmark)

    Conradsen, Isa

    The main focus of this dissertation lies within the area of epileptic seizure detection. Medically refractory epileptic patients suffer from the unawareness of when the next seizure sets in, and what the consequences will be. A wearable device based on uni- or multi-modalities able to detect and ...

  2. Phenytoin as the first option in female epileptic patients? Fenitoína como primeira opção em mulheres com epilepsia?

    Directory of Open Access Journals (Sweden)

    PAULO CÉSAR TREVISOL-BITTENCOURT

    1999-09-01

    Full Text Available OBJECTIVE: Phenytoin (PHT is one of the first-choice drugs in several epileptic syndromes, mostly in partial epilepsies, in which case it is effective as carbamazepine and phenobarbital. However, like any other anti-epileptic drug (AED, unpleasant side-effects are not rare. The aim of this study is the evaluation of dermatological troubles related to chronic PHT usage in female patients. METHOD: Between 1990-93, 731 new patients underwent investigation for epilepsy at the Multidisciplinary Clinic for Epilepsy in our State. In this sample 283 were AED users at the time of the first assessment. Sixty one female patients taking PHT were identified. They were taking PHT in a dosage ranging from 100 to 300 mg daily, in mono or polytherapy regimen, during 1-5 previous years. RESULTS: More than 50% of the sample showed coarse facial features made by the combination of several degrees of acne, hirsutism and gingival hyperplasia. CONCLUSION: Except in emergency situations, PHT should not be prescribed as the first option to the treatment of female epileptic patients, because not uncommonly the cosmetic side-effects are more socially handicapping than the epileptic syndrome by itself.OBJETIVO: Fenitoína (PHT é uma das principais drogas no tratamento de epilepsias diversas, principalmente as parciais, para a qual ela é tão eficaz quanto carbamazepina e fenobarbital. Entretanto, como qualquer outra droga anti-epiléptica (DAE da atualidade, efeitos desagradáveis não são raros. O alvo deste estudo é a avaliação dos efeitos dermatológicos relacionados com o uso prolongado de PHT em pacientes femininas. MÉTODO: Entre 1990-93, foram admitidos para avaliação 731 novos pacientes na Clínica Multidisciplinar de Epilepsia/SUS, Florianópolis/SC. Destes, 238 já estavam em uso de DAE, sendo que 61 eram mulheres usuárias de fenitoína, numa dosagem que variava de 100-300 mg/dia, em mono ou politerapia, por um período prévio de 1-5 anos. RESULTADOS

  3. Successful management of acute respiratory failure with noninvasive mechanical ventilation after drowning, in an epileptic-patient.

    Science.gov (United States)

    Ruggeri, Paolo; Calcaterra, Salvatore; Bottari, Antonio; Girbino, Giuseppe; Fodale, Vincenzo

    2016-01-01

    Sea drowning is a common cause of accidental death worldwide. Respiratory complications such as acute pulmonary oedema, which is often complicated by acute respiratory distress syndrome, is often seen. Noninvasive ventilation is already widely used as a first approach to treat acute respiratory failure resulting from multiple diseases. We report a case of a 45 year old man with a history of epilepsy, motor and mental handicap who developed acute respiratory failure secondary to sea water drowning after an epileptic crisis. We illustrate successful and rapid management of this case with noninvasive ventilation. We emphasize the advantages and limitations of using noninvasive ventilation to treat acute respiratory failure due to sea water drowning syndrome. PMID:27222793

  4. Mental Development of Children with Non-epileptic Paroxysmal States in Medical History

    OpenAIRE

    Turovskaya N.G.,

    2015-01-01

    The author studied mental functions disorders in children with a history of paroxysmal states of various etiologies and compared mental development disorder patterns in patients with epileptic and non-epileptic paroxysms. Study sample were 107 children, aged 6 to 10 years. The study used experimental psychological and neuropsychological techniques. According to the empirical study results, non-epileptic paroxysms unlike epileptic much less combined with a number of mental functions disorders ...

  5. Design considerations for adult patient education.

    Science.gov (United States)

    Walsh, P L

    1982-01-01

    A variety of factors require attention in the design of patient education programs for adults. Andragogy, the art and science of helping adults learn, describes certain conditions of learning that are more conducive to growth and development for adults and prescribes practices in the learning-teaching transaction to meet them. Stigma, a special discrepancy between virtual and actual social identity, reduces a patient's self-esteem and fosters a feeling of dependence on others for care. Anxiety related to diagnosis and illness creates a situation in which patients cannot productively learn. The stages in acceptance of diagnosis provide a roadmap for understanding a patient's feelings/psychological processes and insight into opportunities to intervene with patient education. The specific disease a patient has effects his ability to learn. Each of these factors is considered with implications described for designing and implementing patient education activities for adults. PMID:10258421

  6. Estudo clínico do RO-5-4023 no tratamento de epilepsias Clinical essay with RO-5-4023 in epileptic patients

    Directory of Open Access Journals (Sweden)

    A. D'Onghia C.

    1973-03-01

    Full Text Available Foram estudados 76 pacientes epilépticos (crianças e adultos submetidos a tratamento com o RO-5-4023. Houve predomínio dos casos com menos de 19 anos, sendo 44 do sexo masculino e 32 do sexo feminino. A droga foi utilizada isoladamente (34 casos ou em associação com outros anti-comiciais (42 casos. A dose foi variável, com média de 5 mg/dia. A duração do tratamento variou de 3 a 11 meses, com média de 7 meses. Em todos os casos foi feito estudo eletrencefalográficos e liquórico. Em 32 casos foi feito estudo comparativo de EEG antes e depois do tratamento. Levando em conta os resultados obtidos os autores chegaram às seguintes conclusões: 1 foram obtidos resultados satisfatórios em 61 casos (81%; 2 levando em conta as formas clínicas da epilepsia, os melhores resultados foram obtidos nas formas generalizadas (GM e PM e focais não convulsivas; 3 os pacientes que utilizaram outros medicamentos anti-comiciais associados ao RO-5-4023, se beneficiaram mais que os que receberam a droga isoladamente; 4 nos pacientes em que foi feito o EEG de controle, foi observada normalização do traçado em 46,5% dos casos; 5 efeitos colaterais ocorreram em 32,8% dos casos, sendo mais freqüentemente observadas sonolência, ataxia, agitação, fadiga e agressividade; essas manifestações melhoraram ou desapareceram até o décimo dia do tratamento.Seventy six epileptic patients (children and adults submitted to treatment with RO-5-4023 were studied. RO-5-4023 was administered alone (34 cases or in association with other antiepileptic drugs. The average dose was 5 mg/day. The cerebrospinal fluid examination was performed in all cases with normal results. In 32 cases the elertoencephalogram was made before and after the treatment. The study allows the authors to draw the following conclusions: 1 the results of therapy were good in 61 cases (81%; 2 the better results were obtained in cases of generalized epilepsy (GM and PM and in cases of focal non

  7. [Unusual dreams in epileptics].

    Science.gov (United States)

    Boldyrev, A I

    1984-01-01

    The author discusses bizarre dreams characteristic of epileptics and never occurring in normal subjects which have an important practical implication especially for early detection of epilepsy and the prevention of severe forms of the disease. This group of dreams includes vivid nightmares with vital fear, dreams not infrequently transforming into pro-dream states; persistently repeated stereotyped dreams and dreams with invariably the same unpleasant sensations representing an isolated aura of subsequent epileptic attacks. Diagnostically important may also be dreams with the symptoms of derealization and depersonalization, vague dream images and the deja vu phenomenon. PMID:6464602

  8. Oxidant-Antioxidant Balance In Epileptic Children

    International Nuclear Information System (INIS)

    Epilepsy is one of the most common neurological disorders which are characterized by recurrent unprovoked seizures. It is usually controlled, but cannot be cured with medications, although surgery may be considered in difficult cases. Over 30% of people with epilepsy don't have seizure control even with the best available medications. In epileptic children, oxidant-antioxidant balance is disturbed. Glutathione homeostasis may be altered as a consequence of reactive metabolites and/or reactive oxygen species produced during treatment with antiepileptic drugs. Per-oxidation of membrane lipid caused by an increase in generation of free radical or decrease in the activities of antioxidant defense systems have been suggested to be critically involved in seizure control. The effect of antiepileptic monotherapy as valproic acid (VPA) or carbamazepine (CBZ) or both on level of glutathione-S-transferase (GST) as an index of antioxidant and the plasma of malondialdehyde (MDA) as an index of oxidative stress were studied in this study. Forty children (18 males and 22 females) with idiopathic generalized epilepsy, diagnosed in the Pediatric Neurology Unit, Children Hospital, Ain Shams University, Cairo, Egypt, were selected to represent group (1) with mean age of 5.13 ± 4.36 years. Thirty healthy children (14 males and 16 females) matched in age, sex and social life status served as normal control group (2). The results revealed that there was high significant increase in the plasma level of MDA in patients with idiopathic epilepsy as compared to the control while the serum level of GST was significantly decreased in epileptic children as compared to the control group. Non-significant difference in plasma level of MDA and serum level of GST among the epileptic subgroups was observed. In uncontrolled epileptic patients (seizures more than 4/month), the plasma level of MDA displayed higher significant increase than in controlled epileptic patients. On the other hand, serum GST

  9. [Civil and criminal responsibility of epileptics].

    Science.gov (United States)

    Villanueva, F

    1997-03-01

    Since the new Penal Code has come into force, certain sections have been altered, such as those dealing with exculpatory circumstances, and as specialists treating patients with possible mental changes, we should be aware that section 20 now takes the place of the former section 8. The situation of the epileptic with regard to civil and criminal responsibility, has hardly changed. This is not surprising in view of current clinico-therapeutic knowledge. Epileptic patients are legally able to testify, inherit etc. and also have the obligation to compensate for damage they have caused. An attempt is made to define the immunity from prosecution of epileptics in accordance with non-static criteria, and to use a mixed biological-mental formula, which would make it possible to discover whether there was an alteration or anomaly of mental state at the time of the criminal offence, which would mean that the patient was unable to understand the unlawfulness of his action, or to act in accordance with such understanding. The deed itself is considered, without labelling illnesses or persons, seeking a simple definition of immunity from prosecution. The epileptic is immune from prosecution during a full attack, whilst during the rest of the time each case has to be decided individually. We emphasize the necessity of 'declassifying' epilepsy as a typical endogenous psychosis, which puts these patients into the group of the insane, although this term is no longer included in the new legal code. PMID:9147782

  10. Hospital Patients Are Adult Learners.

    Science.gov (United States)

    Caffarella, Rosemary S.

    Patient education is recognized by health care providers and patients themselves as an important component of adequate health care for hospital patients. Through this informational process, patients receive information about specific health problems, learn the necessary competencies to deal with them, and develop accepting attitudes toward the…

  11. Diagnosis of Adult Patients with Cystic Fibrosis.

    Science.gov (United States)

    Nick, Jerry A; Nichols, David P

    2016-03-01

    The diagnosis of cystic fibrosis (CF) is being made with increasing frequency in adults. Patients with CF diagnosed in adulthood typically present with respiratory complaints, and often have recurrent or chronic airway infection. At the time of initial presentation individuals may appear to have clinical manifestation limited to a single organ, but with subclinical involvement of the respiratory tract. Adult-diagnosed patients have a good response to CF center care, and newly available cystic fibrosis transmembrane receptor-modulating therapies are promising for the treatment of residual function mutation, thus increasing the importance of the diagnosis in adults with unexplained bronchiectasis. PMID:26857767

  12. Seizure-Control Effect of Levatiracetam on Juvenile Myoclonic Epilepsy and Other Epileptic Syndromes: Literature Review of Recent Studies

    Directory of Open Access Journals (Sweden)

    Arsalan HASHEMIAGHDAM

    2015-06-01

    Full Text Available How to Cite This Article: Hashemiaghdam A, Sharifi A, Miri M, Tafakhori A. Seizure-Control Effect of Levatiracetam on Juvenile Myoclonic Epilepsy and Other Epileptic Syndromes: Literature Review of Recent Studies. Iran J Child Neurol. Spring 2015;9(2:1-8.AbstractObjectiveVarious epileptic syndromes may present in adolescence and Juvenile Myoclonic Epilepsy (JME is known to be the most common idiopathic generalized epileptic syndrome presenting itself with different types of seizure activity. The exact etiology of JME is still unknown, but hypoxia, storage disease, toxic-metabolic disorders, drug reactions, and neurodegenerative disorders have been revealed to cause disease manifestation. Previous research shows that JME includes 5–10% of all cases diagnosed with epilepsy. It is estimated to include 18% of idiopathic generalized epilepsies. Females are at higher risk of developing this condition. Levatiracetam (LEV is an anti-epileptic drug that has become one of the most used drugs for the management of epileptic syndromes. It has less drug interactions, milder side effects, and broad-spectrum efficacy to make it an ideal drug to control seizures. Different mechanisms of actions have made LEV a novel anti-epileptic drug. This new medication can be used as a mono- or add-on therapy to previous anti-epileptic drugs. One of the clinically valuablepharmacological aspects of LEV is that it can be started at a high therapeutic dosage and is well tolerated. The median starting dosage varied according to patients underlying disease, age, and disease severity. We have also discussed the effect of LEV on other epileptic syndromes, which showed promising results in both adults and children. In childhood epilepsy, there is evidence proving that a higher rate of behavioral disturbances with neurological disorders can beimproved by LEV therapy. Finally, our review showed the beneficial effects of LEV on seizure-control in different

  13. ANALYSIS OF MAIN REASONS FOR MISTAKES IN DIAGNOSTICS OF EPILEPTIC SEIZURES AND EPILEPTIC SYNDROMES (CLINICAL PECULIARITIES OF EPILEPTIC SEIZURES)

    OpenAIRE

    M. B. Mironov

    2015-01-01

    Epilepsy is a chronic brain disease that requires long therapy and continuous careful supervision of the status of the patient. In connection with this, both overdiagnosis and underdiagnosis of this disease is extremely dangerous. Overdiagnosis causes ungrounded social "label", limitation in rights, significant decreasing quality of life of the patient, family problems, prescription of long-term anti-epileptic therapy that may cause potential side effects. Underdiagnosis of epilepsy frequentl...

  14. Cognitive functions, epileptic syndromes and antiepileptic drugs

    Directory of Open Access Journals (Sweden)

    Paulo R. M. Bittencourt

    1992-03-01

    Full Text Available Cognitive function of patients on monotherapy specific for their epileptic syndrome has been studied infrequently. We evaluated 7 patients with symptomatic localised epilepsies (SEL on phenytoin aged 30±12 (mean±standard deviation years, 8 with idiopathic generalised epilepsies on sodium valproate aged 18±4 years, 16 with SEL on carbamazepine aged 28±11 years, and 35 healthy controls aged 27±11 years. All subjects were of normal intelligence, educated appropriately to age, and led productive lives in the community. Two of the patients on carbamazepine and one on valproate had less than five partial, absence or myoclonic seizures monthly, the remaining were controlled. Carbamazepine serum concentrations were 12±5 ug/ml, phenytoin were 23±7, and valproate were 62±23 (mean±sd. Tests included immediate recall and recognition for pictures, Stroop test, delayed recall and recognition of pictures. Patients on phenytoin and valproate performed significantly worse than controls on immediate recall, and patients on carbamazepine performed significantly worse than controls in Stroop test (p<0,01. The results indicate relatively minor effects of the epileptic syndromes and of phenytoin, carbamazepine and valproate on cognition of patients with controlled epilepsy leading productive lives in the community. We conclude that the cognitive deficit found in chronic epileptic patients on polytherapeutic drug regimen must be multifactorial, and that future studies need to control for all possible variables in order to achieve meaningul results.

  15. Epileptic seizures in supratentorial gliomas.

    Directory of Open Access Journals (Sweden)

    Tandon P

    2001-01-01

    Full Text Available Two hundred patients with supratentorial glioma; astrocytoma (pilocytic, fibrillary, gemistocytic 82, mixed glioma (oligoastrocytoma 46, oligodendroglioma 8, malignant (anaplastic astrocytoma 33 and glioblastoma multiforme 31, surgically treated for the tumours and followed up for one to sixteen years, were retrospectively analysed for the incidence of pre and postoperative epileptic seizures. 122 patients (61% had seizures preoperatively. 62 (50.8% of them had at least one or more seizures during follow up. Seizures were persistent in 22 patients. Doubtful, or one or two minor seizures occurred in 19 cases. Six patients in this group had seizure only at the time of CT confirmed recurrence, after a seizure free interval of one to nine years. Amongst 78 patients who did not have seizures preoperatively, 24 (30.6% developed seizures during the postoperative follow up period. Recurrent attacks were reported only by 5 patients while 15 patients had seizure(s only at the time of recurrence of tumour. Two patients had a few seizures in the early postoperative period and none thereafter, while doubtful seizures were reported by two patients.

  16. Surgical Treatment of Pediatric Epileptic Encephalopathies

    Directory of Open Access Journals (Sweden)

    J. Fridley

    2013-01-01

    Full Text Available Pediatric epileptiform encephalopathies are a group of neurologically devastating disorders related to uncontrolled ictal and interictal epileptic activity, with a poor prognosis. Despite the number of pharmacological options for treatment of epilepsy, many of these patients are drug resistant. For these patients with uncontrolled epilepsy, motor and/or neuropsychological deterioration is common. To prevent these secondary consequences, surgery is often considered as either a curative or a palliative option. Magnetic resonance imaging to look for epileptic lesions that may be surgically treated is an essential part of the workup for these patients. Many surgical procedures for the treatment of epileptiform encephalopathies have been reported in the literature. In this paper the evidence for these procedures for the treatment of pediatric epileptiform encephalopathies is reviewed.

  17. A 1.83 μJ/Classification, 8-Channel, Patient-Specific Epileptic Seizure Classification SoC Using a Non-Linear Support Vector Machine.

    Science.gov (United States)

    Bin Altaf, Muhammad Awais; Yoo, Jerald

    2016-02-01

    A non-linear support vector machine (NLSVM) seizure classification SoC with 8-channel EEG data acquisition and storage for epileptic patients is presented. The proposed SoC is the first work in literature that integrates a feature extraction (FE) engine, patient specific hardware-efficient NLSVM classification engine, 96 KB SRAM for EEG data storage and low-noise, high dynamic range readout circuits. To achieve on-chip integration of the NLSVM classification engine with minimum area and energy consumption, the FE engine utilizes time division multiplexing (TDM)-BPF architecture. The implemented log-linear Gaussian basis function (LL-GBF) NLSVM classifier exploits the linearization to achieve energy consumption of 0.39 μ J/operation and reduces the area by 28.2% compared to conventional GBF implementation. The readout circuits incorporate a chopper-stabilized DC servo loop to minimize the noise level elevation and achieve noise RTI of 0.81 μ Vrms for 0.5-100 Hz bandwidth with an NEF of 4.0. The 5 × 5 mm (2) SoC is implemented in a 0.18 μm 1P6M CMOS process consuming 1.83 μ J/classification for 8-channel operation. SoC verification has been done with the Children's Hospital Boston-MIT EEG database, as well as with a specific rapid eye-blink pattern detection test, which results in an average detection rate, average false alarm rate and latency of 95.1%, 0.94% (0.27 false alarms/hour) and 2 s, respectively. PMID:25700471

  18. Efficacy of Attribution Retraining on Mental Health of Epileptic Children

    OpenAIRE

    Pourmohamadreza Tajrishi, Masoume; Abbasi, Saeid; Najafi Fard, Tahereh; Yousefi, Saheb; Mohammadi Malek Abadi, Athar; DELAVAR KASMAEI, Hosein

    2015-01-01

    Background: Epilepsy affects children’s quality of life and leads to social and mental problems. Promoting the mental health of children, especially epileptic ones, and preventing problems affecting them constitute major concerns for every country. Mental health promotion requires intervention programs. Objectives: We sought to assess the efficacy of attribution retraining on the mental health of epileptic children. Patients and Methods: The present study is a semi-experimental investigation ...

  19. Glutamate Release by Primary Brain Tumors Induces Epileptic Activity

    OpenAIRE

    Buckingham, Susan C.; Campbell, Susan L.; Haas, Brian R.; Montana, Vedrana; Robel, Stefanie; Ogunrinu, Toyin; Sontheimer, Harald

    2011-01-01

    Epileptic seizures are a common and poorly understood co-morbidity for individuals with primary brain tumors. To investigate peritumoral seizure etiology, we implanted patient-derived glioma cells into scid mice. Within 14–18 days, glioma-bearing animals developed spontaneous, recurring abnormal EEG events consistent with epileptic activity that progressed over time. Acute brain slices from these animals showed significant glutamate release from the tumor mediated by the system xc − cystine/g...

  20. O sono como ativador do eletrencefalograma nos pacientes epilépticos The sleep as an activator on epileptic patient's electroencephalogram

    Directory of Open Access Journals (Sweden)

    Rosa Helena Longo

    1973-09-01

    Full Text Available Visando ao estudo da ação do sono como ativador do eletrencefalograma em pacientes epilépticos, foram estudados 1.868 pacientes com síndromes convulsivas (572 com crises generalizadas, 121 com crises temporais não psicomostras, 118 com crises psicomotoras, 410 com crises focais não temporais, 314 com crises noturnas, 165 com crises febris, 168 com crises convulsivas associadas a retardo psicomotor. Em todos os pacientes foram feitos eletrencefalogramas em vigília (repouso e hiperpnéia e durante o sono (fase lenta sendo os achados comparados. Em nosso material não encontramos diferença significativa de resposta entre o sono espontâneo e o medicamentoso. Na maioria de nossos pacientes o traçado realizado durante o sono confirmou os achados registrados em vigília. A ação ativadora do sono foi evidenciada em um número relativamente pequeno de casos, tendo atingido o seu máximo no grupo de pacientes com crises psicomotoras (26%. Nas crises generalizadas, temporais não psicomotoras, focais não temporais e noturnas o sono funcionou mais como desativador do que como ativador das anormalidades registradas em vigília.In order to study the influence of sleep on the electroencephalograms of epileptic patients the tracings obtained of 1.868 such patients were analised (572 generalized seizures; 121 non-psychomotor temporal; 118 psychomotor; 410 non-temporal focal; 314 noctural seizures; 165 febrile seizures; 168 convulsive seizures associated with psychomotor retard. The electroencephalograms were made with the patients awake (rest and hyperpnea and sleeping (slow phase, the findings being compared. There was not found any significant difference between the EEG tracings obtained during spontaneous sleep and medically induced sleep. In the majority of the cases the records obtained while the patients were asleep merely confirmed the ones made while the patients were awake. The activator action of sleep appeared only in small number of the

  1. [Transient epileptic amnesia].

    Science.gov (United States)

    Muramatsu, Kazuhiro; Yoshizaki, Takahito

    2016-03-01

    Transient amnesia is one of common clinical phenomenon of epilepsy that are encountered by physicians. The amnestic attacks are often associated with persistent memory disturbances. Epilepsy is common among the elderly, with amnesia as a common symptom and convulsions relatively uncommon. Therefore, amnesia due to epilepsy can easily be misdiagnosed as dementia. The term 'transient epileptic amnesia (TEA)' was introduced in the early 1990s by Kapur, who highlighted that amnestic attacks caused by epilepsy can be similar to those occurring in 'transient global amnesia', but are distinguished by features brevity and recurrence. In 1998, Zeman et al. proposed diagnostic criteria for TEA. PMID:27025088

  2. Extracting Epileptic Feature Spikes Using Independent Component Analysis

    Institute of Scientific and Technical Information of China (English)

    YAN Hong-mei; XIA Yang; LIU Yan-su; LAI Yong-xiu; YAO De-zhong; ZHOU Dong

    2005-01-01

    In recent years, blind source separation (BSS) by independent component analysis (ICA) has been drawing much attention because of its potential applications in signal processing such as in speech recognition systems, telecommunication and medical signal processing. In this paper, two algorithms of independent component analysis (fixed-point ICA and natural gradient-flexible ICA) are adopted to extract human epileptic feature spikes from interferential signals. Experiment results show that epileptic spikes can be extracted from noise successfully. The kurtosis of the epileptic component signal separated is much better than that of other noisy signals. It shows that ICA is an effective tool to extract epileptic spikes from patients' electroencephalogram EEG and shows promising application to assist physicians to diagnose epilepsy and estimate the epileptogenic region in clinic.

  3. A Case of Lung Cancer with Brain Metastases Diagnosed After Epileptic Seizure

    Directory of Open Access Journals (Sweden)

    Murat Eroglu

    2014-03-01

    Full Text Available    Epileptic seizures can accompany benign diseases, also can be the first sign of malign tumors. In brain metastasis, epileptic seizures can be seen before the symptoms of the primary lesion. Brain metastasis is bad prognostic factor in all malignancies and it is determined that lung cancers are the most metastatic tumors to the brain. Especially in new onset epileptic seizures in elderly patients, metastatic brain tumors are frequent in etiology. We aimed to present a lung cancer patient with brain metastasis who admitted emergency department with first epileptic seizure.

  4. Constrained fixed-fulcrum reverse shoulder arthroplasty improves functional outcome in epileptic patients with recurrent shoulder instability

    Science.gov (United States)

    Thangarajah, Tanujan; Higgs, Deborah; Bayley, J I L; Lambert, Simon M

    2016-01-01

    AIM: To report the results of fixed-fulcrum fully constrained reverse shoulder arthroplasty for the treatment of recurrent shoulder instability in patients with epilepsy. METHODS: A retrospective review was conducted at a single facility. Cases were identified using a computerized database and all clinic notes and operative reports were reviewed. All patients with epilepsy and recurrent shoulder instability were included for study. Between July 2003 and August 2011 five shoulders in five consecutive patients with epilepsy underwent fixed-fulcrum fully constrained reverse shoulder arthroplasty for recurrent anterior shoulder instability. The mean duration of epilepsy in the cohort was 21 years (range, 5-51) and all patients suffered from grand mal seizures. RESULTS: Mean age at the time of surgery was 47 years (range, 32-64). The cohort consisted of four males and one female. Mean follow-up was 4.7 years (range, 4.3-5 years). There were no further episodes of instability, and no further stabilisation or revision procedures were performed. The mean Oxford shoulder instability score improved from 8 preoperatively (range, 5-15) to 30 postoperatively (range, 16-37) (P = 0.015) and the mean subjective shoulder value improved from 20 (range, 0-50) preoperatively to 60 (range, 50-70) postoperatively (P = 0.016). Mean active forward elevation improved from 71° preoperatively (range, 45°-130°) to 100° postoperatively (range, 80°-90°) and mean active external rotation improved from 15° preoperatively (range, 0°-30°) to 40° (20°-70°) postoperatively. No cases of scapular notching or loosening were noted. CONCLUSION: Fixed-fulcrum fully constrained reverse shoulder arthroplasty should be considered for the treatment of recurrent shoulder instability in patients with epilepsy. PMID:27458554

  5. De novo mutations in epileptic encephalopathies.

    Science.gov (United States)

    Allen, Andrew S; Berkovic, Samuel F; Cossette, Patrick; Delanty, Norman; Dlugos, Dennis; Eichler, Evan E; Epstein, Michael P; Glauser, Tracy; Goldstein, David B; Han, Yujun; Heinzen, Erin L; Hitomi, Yuki; Howell, Katherine B; Johnson, Michael R; Kuzniecky, Ruben; Lowenstein, Daniel H; Lu, Yi-Fan; Madou, Maura R Z; Marson, Anthony G; Mefford, Heather C; Esmaeeli Nieh, Sahar; O'Brien, Terence J; Ottman, Ruth; Petrovski, Slavé; Poduri, Annapurna; Ruzzo, Elizabeth K; Scheffer, Ingrid E; Sherr, Elliott H; Yuskaitis, Christopher J; Abou-Khalil, Bassel; Alldredge, Brian K; Bautista, Jocelyn F; Berkovic, Samuel F; Boro, Alex; Cascino, Gregory D; Consalvo, Damian; Crumrine, Patricia; Devinsky, Orrin; Dlugos, Dennis; Epstein, Michael P; Fiol, Miguel; Fountain, Nathan B; French, Jacqueline; Friedman, Daniel; Geller, Eric B; Glauser, Tracy; Glynn, Simon; Haut, Sheryl R; Hayward, Jean; Helmers, Sandra L; Joshi, Sucheta; Kanner, Andres; Kirsch, Heidi E; Knowlton, Robert C; Kossoff, Eric H; Kuperman, Rachel; Kuzniecky, Ruben; Lowenstein, Daniel H; McGuire, Shannon M; Motika, Paul V; Novotny, Edward J; Ottman, Ruth; Paolicchi, Juliann M; Parent, Jack M; Park, Kristen; Poduri, Annapurna; Scheffer, Ingrid E; Shellhaas, Renée A; Sherr, Elliott H; Shih, Jerry J; Singh, Rani; Sirven, Joseph; Smith, Michael C; Sullivan, Joseph; Lin Thio, Liu; Venkat, Anu; Vining, Eileen P G; Von Allmen, Gretchen K; Weisenberg, Judith L; Widdess-Walsh, Peter; Winawer, Melodie R

    2013-09-12

    Epileptic encephalopathies are a devastating group of severe childhood epilepsy disorders for which the cause is often unknown. Here we report a screen for de novo mutations in patients with two classical epileptic encephalopathies: infantile spasms (n = 149) and Lennox-Gastaut syndrome (n = 115). We sequenced the exomes of 264 probands, and their parents, and confirmed 329 de novo mutations. A likelihood analysis showed a significant excess of de novo mutations in the ∼4,000 genes that are the most intolerant to functional genetic variation in the human population (P = 2.9 × 10(-3)). Among these are GABRB3, with de novo mutations in four patients, and ALG13, with the same de novo mutation in two patients; both genes show clear statistical evidence of association with epileptic encephalopathy. Given the relevant site-specific mutation rates, the probabilities of these outcomes occurring by chance are P = 4.1 × 10(-10) and P = 7.8 × 10(-12), respectively. Other genes with de novo mutations in this cohort include CACNA1A, CHD2, FLNA, GABRA1, GRIN1, GRIN2B, HNRNPU, IQSEC2, MTOR and NEDD4L. Finally, we show that the de novo mutations observed are enriched in specific gene sets including genes regulated by the fragile X protein (P < 10(-8)), as has been reported previously for autism spectrum disorders. PMID:23934111

  6. Spontaneous and visually-driven high-frequency oscillations in the occipital cortex: Intracranial recording in epileptic patients

    OpenAIRE

    Nagasawa, Tetsuro; Juhász, Csaba; Rothermel, Robert; Hoechstetter, Karsten; Sood, Sandeep; Asano, Eishi

    2011-01-01

    High-frequency oscillations (HFOs) at ≧80 Hz of nonepileptic nature spontaneously emerge from human cerebral cortex. In 10 patients with extra-occipital lobe epilepsy, we compared the spectral-spatial characteristics of HFOs spontaneously arising from the nonepileptic occipital cortex with those of HFOs driven by a visual task as well as epileptogenic HFOs arising from the extra-occipital seizure focus. We identified spontaneous HFOs at ≧80 Hz with a mean duration of 330 msec intermittently e...

  7. Correlation between IL-10 and microRNA-187 expression in epileptic rat hippocampus and patients with temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Walid A. Alsharafi

    2015-12-01

    Full Text Available Accumulating evidence is emerging that microRNAs (miRs are key regulators controlling neuroinflammatory processes, which are known to play a potential role in the pathogenesis of temporal lobe epilepsy (TLE. The aim of the present study was to investigate the dynamic expression pattern of interleukin (IL–10 as an anti-inflammatory cytokine and miR-187 and post-transcriptional inflammation-related miRNA in the hippocampus of a rat model of status epilepticus (SE and patients with TLE. We performed a real-time quantitative PCR and western blot on rat hippocampus (2 hours, 7 days, 21 days and 60 days following pilocarpine-induced SE, and on hippocampus obtained from TLE patients and normal controls. To detect the relationship between IL-10 and miR-187 on neurons, lipopolysaccharide (LPS and IL-10-stimulated neurons were prepared. Furthermore, we identified the effect of antagonizing of miR-187 by its antagomir on IL-10 secretion. Here we reported that that IL-10 secretion and miR-187 expression levels are inversely correlated after SE.. In patients with TLE, the expression levels of IL-10 was also significantly upregulated, whereas miR-187 expression was significantly downregulated. Moreover, miR-187 expression was significantly reduced following IL-10 stimulation in an IL-10–dependent manner. On the other hand, antagonizing miR-187 reduced the production of IL-10 in hippocampal tissues of rat model of SE. Our findings demonstrate a critical role of miR-187 in the physiological regulation of IL-10 anti-inflammatory responses and elucidate the role of neuro-inflammation in the pathogenesis of TLE. Therefore, modulation of the IL-10 / miR-187 axis may be a new therapeutic approach for TLE.

  8. Quantification of human brain benzodiazepine receptors using [{sup 18}F]fluoroethylflumazenil: a first report in volunteers and epileptic patients

    Energy Technology Data Exchange (ETDEWEB)

    Leveque, Philippe [Unite de Tomographie par Positrons, Universite Catholique de Louvain, Louvain-la-Neuve (Belgium); Unite de Chimie Pharmaceutique et de Radiopharmacie, CMFA/REMA, Universite Catholique de Louvain, 73-40 Avenue Mounier, 1200, Bruxelles (Belgium); Sanabria-Bohorquez, Sandra [Imaging Research, Merck Research Laboratories, West Point, Philadelphia (United States); Bol, Anne; Volder, Anne de; Labar, Daniel [Unite de Tomographie par Positrons, Universite Catholique de Louvain, Louvain-la-Neuve (Belgium); Rijckevorsel, K. van [Service de Neurologie, Cliniques Universitaires Saint-Luc, Bruxelles (Belgium); Gallez, Bernard [Unite de Chimie Pharmaceutique et de Radiopharmacie, CMFA/REMA, Universite Catholique de Louvain, 73-40 Avenue Mounier, 1200, Bruxelles (Belgium); Unite de Resonance Magnetique Biomedicale, Universite Catholique de Louvain, Bruxelles (Belgium)

    2003-12-01

    Fluorine-18 fluoroethylflumazenil ([{sup 18}F]FEF) is a tracer for central benzodiazepine (BZ) receptors which is proposed as an alternative to carbon-11 flumazenil for in vivo imaging using positron emission tomography (PET) in humans. In this study, [{sup 18}F]FEF kinetic data were acquired using a 60-min two-injection protocol on three normal subjects and two patients suffering from mesiotemporal epilepsy as demonstrated by abnormal magnetic resonance imaging and [{sup 18}F]fluorodeoxyglucose positron emission tomography. First, a tracer bolus injection was performed and [{sup 18}F]FEF rapidly distributed in the brain according to the known BZ receptor distribution. Thirty minutes later a displacement injection of 0.01 mg/kg of unlabelled flumazenil was performed. Activity was rapidly displaced from all BZ receptor regions demonstrating the specific binding of [{sup 18}F]FEF. No displacement was observed in the pons. Plasma input function was obtained from arterial blood sampling, and metabolite analysis was performed by high-performance liquid chromatography. Metabolite quantification revealed a fast decrease in tracer plasma concentration, such that at 5 min post injection about 70% of the total radioactivity in plasma corresponded to [{sup 18}F]FEF, reaching 24% at 30 min post injection. The interactions between [{sup 18}F]FEF and BZ receptors were described using linear compartmental models with plasma input and reference tissue approaches. Binding potential values were in agreement with the known distribution of BZ receptors in human brain. Finally, in two patients with mesiotemporal sclerosis, reduced uptake of [{sup 18}F]FEF was clearly observed in the implicated left hippocampus. (orig.)

  9. Ictal technetium-99 m ethyl cysteinate dimer single-photon emission tomographic findings in epileptic patients with polymicrogyria syndromes: A subtraction of ictal-interictal SPECT coregistered to MRI study

    International Nuclear Information System (INIS)

    To describe the ictal technetium-99 m-ECD SPECT findings in polymicrogyria syndromes (PMG) during epileptic seizures. We investigated 17 patients with PMG syndromes during presurgical workup, which included long-term video-electroencephalographic (EEG) monitoring, neurological and psychiatry assessments, invasive EEG, and the subtraction of ictal-interictal SPECT coregistered to magnetic resonance imaging (MRI) (SISCOM). The analysis of the PMG cortex, using SISCOM, revealed intense hyperperfusion in the polymicrogyric lesion during epileptic seizures in all patients. Interestingly, other localizing investigations showed heterogeneous findings. Twelve patients underwent epilepsy surgery, three achieved seizure-freedom, five have worthwhile improvement, and four patients remained unchanged. Our study strongly suggests the involvement of PMG in seizure generation or early propagation. Both conventional ictal single-photon emission computed tomography (SPECT) and SISCOM appeared as the single contributive exam to suggest the localization of the epileptogenic zone. Despite the limited number of resective epilepsy surgery in our study (n = 9), we found a strong prognostic role of SISCOM in predicting surgical outcome. This result may be of great value on surgical decision-making of whether or not the whole or part of the PMG lesion should be surgically resected. (orig.)

  10. Mental Development of Children with Non-epileptic Paroxysmal States in Medical History

    Directory of Open Access Journals (Sweden)

    Turovskaya N.G.,

    2015-10-01

    Full Text Available The author studied mental functions disorders in children with a history of paroxysmal states of various etiologies and compared mental development disorder patterns in patients with epileptic and non-epileptic paroxysms. Study sample were 107 children, aged 6 to 10 years. The study used experimental psychological and neuropsychological techniques. According to the empirical study results, non-epileptic paroxysms unlike epileptic much less combined with a number of mental functions disorders and intelligence in general. However, non-epileptic paroxysmal states as well as epileptic seizure associated with increasing activity exhaustion and abnormal function of the motor analyzer (dynamic and kinesthetic dyspraxia. Visual memory disorders and modal-nonspecific memory disorders have more pronounced importance in the mental ontogenesis structure in children with convulsive paroxysms compared to children with cerebral pathology without paroxysms history

  11. 癫癎患者服药依从性调查及影响因素分析%Medication Compliance of Epileptic Patients and Its Influencing Factors

    Institute of Scientific and Technical Information of China (English)

    陈义彤; 曹春霞

    2012-01-01

    目的 了解癫疒间患者服药依从性,探讨其影响因素,为提出相应的护理干预措施提供依据.方法 采用Morisky的服药依从性问卷中文版对148例癫疒间患者进行服药依从性调查,分析年龄、文化程度、居住地、医疗保障情况、病程、药物不良反应、家庭社会支持程度等因素对患者服药依从性的影响.结果 50例癫疒间患者服药依从性好,依从率33.8%;64例对停药、换药、增减药物的注意事项不了解(占43.3%),51例对定期检查血药浓度及肝功能的意义不了解(占34.5%);多因素Logistic回归分析显示患者的年龄、居住地、病程、医疗保障、家庭社会支持程度对其服药依从性有不同程度的影响(P<0.05).结论 患者服药依从性较差,应加强健康教育,建立良好护患关系,加强心理护理,发挥社会家庭支持系统,指导合理使用抗癫疒间药物,从而提高癫疒间患者服药依从性.%Objective To analyze the medication compliance of epileptic patients and its influencing factors and to put forward appropriate nursing interventions. Methods Morisky Medication Adherence Questionnaire (Chinese version) was applied among 148 epilepsy patients. Information about age, educational background, residence, health insurance, duration, adverse drug reactions, family and social support and disease knowledge was collected and then multivariate Logistic regression analysis was conducted. Results Of the total, 50 cases were with good compliance, with a compliance rate of 33.8% while 64 paid little attention to drug precautions, accounting for 43.3%. In addition, 51 patients (34.5%) presented inadequate knowledge about the significance of regular plasma concentration checking and liver function. Patient's age, residence, duration of disease, health insurance, family and social support had different effects on their medication compliance (P<0.05). Conclusion In general, patients are with poor medication compliance

  12. Suicide-related behaviors in older patients with new anti-epileptic drug use: data from the VA hospital system

    Directory of Open Access Journals (Sweden)

    Dersh Jeffrey J

    2010-01-01

    Full Text Available Abstract Background The U.S. Food and Drug Administration (FDA recently linked antiepileptic drug (AED exposure to suicide-related behaviors based on meta-analysis of randomized clinical trials. We examined the relationship between suicide-related behaviors and different AEDs in older veterans receiving new AED monotherapy from the Veterans Health Administration (VA, controlling for potential confounders. Methods VA and Medicare databases were used to identify veterans 66 years and older, who received a care from the VA between 1999 and 2004, and b an incident AED (monotherapy prescription. Previously validated ICD-9-CM codes were used to identify suicidal ideation or behavior (suicide-related behaviors cases, epilepsy, and other conditions previously associated with suicide-related behaviors. Each case was matched to controls based on prior history of suicide-related behaviors, year of AED prescription, and epilepsy status. Results The strongest predictor of suicide-related behaviors (N = 64; Controls N = 768 based on conditional logistic regression analysis was affective disorder (depression, anxiety, or post-traumatic stress disorder (PTSD; Odds Ratio 4.42, 95% CI 2.30 to 8.49 diagnosed before AED treatment. Increased suicide-related behaviors were not associated with individual AEDs, including the most commonly prescribed AED in the US - phenytoin. Conclusion Our extensive diagnostic and treatment data demonstrated that the strongest predictor of suicide-related behaviors for older patients newly treated with AED monotherapy was a previous diagnosis of affective disorder. Additional, research using a larger sample is needed to clearly determine the risk of suicide-related behaviors among less commonly used AEDs.

  13. Enhanced Susceptibility to Spontaneous Seizures of Noda Epileptic Rats by Loss of Synaptic Zn2+

    OpenAIRE

    Atsushi Takeda; Masashi Iida; Masaki Ando; Masatoshi Nakamura; Haruna Tamano; Naoto Oku

    2013-01-01

    Zinc homeostasis in the brain is associated with the etiology and manifestation of epileptic seizures. Adult Noda epileptic rats (NER, >12-week-old) exhibit spontaneously generalized tonic-clonic convulsion about once a day. To pursue the involvement of synaptic Zn(2+) signal in susceptibility to spontaneous seizures, in the present study, the effect of zinc chelators on epileptogenesis was examined using adult NER. Clioquinol (CQ) and TPEN are lipophilic zinc chelotors, transported into the ...

  14. A novel dynamic update framework for epileptic seizure prediction.

    Science.gov (United States)

    Han, Min; Ge, Sunan; Wang, Minghui; Hong, Xiaojun; Han, Jie

    2014-01-01

    Epileptic seizure prediction is a difficult problem in clinical applications, and it has the potential to significantly improve the patients' daily lives whose seizures cannot be controlled by either drugs or surgery. However, most current studies of epileptic seizure prediction focus on high sensitivity and low false-positive rate only and lack the flexibility for a variety of epileptic seizures and patients' physical conditions. Therefore, a novel dynamic update framework for epileptic seizure prediction is proposed in this paper. In this framework, two basic sample pools are constructed and updated dynamically. Furthermore, the prediction model can be updated to be the most appropriate one for the prediction of seizures' arrival. Mahalanobis distance is introduced in this part to solve the problem of side information, measuring the distance between two data sets. In addition, a multichannel feature extraction method based on Hilbert-Huang transform and extreme learning machine is utilized to extract the features of a patient's preseizure state against the normal state. At last, a dynamic update epileptic seizure prediction system is built up. Simulations on Freiburg database show that the proposed system has a better performance than the one without update. The research of this paper is significantly helpful for clinical applications, especially for the exploitation of online portable devices. PMID:25050381

  15. Impaired picture recognition in transient epileptic amnesia.

    Science.gov (United States)

    Dewar, Michaela; Hoefeijzers, Serge; Zeman, Adam; Butler, Christopher; Della Sala, Sergio

    2015-01-01

    Transient epileptic amnesia (TEA) is an epileptic syndrome characterized by recurrent, brief episodes of amnesia. Transient epileptic amnesia is often associated with the rapid decline in recall of new information over hours to days (accelerated long-term forgetting - 'ALF'). It remains unknown how recognition memory is affected in TEA over time. Here, we report a systematic study of picture recognition in patients with TEA over the course of one week. Sixteen patients with TEA and 16 matched controls were presented with 300 photos of everyday life scenes. Yes/no picture recognition was tested 5min, 2.5h, 7.5h, 24h, and 1week after picture presentation using a subset of target pictures as well as similar and different foils. Picture recognition was impaired in the patient group at all test times, including the 5-minute test, but it declined normally over the course of 1week. This impairment was associated predominantly with an increased false alarm rate, especially for similar foils. High performance on a control test indicates that this impairment was not associated with perceptual or discrimination deficits. Our findings suggest that, at least in some TEA patients with ALF in verbal recall, picture recognition does not decline more rapidly than in controls over 1week. However, our findings of an early picture recognition deficit suggest that new visual memories are impoverished after minutes in TEA. This could be the result of deficient encoding or impaired early consolidation. The early picture recognition deficit observed could reflect either the early stages of the process that leads to ALF or a separable deficit of anterograde memory in TEA. Lastly, our study suggests that at least some patients with TEA are prone to falsely recognizing new everyday visual information that they have not in fact seen previously. This deficit, alongside their ALF in free recall, likely affects everyday memory performance. PMID:25506793

  16. Predicting epileptic seizures in advance.

    Directory of Open Access Journals (Sweden)

    Negin Moghim

    Full Text Available Epilepsy is the second most common neurological disorder, affecting 0.6-0.8% of the world's population. In this neurological disorder, abnormal activity of the brain causes seizures, the nature of which tend to be sudden. Antiepileptic Drugs (AEDs are used as long-term therapeutic solutions that control the condition. Of those treated with AEDs, 35% become resistant to medication. The unpredictable nature of seizures poses risks for the individual with epilepsy. It is clearly desirable to find more effective ways of preventing seizures for such patients. The automatic detection of oncoming seizures, before their actual onset, can facilitate timely intervention and hence minimize these risks. In addition, advance prediction of seizures can enrich our understanding of the epileptic brain. In this study, drawing on the body of work behind automatic seizure detection and prediction from digitised Invasive Electroencephalography (EEG data, a prediction algorithm, ASPPR (Advance Seizure Prediction via Pre-ictal Relabeling, is described. ASPPR facilitates the learning of predictive models targeted at recognizing patterns in EEG activity that are in a specific time window in advance of a seizure. It then exploits advanced machine learning coupled with the design and selection of appropriate features from EEG signals. Results, from evaluating ASPPR independently on 21 different patients, suggest that seizures for many patients can be predicted up to 20 minutes in advance of their onset. Compared to benchmark performance represented by a mean S1-Score (harmonic mean of Sensitivity and Specificity of 90.6% for predicting seizure onset between 0 and 5 minutes in advance, ASPPR achieves mean S1-Scores of: 96.30% for prediction between 1 and 6 minutes in advance, 96.13% for prediction between 8 and 13 minutes in advance, 94.5% for prediction between 14 and 19 minutes in advance, and 94.2% for prediction between 20 and 25 minutes in advance.

  17. Mental development of tuberous sclerosis with regard to epileptic seizures and CT findings

    International Nuclear Information System (INIS)

    The relation of mental development to epileptic seizures and CT findings was examined in 17 patients with tuberous sclerosis. Epileptic seizures occurred in 16 of the 17 patients. The earlier it occurred, the higher the incidence of mental retardation was. There was no constant correlation between mental development and the type of epileptic seizures or the attainment of inhibition of seizures. In two patients in whom calcification spreading to the cerebral cortex and subcortical region was detected on CT, in addition to calcified tubercles around the cerebral ventricle, an intelligence quotient was significantly lower than in the other patients. (Namekawa, K.)

  18. Comparison of personality characteristics on the bear-fedio inventory between patients with epilepsy and those with non-epileptic seizures.

    Science.gov (United States)

    Tremont, Geoffrey; Smith, Megan M; Bauer, Lyndsey; Alosco, Michael L; Davis, Jennifer D; Blum, Andrew S; LaFrance, W Curt

    2012-01-01

    This study used the Bear-Fedio Personality Inventory (BFI) to compare 41 individuals with temporal lobe epilepsy (TLE) and 37 with psychogenic non-epileptic seizures (NES). Both groups exhibited similar elevations on the BFI, although TLE individuals show greater endorsement of at least one hypergraphia symptom, as compared with those with NES. The correlates of the BFI with demographic and seizure characteristics differed between the groups. These results argue against a specific TLE personality syndrome and suggest that personality characteristics may be related to the experience of having repeated seizures, rather than the specific underlying pathophysiology of temporal lobe epilepsy. PMID:22450613

  19. A new approach towards predictability of epileptic seizures: KLT dimension.

    Science.gov (United States)

    Venugopal, Rajeshkumar; Narayanan, K; Prasad, Awadhesh; Spanias, A; Sackellares, J C; Iasemidis, L D

    2003-01-01

    This paper proposes a measure of complexity of the epileptic electroencephalogram (EEG) based on the dimensionality of the Karhunen-Loeve Transform (KLT) in the time domain. We estimate the KLT dimensionality by assuming the same observation noise level in the EEG during the interictal period (between the seizures) as the one during an epileptic seizure (ictal period). Utilizing an optimality criterion based on the T-index [1] and the predictability time, derived from the created KLT dimensionality profiles, we show that 10 out of 15 seizures in one patient with temporal lobe epilepsy were predictable with an average predictability time of about 36 minutes. PMID:12724880

  20. Oxidative Status in Epileptic Children Using Carbamazepine

    Directory of Open Access Journals (Sweden)

    Murat Tutanc

    2015-12-01

    Full Text Available Background: There is an increasing attention towards the relationship between oxidative stress and epilepsy. The effect of antiepileptic drugs on oxidant status is of major interest. Antiepileptic drugs can increase levels of free radicals, which consequently might lead to seizures. Carbamazepine (CBZ is an antiepileptic drug commonly used in childhood and adolescence. Objectives: Therefore we aimed to investigate the effects of CBZ on total antioxidant status, total oxidant stress, and oxidative stress index. Patients and Methods: The study included 40 epileptic patients and 31 healthy children between 4 and 12 years of age. Serum CBZ level, total antioxidant capacity and total oxidant status were measured. Oxidative stress index was also calculated both in controls and patients. Results: In the epileptic group, decreased levels of total antioxidant capacity, increased total oxidative stress and oxidative stress index levels were found. Positive correlation between plasma CBZ levels and total oxidant status was observed. Conclusions: Antioxidant action could not be playing any role in antiepileptic effect of CBZ. Furthermore, increased oxidative stress induced by CBZ could be the cause of CBZ-induced seizures. Therefore combining CBZ with antioxidants could be beneficial.

  1. GRIN1 Mutations in Early-Onset Epileptic Encephalopathy

    Directory of Open Access Journals (Sweden)

    Wenjuan Chen

    2015-06-01

    Full Text Available Investigators from Yokohama City University and other medical centers in Israel and Japan reported mutations on N-methyl-D-aspartate (NMDA receptors subunit GRIN1 (GluN1 identified in patients with nonsyndromic intellectual disability and early-onset epileptic encephalopathy.

  2. Recognition of psychogenic non-epileptic seizures: a curable neurophobia?

    LENUS (Irish Health Repository)

    O'Sullivan, S S

    2013-02-01

    Diagnosing psychogenic non-epileptic seizures (PNES) remains challenging. The majority of \\'PNES status\\' cases are likely to be seen in the emergency department or similar non-specialised units, where patients are initially assessed and managed by physicians of varying expertise in neurology.

  3. Lead encephalopathy in adults

    Directory of Open Access Journals (Sweden)

    Janapareddy Vijaya Bhaskara Rao

    2014-01-01

    Full Text Available Lead poisoning is a common occupational health hazard in developing countries. We report the varied clinical presentation, diagnostic and management issues in two adult patients with lead encephalopathy. Both patients worked in a battery manufacturing unit. Both patients presented with seizures and one patient also complained of abdominal colic and vomiting. Both were anemic and a lead line was present. Blood lead level in both the patients was greater than 25 µg/dl. Magnetic resonance imaging of brain revealed bilateral symmetric involvement of the thalamus, lentiform nucleus in both patients and also the external capsules, sub-cortical white matter in one patient. All these changes, seen as hyperintensities in T2-weighted images suggested demyelination. They were advised avoidance of further exposure to lead and were treated with anti-epileptics; one patient also received D-penicillamine. They improved well on follow-up. Lead encephalopathy is an uncommon but important manifestation of lead toxicity in adults.

  4. How Sleep Activates Epileptic Networks?

    Directory of Open Access Journals (Sweden)

    Peter Halász

    2013-01-01

    Full Text Available Background. The relationship between sleep and epilepsy has been long ago studied, and several excellent reviews are available. However, recent development in sleep research, the network concept in epilepsy, and the recognition of high frequency oscillations in epilepsy and more new results may put this matter in a new light. Aim. The review address the multifold interrelationships between sleep and epilepsy networks and with networks of cognitive functions. Material and Methods. The work is a conceptual update of the available clinical data and relevant studies. Results and Conclusions. Studies exploring dynamic microstructure of sleep have found important gating mechanisms for epileptic activation. As a general rule interictal epileptic manifestations seem to be linked to the slow oscillations of sleep and especially to the reactive delta bouts characterized by A1 subtype in the CAP system. Important link between epilepsy and sleep is the interference of epileptiform discharges with the plastic functions in NREM sleep. This is the main reason of cognitive impairment in different forms of early epileptic encephalopathies affecting the brain in a special developmental window. The impairment of cognitive functions via sleep is present especially in epileptic networks involving the thalamocortical system and the hippocampocortical memory encoding system.

  5. Nonlinear analysis of EEG for epileptic seizures

    Energy Technology Data Exchange (ETDEWEB)

    Hively, L.M.; Clapp, N.E.; Daw, C.S.; Lawkins, W.F. [Oak Ridge National Lab., TN (United States); Eisenstadt, M.L. [Knoxville Neurology Clinic, St. Mary`s Medical Center, Knoxville, TN (United States)

    1995-04-01

    We apply chaotic time series analysis (CTSA) to human electroencephalogram (EEG) data. Three epoches were examined: epileptic seizure, non-seizure, and transition from non-seizure to seizure. The CTSA tools were applied to four forms of these data: raw EEG data (e-data), artifact data (f-data) via application of a quadratic zero-phase filter of the raw data, artifact-filtered data (g- data) and that was the residual after subtracting f-data from e-data, and a low-pass-filtered version (h-data) of g-data. Two different seizures were analyzed for the same patient. Several nonlinear measures uniquely indicate an epileptic seizure in both cases, including an abrupt decrease in the time per wave cycle in f-data, an abrupt increase in the Kolmogorov entropy and in the correlation dimension for e-h data, and an abrupt increase in the correlation dimension for e-h data. The transition from normal to seizure state also is characterized by distinctly different trends in the nonlinear measures for each seizure and may be potential seizure predictors for this patient. Surrogate analysis of e-data shows that statistically significant nonlinear structure is present during the non-seizure, transition , and seizure epoches.

  6. Fractal Dimension in Epileptic EEG Signal Analysis

    Science.gov (United States)

    Uthayakumar, R.

    greater speed and the criterion to choose the maximum and minimum values for time intervals. Comparisons with the other waveform fractal dimension algorithms are also demonstrated. In order to discriminate the Healthy and the Epileptic EEGs, an improved method of Multifractal Measure such as Generalized Fractal Dimensions (GFD) is also proposed. Finally we conclude that there are significant differences between the Healthy and Epileptic Signals in the designed method than the GFD through graphical and statistical tools. The improved multifractal measure is very efficient technique to analyze the EEG Signals and to compute the state of illness of the Epileptic patients.

  7. Mozart's music in children with drug-refractory epileptic encephalopathies.

    Science.gov (United States)

    Coppola, Giangennaro; Toro, Annacarmela; Operto, Francesca Felicia; Ferrarioli, Giuseppe; Pisano, Simone; Viggiano, Andrea; Verrotti, Alberto

    2015-09-01

    Mozart's sonata for two pianos in D major, K448, has been shown to decrease interictal EEG discharges and recurrence of clinical seizures in both adults and young patients. In this prospective, open-label study, we evaluated the effect of listening to a set of Mozart's compositions, according to the Tomatis method, on sleep quality and behavioral disorders, including auto-/hetero-aggression, irritability, and hyperactivity, in a group of children and adolescents with drug-resistant epilepsy. The study group was composed of 11 outpatients (7 males and 4 females), between 1.5years and 21years of age (mean age: 11.9years), all suffering from drug-resistant epileptic encephalopathy (n=11). All of them had a severe/profound intellectual disability associated with cerebral palsy. During the study period, each patient had to listen to a set of Mozart's compositions 2h per day for fifteen days for a total of 30h, which could be distributed over the day depending on the habits and compliance of each patient. The music was filtered by a device preferably delivering higher sound frequencies (>3000Hz) according to the Tomatis principles. The antiepileptic drug therapy remained unchanged throughout the study period. During the 15-day music therapy, 2 out of 11 patients had a reduction of 50-75% in seizure recurrence, and 3 out of 12 patients had a reduction of 75-89%. Overall, 5 (45.4%) out of 11 patients had a ≥50% reduction in the total number of seizures, while the percentage decrease of the total seizure number (11/11) compared with baseline was -51.5% during the 15-day music therapy and -20.7% in the two weeks after the end of treatment. All responders also had an improvement in nighttime sleep and daytime behavior. PMID:26093514

  8. Clinical features of Todd's post-epileptic paralysis.

    OpenAIRE

    Rolak, L A; Rutecki, P; Ashizawa, T; Harati, Y

    1992-01-01

    Two hundred and twenty nine patients with generalised tonic-clonic seizures were prospectively evaluated. Fourteen were identified who had transient focal neurological deficits thought to be Todd's post-epileptic paralysis (PEP). Eight of these 14 patients had underlying focal brain lesions associated with the postictal deficits. All patients with PEP were weak, but there was wide variation in the pattern (any combination of face, arm, leg), severity (plegia to mild), tone (spastic, flaccid, ...

  9. Dietary intake and nutritional status in cancer patients: comparing adults and older adults

    Directory of Open Access Journals (Sweden)

    Henyse Gómez Valiente da Silva

    2014-04-01

    Full Text Available Objective: Evaluate the nutrient intake and nutritional status of food in cancer patients admitted to a university hospital, with comparison of adult and older adult age category Methods: Cross-sectional study. This study involved cancer patients admitted to a hospital in 2010. Dietary habits were collected using a Brazilian food frequency questionnaire. Participants were divided in two groups: adults or older adults and in 4-cancer category: hematologic, lung, gastrointestinal and others. Body Mass Index evaluated nutritional status. Results: A total of 86 patients with a mean age of 56.5 years, with 55% males and 42% older adults were evaluated. The older adult category had a higher frequency of being underweight (24.4% vs 16.3%, p < 0.01 and a lower frequency of being overweight (7% vs. 15.1%, p < 0.01 than adults. Both, adult and older adults had a high frequency of smoking, alcohol consumption and physical inactivity. The older adults had lower consumption of calories, intake of iron and folic acid. Inadequacy of vitamin intake was observed in both groups; respectively, 52%, 43%, 95%, 76% and 88% for Vitamin A, C, D, E and folic acid. The older adults had a higher folic acid and calcium inadequacy than the adults (97% vs 82%, p <0.01; 88% vs 72%, p < 0.01. There was no association of micronutrient intake with cancer, nor with nutritional status. Conclusion: The food intake, macro and micronutrients ingestion is insufficient among cancer individuals. Food intake of older adults was inferior, when compared to the adult category. There was a high prevalence of BMI excess in the adult group and a worst nutritional status in the older adult category.

  10. Recognition of Epileptic EEG Using Probabilistic Neural Network

    CERN Document Server

    Bao, Forrest Sheng; Lie, Donald Yu-Chun

    2008-01-01

    Epilepsy is one of the most common neurological disorders that greatly impair patients' daily lives. A classifier for automated epileptic EEG detection and patient monitoring can be very important for epilepsy diagnosis and patients' quality of life, especially for rural areas and developing countries where medical resources are limited. This paper describes our development of an accurate and fast EEG classifier that can differentiate the EEG data of healthy people from that of epileptic patients, and also detect patients' status (i.e., interictal vs. ictal). We deployed Probabilistic Neural Network (PNN) and fed it with 38 features extracted from the EEG data. The resulting PNN EEG classifier achieves an impressive accuracy greater than 96 as indicated by cross-validation. This prototype classifier is therefore suitable for automated epilepsy detection/diagnosis and seizure monitoring. It may even facilitate seizure prediction.

  11. The relationship between interictal epileptic discharges and sleep cycle of 240 epilepsy patients%癫痫患者240例发作间期癫痫样放电与睡眠周期的关系

    Institute of Scientific and Technical Information of China (English)

    吕玉丹; 初凤娜; 孟红梅; 崔俐; 王赞

    2014-01-01

    目的 癫痫患者的癫痫样放电(EDs)常常引起较差的睡眠质量.我们通过观察癫痫患者不同睡眠分期中EDs情况,探讨EDs与睡眠周期的关系.方法 240例癫痫患者与213名健康志愿者参与此项研究,所有参与者均行24 h视频脑电监测及多导睡眠图检查,检测EDs及分析睡眠结构.结果 在88.7% (213/240)的癫痫患者中检测出EDs,但最常见于颞叶癫痫.不同睡眠分期中EDs的构成比不同,如:清醒期EDs的构成比为20.6% (44/213),睡眠期EDs的构成比为40.4%(86/213),清醒及睡眠期EDs构成比为38.9%(83/213).总睡眠时间及快速眼动期睡眠时间在癫痫患者及健康志愿者中无差异,但癫痫患者非快速眼动睡眠Ⅰ~Ⅱ期睡眠时间明显延长于健康人群[(304±39) min与(225±29) min,t=3.51,P=0.000],非快速眼动睡眠Ⅲ~Ⅳ期睡眠时间明显缩短[(49±7) min与(133±17) min,t=2.30,P=0.000],两组总睡眠时间及快速眼动睡眠时间差异无统计学意义.此外,睡眠纺锤波不对称性、高觉醒指数出现于癫痫组睡眠结构中.结论 长程视频脑电图及多导睡眠图联合应用,有助于分析EDs与睡眠周期之间的关系,有助于识别癫痫患者的睡眠障碍,进行早期的干预及治疗.%Objective The poor sleep quality of epileptic patients may be partly due to the occurrence epileptiform discharges (EDs).We observed the number of interictal discharges in each sleep stage and explored the associations between EDs and sleep phases in epilepsy patients.Methods Two hundred and forty epileptic patients and 213 healthy volunteers were enrolled in the current study.For all subjects,video-electroencephalogram monitoring and 24 h-night polysomnography were conducted to detect EDs and analyze the sleep structures.Results EDs were detected in 88.7% (213/240) of epilepsy patients with the most frequent cases from the temporal lobe.The EDs detected during waking,sleeping,or both waking and non-rapid eye

  12. Antiepileptic Drugs Effect on Vitamin D Status of Epileptic Children

    Directory of Open Access Journals (Sweden)

    Siamak Shiva

    Full Text Available Objective: As epilepsy and seizure disorders are common in children, antiepileptic drugs are used more commonly in this age group than in adults. This study was carried out in order to determine the vitamin D and calcium status of children receiving antiepileptic drugs and evaluation of effects of these drugs on vitamin D and calcium metabolism.Material & Methods: Sixty epileptic children and adolescents visiting Children's Neurology Clinic who were taking antiepileptic drugs and had inclusion criterions were selected as simple sampling from July 2005 to June 2006. Thirty age and sex matched normal children and adolescents were considered as control group. Serum levels of 25OHD3, calcium and alkaline phosphatase is compared between groups.Findings: Serum levels of 25OHD3 (P<0.001, calcium (P<0.001 and alkaline phosphatase (P<0.001 were significantly different between groups. Ten percent of patients had serum 25OHD3 level below lower normal limit. There was a reverse correlation between duration of drug therapy and serum level of 25OHD3 (r = - 0.345, P=0.011.Conclusion: Antiepileptic drug treatment in children results in reducing serum 25OHD3 and calcium levels and increases bone turnover. With longer duration of treatment serum 25OHD3 level decreases more.

  13. Comparison of Nutritional Parameters among Adult and Elderly Hemodialysis Patients

    OpenAIRE

    Gülperi Çelik, Bahar Oc, Inci Kara, Mümtaz Yılmaz, Ali Yuceaktas, Seza Apiliogullari

    2011-01-01

    Aim: The aim of this study was to compare the nutritional biochemical parameters, prealbumin levels, and bioimpedance analysis parameters of adult and elderly hemodialysis (HD) patients.Methods: This prospective cross-sectional study included 50 adult HD patients (42.0 % female). Nutritional status was assessed by post-dialysis multifrequency bioimpedance analysis (BIA), serum prealbumin and other nutritional biochemical parameters.Results: Mean age of patients was 57.4±15.1 years (range...

  14. Comparison of Nutritional Parameters among Adult and Elderly Hemodialysis Patients

    OpenAIRE

    Çelik, Gülperi; Oc, Bahar; Kara, Inci; Yılmaz, Mümtaz; Yuceaktas, Ali; Apiliogullari, Seza

    2011-01-01

    Aim: The aim of this study was to compare the nutritional biochemical parameters, prealbumin levels, and bioimpedance analysis parameters of adult and elderly hemodialysis (HD) patients. Methods: This prospective cross-sectional study included 50 adult HD patients (42.0 % female). Nutritional status was assessed by post-dialysis multifrequency bioimpedance analysis (BIA), serum prealbumin and other nutritional biochemical parameters. Results: Mean age of patients was 57.4±15.1 years (range: 3...

  15. Attention Deficit Hyperactivity Disorder in Epileptic Children

    OpenAIRE

    Kim, Gun-Ha; Kim, Ji Yeon; Byeon, Jung Hye; Eun, Baik-Lin; Rhie, Young Jun; Seo, Won Hee; Eun, So-Hee

    2012-01-01

    It is well-known that the prevalence of attention deficit hyperactivity disorder (ADHD) is higher in epileptic children than in the general pediatric population. The aim of this study was to compare the accompaniment of ADHD in epileptic children with well-controlled seizures and no significant intellectual disability with that in healthy controls. We included epileptic children between the ages of 6 and 12 yr visiting our clinic for six consecutive months and controls without significant med...

  16. Acute lymphoblastic leukaemia presenting with arthritis in an adult patient

    OpenAIRE

    Usalan, C.; Ozarslan, E; Zengin, N.; Buyukayk, Y.; Gullu, Y.

    1999-01-01

    The earliest manifestations of leukaemia often include rheumatic signs and symptoms. Arthritis is a well recognised complication of leukaemia in children, but acute and chronic leukaemia may also cause arthritis in adults. Leukaemic arthritis may occur at any time during the course of leukaemia and may be the presenting manifestation. It should therefore be considered in the differential diagnosis of both childhood and adult rheumatic disease. We present an adult patient presenting with arthr...

  17. The clinical presentation and diagnosis of epileptic autonomic auras

    Directory of Open Access Journals (Sweden)

    Marina Revditovna Kremenchugskaya

    2012-12-01

    Full Text Available Objective: to refine the pattern of clinical manifestations of epileptic autonomic auras (EAA and to reveal clinical, electroencephalographic, and neuroimaging ratios. Patients and methods. Eighteen patients (8, 41% men and 10, 59% women aged 9 to 27years (mean 18±5years were examined. The examination encompassed analysis of history data, clinical and neurological studies, long-term video-assisted electroencephalographic monitoring, and magnetic resonance imaging (MRI of the brain. Results. In most patients (n = 12, 67%, the symptoms of EAA corresponded to the criteria for abdominal one. In the other patients, the clinical manifestations resembled autonomic paroxysms as attacks of panic. Interictal pathological changes on an electroencephalogram (EEG were present in the frontal, temporal, and frontotemporal regions in 4 (22%, 6 (33%, and 7 (39% patients, respectively, as well as in both the left and right hemispheres without significant differences. Pathological EEG changes were not found in one case. MRI detected that 13 (72% patients had structural changes that were potentially eliptogenic. Conclusion. The clinical symptoms of EAA give information on the site of a primary pathological focus. It is necessary to differentiate EAA from non-epileptic paroxysmal states. The autonomic phenomena of epileptic genesis help study the functional organizations of the autonomic nervous system.

  18. Physical and psychosocial challenges in adult hemophilia patients with inhibitors

    Directory of Open Access Journals (Sweden)

    duTreil S

    2014-07-01

    Full Text Available Sue duTreil Louisiana Center for Bleeding and Clotting Disorders, Tulane University Health Sciences Center, New Orleans, LA, USA Abstract: Numerous challenges confront adult hemophilia patients with inhibitors, including difficulty in controlling bleeding episodes, deterioration of joints, arthritic pain, physical disability, emotional turmoil, and social issues. High-intensity treatment regimens often used in the treatment of patients with inhibitors also impose significant scheduling, economic, and emotional demands on patients and their families or primary caregivers. A comprehensive multidisciplinary assessment of the physical, emotional, and social status of adult hemophilia patients with inhibitors is essential for the development of treatment strategies that can be individualized to address the complex needs of these patients. Keywords: adult hemophilia patients with inhibitors, adherence, physical challenges, psychosocial challenges, health-related quality of life

  19. Advances in anti-epileptic drug testing.

    Science.gov (United States)

    Krasowski, Matthew D; McMillin, Gwendolyn A

    2014-09-25

    In the past twenty-one years, 17 new antiepileptic drugs have been approved for use in the United States and/or Europe. These drugs are clobazam, ezogabine (retigabine), eslicarbazepine acetate, felbamate, gabapentin, lacosamide, lamotrigine, levetiracetam, oxcarbazepine, perampanel, pregabalin, rufinamide, stiripentol, tiagabine, topiramate, vigabatrin and zonisamide. Therapeutic drug monitoring is often used in the clinical dosing of the newer anti-epileptic drugs. The drugs with the best justifications for drug monitoring are lamotrigine, levetiracetam, oxcarbazepine, stiripentol, and zonisamide. Perampanel, stiripentol and tiagabine are strongly bound to serum proteins and are candidates for monitoring of the free drug fractions. Alternative specimens for therapeutic drug monitoring are saliva and dried blood spots. Therapeutic drug monitoring of the new antiepileptic drugs is discussed here for managing patients with epilepsy. PMID:24925169

  20. Anesthesia for an Adult Patient with Congenital Diaphragmatic Eventration

    OpenAIRE

    Uysal, Hale Yarkan

    2007-01-01

    Congenital diaphragmatic eventration is an uncommon condition in adults and is defined as an abnormal elevation of the diaphragm. In adults, diaphragmatic eventration causes respiratory impairment that is associated with severe dyspnea, orthopnea and hypoxia. Most of the symptomatic patients may survive with supportive therapy without any need for surgical correction, though they are at risk of spontaneous diaphragm rupture. Spontaneous diaphragmatic rupture may develop in a patient with dia...

  1. Convulsive Syncope Induced by Ventricular Arrhythmia Masquerading as Epileptic Seizures: Case Report and Literature Review

    OpenAIRE

    Sabu, John; Regeti, Kalyani; Mallappallil, Mary; Kassotis, John; Islam, Hamidul; Zafar, Shoaib; Khan, Rafay; Ibrahim, Hiyam; Kanta, Romana; Sen, Shuvendu; Yousif, Abdalla; Nai, Qiang

    2016-01-01

    It is important but difficult to distinguish convulsive syncope from epileptic seizure in many patients. We report a case of a man who presented to emergency department after several witnessed seizure-like episodes. He had a previous medical history of systolic heart failure and automated implantable converter defibrillator (AICD) in situ. The differential diagnoses raised were epileptic seizures and convulsive syncope secondary to cardiac arrhythmia. Subsequent AICD interrogation revealed ve...

  2. De novo loss- or gain-of-function mutations in KCNA2 cause epileptic encephalopathy

    OpenAIRE

    Syrbe, Steffen; Hedrich, Ulrike B.S.; Riesch, Erik; Djémié, Tania; Müller, Stephan; Møller, Rikke S.; Maher, Bridget; Hernandez-Hernandez, Laura; Synofzik, Matthis; Caglayan, Hande S.; Arslan, Mutluay; Serratosa, José M.; Nothnagel, Michael; May, Patrick; Krause, Roland

    2015-01-01

    Epileptic encephalopathies are a phenotypically and genetically heterogeneous group of severe epilepsies accompanied by intellectual disability and other neurodevelopmental features 1-6 . Using next generation sequencing, we identified four different de novo mutations in KCNA2, encoding the potassium channel KV1.2, in six patients with epileptic encephalopathy (one mutation recurred three times independently). Four individuals presented with febrile and multiple afebrile, often focal seizure ...

  3. Are brief or recurrent transient global amnesias of epileptic origin?

    OpenAIRE

    Melo, T P; Ferro, J. M.; Paiva, T.

    1994-01-01

    To evaluate if short (less than one hour) or recurrent, or both, episodes of transient global amnesia (TGA) have an epileptic origin or carry a subsequent risk of epilepsy a group of patients with these types of TGA attacks was studied. The group was selected from a prospective series of 103 patients with TGA. Sixteen patients had an episode lasting less than one hour, 13 had more than one episode, and five patients had both short and recurrent attacks. For each patient the number of recurren...

  4. Compliance with treatment in adult patients with cystic fibrosis.

    OpenAIRE

    Conway, S P; Pond, M. N.; Hamnett, T.; Watson, A.

    1996-01-01

    BACKGROUND: Patients with chronic disease comply with about 50% of their treatment. The complex and time consuming daily drug regimens needed in the care of adult patients with cystic fibrosis encourage non-compliance with prescribed treatments. Understanding the reasons for, and the extent of, non-compliance is essential for a realistic appraisal of the patient's condition and sensible planning of future treatment programmes. METHODS: Patients were invited to complete a questionnaire which a...

  5. Complete remission of epileptic psychosis after temporal lobectomy: case report

    Directory of Open Access Journals (Sweden)

    Marchetti Renato Luiz

    2001-01-01

    Full Text Available We report a case of a female patient with refractory complex partial seizures since 15 years of age, recurrent postictal psychotic episodes since 35 which evolved to a chronic refractory interictal psychosis and MRI with right mesial temporal sclerosis (MTS. After a comprehensive investigation (video-EEG intensive monitoring, interictal and ictal SPECT, and a neuropsychological evaluation including WADA test she was submitted to a right temporal lobectomy. Since then, she has been seizure-free with remission of psychosis, although with some persistence of personality traits (hiperreligiosity, viscosity which had been present before surgery. This case supports the idea that temporal lobectomy can be a safe and effective therapeutic measure for patients with MTS, refractory epilepsy and recurrent postictal epileptic psychosis or interictal epileptic psychosis with postictal exacerbation.

  6. Pulmonary manifestations in adult patients with chronic granulomatous disease.

    Science.gov (United States)

    Salvator, Hélène; Mahlaoui, Nizar; Catherinot, Emilie; Rivaud, Elisabeth; Pilmis, Benoit; Borie, Raphael; Crestani, Bruno; Tcherakian, Colas; Suarez, Felipe; Dunogue, Bertrand; Gougerot-Pocidalo, Marie-Anne; Hurtado-Nedelec, Margarita; Dreyfus, Jean-François; Durieu, Isabelle; Fouyssac, Fanny; Hermine, Olivier; Lortholary, Olivier; Fischer, Alain; Couderc, Louis-Jean

    2015-06-01

    Chronic granulomatous disease (CGD) is a primary immunodeficiency caused by failure of superoxide production in phagocytic cells. The disease is characterised by recurrent infections and inflammatory events, frequently affecting the lungs. Improvement of life expectancy now allows most patients to reach adulthood. We aimed to describe the pattern of pulmonary manifestations occurring during adulthood in CGD patients. This was a retrospective study of the French national cohort of adult patients (≥16 years old) with CGD. Medical data were obtained for 67 adult patients. Pulmonary manifestations affected two-thirds of adult patients. Their incidence was significantly higher than in childhood (mean annual rate 0.22 versus 0.07, p=0.01). Infectious risk persisted despite anti-infectious prophylaxis. Invasive fungal infections were frequent (0.11 per year per patient) and asymptomatic in 37% of the cases. They often required lung biopsy for diagnosis (10 out of 30). Noninfectious respiratory events concerned 28% of adult patients, frequently associated with a concomitant fungal infection (40%). They were more frequent in patients with the X-linked form of CGD. Immune-modulator therapies were required in most cases (70%). Respiratory manifestations are major complications of CGD in adulthood. Noninfectious pulmonary manifestations are as deleterious as infectious pneumonia. A specific respiratory monitoring is necessary. PMID:25614174

  7. Comparison of Nutritional Parameters among Adult and Elderly Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Gülperi Çelik, Bahar Oc, Inci Kara, Mümtaz Yılmaz, Ali Yuceaktas, Seza Apiliogullari

    2011-01-01

    Full Text Available Aim: The aim of this study was to compare the nutritional biochemical parameters, prealbumin levels, and bioimpedance analysis parameters of adult and elderly hemodialysis (HD patients.Methods: This prospective cross-sectional study included 50 adult HD patients (42.0 % female. Nutritional status was assessed by post-dialysis multifrequency bioimpedance analysis (BIA, serum prealbumin and other nutritional biochemical parameters.Results: Mean age of patients was 57.4±15.1 years (range: 30-83 years and mean dialysis duration was 68.3 ± 54.5 months (range: 3-240 months. When the patients were divided into two groups according to age of patients (<65 and ≥65, prealbumin (p=0.003, blood urea nitrogen (BUN (p=0.000, serum creatinine (p=0.013, albumin (p=0.016, protein catabolic rate per normalized body weight (nPCR (p=0.001, intracellular water (ICW/total body weight (0.003 , body fat mass (p00.000, lean body mass (p=0.031, lean dry mass (p=0.001, illness marker (p=0.005, basal metabolism (p=0.007, body mass index (BMI (p=0.028, body fat mass index (BFMI (p=0.000, fat free mass index (FFMI (p=0.040 values were significantly different between the groups. In the elderly patients (age ≥65, body fat mass, illness marker, BMI, BFMI were higher compared to adult patients (age <65. Additionally, in the elderly patients, prealbumin, BUN, creatinine, albumin, nPCR, ICW/ total body weight, lean body weight, lean dry weight, basal metabolism and FFMI were lower than adult patients.Conclusions: Our results indicate that BFMI were higher, albumin, prealbumin, nPCR and lean body mass and FFMI were lower in elderly patients compared to adults. These results imply that elderly HD patients may be prone sarcopenic obesity and may require special nutritional support.

  8. [Diagnosis and treatment of non-triggered single epileptic seizures].

    Science.gov (United States)

    Martinez-Juarez, I E; Moreno, J; Ladino, L D; Castro, N; Hernandez-Vanegas, L; Burneo, J G; Hernandez-Ronquillo, L; Tellez-Zenteno, J F

    2016-08-16

    Epileptic seizures are one of the main reasons for neurological visits in an emergency department. Convulsions represent a traumatic event for the patient and the family, with significant medical and social consequences. Due to their prevalence and impact, the initial management is of vital importance. Although following the first epileptic seizure, early recurrence diminishes after establishing treatment with antiepileptic drugs, the forecast for developing epilepsy and long-term outcomes are not altered by any early intervention. Detailed questioning based on the symptoms of the convulsions, the patient's medical history and a full electroencephalogram and neuroimaging study make it possible to define the risk of recurrence of the seizure and the possible diagnosis of epilepsy. Epileptic abnormalities, the presence of old or new potentially epileptogenic brain lesions, as well as nocturnal seizures, increase the risk of recurrence. Physicians must assess each patient on an individual basis to determine the most suitable treatment, and explain the risk of not being treated versus the risk that exists if treatment with antiepileptic drugs is established. PMID:27439486

  9. Pontas positivas occipitais transitórias no eletrencefalograma de pacientes epilépticos submetidos a privação do sono Sleep occipital positive transient spikes seen at EEG of epileptic patients submitted to sleep deprivation

    Directory of Open Access Journals (Sweden)

    Gilson Edmar Gonçalves e Silva

    2007-06-01

    Full Text Available OBJETIVO: Comparar o aparecimento do grafoelemento de ponta positiva occipital transitória do sono em eletrencefalograma (EEG de pacientes epilépticos com e sem privação do sono, como método de ativação. MÉTODO: Foram analisados 40 EEG de 20 pacientes epilépticos com idade variando de 12 a 43 anos sendo 60% do sexo masculino, atendidos no Hospital das Clínicas da Universidade Federal de Pernambuco, no período de 1995 a 2000. Foram incluídos pacientes com epilepsia diagnosticada clinicamente e EEG sem alteração. Cada paciente foi submetido a um EEG sem privação de sono e outro após 36 horas de privação. O registro dos dois EEG foi separado por intervalo de 48 horas, obedecendo ao protocolo padrão. O efeito da privação do sono foi avaliado pelo aparecimento do grafoelemento PPOTS durante o estágio NREM do sono. RESULTADOS: No EEG sem privação do sono, a PPOTS foi identificada em 6 (30% pacientes no estágio I e em 1 (5% paciente em ambos os estágios I e II NREM. Após privação do sono, PPOTS estiveram ausentes em apenas um paciente, mas presentes em 25% casos no estágio I NREM e em 70%, nos estágios I e II NREM. CONCLUSÃO: O aumento da freqüência de PPOTS após privação do sono, parece indicar a existência da liberação de neurotransmissores excitatórios, o que pode contribuir significativamente para a investigação da excitabilidade cerebral.OBJECTIVE: To compare the presence of "sleep occipital positive transient spikes" (SOPTS in the electroencephalogram (EEG of epileptic patients without sleep deprivation (SD to those with SD, as an activation method. METHOD: The author analyzed 40 EEG of 20 epileptic patients, aging from 12 to 43 years, 60%, males. Those patients were attempted at the Clinics Hospital of Universidade Federal de Pernambuco, from 1995 to 2000. Every patient included in this study had epilepsy clinically diagnosed and all EEG without abnormalities. Each subject was submitted to one EEG

  10. Concordance of Epileptic Networks Associated with Epileptic Spikes Measured by High-Density EEG and Fast fMRI

    OpenAIRE

    Jäger, Vera; Dümpelmann, Matthias; LeVan, Pierre; Ramantani, Georgia; Mader, Irina; Schulze-Bonhage, Andreas; Jacobs, Julia

    2015-01-01

    Objective The present study aims to investigate whether a newly developed fast fMRI called MREG (magnetic resonance encephalography) measures metabolic changes related to interictal epileptic discharges (IED). For this purpose BOLD changes are correlated with the IED distribution and variability. Methods Patients with focal epilepsy underwent EEG-MREG using a 64 channel cap. IED voltage maps were generated using 32 and 64 channels and compared regarding their correspondence to the BOLD respon...

  11. Wilms Tumor: An Uncommon Entity in the Adult Patient

    Science.gov (United States)

    Mahmoud, Fade; Allen, M Brandon; Cox, Roni; Davis, Rodney

    2016-01-01

    Wilms tumor, the most common kidney tumor in children, is rarely seen in adults, making it a challenge for the adult oncologist to diagnose and treat. Unlike with renal cell carcinoma, patients with Wilms tumor should receive adjuvant chemotherapy with or without radiation therapy. Adult oncologists may not be familiar with pediatric oncology protocols, so it is important to consult with pediatric oncologists who have more experience in this disease. Multimodal therapy based on pediatric protocols improved the outcomes of adults with Wilms tumor worldwide. We report a rare case of a 24-year-old woman with a slow-growing mass of the left kidney during a 4-year period. The mass was surgically removed and final diagnosis confirmed by pathology to be Wilms tumor. The patient received adjuvant chemotherapy and has been free of disease since 2014. PMID:27043834

  12. Outpatient percutaneous renal biopsy in adult patients

    International Nuclear Information System (INIS)

    To study the safety and efficacy of performing percutanaeous renal biopsy in the outpatient department compared to the traditional inpatient policy, we studied 44 consecutive patients with proteinuria and other urinary sediment abnormalities, at King Fahd Hospital of the University, Al-Khobar, Saudi Arabia, during the period from September 2004 to August 2006. The patients were divided into two groups: group I, in whom kidney biopsy was performed and followed by 1-day hospital admission; and group II, in whom renal biopsy was performed in the outpatient department and followed by 6 hours observation period and then by regular outpatient visits. All biopsies were performed with the use of real-time ultrasound and automated biopsy needle. Patients with a history of bleeding diathesis or abnormal coagulation profile and those receiving warfarin, heparin, aspirin or nonsteroidal anti-inflammatory drugs were excluded from the study. Only minor biopsy-related complications such as gross hematuria, perinephric hematoma that resolved without the need for blood transfusion or surgical intervention occurred in three (13.6%) patients in group I and in two (9.1%) patients in group II. The complications were apparent within 6 hours in all but one patient (97.7%). Overall, hematuria was identified in 52% of patients at <-72 hours, 85% at <-4 hours and 97.7% at <- 6 hours. The 24-hour hematocrit levels were not significantly different between the study groups. One (4.5%) patient from group II had a small perinephric hematoma, which was detected by ultrasound examination at 24 hours but not at 6 hours post biopsy period; it resolved spontaneously without intervention. We conclude that in selected patients, same day discharge after 6 hours of renal biopsy may be given safety without increased risk of complications. (author)

  13. Orthodontic – prosthetic treatment of adult patients with forced

    OpenAIRE

    Radeska, Ana; Radeski, Josif; Zlatanovska, Katerina

    2012-01-01

    Introduction:Adult patient with forced progenia , bilateral hipodontia of maxillary lateral incisors, diastema mediana and cross bite of 2mm in front.Purpose:To present the interdisciplinary cooperation between orthodontist and prosthodontist in resolving malocclusions of this kind. Material and method: The patient ZH.K age 22 years with forced progenia , bilateral hipodontia of the maxillary lateral incisors and cross bite of 2mm in front. The patient was treated with active orthodontic mobi...

  14. Treatment with active orthodontic appliance in adult patient

    OpenAIRE

    Radeska, Ana; Radeski, Josif; Zlatanovska, Katerina; Papakoca, Kiro; Zarkova, Julija

    2012-01-01

    Aim: Showing the efficiency of orthodontic mobile appliance in treatment of adult patient Case summary: The patient A.K. Age 25 years whit forced progenia, bilateral hypodontia of the maxillary incisors and cross bite of 2 mm in front. The patient was treated with active orthodontic appliance whit bitten ridge and down labial arch. The treatment lasted 18 months after which periods is reached normal occlusion with normal overlap in front and closed diastema mediana. The hypodontia of the m...

  15. Serum 25 Hydroxy Vitamin D Levels In Adult Asthmatic Patients

    OpenAIRE

    Mostafa M. Shaaban*, Manal Hashem

    2012-01-01

    Purpose: Patients with chronic lung disease as asthma appear to be at increased risk for vitamin D deficiency for reasons that are not clear. Methods: A cross sectional study including 75 asthmatic adults aged older than 18 years and 75 adults healthy control aged older than 18 years (35 males and 40 females for both groups) assessing the relationship between serum 25 hydroxy vitamin D levels and lung function. Result: In our study only (12٫31%) of our asthmatic adults had sufficient vitamin...

  16. Iopentol for cardioangiography in adult patients

    International Nuclear Information System (INIS)

    Cineangiography of the left ventricle, the ascending aorta, and the coronary arteries was performed with iopentol 350 mg I/ml in an open Phase II trial in 11 patients with coronary artery disease. Iopentol was well tolerated, both subjectively by the patients, and as shown by evaluation of results in several haemodynamic, electrocardiographic and clinical chemical parameters. Films of high quality were obtained for all patients. Thereafter, a randomized double-blind Phase III study was performed in two comparable groups of patients, using the same procedures as in the open series. One group was examined with iopentol and the other with iohexol, both media with 350 mg I/ml. Iopentol was found to be well suited for cardioangiography and its properties appear similar to those of iohexol. (author). 8 refs.; 1 tab

  17. [Mesial temporal sclerosis syndrome in adult patients].

    Science.gov (United States)

    Consalvo, D; Giobellina, R; Silva, W; Rugilo, C; Saidón, P; Schuster, G; Kochen, S; Sica, R

    2000-01-01

    Magnetic resonance imaging (MRI) has become an essential tool in the work-up of epilepsy. Since its appearance it has been possible to identify pathologies, such as hippocampal sclerosis (HS), that had previously only been detected by histopathological assays. The aim of this study was to analyze the clinical manifestations, EEG and the outcome of patients with HS as shown by MRI. We revised the clinical histories of 384 outpatients from the Epilepsy Center, Ramos Mejía Hospital, who had been studied by MRI. Thirty five of them (15.5%) had a diagnosis of HS, based on the structural changes observed on the images. Six patients were excluded because of incomplete clinical data. Therefore, we studied 29 patients including 15 men. The mean age was 32.7 +/- 10.2 years (range: 19-58). All of them had partial seizures. Ten subjects had had febrile convulsions (34.5%) in childhood. Neurological examination was normal in all subjects. Interictal EEG showed focal abnormalities that were coincident in their location with the MRI abnormalities in 16 patients (55.1%). Fourteen patients (48.3%) showed right side hippocampal lesions on MRI, thirteen on the left side (44.9%) and 2 bilateral HS (6.8%). Twenty-seven patients (93.1%) had intractable epilepsy. Anterior temporal lobectomy was performed in 3 subjects with good outcome. The identification of these patients who present certain clinical and MRI characteristics, provides an opportunity to define the mesial temporal sclerosis syndrome. This could benefit patients in their prognosis and for specific treatments. PMID:10962804

  18. Assortative mixing in functional brain networks during epileptic seizures

    CERN Document Server

    Bialonski, Stephan

    2013-01-01

    We investigate assortativity of functional brain networks before, during, and after one-hundred epileptic seizures with different anatomical onset locations. We construct binary functional networks from multi-channel electroencephalographic data recorded from 60 epilepsy patients, and from time-resolved estimates of the assortativity coefficient we conclude that positive degree-degree correlations are inherent to seizure dynamics. While seizures evolve, an increasing assortativity indicates a segregation of the underlying functional network into groups of brain regions that are only sparsely interconnected, if at all. Interestingly, assortativity decreases already prior to seizure end. Together with previous observations of characteristic temporal evolutions of global statistical properties and synchronizability of epileptic brain networks, our findings may help to gain deeper insights into the complicated dynamics underlying generation, propagation, and termination of seizures.

  19. Current understanding and neurobiology of epileptic encephalopathies.

    Science.gov (United States)

    Auvin, Stéphane; Cilio, Maria Roberta; Vezzani, Annamaria

    2016-08-01

    Epileptic encephalopathies are a group of diseases in which epileptic activity itself contributes to severe cognitive and behavioral impairments above and beyond what might be expected from the underlying pathology alone. These impairments can worsen over time. This concept has been continually redefined since its introduction. A few syndromes are considered epileptic encephalopathies: early myoclonic encephalopathy and Ohtahara syndrome in the neonatal period, epilepsy of infancy with migrating focal seizures, West syndrome or infantile spasms, Dravet syndrome during infancy, Lennox-Gastaut syndrome, epileptic encephalopathy with continuous spikes-and-waves during sleep, and Landau-Kleffner syndrome during childhood. The inappropriate use of this term to refer to all severe epilepsy syndromes with intractable seizures and severe cognitive dysfunction has led to confusion regarding the concept of epileptic encephalopathy. Here, we review our current understanding of those epilepsy syndromes considered to be epileptic encephalopathies. Genetic studies have provided a better knowledge of neonatal and infantile epilepsy syndromes, while neuroimaging studies have shed light on the underlying causes of childhood-onset epileptic encephalopathies such as Lennox-Gastaut syndrome. Apart from infantile spasm models, we lack animal models to explain the neurobiological mechanisms at work in these conditions. Experimental studies suggest that neuroinflammation may be a common neurobiological pathway that contributes to seizure refractoriness and cognitive involvement in the developing brain. PMID:26992889

  20. Hematological abnormalities in adult patients with Down's syndrome.

    LENUS (Irish Health Repository)

    McLean, S

    2012-02-01

    BACKGROUND: There is a paucity of data regarding hematological abnormalities in adults with Down\\'s syndrome (DS). AIMS: We aimed to characterize hematological abnormalities in adult patients with DS and determine their long-term significance. METHODS: We retrospectively studied a cohort of nine DS patients referred to the adult hematology service in our institution between May 2001 and April 2008. Data collected were: full blood count (FBC), comorbidities, investigations performed, duration of follow-up and outcome to most recent follow-up. RESULTS: Median follow-up was 26 months (9-71). Of the nine patients, two had myelodysplastic syndrome (MDS) at presentation. Of these, one progressed, with increasing marrow failure, and requiring support with transfusions and gCSF. The remaining eight patients, with a variety of hematological abnormalities including leukopenia, macrocytosis, and thrombocytopenia, had persistently abnormal FBCs. However there was no evidence of progression, and no patient has evolved to acute myeloid leukemia (AML). CONCLUSIONS: MDS is a complication of DS and may require supportive therapy. However, minor hematological abnormalities are common in adult DS patients, and may not signify underlying marrow disease.

  1. Characterizing older adult patients suffering from epilepsy in two hospitals in Bogotá (Colombia

    Directory of Open Access Journals (Sweden)

    Gutiérrez-Álvarez AM

    2011-12-01

    Full Text Available Epilepsy’s overall prevalence in Colombia is 1.13%. Its prevalence in patients aged over 65 could be around 1.5%. Objective: describe demographic and clinical characteristics of patients older than 65 years of age with epilepsy. Materials and methods: A cross-sectional descriptive study was carried out in two high complexity hospitals in Bogotá, Colombia during 2005-2008. Demographic data were compiled and patients characterized regarding the type, frequency and diagnosis of seizures (based on ILAE classification, probable etiology, having a family background of epilepsy, and current pharmacological management. Results: 211 clinical histories were reviewed and 179 of them selected. Mean patient age was 75 (65-98 and average age at onset of epilepsy was 67.5 (7-93. 84% of the seizures were classified as being focal. The most frequently occurring diagnosis was symptomatic focal epilepsy (94.4%. 74 cases (41.3% had an etiological diagnosis. The most important cause was cerebrovascular disease (61 patients. First generation anti-epileptic drugs were the most used ones (99%. 81/104 patients were found not to be free from epileptic episodes. Conclusions: Most seizures have a partial beginning, resulting from symptomatic partial epilepsy as a consequence of a vascular lesion. Pharmacological treatment must be considered following the first seizure. Treatment with second generation anti-epileptic drugs such as Lamotrigine, Gabapentin, Levetiracetam and Topiramate must be begun for minimizing secondary effects and low doses must be maintained from the start of treatment. Costs may limit the use of the above antiepileptic drugs, in such cases Phenytoin and Carbamazepine may be used with extreme caution.

  2. Automatic Epileptic Seizure Onset Detection Using Matching Pursuit

    DEFF Research Database (Denmark)

    Sorensen, Thomas Lynggaard; Olsen, Ulrich L.; Conradsen, Isa;

    2010-01-01

    An automatic alarm system for detecting epileptic seizure onsets could be of great assistance to patients and medical staff. A novel approach is proposed using the Matching Pursuit algorithm as a feature extractor combined with the Support Vector Machine (SVM) as a classifier for this purpose. The...... combination of Matching Pursuit and SVM for automatic seizure detection has never been tested before, making this a pilot study. Data from red different patients with 6 to 49 seizures are used to test our model. Three patients are recorded with scalp electroencephalography (sEEG) and three with intracranial...

  3. Focal seizures and epileptic spasms in a child with Down syndrome from a family with a PRRT2 mutation.

    Science.gov (United States)

    Igarashi, Ayuko; Okumura, Akihisa; Shimojima, Keiko; Abe, Shinpei; Ikeno, Mitsuru; Shimizu, Toshiaki; Yamamoto, Toshiyuki

    2016-06-01

    We describe a girl with Down syndrome who experienced focal seizures and epileptic spasms during infancy. The patient was diagnosed as having trisomy 21 during the neonatal period. She had focal seizures at five months of age, which were controlled with phenobarbital. However, epileptic spasms appeared at seven months of age in association with hypsarrhythmia. Upon treatment with adrenocorticotropic hormone, her epileptic spasms disappeared. Her younger brother also had focal seizures at five months of age. His development and interictal electroencephalogram were normal. The patient's father had had infantile epilepsy and paroxysmal kinesigenic dyskinesia. We performed a mutation analysis of the PRRT2 gene and found a c.841T>C mutation in the present patient, her father, and in her younger brother. We hypothesized that the focal seizures in our patient were caused by the PRRT2 mutation, whereas the epileptic spasms were attributable to trisomy 21. PMID:26867511

  4. [Adult patients with congenital heart disease].

    Science.gov (United States)

    Grabitz, R G; Kaemmerer, H; Mohr, F-W

    2013-01-01

    Unlike a few decades ago, today most patients with congenital heart disease reach adulthood after intervention or reparative surgery. As complete correction is generally not possible, a patient population with great complexity and a particular challenge to medical management is rising and a regular follow-up is mandatory. The aim of care is the timely recognition of residual or associated problems. Frequency and intensity of follow-up examinations depend on type and complexity of the lesion. The standard repertoire at follow-up consists of a specific history, clinical examination, ECG, Holter-monitoring, exercise tests, and echocardiography. Depending on the indication, cardio-MRI, CT scan, and sophisticated cardiac catheterization may become necessary. Long-term complications like rhythm disturbances, pulmonary hypertension, or heart failure are frequent, despite optimal care. Acute complications like arrhythmias, infective endocarditis, cerebral events, cerebral abscesses, aortic dissection, pulmonary embolism, and bleeding have to be recognized early and treated appropriately. Additional focus has to be placed on counseling and management of noncardiac disease and surgery, pregnancy and delivery, exercise at work and in private life, driving, and insurance issues. Training and certification of physicians as well as the establishment of specialized centers will help to ensure high quality health care for the affected patient population. PMID:23318541

  5. Peculiarities of Anxiety Score Distribution in Adult Cancer Patients.

    Science.gov (United States)

    Blank, Mikhail; Blank, Olga; Myasnikova, Ekaterina; Denisova, Daria

    2015-01-01

    The goal of the present research is to investigate and analyze possible peculiarities of the psychological state of cancer patients undergoing treatment. Scores characterizing the trait and state anxiety were acquired using the Integrative Anxiety Test from four groups: adults with no appreciable disease, pregnant women, cancer patients examined during the specific antitumor treatment, and cancer patients brought into lasting clinical remission. Statistical analysis of the testing results revealed the bimodal type of the distribution of scores. The only statistically significant exception was the distribution of the state anxiety scores in cancer patients undergoing treatment that was clearly unimodal. PMID:26176239

  6. The role of astroglia in the epileptic brain

    Directory of Open Access Journals (Sweden)

    Gabriele eLosi

    2012-07-01

    Full Text Available Epilepsies comprise a family of multifactorial neurological disorders that affect at least 50 million people worldwide. Despite a long history of neurobiological and clinical studies the mechanisms that lead the brain network to a hyperexcitable state and to the intense, massive neuronal discharges reflecting a seizure episode are only partially defined. Most epilepsies of genetic origin are related to mutations in ionic channels that cause neuronal hyperexcitability. However, idiopathic epilepsies of unclear origin represent the majority of these brain disorders. A large body of evidence suggests that in the epileptic brain neurons are not the only players. Indeed, the glial cell astrocyte is known to be morphologically and functionally altered in different types of epilepsy. Although it is unclear whether these astrocyte dysfunctions can have a causative role in epileptogenesis, the hypothesis that astrocytes contribute to epileptiform activities recently received a considerable experimental support. Notably, currently used antiepileptic drugs (AEDs, that act mainly on neuronal ion channels, are ineffective in a large group of patients. Clarifying astrocyte functions in the epileptic brain tissue could unveil astrocytes as novel therapeutic targets. In this review we present first a short overview on the role of astrocytes in the epileptic brain starting from the historical observations on their fundamental modulation of brain homeostasis, such as the control of water content, ionic equilibrium and neurotransmitters concentrations. We then focus our review on most recent studies that hint at a distinct contribution of these cells in the generation of focal epileptiform activities.

  7. Efficacy of Attribution Retraining on Mental Health of Epileptic Children

    Science.gov (United States)

    Pourmohamadreza Tajrishi, Masoume; Abbasi, Saeid; Najafi Fard, Tahereh; Yousefi, Saheb; Mohammadi Malek Abadi, Athar; Delavar Kasmaei, Hosein

    2015-01-01

    Background: Epilepsy affects children’s quality of life and leads to social and mental problems. Promoting the mental health of children, especially epileptic ones, and preventing problems affecting them constitute major concerns for every country. Mental health promotion requires intervention programs. Objectives: We sought to assess the efficacy of attribution retraining on the mental health of epileptic children. Patients and Methods: The present study is a semi-experimental investigation with a pretest and posttest design and includes a control group. Thirty children, comprising 17 boys and 13 girls, were selected randomly from the Iranian epilepsy association in Tehran and assigned to experimental and control groups. They answered to the general health questionnaire (Goldberg and Hiller, 1979). The experimental group participated in 11 training sessions (twice a week; 45 minutes for each session) and received attribution retraining. The data were analyzed using the multiple analysis of covariance. Results: The findings showed that the experimental group, in comparison with the control group, experienced a reduction in physical symptoms, anxiety and insomnia, social dysfunction, and depression and an increase in mental health significantly (P < 0.01) after the training sessions. There were no significant differences, however, between the two groups at 6 weeks’ follow-up. Conclusions: Attribution retraining improved mental health in the epileptic children in our study. It, therefore, seems to be an appropriate intervention for promoting the mental health of children. PMID:26568854

  8. [Portable Epileptic Seizure Monitoring Intelligent System Based on Android System].

    Science.gov (United States)

    Liang, Zhenhu; Wu, Shufeng; Yang, Chunlin; Jiang, Zhenzhou; Yu, Tao; Lu, Chengbiao; Li, Xiaoli

    2016-02-01

    The clinical electroencephalogram (EEG) monitoring systems based on personal computer system can not meet the requirements of portability and home usage. The epilepsy patients have to be monitored in hospital for an extended period of time, which imposes a heavy burden on hospitals. In the present study, we designed a portable 16-lead networked monitoring system based on the Android smart phone. The system uses some technologies including the active electrode, the WiFi wireless transmission, the multi-scale permutation entropy (MPE) algorithm, the back-propagation (BP) neural network algorithm, etc. Moreover, the software of Android mobile application can realize the processing and analysis of EEG data, the display of EEG waveform and the alarm of epileptic seizure. The system has been tested on the mobile phones with Android 2. 3 operating system or higher version and the results showed that this software ran accurately and steadily in the detection of epileptic seizure. In conclusion, this paper provides a portable and reliable solution for epileptic seizure monitoring in clinical and home applications. PMID:27382736

  9. Emprego de mogadon endovenoso em pacientes epilépticos: estudo clínico e eletrencefalográfico Intravenous Mogadon in epileptic patients: clinical and etectrctencephalographic study

    Directory of Open Access Journals (Sweden)

    Michel Pierre Lison

    1968-12-01

    Full Text Available Mogadon endovenoso foi administrado a 12 pacientes com manifestações epilépticas freqüentes e/ou prolongadas, a 6 pacientes com encefalopatía epiléptica infantil com ponta-ondas difusas e a dois com epilepsia fotossensível. A droga mostrou-se eficaz no controle clínico e eletrencefalográfico dos diferentes tipos de crises em 11 dos 12 primeiros doentes, no controle clínico e eletrencefalográfico de 3 dos 6 pacientes com síndrome de Lennox e no controle das manifestações clínicas e eletrencefalográficas espontâneas e desencadeadas pela SLI nos dois últimos. O estudo limitou-se a pacientes com afecção cerebral crônica, desde que o mais freqüente efeito colateral da droga foi soñolencia. Os efeitos clínicos e eletrencefalográficos foram semelhantes àqueles obtidos com a administração parenteral do Valium. Aspectos particulares quanto à ação desta substância na síndrome de Lennox foram discutidos.Intravenous Mogadon was administred to 12 patients with frequent and/or prolonged seizures, to 6 patients with childhood epileptic encephalopathy with diffuse slow spike-waves, and to 2 with photic induced seizures. Clinically and electroencephalographically 11 of the first 12 patients were improved by the treatment; 3 of the 6 patients with Lennox syndrome were also improved, as well as the two with spontaneous and photic induced clinical and electroencephalographic disorders. Since drowsiness was the most frequent side effect of the drug, only patients with chronic cerebral disorders were used in this study. The clinical and electroencephalographic effects were similar to those of intravenous Valium. Some aspects of the action of this drug in the Lennox syndrome are discussed.

  10. Physical and psychosocial challenges in adult hemophilia patients with inhibitors

    OpenAIRE

    duTreil, Sue

    2014-01-01

    Sue duTreil Louisiana Center for Bleeding and Clotting Disorders, Tulane University Health Sciences Center, New Orleans, LA, USA Abstract: Numerous challenges confront adult hemophilia patients with inhibitors, including difficulty in controlling bleeding episodes, deterioration of joints, arthritic pain, physical disability, emotional turmoil, and social issues. High-intensity treatment regimens often used in the treatment of patients with inhibitors also impose significant scheduling, econ...

  11. Crisis homes for adult psychiatric patients

    DEFF Research Database (Denmark)

    Aagaard, Jørgen; Freiesleben, Michael; Foldager, Leslie

    2008-01-01

    INTRODUCTION: Inspired by the Crisis Home programme in Madison, we have adapted and evaluated the programme at the Community Mental Health (CMH) Centre in Tønder, Denmark. MATERIAL AND METHODS: Procedures and schedules from the Crisis Home programme were applied in this open trial. Questionnaire ...... and the referrers were very satisfied with the programme and the treatment. CONCLUSION: Crisis home stays represent a quality improvement in the treatment package, especially for patients with a more severe mental disorder. Further documentation will require a controlled study....

  12. Potential Harm of Prophylactic Platelet Transfusion in Adult Dengue Patients

    Science.gov (United States)

    Lee, Tau-Hong; Wong, Joshua G. X.; Leo, Yee-Sin; Thein, Tun-Linn; Ng, Ee-Ling; Lee, Linda K.; Lye, David C.

    2016-01-01

    Background Thrombocytopenia is a hallmark of dengue infection, and bleeding is a dreaded complication of dengue fever. Prophylactic platelet transfusion has been used to prevent bleeding in the management of dengue fever, although the evidence for its benefit is lacking. In adult dengue patients with platelet count 50,000/mm3 and increasing length of hospitalization. PMID:27015272

  13. A Future for Adult Educators in Patient Education

    Science.gov (United States)

    Fleming, Jean E.

    2014-01-01

    Adult education in healthcare comes in several forms: degree and certificate programs aimed at preparing better academic and clinical educators; and community education programs aimed at wellness, rehabilitation, or learning to live with chronic diseases. Patient-centered healthcare, however, is part of something new: coordinated and transitional…

  14. 妊高征子痫5例病人临床的抢救与护理%5 cases pregnancy-induced epileptic patients clinical emergency treatment and nursing care

    Institute of Scientific and Technical Information of China (English)

    王琼

    2012-01-01

      目的减少妊娠高血压综合征子痫发生及保证母婴健康.方法总结2009年本院发生分娩期子痫5例及13例产前、产后先兆子痫的临床资料.结论资料中5例子痫的病人均行剖宫产术,经过及时治疗、护理后,4例母婴平安出院.1例因产后病程反复产妇转院治疗.结论提高护士对妊高征临床护理水平,加强分娩期子痫及先兆子痫的护理及预防措施,确保母婴健康.%  Objective reduce the incidence of eclampsia in pregnancy-induced hypertension syndrome and ensure maternal and child health.Methods occurred in homes in 2009 delivery period 5 and 13 cases of antenatal eclampsia, postpartum preeclampsia clinical data.results in the 5 examples of epileptic patients have cesarean, after a process of timely treatment, care, and 4 cases of maternal hospital.course of 1 cases of postpartum maternal hospitals repeatedly.conclusions enhancing nurses ' clinical standard of care on pregnancy-induced hypertension, strengthening the nursing of eclampsia and pre-eclampsia childbirth and prevention measures to ensure maternal and child health.

  15. Reduced hippocampal dentate cell proliferation and impaired spatial memory performance in aged epileptic rats

    Directory of Open Access Journals (Sweden)

    Clarissa F Cavarsan

    2013-07-01

    Full Text Available Increased adult neurogenesis is observed after training in hippocampal-dependent tasks and also after acutely induced status epilepticus (SE although the specific roles of these cells are still a matter of debate. In this study, we investigated hippocampal cell proliferation and differentiation and the spatial learning performance in young or aged chronically epileptic rats. Status was induced by pilocarpine in 3 or 20-month old rats. Either two or twenty months later, rats were treated with bromodeoxyuridine (BrdU and subsequently underwent to 8-day schedule of water maze tests. As expected, learning curves were faster in young than in aged animals (P<0.001. Chronically epileptic animals exhibited impaired learning curves compared to age-matched controls. Interestingly, the duration of epilepsy (2 or 20 months did not correlate with the memory impairment of aged epileptic animals. The number of BrdU-positive cells was greater in young epileptic subjects than in age-matched controls. In contrast, cell proliferation was not increased in aged epileptic animals, irrespective of the time of SE induction. Finally, dentate cell proliferation was not related to performance in the water maze. Based on the present results we conclude that even though aging and epilepsy lead to impairments in spatial learning, their effects are not additive.

  16. Psychogenic non-epileptic seizures and psychoanalytical treatment: results

    Directory of Open Access Journals (Sweden)

    Niraldo de Oliveira Santos

    2014-12-01

    Full Text Available Background: the occurrence of psychogenic non-epileptic seizures (PNES is estimated to be between 2 to 33 cases in every 100,000 inhabitants. The number of patients with PNES reaches 19% of those treated as epileptics. Patients with PNES are treated as if they had intractable epilepsy, with unsatisfactory results even after medication treatment is used to its maximum. The aim of this study is to present the effects of individual psychoanalytical treatment in patients with PNES, assessing its impact in the evolution of the clinical picture and its association with sex, time of disease, social, psychological and professional harm, as well as going through with treatment. Methods: The case base was composed of 37 patients with PNES. The diagnosis was reached with video-EEG monitoring. Psychoanalytical treatment was carried out through 12 months of weekly sessions timed for around 50-minutes each, in a total of 48 individual sessions. Results: This study found a high rate of success in the treatment of PNES patients. 29.7% (n=11 of patients had cessation or cure of symptoms and 51.4% (n=19 had a decrease in the number of episodes. There is an association between cessation or decrease in the number of episodes and sex (p<0.01, religion (p<0.01 and concluding treatment (p<0.01. Conclusion: Individual psychoanalytical treatment applied to patients with PNES is considered effective and can be an essential form of assistance for the reduction or cessation of episodes.

  17. [Diagnosis and therapy of adult patients with facial asymmetry].

    Science.gov (United States)

    Takano-Yamamoto, Teruko; Kuroda, Shingo

    2009-09-01

    The goal of orthodontic treatment is to improve the patient's life by enhancing dental and jaw functions and dentofacial esthetics [Graber TM, et al., Orthodontics current principles and techniques. 4(e) ed. St Louis: Elsevier, 2005.]. Harmonious occlusion is achieved following improvements of malocclusion via orthodontic treatment [Ehmer U and Broll P, Int J Adult Orthod Orthognath Surg 1992;7:153-159. Throckmorton GS, et al., J Prosthet Dent 1984;51:252-261.]. Perfect facial symmetry is extremely rare, and normal faces have a degree of asymmetry. Patients with dentofacial deformity more frequently have asymmetry of the face and jaws. There was a relationship between the type of malocclusion and the prevalence of asymmetry; 28% of the Class III group, but 40% to 42% of the Class I, Class II and long face groups respectively, were asymmetric [Severt TR and Proffit WR, Int J Adult Orthod Orthogn Surg 1997;12:171-176.]; therefore, facial asymmetry is a common complaint among orthodontic patients. Treatment of severe facial asymmetry in adults consists mainly of surgically repositioning the maxilla or the mandible [Bardinet E, et al., Orthod Fr 2002;73:243-315. Guyuron B, Clin Plast Surg 1989;16:795-801. Proffit WR, et al., Contemporary treatment of dentofacial deformity. 2003. St Louis: Mosby, 2003:574-644.], however, new methods, i.e. orthodontic tooth movement with implant anchorage, have recently been introduced [Costa A, et al., Int J Adult Orthod Orthognath Surg 1998;3:201-209. Creekmore TD and Eklund MK, J Clin Orthod 1983;17:266-269. Miyawaki S,et al., Am J Orthod Dentofacial Orthop 2003;124:373-378. Park HS, et al., J Clin Orthod 2001;35:417-422. Roberts WE, et al., Angle Orthod 1989;59:247-256.], and various treatment options can be chosen in patients with facial asymmetry. In this article, we describe the diagnosis and treatment of adult patients with facial asymmetry. PMID:19726025

  18. Dose survey of pediatric and adult patients in Sudan

    International Nuclear Information System (INIS)

    A survey of radiation doses to children and adults from diagnostic radiography has been carried out in seven hospitals in Sudan. In four hospitals only pediatric examinations were died. In two hospitals only adult patients were recorded and in one hospital both kinds of patients (pediatric and adults) were evaluated. For pediatric patients only chest x-ray examination was evaluated and children were divided according to age ranges: from (0-1) and 5) years for chest AP only and from (5-10) and (10-15) for chest PA. For adult patients the examinations were chest AP and PA, abdomen AP and skull AP and PA. Entrance Surface Dose SD) and the Effective Dose (E) were calculated using the Dose Cal software. The mean ESD r children, measured in p.Gy, ranged from (45-53) and (53-56) for (0-1) and (1-5) years, respectively and from (55-71) and (68-85) for (5-10) and (10-15) years, respectively. In two of le pediatric hospitals the mean ESD values were greater than the CEC Reference Dose Levels. In El bulk and Si nar hospitals the values ranged from 167-261 and 186-308 μGy for the age ranges (0-1) and (1-5) respectively and 167-194 and 279-312 μGy for the age ranges of (5-10) and (10-15) respectively. For adult patients the ESD and E dose values evaluated in Alfisal hospital presented values comparable with the CEC Reference Dose Level. However for Alshorta hospital the values were higher for the chest AP and PA with results for ESD 0.446 and 0.551 mGy respectively

  19. Voltage synchronizations between multichannel electroencephalograms during epileptic seizures

    CERN Document Server

    Tuncay, Caglar

    2010-01-01

    The underlying dynamics for the electroencephalographic (EEG) recordings from humans but especially epilepsy patients are usually not completely known. However, the ictal activity is claimed to be characterized by synchronous oscillations in the brain voltages in the literature. These time dependent interdependencies (synchronization, coupling) between the EEG voltages from epileptogenic and non epileptogenic brain sites of nineteen focal epileptic patients are investigated in this work. It is found that strong synchronizationdesynchronization events occur in alternation during most of the investigated seizures. Thus, these seizures are detected with considerable sensitivity (71 of the 79 seizures).

  20. [Chemotherapy for brain tumors in adult patients].

    Science.gov (United States)

    Weller, M

    2008-02-01

    Chemotherapy has become a third major treatment option for patients with brain tumors, in addition to surgery and radiotherapy. The role of chemotherapy in the treatment of gliomas is no longer limited to recurrent disease. Temozolomide has become the standard of care in newly diagnosed glioblastoma. Several ongoing trials seek to define the role of chemotherapy in the primary care of other gliomas. Some of these studies are no longer only based on histological diagnoses, but take into consideration molecular markers such as MGMT promoter methylation and loss of genetic material on chromosomal arms 1p and 19q. Outside such clinical trials chemotherapy is used in addition to radiotherapy, e.g., in anaplastic astrocytoma, medulloblastoma or germ cell tumors, or as an alternative to radiotherapy, e.g., in anaplastic oligodendroglial tumors or low-grade gliomas. In contrast, there is no established role for chemotherapy in other tumors such as ependymomas, meningiomas or neurinomas. Primary cerebral lymphomas are probably the only brain tumors which can be cured by chemotherapy alone and only by chemotherapy. The chemotherapy of brain metastases follows the recommendations for the respective primary tumors. Further, strategies of combined radiochemotherapy using mainly temozolomide or topotecan are currently explored. Leptomeningeal metastases are treated by radiotherapy or systemic or intrathecal chemotherapy depending on their pattern of growth. PMID:18253773

  1. The Clinical and Neurophysiological Features of Epileptic Syndromes Associated with Benign Focal Epileptiform Discharges of Childhood

    Directory of Open Access Journals (Sweden)

    N. A. Ermolaenko

    2014-01-01

    Full Text Available Benign focal epileptiform discharge of childhood (BFEDC is an age-dependent pattern determined in electroencephalograms (EEGs, which is associated with idiopathic benign focal epilepsy (BFE. Studies of BFE revealed symptomatic phenocopies in patients with cerebral struc- tural abnormalities in such conditions as infantile cerebral palsy and malformations. Some arguments against the «benign» nature of BFEDC are presented, since BFEDC may impair various cognitive functions and behavior (e.g., cause epileptic encephalophathies. Objective. To determine the clinical and neurophysiological features of epileptic syndromes associated with prolonged epileptiform activity during sleep in children and adolescents, as well as approaches to rational therapy. Patients and Methods. A total of 1862 children aged 2–18 admitted to the specialized Department of Psychoneurology of the Voronezh Regional Children Clinical Hospital No 1 in 2004–2007, who had epileptic seizures and non-epileptic neurological disorders, were exam- ined. The children underwent assessment of the neurological status, neuropsychological assessment, and video-EEG monitoring. The spike- wave index (SWI was calculated and magnetic resonance imaging (MRI of the brain was performed to register the epileptiform activity during sleep. Results and Discussion. It was demonstrated that when ISW of BFEDC patterns is >30%, evolution into epileptic encephalopathy was observed in 66% of patients (including epilepsy with electrical status epilepticus in sleep in 49% of patients and cognitive epileptiform disinte- gration in 17% of patients. The results prove the justification of prescribing antiepileptic drugs to patients with SWI ≥30% even if they have no epileptic seizures. Duo-therapy with valproate and ethosuximide or levetiracetam is most the effective therapy. Further prospective studies for children with BFEDC will give new insight into this area. 

  2. Milrinone for cardiac dysfunction in critically ill adult patients

    DEFF Research Database (Denmark)

    Koster, Geert; Bekema, Hanneke J; Wetterslev, Jørn;

    2016-01-01

    review was performed according to The Cochrane Handbook for Systematic Reviews of Interventions. Searches were conducted until November 2015. Patients with cardiac dysfunction were included. The primary outcome was serious adverse events (SAE) including mortality at maximum follow-up. The risk of bias...... analyses displayed statistical and/or clinical heterogeneity of patients, interventions, comparators, outcomes, and/or settings and all featured missing data. DISCUSSION: The current evidence on the use of milrinone in critically ill adult patients with cardiac dysfunction suffers from considerable risks...

  3. [Psychogenic non-epileptic seizures: issues of comorbidity in the diagnosis and treatment].

    Science.gov (United States)

    Nikolaev, E L; Serli, T; Rezvyi, G

    2016-01-01

    The paper presents a case report of seizures in a man of 40 years who was assessed by neurologists and psychiatrists for 15 years. Due to the low efficacy of treatment and permanent health deterioration, the patient was recognized as disabled. Later initial diagnosis of psychogenic non-epileptic seizures was completed by comorbid diagnosis of bipolar affective disorder, type II. Treatment with lamotrigine improved the patient's condition. It has been regarded as a positive effect on organic changes in the brain that are associated with affective and epileptic disorders. PMID:27240050

  4. Long-term Effectiveness of Antiepileptic Drug Monotherapy in Partial Epileptic Patients: A 7-year Study in an Epilepsy Center in China

    Directory of Open Access Journals (Sweden)

    Fei Zhu

    2015-01-01

    Full Text Available Background: It is important to choose an appropriate antiepileptic drug (AED to manage partial epilepsy. Traditional AEDs, such as carbamazepine (CBZ and valproate (VPA, have been proven to have good therapeutic effects. However, in recent years, a variety of new AEDs have increasingly been used as first-line treatments for partial epilepsy. As the studies regarding the effectiveness of new drugs and comparisons between new AEDs and traditional AEDs are few, it is determined that these are areas in need of further research. Accordingly, this study investigated the long-term effectiveness of six AEDs used as monotherapy in patients with partial epilepsy. Methods: This is a retrospective, long-term observational study. Patients with partial epilepsy who received monotherapy with one of six AEDs, namely, CBZ, VPA, topiramate (TPM, oxcarbazepine (OXC, lamotrigine (LTG, or levetiracetam (LEV, were identified and followed up from May 2007 to October 2014, and time to first seizure after treatment, 12-month remission rate, retention rate, reasons for treatment discontinuation, and adverse effects were evaluated. Results: A total of 789 patients were enrolled. The median time of follow-up was 56.95 months. CBZ exhibited the best time to first seizure, with a median time to first seizure of 36.06 months (95% confidential interval: 30.64-44.07. CBZ exhibited the highest 12-month remission rate (85.55%, which was significantly higher than those of TPM (69.38%, P = 0.006, LTG (70.79%, P = 0.001, LEV (72.54%, P = 0.005, and VPA (73.33%, P = 0.002. CBZ, OXC, and LEV had the best retention rate, followed by LTG, TPM, and VPA. Overall, adverse effects occurred in 45.87% of patients, and the most common adverse effects were memory problems (8.09%, rashes (7.76%, abnormal hepatic function (6.24%, and drowsiness (6.24%. Conclusion: This study demonstrated that CBZ, OXC, and LEV are relatively effective in managing focal epilepsy as measured by time to first

  5. [Site and propagation of focal epileptic activity: multichannel MEG/EEG analysis].

    Science.gov (United States)

    Stefan, H; Abraham-Fuchs, K; Schüler, P; Schneider, S; Neubauer, P U; Huk, H J; Neundörfer, B

    1991-12-01

    Electrophysiological examinations provide the basis for a deeper pathophysiological understanding of focal epileptic activity. In addition to electroencephalography, magnetoencephalography from field measurements is now available for biomagnetic diagnosis. As magnetoencephalography (MEG) is basically better suited for the localization of focal epileptic activity than EEG, an increase in MEG measurements has taken place over the last years. In this study we discuss magnetic source localization which was combined with anatomical 3-D-MR-images and compared with the results of EEG-registration carried out simultaneously and with other investigative procedures of presurgical diagnosis. The results of investigation show that simultaneous magnetic field measurements over one hemisphere of the skull allow localization of sources both in the temporal lobe and in deeper areas of the brain. Furthermore, propagation of epileptic activity can be registered not only in neighbouring areas of the epileptogenic source but also in regions localized deeper in the temporal lobe. This opens new possibilities for presurgical evaluation as well as an understanding of partial and generalized epilepsies. The results of investigation show primary focal epileptic activity neocortex laterally or surrounding a mesio-temporal lesion in all investigated patients with partial (temporal, frontal) and secondary generalized epilepsies. Furthermore, a pattern of propagation of focal epileptic activity which is directed from neocortical-lateral to mediobasal-limbic brain structures is found in most of these patients. PMID:1795752

  6. Multi-Stage, Multi-Resolution Method for Automatic Characterization of Epileptic Spikes in EEG

    Directory of Open Access Journals (Sweden)

    Ganesan.M

    2010-06-01

    Full Text Available In this paper, a technique is proposed for the automatic detection of the spikes in long term 18 channel human electroencephalograms (EEG with less number of data set. The scheme for detecting epileptic and non epileptic spikes in EEG is based on a multi resolution, multi-level analysis and Artificial Neural Network(ANN approach. Wavelet Transform (WT is a powerful tool for signal compression, recognition, restoration and multi-resolutionanalysis of non-stationary signal. The signal on each EEG channel is decomposed into six sub bands using a non-decimated WT. Each sub band is analyzed by using a non-linear energy operator, in order to detect spikes. A parameter extraction stage extracts theparameters of the detected spikes that can be given as the input to ANN classifier. A robust system that combines multiple signal-processing methods in a multistage scheme, integratingwavelet transform and artificial neural network is proposed here. This system is experimented on a simulated EEG pattern waveform as well as with real patient data. The system is evaluated on testing data from 81 patients, totaling more than 800 hours of recordings.90.0% of the epileptic events were correctly detected and the detection rate of non epileptic events was 98.0%. We conclude that the proposed system has good performance in detecting epileptic form activities; further the multistage multiresolution approach is an appropriate way of automatic classification problems in EEG.

  7. ACG Clinical Guideline: Nutrition Therapy in the Adult Hospitalized Patient.

    Science.gov (United States)

    McClave, Stephen A; DiBaise, John K; Mullin, Gerard E; Martindale, Robert G

    2016-03-01

    The value of nutrition therapy for the adult hospitalized patient is derived from the outcome benefits achieved by the delivery of early enteral feeding. Nutritional assessment should identify those patients at high nutritional risk, determined by both disease severity and nutritional status. For such patients if they are unable to maintain volitional intake, enteral access should be attained and enteral nutrition (EN) initiated within 24-48 h of admission. Orogastric or nasogastric feeding is most appropriate when starting EN, switching to post-pyloric or deep jejunal feeding only in those patients who are intolerant of gastric feeds or at high risk for aspiration. Percutaneous access should be used for those patients anticipated to require EN for >4 weeks. Patients receiving EN should be monitored for risk of aspiration, tolerance, and adequacy of feeding (determined by percent of goal calories and protein delivered). Intentional permissive underfeeding (and even trophic feeding) is appropriate temporarily for certain subsets of hospitalized patients. Although a standard polymeric formula should be used routinely in most patients, an immune-modulating formula (with arginine and fish oil) should be reserved for patients who have had major surgery in a surgical ICU setting. Adequacy of nutrition therapy is enhanced by establishing nurse-driven enteral feeding protocols, increasing delivery by volume-based or top-down feeding strategies, minimizing interruptions, and eliminating the practice of gastric residual volumes. Parenteral nutrition should be used in patients at high nutritional risk when EN is not feasible or after the first week of hospitalization if EN is not sufficient. Because of their knowledge base and skill set, the gastroenterologist endoscopist is an asset to the Nutrition Support Team and should participate in providing optimal nutrition therapy to the hospitalized adult patient. PMID:26952578

  8. The Lombrosian prejudice in medicine. The case of epilepsy. Epileptic psychosis. Epilepsy and aggressiveness.

    Science.gov (United States)

    Granieri, Enrico; Fazio, Patrik

    2012-02-01

    In the nineteenth century, epilepsy became subject of experimental research. Lombroso established a relationship between epilepsy and criminality believing in the existence of epileptoid traits and atavism. He tried to demonstrate the common origin of epilepsy, criminality, and genius; factors deteriorating the CNS would act upon centers, which control behavior and ethics. This impairment would cause a lack of control on the lower nervous centers, reducing restraints of instincts and criminal behavior. He described developmental frontal cortex lesions in epileptic patients (today Taylor's dysplasia) and these observations supported the erroneous conviction of a relationship between criminality and epilepsy. Neurological, behavioral, and criminological sciences analyzed Lombroso's doctrine, whereas it was controversial that epileptic patients should be prone to violent actions and aggressive behavior. Today, there is an international panel of experts on epilepsy, which suggests five relevant criteria to determine if a crime committed with aggressiveness could result from epileptic seizures. PMID:21538126

  9. Ophthalmic disorders in adult lymphoma patients in Africa

    Directory of Open Access Journals (Sweden)

    Omoti Afekhide

    2009-01-01

    Full Text Available Context: Ocular manifestations of lymphoma are rare events. Most reports of ocular involvement in lymphoma are case reports or reports of a few patients. Aims: To determine the ophthalmic disorders in adult, African, lymphoma patients. Settings and Design: A prospective study of ocular disorders in adult patients with lymphoma was conducted at the University of Benin Teaching Hospital, Benin City, Nigeria, between July 2004 and June 2007. Materials and Methods: The patients were interviewed and examined by the authors and the ocular findings recorded. Statistical Analysis: Data was analyzed on computer with the aid of the Instat GraghPad™ v2.05a statistical package software. The mean, standard deviation, Mann-Whitney U-statistic and P value were calculated. Results: A total of 111 patients with hematological malignancies were seen over a period of three years of which 62 (55.85% had lymphomas. Of these, 51(82.3% were non-Hodgkin′s lymphoma and 11(17.7% were Hodgkin′s lymphoma. Ocular disorders occurred in 16 patients (31.4% with non-Hodgkin′s lymphoma and none of the patients with Hodgkin′s lymphoma (Mann-Whitney U-statistic is equal to 7.500, U′ is equal to161.50, P , 0.0001. The ocular disorders due to non-Hodgkin′s lymphoma were seen as - proptosis in six patients (11.8%, retinopathies in three (5.9%, conjunctival infiltration in three (5.9%, optic atrophy in two (3.9%, keratoconjunctivitis in one (two per cent, desquamating nodular lid lesions in one (two per cent, papilloedema in one (two per cent, and upper lid mass in one (two per cent. Four patients (6.5% had monocular blindness. Conclusions: Ophthalmic disorders are relatively common in non-Hodgkin′s lymphoma. Ophthalmic evaluation is needed in these patients for early identification and treatment of potentially blinding conditions.

  10. Slow resolution of inflammation in severe adult dengue patients

    OpenAIRE

    Zhao, Lingzhai; Huang, Xiuyan; Hong, Wenxin; Qiu, Shuang; Wang, Jian; Yu, Lei; Zeng, Yaoying; Tan, Xinghua; Zhang, Fuchun

    2016-01-01

    Background The pathogenesis of severe dengue has not been fully elucidated. The inflammatory response plays a critical role in the outcome of dengue disease. Methods In this study, we investigated the levels of 17 important inflammation mediators in plasma collected from mild or severe adult dengue patients at different time points to understand the contribution of inflammation to disease severity and to seek experimental evidence to optimize the existing clinical treatment strategies. Patien...

  11. The giant cyst of urachus present in the adult patient

    International Nuclear Information System (INIS)

    The urachus cyst is a congenital anomaly included among lesions originated by local or partial resistance of this duct. Is mainly diagnosed during infancy and its main complication is the infection. Authors present the case of an adult patient presenting with a cystic giant abdominal tumor, diagnosed as of urachal origin and treated by surgery. This matter is reviewed emphasizing on main features of disease treatment. (Author)

  12. Psychogenic non-epileptic seizures: management and prognosis

    OpenAIRE

    Irwin, K.; Edwards, M.; Robinson, R

    2000-01-01

    AIM—To determine the outcome and identify predictive factors in children with psychogenic non-epileptic seizures (PNES).
METHOD—The biographies of 35 children with PNES, attending a tertiary paediatric neurology centre, were reviewed.
RESULTS—Thirty five children attending the department between 1987 and 1997 were evaluated at a mean follow up of 4.6 years. The age range was 6-18 years. Twenty four were girls and 11 were boys. Eleven patients had a diagnosis of epilepsy with...

  13. De novo mutations in the classic epileptic encephalopathies

    OpenAIRE

    ,

    2013-01-01

    Epileptic encephalopathies (EE) are a devastating group of severe childhood epilepsy disorders for which the cause is often unknown. Here, we report a screen for de novo mutations in patients with two classical EE: infantile spasms (IS, n=149) and Lennox-Gastaut Syndrome (LGS, n=115). We sequenced the exomes of 264 probands, and their parents, and confirmed 329 de novo mutations. A likelihood analysis showed a significant excess of de novo mutations in the ~4,000 genes that are the most intol...

  14. Osteosarcoma in Adult Patients Living with HIV/AIDS

    Science.gov (United States)

    Marais, Leonard C.; Ferreira, Nando

    2013-01-01

    Background. HIV infection has reached epidemic proportions in South Africa, with an estimated prevalence of 21.5% in adults living in the province of KwaZulu-Natal. Several malignancies have been identified as part of the spectrum of immunosuppression-related manifestations of HIV infection. Very few reports, however, exist regarding the occurrence of non-AIDS-defining sarcomas in the extremities or limb girdles. Methods. A retrospective review was performed on all adult patients, between the ages of 30 and 60 years, with histologically confirmed osteosarcomas of the appendicular skeleton referred to a tertiary-level orthopaedic oncology unit. Results. Five out of the nine patients (62.5%) included in the study were found to be HIV positive. The average CD4 count of these patients was 278 (237–301) cells/mm3, indicating advanced immunological compromise. Three of the malignancies in HIV-positive patients occurred in preexisting benign or low-grade tumours. Conclusion. A heightened index of suspicion is required in HIV patients presenting with unexplained bone and joint pain or swelling. Judicious use of appropriate radiological investigation, including magnetic resonance imaging of suspicious lesions and timely referral to an appropriate specialized orthopaedic oncology unit, is recommended. PMID:23762607

  15. Migração de 81 epilépticos entre as modalidades de trabalho, desemprego e aposentadoria: três anos de seguimento ambulatorial Migration in different sorts of work, unemployment and retirement of 81 epileptic patients: three-year follow-up study

    Directory of Open Access Journals (Sweden)

    MOACIR ALVES BORGES

    2000-03-01

    Full Text Available O objetivo deste estudo foi avaliar as migrações dos epilépticos entre modalidades de trabalho remunerado (formal e informal, o não remunerado e, também, os desempregados e aposentados. Foram analisados evolutivamente (coort 81 pacientes com epilepsia, do Ambulatório de Epilepsia do Hospital de Base de São José do Rio Preto, SP. As percentagens de epilépticos em cada uma das modalidades em março 1996 foram comparadas com as percentagens obtidas por ocasião da última avaliação no transcorrer de 3 anos. A percentagem de epilépticos nas mesmas modalidades não sofreram mudanças estatisticamente significantes. Entretanto, houve importantes migrações entre diferentes modalidades de trabalho, para o desemprego e para aposentadoria. A presente pesquisa mostra a tendência de migração de pacientes epilépticos para diferentes modalidades de trabalho de menor qualificação e segurança social ou para aposentadoria precoce.This study aims to assess epileptic patients migration in different sorts of paid/non paid and formal/informal work, unemployment and retirement. Eighty one epileptic patients were evolutively analyzed (cohort at the Epilepsy Department of Hospital de Base, Medical School, São José do Rio Preto, Brazil. The epileptic percentages in different sorts of work, in March 1996 was compared with the one after three-year follow-up period in March 1999. There were no statistical significant changes among the same sorts of work in this period. However, there were intense migrations in relation to different sorts of work. Paid work showed migration to unemployment and retirement. This research shows the significant migration of epileptic patient either to some kind of a less qualified work or to some social security dependence as well as to early retirement.

  16. Focal epilepsies in adult patients attending two epilepsy centers

    DEFF Research Database (Denmark)

    Gilioli, Isabella; Vignoli, Aglaia; Visani, Elisa;

    2012-01-01

    PURPOSE: To classify the grade of antiepileptic drug (AED) resistance in a cohort of patients with focal epilepsies, to recognize the risk factors for AED resistance, and to estimate the helpfulness of "new-generation" AEDs. METHODS: We included 1,155 adults with focal epilepsies who were observed...... consecutively after 1990 and followed regularly at two epilepsy centers. We systematically collected the clinical, diagnostic, and therapeutic data using a custom-written database. We classified the patients as seizure-free or AED resistant according to the International League Against Epilepsy (ILAE) criteria...... the 729 patients with symptomatic focal epilepsies and was positively associated with electroencephalography (EEG) abnormalities, seizure type, and the presence of mesial temporal sclerosis. Among 426 patients without detectable causes, the percentage of AED resistance was significantly lower (39...

  17. Knowledge and attitude of Iranian community pharmacists about the pharmaceutical care for epileptic females

    International Nuclear Information System (INIS)

    This study was designed to evaluate the knowledge and attitude of a cohort of Iranian community pharmacists about the pharmaceutical care indexes and drug therapy in female epileptic patients. Methodology: This cross-sectional study was conducted in Iran (2011) and one hundred and twenty two community pharmacists were randomly selected using clustering method for sampling. A self-administered questionnaire which was originally made by a clinical pharmacy focus group was used. This questionnaire had 10 true/false questions for knowledge assessing (Spearman-Brown coefficient, 0.65) and 19 attitude statements (with Likert scale) about the intention of pharmacists for providing pharmaceutical care for epileptic females (Croanbach's alpha, 0.802). Face and content validity for both parts of the questionnaire were performed before the study. Results: There was a significant inverse relationship between pharmacists' knowledge on pharmaceutical care for epileptic females and the time elapsed from their graduation date. Considering the minimum passing score of 5, 85% of pharmacists did not have enough knowledge. The range of pharmacists' attitude scores was 35 to 64 and its mean was 46.09. Regarding the minimum passing score of 45, 63.3% of pharmacists had positive attitude to AEDs in epileptic females. Conclusion: It seems that the pharmaceutical care for epileptic females is a missing part of Pharmacy education. It is highly recommended to pay special attention to this topic in continuing education programs for Iranian pharmacists. (author)

  18. Factors related to orthodontic treatment time in adult patients

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    Ana Camila Esteves de Oliveira Melo

    2013-10-01

    Full Text Available INTRODUCTION: The length of time that it takes an orthodontist to treat adult patients varies widely. OBJECTIVE: The aim of this study was to investigate how different variables influence treatment time. METHODS: Seventy clinical case reports of successfully treated adult patients were examined. The patients were selected from 4,723 records held by three experienced orthodontists. The influence exerted by the following variables on treatment time was assessed: age, sex, facial pattern, severity of malocclusion (measured by the PAR index, sagittal relationship of canines, type of brackets (ceramic or metal, tooth extractions, missed appointments and orthodontic appliance issues/breakages, the latter being the dependent variable. Assessment was performed by multiple linear regression analysis, followed by the stepwise method with P < 0.05. RESULTS: The number of times a patient missed their appointment (no-show (R² = 14.4%, p < 0.0001 and the number of appliance issues/breakages (R² = 29.71%, p = 0.0037 significantly affected variability in treatment time, and these two variables together can predict 43.75% (R² total of the overall variability in treatment time. Other factors, such as canine relationship at the beginning of treatment, bracket type (metal or ceramic, tooth extractions, age at start of treatment, severity of the initial malocclusion, sex and facial pattern had no significant bearing on treatment time. CONCLUSIONS: The duration of orthodontic treatment in adults, when performed by experienced orthodontists, is mainly influenced by factors related to patient compliance. However, several factors which were not included in this study may contribute to variability in orthodontic treatment time.

  19. Experimental identification of potential falls in older adult hospital patients.

    Science.gov (United States)

    Cloutier, Aimee; Yang, James; Pati, Debajyoti; Valipoor, Shabboo

    2016-05-01

    Patient falls within hospitals have been identified as serious but largely preventable incidents, particularly among older adult patients. Previous literature has explored intrinsic factors associated with patient falls, but literature identifying possible extrinsic or situational factors related to falls is lacking. This study seeks to identify patient motions and activities along with associated environmental design factors in a patient bathroom and clinician zone setting that may lead to falls. A motion capture experiment was conducted in a laboratory setting on 27 subjects over the age of seventy using scripted tasks and mockups of the bathroom and clinician zone of a patient room. Data were post-processed using Cortex and Visual3D software. A potential fall was characterized by a set of criteria based on the jerk of the upper body׳s center of mass (COM). Results suggest that only motion-related factors, particularly turning, pushing, pulling, and grabbing, contribute most significantly to potential falls in the patient bathroom, whereas only pushing and pulling contribute significantly in the clinician zone. Future work includes identifying and changing precise environmental design factors associated with these motions for an updated patient room and performing motion capture experiments using the new setup. PMID:26920507

  20. [Psychodynamic aspects of the epileptic experience].

    Science.gov (United States)

    Mazza, S; Azzoni, A

    1989-01-01

    The authors deal with the problem of epileptic manifestations from a psychodynamic point of view. The complex aspects of "mind-body" relationship are pointed out. Starting from Freud's theory, several interpretations of the epileptic experience are reviewed. A special attention is drawn to Bion's theory of "protomental apparatus". The authors conclude that it is possible to integrate neuro-physiologic data with psychic aspects of the phenomenon, through a search of its roots in the early phases of Self-setting. PMID:2467374

  1. Patterns of muscle activation during generalized tonic and tonic–clonic epileptic seizures

    DEFF Research Database (Denmark)

    Conradsen, Isa; Wolf, Peter; Sams, Thomas; Sørensen, Helge Bjarup Dissing; Beniczky, Sándor

    2011-01-01

    Purpose: Tonic seizures and the tonic phase of tonic–clonic epileptic seizures are defined as “sustained tonic” muscle contraction lasting a few seconds to minutes. Visual inspection of the surface electromyogram (EMG) during seizures contributed considerably to a better understanding and accurate...... diagnosis of several seizure types. However, quantitative analysis of the surface EMG during the epileptic seizures has received surprisingly little attention until now. The aim of our study was to elucidate the pathomechanism of the tonic muscle activation during epileptic seizures. Methods: Surface EMG...... was recorded from the deltoid muscles, on both sides, during 63 seizures from 20 patients with epilepsy (10 with generalized tonic and 10 with tonic–clonic seizures). Twenty age‐ and gender‐matched normal controls simulated 100 generalized tonic seizures. To characterize the signal properties we...

  2. Magnetic resonance imaging in relation to EEG epileptic foci in tuberous sclerosis

    International Nuclear Information System (INIS)

    In 20 patients with tuberous sclerosis (TS), who were sequentially treated for epilepsy at our clinic, the high signal lesions in the cerebral cortex and subcortex detected on T2 weighted magnetic resonance imaging (MRI) were compared with the interictal EEG findings. In four cases who showed a unilateral distribution of the MRI lesions, there was a good correlation between the laterality of the affected lobes and the localization of the EEG epileptic foci. Thirteen cases with more than four affected lobes in both hemispheres also showed bilateral epileptic foci on EEG. The MRI lesions in the occipital lobes showed the best correlation with the EEG epileptic foci, while the worst correlation was seen in the frontal lobes. In addition, the cases with four or more affected lobes without laterality on MRI are more likely to show bilateral synchronization on EEG. The prognosis of epilepsy in these cases was found to be rather poor. (author)

  3. Neurocisticercose em pacientes internados por epilepsia no Hospital Regional de Chapecó região oeste do Estado de Santa Catarina Prevalence of neurocysticercosis among epileptic in-patients in the west of Santa Catarina - Southern Brazil

    Directory of Open Access Journals (Sweden)

    PAULO CESAR TREVISOL-BITTENCOURT

    1998-03-01

    evaluate NC as aetiology of epilepsy in the west of Santa Catarina. This state belong to southern Brazil and it has a very developed economy. However, due the widespread swine farming in the west district, many of them without any sanitary control, the national health authorities have considered all this area at risk to NC. The study was carried out in Chapecó, the main town in that region, where CT Scan service was started in 1995. All patients put on hospital care due epileptic seizures in 1995-96 were considered. Febrile convulsions were excluded of the sample. We found a very expressive prevalence rate of NC among patients suffering from epilepsy. Roughly 24% of these patients, showed unequivocal tomography evidences for the diagnosis of NC. Our data suggest cysticercosis as a real endemic trouble in the area and, overdosis of information in proper language, diffuse to the whole population, seems to be the only remedy to fight against it. Moreover, we should pay special attention to everyone related to swine farming, does not matter how this activity has been classificated.

  4. Biallelic CACNA1A mutations cause early onset epileptic encephalopathy with progressive cerebral, cerebellar, and optic nerve atrophy.

    Science.gov (United States)

    Reinson, Karit; Õiglane-Shlik, Eve; Talvik, Inga; Vaher, Ulvi; Õunapuu, Anne; Ennok, Margus; Teek, Rita; Pajusalu, Sander; Murumets, Ülle; Tomberg, Tiiu; Puusepp, Sanna; Piirsoo, Andres; Reimand, Tiia; Õunap, Katrin

    2016-08-01

    The CACNA1A gene encodes the transmembrane pore-forming alpha-1A subunit of the Cav 2.1 P/Q-type voltage-gated calcium channel. Several heterozygous mutations within this gene, including nonsense mutations, missense mutations, and expansion of cytosine-adenine-guanine repeats, are known to cause three allelic autosomal dominant conditions-episodic ataxia type 2, familial hemiplegic migraine type 1, and spinocerebellar ataxia type 6. An association with epilepsy and CACNA1A mutations has also been described. However, the link with epileptic encephalopathies has emerged only recently. Here we describe two patients, sister and brother, with compound heterozygous mutations in CACNA1A. Exome sequencing detected biallelic mutations in CACNA1A: A missense mutation c.4315T>A (p.Trp1439Arg) in exon 27, and a seven base pair deletion c.472_478delGCCTTCC (p.Ala158Thrfs*6) in exon 3. Both patients were normal at birth, but developed daily recurrent seizures in early infancy with concomitant extreme muscular hypotonia, hypokinesia, and global developmental delay. The brain MRI images showed progressive cerebral, cerebellar, and optic nerve atrophy. At the age of 5, both patients were blind and bedridden with a profound developmental delay. The elder sister died at that age. Their parents and two siblings were heterozygotes for one of those pathogenic mutations and expressed a milder phenotype. Both of them have intellectual disability and in addition the mother has adult onset cerebellar ataxia with a slowly progressive cerebellar atrophy. Compound heterozygous mutations in the CACNA1A gene presumably cause early onset epileptic encephalopathy, and progressive cerebral, cerebellar and optic nerve atrophy with reduced lifespan. © 2016 Wiley Periodicals, Inc. PMID:27250579

  5. Optic Neuritis in an Adult Patient with Chickenpox

    Directory of Open Access Journals (Sweden)

    Ana Rita Azevedo

    2012-01-01

    Full Text Available Central nervous system involvement in a patient with primary infection with Varicella zoster virus is rare, especially in the immunocompetent adult. In particular, isolated optic neuritis has been described in a small number of cases. The authors present a case of optic neuritis in an immunocompetent patient. A 28-year-old woman presented to the emergency room with a history of headaches during the previous week, without visual symptoms. The examination was unremarkable, except for a rash suggestive of chickenpox and hyperemic and edematous optic disc, bilaterally. Visual acuity and neurological examination were normal. Two days later, she complained of pain on eye movement and decreased visual acuity, which was 20/32 in her right eye and 20/60 in her left eye. Four days after admission, her visual acuity started to improve, and two months later, she had 20/20 visual acuity in both eyes. To our knowledge, this is the first reported case of an immunocompetent adult in which a Varicella zoster virus associated optic neuritis presented with fundoscopic changes before decreased visual acuity. This suggests that this condition may be underdiagnosed in asymptomatic patients.

  6. SIRT1 expression and activity are up-regulated in the brain tissue of epileptic patients and rat models%SIRT1在癫痫患者及大鼠脑组织中的表达与活性

    Institute of Scientific and Technical Information of China (English)

    陈永平; 谢运兰; 王衡; 陈阳美

    2013-01-01

    Objective To investigate the expression and activity of silent information regulator 1 (SIRT1) in the temporal lobe of epileptic patients and rat models and explore its role in the occurrence and progression of epilepsy. Methods The temporal lobe tissue of epileptic patients and rat models (induced by lithium-pilocarpine) were examined for SERT1 expression using immunohistochemistry and Western blotting and also for SIRT1 activity using SIRT1 Deacetylase Assay Kit. Results Immunohistochemistry detected positive SIRT1 expression mainly in the cytoplasm of the neurons in both human and rat brains, and the epileptic groups showed stronger SIRT1 immunoreactivity than the control group. Western blotting and activity assay showed that the expression and activity of SIRT1 were significantly increased in the temporal lobe of patients with refractory epilepsy as compared with the tissues samples from non-epileptic patients (P0.05). In the rat models of epilepsy, SIRT1 expression was up-regulated at 6, 24, and 72 h and at 7,14, 30, and 60 days after kindling (P<0.05) and SIRT1 activity was significantly increased at 6, 24, and 72 h and at 7 and 14 days (P0.05), with the peak level of SIRT1 expression and activity occurring at 72 h. Conclusion Up-regulation of SIRT1 expression and activity in the temporal lobe of epileptic patients and rat models may play an important role in the pathogenesis of epilepsy.%目的 研究沉默信号调控因子1 (SIRT1)在难治性癫痫患者及癫痫大鼠颞叶脑组织中的表达与活性,探讨其与癫痫发生发展的关系.方法 在难治性癫痫患者及氯化锂-匹罗卡品癫痫大鼠颞叶脑组织中,应用蛋白免疫组织化学、免疫印迹技术检测其表达情况,应用SIRT1去乙酰化活性检测试剂盒检测其活性.结果 蛋白免疫组化结果显示:SIRT1主要表达于人与大鼠神经元细胞浆中,且癫痫组SIRT1的表达明显强于对照组.蛋白免疫印迹及活性检测结果显示:相对

  7. Reduced Hippocampal Dentate Cell Proliferation and Impaired Spatial Memory Performance in Aged-Epileptic Rats

    OpenAIRE

    LucieneCovolan; ClaudioM TQueiroz; JairGuilhermeSantos; GilbertoFXavier

    2013-01-01

    Increased adult neurogenesis is observed after training in hippocampal-dependent tasks and also after acutely induced status epilepticus (SE) although the specific roles of these cells are still a matter of debate. In this study, we investigated hippocampal cell proliferation and differentiation and the spatial learning performance in young or aged chronically epileptic rats. Status was induced by pilocarpine in 3 or 20-month old rats. Either two or twenty months later, rats were treated with...

  8. Epileptic aura and perception of self-control

    DEFF Research Database (Denmark)

    Lohse, Allan; Kjaer, Troels W; Sabers, Anne;

    2015-01-01

    OBJECTIVE: The health locus of control is the subjective perception of control over one's health. It has been studied for years as one of several factors that determine patient health-related behaviors. The aim of this study was to investigate how the epileptic aura is associated with the health...... locus of control, anxiety, and depression. METHODS: Patients were included retrospectively, based on patient records from the epilepsy monitoring unit of the Rigshospitalet University Hospital. Participants were asked about the presence and nature of auras in a semistructured interview....... The Multidimensional Health Locus of Control Scale, Form C was used to evaluate the health locus of control. Three domains were evaluated: internal, where health is controlled by personal action; chance, where health is controlled by fate or luck; and powerful others, where health is controlled by the actions...

  9. Expression of mRNA coding voltage - gated sodium channel α-subunit in spontaneously epileptic rat

    Institute of Scientific and Technical Information of China (English)

    DUWa; CAIJi-Qun

    2004-01-01

    OBJECTIVE Subtypes Ⅰ,Ⅱ and Ⅲ of sodium channel α- subunit mRNA were analyzed in adult rat brain of spontaneously epileptic rats, and investigated the relationship between sodium channel expression and epilepsy. METHODS Tissue samples were microdissected from occipital neocortex, CA1 and CA3 hippocampus areas and dentate gyms, observe

  10. Dynamic imaging of coherent sources reveals different network connectivity underlying the generation and perpetuation of epileptic seizures.

    Directory of Open Access Journals (Sweden)

    Lydia Elshoff

    Full Text Available The concept of focal epilepsies includes a seizure origin in brain regions with hyper synchronous activity (epileptogenic zone and seizure onset zone and a complex epileptic network of different brain areas involved in the generation, propagation, and modulation of seizures. The purpose of this work was to study functional and effective connectivity between regions involved in networks of epileptic seizures. The beginning and middle part of focal seizures from ictal surface EEG data were analyzed using dynamic imaging of coherent sources (DICS, an inverse solution in the frequency domain which describes neuronal networks and coherences of oscillatory brain activities. The information flow (effective connectivity between coherent sources was investigated using the renormalized partial directed coherence (RPDC method. In 8/11 patients, the first and second source of epileptic activity as found by DICS were concordant with the operative resection site; these patients became seizure free after epilepsy surgery. In the remaining 3 patients, the results of DICS / RPDC calculations and the resection site were discordant; these patients had a poorer post-operative outcome. The first sources as found by DICS were located predominantly in cortical structures; subsequent sources included some subcortical structures: thalamus, Nucl. Subthalamicus and cerebellum. DICS seems to be a powerful tool to define the seizure onset zone and the epileptic networks involved. Seizure generation seems to be related to the propagation of epileptic activity from the primary source in the seizure onset zone, and maintenance of seizures is attributed to the perpetuation of epileptic activity between nodes in the epileptic network. Despite of these promising results, this proof of principle study needs further confirmation prior to the use of the described methods in the clinical praxis.

  11. Psychopharmacological options for adult patients with anorexia nervosa.

    Science.gov (United States)

    Miniati, Mario; Mauri, Mauro; Ciberti, Agnese; Mariani, Michela Giorgi; Marazziti, Donatella; Dell'Osso, Liliana

    2016-04-01

    The aim of this review was to summarize evidence from research on psychopharmacological options for adult patients with anorexia nervosa (AN). Database searches of MEDLINE and PsycINFO (from January 1966 to January 2014) were performed, and original articles published as full papers, brief reports, case reports, or case series were included. Forty-one papers were screened in detail, and salient characteristics of pharmacological options for AN were summarized for drug classes. The body of evidence for the efficacy of pharmacotherapy in AN was unsatisfactory, the quality of observations was questionable (eg, the majority were not blinded), and sample size was often small. More trials are needed, while considering that nonresponse and nonremission are typical of patients with AN. PMID:26145463

  12. Techniques and radiation dose in CT examinations of adult patients

    International Nuclear Information System (INIS)

    The use of CT in medical diagnosis delivers radiation dose to patients that are higher than those from other radiological procedures. Lake of optimized protocols could be an additional source of increased dose. The aim of this study was to measure radiation doses in CT examination of the adults in three Sudanese hospitals. Details were obtained from approximately 160 CT examination carried out in 3 hospitals (3 CT scanners). Effective dose was calculated for each examination using CT dose indices. exposure related parameters and CT D1- to- effective dose conversion factors. CT air kerma index (CT D1) and dose length products (DLP) determined were below the established international reference dose levels. The mean effective doses in this study for the head, chest, and abdomen are 0.82, 3.7 and 5.4 mGy respectively. These values were observed that the effective dose per examination was lower in Sudan than in other countries. The report of a CT survey done in these centers indicates that the mean DLP values for adult patients were ranged from 272-460 mGy cm (head) 195-995 mGy cm (chest), 270-459 mGy cm (abdomen). There are a number of observed parameters that greatly need optimization, such as minimize the scan length, without missing any vital anatomical regions, modulation of exposure parameters (kV, mA, exposure time, and slice thickness) based on patient size and age. Another possible method is through use of contrast media only to optimize diagnostic yield. The last possible method is the use of radio protective materials for protection however, in order to achieve the above optimization strategies: there is great demand to educate CT personnel on the effects of scan parameter settings on radiation dose to patients and image quality required for accurate diagnosis. (Author)

  13. Dengue Hemorrhagic Fever. Clinical Study of Hospitalized Adult Patients

    Directory of Open Access Journals (Sweden)

    Alfredo Espinosa Brito

    2014-08-01

    Full Text Available Background: the description of an epidemic is crucial from a clinical and epidemiological point of view.Objective: to identify the main clinical characteristics of hospitalized adult patients diagnosed with dengue hemorrhagic fever. Methods: a prospective case series study was conducted in 997 patients who met the diagnostic criteria for dengue hemorrhagic fever and were discharged from the Dr. Gustavo Aldereguía Lima Hospital from June 1st. to August 31, 1981. An automated database was developed based on the information collected from medical records using forms designed for the purpose. Results: forty eight point seven percent of the patients were in the third and fourth decades of life; females predominated (60.1 %. General symptoms were fever (97.4 %, asthenia (78.6 %, headache (76.4 %, anorexia (75.9 %, myalgia (62.1 % and sweating (37.2 %. The digestive symptoms included: nausea (57.8 %, vomiting (46.2 %, abdominal pain (31.6 % and diarrhea (14.1 %. The rash was developed by 32.5 % of the patients. Among the hemorrhagic manifestations were: petechiae (31.2 %, ecchymosis (11.5 %, epistaxis (7.6 %, hematemesis (6.2 %, hematuria (5.5 %, melena (3.4 %, gingival bleeding (3.4 %, enterorrhagia (2.2 %, metrorrhagia (2.1 %. The signs included: abdominal tenderness (53.6 %, tachycardia (25.9 %, lymphadenopathy (22.1 %, hypotension (12.0 %, pharyngeal redness (11.7 %, hepatomegaly (8.3 %, shock or "pre-shock" (6.9 % and splenomegaly (6.2%. Symptoms and signs were more frequent and severe among women. Eighty one point five percent of the patients were admitted one to three days after developing the symptoms. Thrombocytopenia (less than 100 000 platelets per mm3 was found in all cases and leukopenia was observed in 38.9 % of females and 20.6 % of men. Fourteen patients were admitted to intensive care, mostly due to shock; four of them with severe hemorrhagic manifestations. Only one patient died. Conclusions: the high morbidity due to dengue

  14. Prosthodontic treatment of the edentulous adult cleft palate patient.

    Science.gov (United States)

    Sykes, Leanne M

    2003-03-01

    Clefts of the upper lip and plate are relatively common, yet dental treatment of these patients is still very poor and many grow up suffering dental neglect. Dental practitioners should become involved in the treatment team as dental needs are present from birth to death. Adult cleft patients often need tooth replacement with obturation of any residual clefts. They are best treated with tooth-supported removable appliances including partial and complete overdentures, thus preservation of their natural dentition is desirable. Edentulous cleft palate patients present with restorative difficulties due to their compromised maxillary arches as well as the presence of scar tissue in their palates and lips. An outline of these complications and guidelines for their treatment is illustrated in the form of three case reports from members of one family all presenting with varying cleft lip and palate defects. This article highlights the need for dental students to be exposed to dentally compromised patients so that they will feel confident enough to treat them in private practice. PMID:12800267

  15. Clinical characteristics of intermediate uveitis in adult Turkish patients

    Institute of Scientific and Technical Information of China (English)

    Esra; Kardes; Betul; Ilkay; Sezgin; Akcay; Kansu; Bozkurt; Cihan; Unlu; Gurkan; Erdogan; Gulunay; Akcali

    2015-01-01

    ·AIM: To describe the clinical characteristics of Turkish patients with intermediate uveitis(IU) and to investigate the effect of clinical findings and complications on final visual acuity(VA).·METHODS: We retrospectively analyzed the medical records of patients with IU who had at least 6mo of follow-up and were older than 16 y.· RESULTS: A total of 78 eyes of 45 patients were included in the study and the mean follow-up period was19.4mo. The mean age at the time of presentation was42.9s. Systemic disease associations were found in17.7% of cases; sarcoidosis(8.8%) and multiple sclerosis(6.6%) were the most common diseases. Recurrence rate(odds ratio=45.53; 95%CI: 2.181-950.58), vitritis equals to or more than 3+ cells(odds ratio =57.456; 95%CI: 4.154-794.79) and presenting with VA less than 20/40(odds ratio =43.81; 95% CI: 2.184-878.71) were also found as high risk factors for poor final VA. At the last follow-up examination, 67.9% of eyes had VA of 20/40 or better.·CONCLUSION: IU is frequently seen at the beginning of the fourth decade of life. The disease is most commonly idiopathic in adult Turkish patients. Patients with severe vitritis at presentation and patients with frequent recurrences are at high risk for poor visual outcome.

  16. Eleven influential factors for quality of life in adults with epilepsy

    Institute of Scientific and Technical Information of China (English)

    Tongge Wang; Hao Wang; Jianhua Cheng

    2008-01-01

    BACKGROUND: Research focused on the quality of life of epileptic patients began only very recently in China; in particular, most research has focused on children, but less on epileptic adults.OBJECTIVE: To survey and analyze 11 influential factors for quality of life in adults with epilepsy by using quality of life epilepsy-31 scale.DESIGN: Cross-sectional study.SETTING: Department of Neurology, First Hospital Affiliated to Jinan University; Department of Neurology, First Affiliated Hospital of Wenzhou Medical College.PARTICIPANTS: A total of 107 adults with epilepsy for longer than one year were selected from Department of Neurology, First Hospital Affiliated to Jinan University between March 2004 and December 2006. The included patients met the Classification and Diagnostic Criteria of Epileptic Attack published by International Anti-Epilepsy League in 1981, and they provided informed consent. METHODS: General states, including course, attack frequency, marriage status, educational level, occupational types, economic status, attack types, drug types, and drug amount, were recorded. There were seven aspects in the Quality of Life Epilepsy-31 scale, including attack worry, life satisfaction, emotion, vigor/tiredness, drug influence, cognitive function, and social function. The scores positively correlated with the quality of life. Possible influential factors for quality of life were analyzed by one-way ANOVA and multivariate regression analysis.MAIN OUTCOME MEASURES: Course, attack frequency, marriage status, educational level, occupational types, economic status, attack types, drug types, drug amount, age, and sex.RESULTS: A total of 107 epileptic patients were included in the final analysis. Influential factors for quality of life in epileptic adults included attack frequency, educational level, economic status, attack types, drug amount, age, and course of disease (P < 0.05). Among them, attack frequency negatively correlated with attack worry, life

  17. Pyridoxal phosphate-dependent neonatal epileptic encephalopathy

    OpenAIRE

    Bagci, S.; Zschocke, J.; Hoffmann, G F; Bast, T.; Klepper, J; Müller, A.; Heep, A; Bartmann, P.; Franz, A R

    2009-01-01

    Pyridox(am)ine-5′-phosphate oxidase converts pyridoxine phosphate and pyridoxamine phosphate to pyridoxal phosphate, a cofactor in many metabolic reactions, including neurotransmitter synthesis. A family with a mutation in the pyridox(am)ine-5′-phosphate oxidase gene presenting with neonatal seizures unresponsive to pyridoxine and anticonvulsant treatment but responsive to pyridoxal phosphate is described. Pyridoxal phosphate should be considered in neonatal epileptic encephalopathy unrespons...

  18. Primary Care for the Older Adult Patient: Common Geriatric Issues and Syndromes.

    Science.gov (United States)

    Thompson, Katherine; Shi, Sandra; Kiraly, Carmela

    2016-06-01

    Older adults are the fastest growing segment of the US population and the majority of older adults are women. Primary care for the older adult patient requires a wide variety of skills, reflecting the complexity and heterogeneity of this patient population. Individualizing care through consideration of patients' goals, medical conditions, and prognosis is paramount. Quality care for the older adult patient requires familiarity with common geriatric syndromes, such as dementia, falls, and polypharmacy. In addition, developing the knowledge and communication skills necessary for complex care and end-of-life care planning is essential. PMID:27212097

  19. Assessing general practitioners' care of adult patients with learning disability: case-control study.

    OpenAIRE

    Whitfield, M.; Langan, J; Russell, O

    1996-01-01

    OBJECTIVE--To compare general practitioners' care of adult patients with learning disability with that of control patients in the same practice. DESIGN--Case-control study of patients and controls by a structured interview study of general practitioners. SETTING--Avon. PATIENTS--78 adult patients with learning disability and 78 age and sex matched controls--cared for by 62 general practitioners. MAIN MEASURES--Number and content of consultations and opinions of the general practitioners. RESU...

  20. QL-04FACTORS ASSOCIATED WITH SUICIDAL IDEATION IN CLINICALLY DISTRESSED ADULT GLIOMA PATIENTS

    OpenAIRE

    Banerjee, Pia; Cloughesy, Timothy; Cervantes, Sandra; Pham, Jennifer; Nghiemphu, Phioanh; Lai, Albert; Wellisch, David

    2014-01-01

    OBJECTIVE: During patient care, it is critical to identify the glioma patients who are experiencing suicidal ideation among those who present with elevated levels of psychological distress, so appropriate interventions can be implemented. The aim of this study was to determine the factors that differentiated adult glioma patients with possible suicidal ideation from those without suicidal ideation among patients experiencing psychological distress. METHODS: 317 adult patients with WHO Grade I...

  1. Research proposal: evaluation of ART in adult patients.

    Science.gov (United States)

    Zanata, Régia Luzia

    2006-01-01

    The primary objective of the Atraumatic Restorative Treatment (ART) is to reduce the indication of tooth extraction by means of a low-cost technique. Considering the difficulties of Brazilian public services to meet the demand of care of the low-income population, with lack of care to the adult population, which usually receives only emergency care, the aim of this study is to assess the performance of high-viscosity glass ionomer cements accomplished by the modified atraumatic restorative treatment in one- and multiple-surface cavities, compared to the conventional restorative approach. It will be analyzed the clinical performance of the materials; cost (material and human resources); patient satisfaction with the treatment received; and preventive effect of treatment. PMID:19089083

  2. Ohtahara syndrome: Early infantile epileptic encephalopathy

    Directory of Open Access Journals (Sweden)

    Knežević-Pogančev Marija

    2008-01-01

    Full Text Available DEFINITION Ohtahara syndrome (early infantile epileptic encephalopathy with suppression bursts, is the earliest developing form of epileptic encephalopathy. ETHIOLOGY It considered to be a result of static structural developing brain damage. CLINICAL PICTURE Variable seizures develop mostly within the first 10 days of life, but may occur during the first hour after delivery. The most frequently observed seizure type are epileptic spasms, which may be either generalized and symmetrical or lateralized. The tonic spasms may occur in clusters or singly, while awake and during sleep alike. The duration of spasms is up to 10 seconds, and the interval between spasms within cluster ranges from 9 to 15 seconds. In one third of cases, other seizure types include partial motor seizures or hemiconvulsions The disorder takes a progressively deteriorating course with increasing frequency of seizures and severe retardation of psychomotor development. DIAGNOSTIC WORKUP In the initial stage of Ohtahara syndrome, interictal EEG shows a pattern of suppression-burst with high-voltage paroxysmal discharges separated by prolonged periods of nearly flat tracing that last for up to 18 seconds. PROGNOSIS AND THREATMENT Half of the reported children having Ohtahara syndrome die in infancy. Anticonvulsant helps little in controlling the seizures and halting the deterioration of psychomotor development. Severe psychomotor retardation is the rule. With time, the disorder may evolve into West syndrome or partial epilepsy. Psychomotor development may be slightly better if the infants do not develop West and later Lennox-Gastaut syndrome.

  3. The functional organization of human epileptic hippocampus.

    Science.gov (United States)

    Klimes, Petr; Duque, Juliano J; Brinkmann, Ben; Van Gompel, Jamie; Stead, Matt; St Louis, Erik K; Halamek, Josef; Jurak, Pavel; Worrell, Gregory

    2016-06-01

    The function and connectivity of human brain is disrupted in epilepsy. We previously reported that the region of epileptic brain generating focal seizures, i.e., the seizure onset zone (SOZ), is functionally isolated from surrounding brain regions in focal neocortical epilepsy. The modulatory effect of behavioral state on the spatial and spectral scales over which the reduced functional connectivity occurs, however, is unclear. Here we use simultaneous sleep staging from scalp EEG with intracranial EEG recordings from medial temporal lobe to investigate how behavioral state modulates the spatial and spectral scales of local field potential synchrony in focal epileptic hippocampus. The local field spectral power and linear correlation between adjacent electrodes provide measures of neuronal population synchrony at different spatial scales, ∼1 and 10 mm, respectively. Our results show increased connectivity inside the SOZ and low connectivity between electrodes in SOZ and outside the SOZ. During slow-wave sleep, we observed decreased connectivity for ripple and fast ripple frequency bands within the SOZ at the 10 mm spatial scale, while the local synchrony remained high at the 1 mm spatial scale. Further study of these phenomena may prove useful for SOZ localization and help understand seizure generation, and the functional deficits seen in epileptic eloquent cortex. PMID:27030735

  4. Analysis of Epileptic Seizures with Complex Network

    Directory of Open Access Journals (Sweden)

    Yan Ni

    2014-01-01

    Full Text Available Epilepsy is a disease of abnormal neural activities involving large area of brain networks. Until now the nature of functional brain network associated with epilepsy is still unclear. Recent researches indicate that the small world or scale-free attributes and the occurrence of highly clustered connection patterns could represent a general organizational principle in the human brain functional network. In this paper, we seek to find whether the small world or scale-free property of brain network is correlated with epilepsy seizure formation. A mass neural model was adopted to generate multiple channel EEG recordings based on regular, small world, random, and scale-free network models. Whether the connection patterns of cortical networks are directly associated with the epileptic seizures was investigated. The results showed that small world and scale-free cortical networks are highly correlated with the occurrence of epileptic seizures. In particular, the property of small world network is more significant during the epileptic seizures.

  5. Alterations in the carnitine metabolism in epileptic children treated with valproic acid.

    OpenAIRE

    Chung, S; Choi, J; Hyun, T.; Rha, Y.; Bae, C.

    1997-01-01

    Serum concentrations of total carnitine, free carnitine and acylcarnitine were measured in forty-one epileptic patients treated with valproic acid (VPA). Among them, 14 patients were on VPA monotherapy and 27 were on VPA polytherapy. Forty-one age and sex matched healthy normal controls were also evaluated for carnitine metabolism. The mean total and free carnitine were significantly lower in both the VPA monotherapy and polytherapy groups compared with the controls. However, there were no si...

  6. Properties of functional brain networks correlate frequency of psychogenic non-epileptic seizures

    OpenAIRE

    Mahdi Jalili; Rossetti, Andrea O

    2012-01-01

    Abnormalities in the topology of brain networks may be an important feature and etiological factor for psychogenic non-epileptic seizures (PNES). To explore this possibility, we applied a graph theoretical approach to functional networks based on resting state EEGs from 13 PNES patients and 13 age- and gender-matched controls. The networks were extracted from Laplacian-transformed time-series by a cross-correlation method. PNES patients showed close to normal local and global connectivity and...

  7. Properties of functional brain networks correlate with frequency of psychogenic non-epileptic seizures.

    OpenAIRE

    Barzegaran, Elham; Joudaki, Amir; Jalili, Mahdi; Rossetti, Andrea O; Frackowiak, Richard S.; Knyazeva, Maria G.

    2012-01-01

    Abnormalities in the topology of brain networks may be an important feature and etiological factor for psychogenic non-epileptic seizures (PNES). To explore this possibility, we applied a graph theoretical approach to functional networks based on resting state EEGs from 13 PNES patients and 13 age- and gender-matched controls. The networks were extracted from Laplacian-transformed time-series by a cross-correlation method. PNES patients showed close to normal local and global connectivity and...

  8. Nonlinear Analysis of Clinical Epileptic EEG by Approximate Entropy

    Institute of Scientific and Technical Information of China (English)

    LIU Yan-su; XIA Yang; XU Hong-ru; ZHOU Dong; YAO De-zhong

    2005-01-01

    By the means of computing approximate entropy (ApEn) of video-EEG from some clinical epileptic, ApEn of EEG with epileptiform discharges is found significantly different from that of EEG without epileptiform discharges, (p=0. 002). Meanwhile, dynamic ApEn shows consistent change of EEG signal withdischarges of epileptic waves inside. These results suggest that ApEn may be a useful tool for automatic recognition and detection of epileptic activity and for understanding epileptogenic mechanism.

  9. Epileptic nystagmus: description of a pediatric case with EEG correlation and SPECT findings.

    Science.gov (United States)

    Nicita, F; Papetti, L; Spalice, A; Ursitti, F; Massa, R; Properzi, E; Iannetti, P

    2010-11-15

    Epileptic nystagmus (EN) describes repetitive eye movements that result from seizure activity. We describe a patient with EN and vertigo first noted at the age of 4 yr and 10 mo. Brain MRI did not show anomalies. Ictal EEG recordings revealed epileptic activity during three episodes of horizontal, left-beating nystagmus not crossing the midline. Ictal 99mTc-ECD SPECT demonstrated the presence of active foci in multiple cerebral regions including bilateral prefrontal, bilateral parieto-temporo-occipital and the left parieto-insular-vestibular areas. A wide area of hypoperfusion was also evident in the right hemisphere, prevailing in the parieto-occipital regions and the medial prefrontal gyrus. Topiramate was started at a dose of 2 mg/kg/d with complete seizure control after 14 d. EEG and SPECT were repeated after a seizure-free period of 1 mo; disappearance of epileptic activity and modification of cerebral perfusion were evident. This case reaffirms the cortical origin and involvement of temporo-occipital and frontal cortex in the genesis of saccadic epileptic nystagmus. Rapid complete control of clinical events coincided with the normalization of EEG and improvement of the SPECT pattern. PMID:20832824

  10. Enhancement of asynchronous release from fast-spiking interneuron in human and rat epileptic neocortex.

    Directory of Open Access Journals (Sweden)

    Man Jiang

    Full Text Available Down-regulation of GABAergic inhibition may result in the generation of epileptiform activities. Besides spike-triggered synchronous GABA release, changes in asynchronous release (AR following high-frequency discharges may further regulate epileptiform activities. In brain slices obtained from surgically removed human neocortical tissues of patients with intractable epilepsy and brain tumor, we found that AR occurred at GABAergic output synapses of fast-spiking (FS neurons and its strength depended on the type of connections, with FS autapses showing the strongest AR. In addition, we found that AR depended on residual Ca²⁺ at presynaptic terminals but was independent of postsynaptic firing. Furthermore, AR at FS autapses was markedly elevated in human epileptic tissue as compared to non-epileptic tissue. In a rat model of epilepsy, we found similar elevation of AR at both FS autapses and synapses onto excitatory neurons. Further experiments and analysis showed that AR elevation in epileptic tissue may result from an increase in action potential amplitude in the FS neurons and elevation of residual Ca²⁺ concentration. Together, these results revealed that GABAergic AR occurred at both human and rat neocortex, and its elevation in epileptic tissue may contribute to the regulation of epileptiform activities.

  11. BDNF modulates GABAA receptors microtransplanted from the human epileptic brain to Xenopus oocytes

    Science.gov (United States)

    Palma, E.; Torchia, G.; Limatola, C.; Trettel, F.; Arcella, A.; Cantore, G.; Di Gennaro, G.; Manfredi, M.; Esposito, V.; Quarato, P. P.; Miledi, R.; Eusebi, F.

    2005-01-01

    Cell membranes isolated from brain tissues, obtained surgically from six patients afflicted with drug-resistant temporal lobe epilepsy and from one nonepileptic patient afflicted with a cerebral oligodendroglioma, were injected into frog oocytes. By using this approach, the oocytes acquire human GABAA receptors, and we have shown previously that the “epileptic receptors” (receptors transplanted from epileptic brains) display a marked run-down during repetitive applications of GABA. It was found that exposure to the neurotrophin BDNF increased the amplitude of the “GABA currents” (currents elicited by GABA) generated by the epileptic receptors and decreased their run-down; both events being blocked by K252A, a neurotrophin tyrosine kinase receptor B inhibitor. These effects of BDNF were not mimicked by nerve growth factor. In contrast, the GABAA receptors transplanted from the nonepileptic human hippocampal uncus (obtained during surgical resection as part of the nontumoral tissue from the oligodendroglioma margins) or receptors expressed by injecting rat recombinant α1β2γ2 GABAA receptor subunit cDNAs generated GABA currents whose time-course and run-down were not altered by BDNF. Loading the oocytes with the Ca2+ chelator 1,2-bis(2-aminophenoxy)ethane-N,N,N′,N′-tetraacetate-acetoxymethyl ester (BAPTA-AM), or treating them with Rp-8-Br-cAMP, an inhibitor of the cAMP-dependent PKA, did not alter the GABA currents. However, staurosporine (a broad spectrum PK inhibitor), bisindolylmaleimide I (a PKC inhibitor), and U73122 (a phospholipase C inhibitor) blocked the BDNF-induced effects on the epileptic GABA currents. Our results indicate that BDNF potentiates the epileptic GABAA currents and antagonizes their use-dependent run-down, thus strengthening GABAergic inhibition, probably by means of activation of tyrosine kinase receptor B receptors and of both PLC and PKC. PMID:15665077

  12. Migraine pain location in adult patients from eastern India

    Directory of Open Access Journals (Sweden)

    Chakravarty Ambar

    2008-01-01

    Full Text Available Background: Sparse literature documenting the location of pain at the onset of migraine attacks and during established headaches is available. Objectives: A prospective study (2003-05 on 800 adult migraine patients (International Classifications of Headache Disorders (ICHD, 2:1.1, 1.2.1 and 1.6.1 was conducted to document (a sites of onset of pain and (b location of pain during established attacks (in> 50% occasions through semistructured interviews. Results: Demography: N = 800; M:F = 144:656 (1:4.56; age, 16-42 years (mean, 26 years; duration of migraine, 1-18 years (mean, 6.8 years. 87% of the subjects were ethnic Bengalis from the eastern Indian state of West Bengal, Calcutta being the capital city. Migraine types (on the basis of> 50% headache spells: N = 800; 1.1:668 (83.5%; 1.2.1:18 (2.25%; 1.6.1:114 (14.25%. Location of pain at onset: Unilateral onset was present in 41.38% of the patients; of these, 53.17% had eye pain; 8.16%, frontal pain and 38.67%, temporal pain. In 32.25% of the patients, bilateral/central location of pain, mostly bitemporal or at vertex was noted. Cervico-occipital pain onset was noted in 26.43% patients (predominantly occipital, 14.68%; predominantly cervical, 11.75%. Location of established headaches: In 47.4% of the patients, with unilateral ocular or temporal onset, pain remained at the same site. Pain became hemicranial in 32.9%. In most patients, unilateral frontal onset pain (55.5% became bilateral or holocranial. Most bilateral ocular (69.4% and temporal onset (69.7% pains remained at the same location. However, most bifrontal (55.6% and vertex onset (56.9% pains subsequently became holocranial. Most occipital pains at onset became holocranial (45.3%, but cervical pains subsequently became either hemicranial (38.3% or holocranial (36.2%. Conclusions: This study documents location of pain at the onset and during established headaches in migraine patients largely from a specific ethnic group. Migraine with

  13. Target-selectivity of parvalbumin-positive interneurons in layer II of medial entorhinal cortex in normal and epileptic animals.

    Science.gov (United States)

    Armstrong, Caren; Wang, Jessica; Yeun Lee, Soo; Broderick, John; Bezaire, Marianne J; Lee, Sang-Hun; Soltesz, Ivan

    2016-06-01

    The medial entorhinal cortex layer II (MEClayerII ) is a brain region critical for spatial navigation and memory, and it also demonstrates a number of changes in patients with, and animal models of, temporal lobe epilepsy (TLE). Prior studies of GABAergic microcircuitry in MEClayerII revealed that cholecystokinin-containing basket cells (CCKBCs) select their targets on the basis of the long-range projection pattern of the postsynaptic principal cell. Specifically, CCKBCs largely avoid reelin-containing principal cells that form the perforant path to the ipsilateral dentate gyrus and preferentially innervate non-perforant path forming calbindin-containing principal cells. We investigated whether parvalbumin containing basket cells (PVBCs), the other major perisomatic targeting GABAergic cell population, demonstrate similar postsynaptic target selectivity as well. In addition, we tested the hypothesis that the functional or anatomic arrangement of circuit selectivity is disrupted in MEClayerII in chronic TLE, using the repeated low-dose kainate model in rats. In control animals, we found that PVBCs innervated both principal cell populations, but also had significant selectivity for calbindin-containing principal cells in MEClayerII . However, the magnitude of this preference was smaller than for CCKBCs. In addition, axonal tracing and paired recordings showed that individual PVBCs were capable of contacting both calbindin and reelin-containing principal cells. In chronically epileptic animals, we found that the intrinsic properties of the two principal cell populations, the GABAergic perisomatic bouton numbers, and selectivity of the CCKBCs and PVBCs remained remarkably constant in MEClayerII . However, miniature IPSC frequency was decreased in epilepsy, and paired recordings revealed the presence of direct excitatory connections between principal cells in the MEClayerII in epilepsy, which is unusual in normal adult MEClayerII . Taken together, these findings advance

  14. The evaluation of 25-hydroxy vitamin D, calcium, phosphate and alkaline phosphatase levels in epileptic children under antiepileptic medication

    Directory of Open Access Journals (Sweden)

    Keyhani doost Z

    2011-01-01

    Full Text Available "n 800x600 Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 st1":*{behavior:url(#ieooui } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman","serif";} Background: Epilepsy is a common disease in the pediatric neurology. There are frequent anti-epileptic drugs which are used in management of epilepsy. Anti-epileptic drugs may have some complications on bone and vitamin-D metabolism. In this study we aimed to evaluate vitamin-D metabolism in epileptic children."n"nMethods: The study was a prospective and cross sectional one. A total 89 epileptic children who were taking anti-epileptic drugs for longer than six months with no underlying disorder in Imam Khomeini and Bahrami Hospitals in Tehran, Iran were enrolled in our study"n"nResults: Forty nine boys and 40 girls were enrolled in this study; mean age of the patients was 7.8±2.1 years. Mean duration of anti-epileptic drug therapy was 2.3 years (SD=0.4, 70 of patients were under monotherapy and 19 were under polytherapy. None of the patients had signs of rickets. Serum calcium and phosphor levels were within normal ranges. Serum alkaline phosphates levels were increased more than two times in 43%. 42% had vitamin-D deficiency (25-OH Vit D<10 ng/ml and another 33% had vitamin-D insufficiency (10<25-oh Vit D<20 ng/ml. 29 patients (32% were taking prophylactic supplemental Vit D (200-400 IU/day. There was significant difference between patients taking supplemental vitamin-D as prophylaxis and patients who did not (p=0.04. There was no significant difference in vitamin-D levels between patients according to age, gender or different drugs."n"nConclusion: Periodic

  15. Correlation analysis between epilepsy and anti-epileptic drugs and bone mineral density of patients with epilepsy%癫痫病及抗癫痫药物对癫痫患者骨密度影响的相关性分析

    Institute of Scientific and Technical Information of China (English)

    郭华爱; 毓青; 王凤楼; 杨卫东; 陈英; 陈旨娟; 杨二娟

    2013-01-01

    Objective: To investigate the effects of epilepsy and anti-epileptic drugs(AEDs) on bone mineral density(BMD) of patients with epilepsy. Methods: 160 cases aged between 20 and 60 years old were selected as subjects. All of them had the disease for more than nine months and had been taking AEDs for more than six months. All were free of other diseases and none was taking any medication that might interfere with bone metabolism other than AEDs. BMDs at the right heel were measured with the ultrasonic BMD instrument. Detailed clinical information of each patient were obtained by the researcher. All of the related risk factors in the data were stratified according to certain degree. Fifty normal controls were involved. Then single factor chi-square test and multivariate logistic regression analysis were analyzed. Results: There was statistically significant difference between epileptics and normal group in BMD (P0.05). Multivariate logistic regression analysis identified GTCS,polytherapy and the duration of anticonvulsant therapy were as the related and independent risk factors(OR value, 1.105, 5.710, 5.820, respectively; P<0.05). Conclusion: The results indicate that both epilepsy and anti-epileptic drugs can lead to the change of BMD of patients with epilepsy, and GTCS, polytherapy and the duration of anticonvulsant therapy are important risk factors of low BMD. It can be used as valuable reference to prevent bone mass loss and fractures of epileptic patients effectively.%目的:研究癫痫病本身及抗癫痫药物(AEDs)与癫痫患者骨密度(BMD)异常的相关性.方法:采用超声法对160例年龄在20~60岁、病程≥9个月、AEDs治疗时间≥6个月的癫痫患者进行BMD检测,收集相关的临床资料并设置正常对照组50例.根据癫痫的病程、发作类型、服用AEDs的数量及种类、治疗时间分组,分析各组临床指标与骨量异常的相关性.结果:癫痫患者组BMD异常率与正常对照组比较有显著差

  16. Investigation of Hypothalamus-Pituitary-Gonadal Axis in Epileptic Women Treated for Epilepsy

    Directory of Open Access Journals (Sweden)

    Füsun Ferda Erdoğan

    2012-06-01

    Full Text Available Objectives: Reproductive endocrine disorders, especially polycystic ovary syndrome (PCOS are common in epileptic women who are less fertile and suffer from more menstrual and reproductive endocrine disorders than non-epileptic women. The etiology of reproductive endocrine dysfunction in epilepsy has not been determined precisely. The aim of the study was to investigate the hypotalamus-pituitary-gonadal axis, insulin resistance and the prevalence of PCOS in patients with generalized idiopathic or cryptogenic epilepsy and receiving treatment with valproate (VPA and carbamazepine (CBZ. Method: This study included 48 epileptic women with a mean age of 24.2±5.5 years. The patient groups consisted of 34 (70.8% women with epilepsy on VPA and 14 (29.2% women with epilepsy on CBZ. The control group consisted of 20 healthy women. Fasting blood samples were obtained for the determination of glucose, insulin, gonadotrophins, estradiol, androgens, 17-OH progesteron (17-OHP, and sex hormone-binding globulin (SHBG levels. All subjects underwent oral glucose tolerance test (OGTT and the buserelin stimulation test for glucose tolerance status, insulin resistance parameters and hypothalamus-pituitary-gonadal axis evaluation. Results: PCOS was diagnosed in 17 (35.4% epileptic patients and glucose intolerance was found in two (4.1% patients. Basal insulin levels, glucose and insulin responses to OGTT were significantly higher in the patients than in the controls. Peak and area under curve (AUC 17-OHP responses to the buserelin stimulation test were significantly higher in the patients than in the controls. Discussion: The prevalence of PCOS among women with epilepsy receiving VPA or CBZ treatment was higher than expected. Those patients had increased ovarian stroma and hormonal activity characterized by hyperandrogenemia, as demonstrated by buserelin testing and insulin resistance as demonstrated by OGTT. (Arc­hi­ves of Neu­ropsy­chi­atry 2012;49: 133-138

  17. Experiences of adult patients hearing loss postlingually with Cochlear Implant

    Directory of Open Access Journals (Sweden)

    Teresa María Lizcano Tejado

    2013-09-01

    Full Text Available Hearing loss is a significant public health problem. The incidence is difficult to establish because of the lack of data in people under age three, but is estimated about 1 per thousand for severe and profound hearing loss.A cochlear implant (CI is a device that converts sounds into electrical energy that triggers a sensation of hearing. The IC is indicated in patients with severe bilateral sensorineural hearing loss with null or poor benefit use of hearing aids.The general objective of this project is to understand the experiences of adult patients with severe-profound sensorineural hearing loss with IC postlingually throughout the implementation process.A personal vision of those implemented will allow us to learn how to face the possibility to hear and interact with their environment, applying this information to improve health care provided to them and identifying those areas where such assistance should be improved. Also allow us to compare the initial expectations and have been achieved, creating realistic expectations for future candidates.For its development we have designed a qualitative study, based on the principles and procedures of grounded theory, semistructured interviews, participant observation and discussion groups.The data will be analyzed using the software Nudist ViVo 9.

  18. Genetic risk factors of cisplatin induced ototoxicity in adult patients.

    Science.gov (United States)

    Talach, T; Rottenberg, J; Gal, B; Kostrica, R; Jurajda, M; Kocak, I; Lakomy, R; Vogazianos, E

    2016-01-01

    Ototoxicity is an important adverse effect of using Cisplatin (cis-diamminedichloroplatinum) (CDDP) as a form of chemotherapy. The clinical picture of CDDP induced ototoxicity includes perceptive hearing impairment (reversible or permanent) and tinnitus. Ototoxicity manifests with considerable variability between patients. The objective of this prospective study was to investigate a possible genetic background to this variability. We assessed ototoxicity induced by therapeutic doses of CDDP in adult patients with germinative testicular tumors, or other tumors treated with an identical CDDP dosage scheme. Audiological examination before, during and after the treatment has shown deterioration in hearing; first in the high-frequencies and with increased CDDP cumulative doses, impairment in other frequencies as well. Occurrence of tinnitus was not dependent on the administered dose of CDDP, or the other risk factors examined in this study. The association of CDDP induced ototoxicity with genetic polymorphisms in candidate genes was examined. Our study has demonstrated an association of early onset of CDDP induced ototoxicity with the presence of two copies of GSTT1 gene (p=0,009) and with T allele of rs9332377 polymorphism in COMT gene (p=0,001). PMID:26774148

  19. Detección de puntas epilépticas en señales electroencefalográficas para pacientes con epilepsia del lóbulo temporal utilizando wavelets Detection of epileptic spikes in electroencephalographic signals for patients with temporal lobe epilepsy using wavelets

    Directory of Open Access Journals (Sweden)

    Nelson Eduardo Castaño

    2009-06-01

    Full Text Available En este trabajo se describe un método para la detección de puntas epilépticasen un registro electroencefalográfico(EEG de superficie tomando un solocanal. Se identificó un patrón al utilizar el análisis multirresolución con unawavelet biortogonal después de procesar y analizar con el Toolbox Waveletde Matlab, 207 registros de puntas y 132 registros de artificios previamenteclasificadas por el neurofisiólogo. Este patrón permitió diseñar un algoritmopara la detección de puntas en pacientes con epilepsia refractaria del lóbulotemporal, a partir de los máximos voltajes en cada uno de los seis niveles de reconstrucción usando la wavelet biortogonal 3.7. El algoritmo se aplicó sobreregistros de pacientes con epilepsia, obteniéndose una sensibilidad del 92% yuna especificidad del 80% en el diagnóstico de las puntas epilépticas.This paper describes a method for detecting epileptic spikes in a record electroencephalographic (EEG surface by taking a single channel. We identified a pattern using multiresolution analysis with a biorthogonal wavelet after processing and analyzing the Wavelet Toolbox of Matlab, 207 records and 132 records of tips tricks previously classified by Neurophysiologist. This pattern enabled an algorithm for detecting spikes in patients with refractory temporal lobe epilepsy, based on the maximum voltage in each of the six levels of reconstruction using biorthogonal 3.7 wavelet. The algorithm was applied on records of patients with epilepsy, getting a sensitivity of 92% and a specificity of 80% in the diagnosis of epileptic spikes.

  20. Clinical features of adult patients with Eisenmenger syndrome associated with different types of congenital heart disease

    Institute of Scientific and Technical Information of China (English)

    陈果

    2013-01-01

    Objective To explore the clinical features and hemodynamics of adult patients with Eisenmenger syndrome in different types of congenital heart diseases (CHD) .Methods Patients with Eisenmenger syndrome with different types of CHD diagnosed by right heart

  1. Brain ventricular dimensions and relationship to outcome in adult patients with bacterial meningitis

    DEFF Research Database (Denmark)

    Sporrborn, Janni L; Baunbæk-Knudsen, Gertrud Louise; Sølling, Mette; Seierøe, Karina; Farre, Annette; Lindhardt, Bjarne Ø; Benfield, Thomas; Brandt, Christian T

    2015-01-01

    BACKGROUND: Experimental studies suggest that changes in brain ventricle size are key events in bacterial meningitis. This study investigated the relationship between ventricle size, clinical condition and risk of poor outcome in patients with bacterial meningitis. METHODS: Adult patients diagnosed...

  2. Asymmetric periflexural exanthema: A report in an adult patient

    Directory of Open Access Journals (Sweden)

    Zawar V

    2003-11-01

    Full Text Available Asymmetric periflexural exanthem (APE is a distinctive exanthem, probably viral in origin. It is largely a disease of childhood and is uncommon in adults. We report an adult man presenting with the typical clinical findings of APE.

  3. Concordance of Epileptic Networks Associated with Epileptic Spikes Measured by High-Density EEG and Fast fMRI.

    Directory of Open Access Journals (Sweden)

    Vera Jäger

    Full Text Available The present study aims to investigate whether a newly developed fast fMRI called MREG (magnetic resonance encephalography measures metabolic changes related to interictal epileptic discharges (IED. For this purpose BOLD changes are correlated with the IED distribution and variability.Patients with focal epilepsy underwent EEG-MREG using a 64 channel cap. IED voltage maps were generated using 32 and 64 channels and compared regarding their correspondence to the BOLD response. The extents of IEDs (defined as number of channels with >50% of maximum IED negativity were correlated with the extents of positive and negative BOLD responses. Differences in inter-spike variability were investigated between interictal epileptic discharges (IED sets with and without concordant positive or negative BOLD responses.17 patients showed 32 separate IED types. In 50% of IED types the BOLD changes could be confirmed by another independent imaging method. The IED extent significantly correlated with the positive BOLD extent (p = 0.04. In 6 patients the 64-channel EEG voltage maps better reflected the positive or negative BOLD response than the 32-channel EEG; in all others no difference was seen. Inter-spike variability was significantly lower in IED sets with than without concordant positive or negative BOLD responses (with p = 0.04.Higher density EEG and fast fMRI seem to improve the value of EEG-fMRI in epilepsy. The correlation of positive BOLD and IED extent could suggest that widespread BOLD responses reflect the IED network. Inter-spike variability influences the likelihood to find IED concordant positive or negative BOLD responses, which is why single IED analysis may be promising.

  4. Exercise capacity in adult patients with congenitally corrected transposition of the great arteries

    OpenAIRE

    Fredriksen, P; Chen, A.; Veldtman, G; S Hechter; Therrien, J.; Webb, G.

    2001-01-01

    OBJECTIVE—To examine cardiopulmonary values, static lung function, and ejection fraction in adult patients with congenitally corrected transposition of the great arteries (CCTGA).
PATIENTS AND METHODS—41 patients who had undergone static lung function testing and cardiopulmonary exercise tests with measurements of ejection fraction were identified at the Toronto Congenital Cardiac Centre for Adults.
RESULTS—Aerobic capacity in patients with CCTGA was severely diminished, varying from 30-50% o...

  5. Warming up Improves Speech Production in Patients with Adult Onset Myotonic Dystrophy

    Science.gov (United States)

    de Swart, B.J.M.; van Engelen, B.G.M.; Maassen, B.A.M.

    2007-01-01

    This investigation was conducted to study whether warming up decreases myotonia (muscle stiffness) during speech production or causes adverse effects due to fatigue or exhaustion caused by intensive speech activity in patients with adult onset myotonic dystrophy. Thirty patients with adult onset myotonic dystrophy (MD) and ten healthy controls…

  6. Adult growth hormone (GH)-deficient patients demonstrate heterogeneity between childhood onset and adult onset before and during human GH treatment. Adult Growth Hormone Deficiency Study Group

    DEFF Research Database (Denmark)

    Attanasio, A F; Lamberts, S W; Matranga, A M;

    1997-01-01

    The onset of adult GH deficiency may be during either adulthood (AO) or childhood (CO), but potential differences have not previously been examined. In this study the baseline and GH therapy (12.5 micrograms/kg per day) data from CO (n = 74; mean age 29 yr) and AO (n = 99; mean age 44 yr) GH......-deficient adult patients have been compared. The first 6 months comprised randomized, double-blind treatment with GH or placebo, then all patients were GH-treated for a further 12 months. At baseline the height, body weight, body mass index, lean body mass, and waist/hip ratio of AO patients were significantly (P...

  7. Localization and cure of epileptic foci with the use of MEG measurements.

    Science.gov (United States)

    Anninos, P A; Tsagas, N

    1989-06-01

    Systematic studies with pathological subjects with focal and general epilepsies using magnetoencephalographic (MEG) measurements showed significant brain activities even if they are not present in the electroencephalogram EEG. Using a mapping technique characterized by an isospectral amplitude (ISO-SA) of the scalp distribution of specified spectral components or frequency bands of the MEG power spectrum we were able to localize the epileptic foci. This localization of epileptic foci gives us information on the emitted magnetic field intensity and frequency for each focal point on the map of the patient. Using this information we can cure the patient by adjusting an electronic device which can emit back to the specific scalp point a magnetic field of the same intensity and frequency as the one which-is emitted from it. The principle of this technique is based on the physical phenomenon of Young's double-slit experiment by which under certain condition light plus light gives darkness. PMID:2506144

  8. Preoperative localization of epileptic foci with SPECT brain perfusion imaging, electrocorticography, surgery and pathology

    International Nuclear Information System (INIS)

    Objective: The value of preoperative localization of epileptic foci with SPECT brain perfusion imaging was investigated. Methods: The study population consisted of 23 patients with intractable partial seizures which was difficult to control with anticonvulsant for long period. In order to preoperatively locate the epileptic foci, double SPECT brain perfusion imaging was performed during interictal and ictal stage. The foci were confirmed with electrocorticography (EcoG), surgery and pathology. Results: The author checked with EcoG the foci shown by SPECT, 23 patients had all typical spike discharge. The regions of radioactivity increase in ictal matched with the abnormal electrical activity areas that EcoG showed. The spike wave originated in the corresponding cerebrum cortex instead of hyperplastic and adherent arachnoid or tumor itself. Conclusions: SPECT brain perfusion imaging contributes to distinguishing location, size, perfusion and functioning of epileptogenic foci, and has some directive function on to making out a treatment programme at preoperation

  9. Temporal epileptic seizures and occupational exposure to solvents

    DEFF Research Database (Denmark)

    Jacobsen, M; Bælum, Jesper; Bonde, J P

    1994-01-01

    Long term exposure to organic solvents is usually not considered as a possible cause of chronic epileptic seizures. A case that shows a remarkable coincidence between exposure to organic solvents and occurrence of epileptic seizures is reported. The man was a 58 year old sign writer with lifelong...

  10. Latarjet 手术治疗癫痫患者复发性肩关节前脱位伴重度骨缺损的短期疗效分析%Curative effect analysis on Latarjet procedure in treatment of epileptic patients of recurrent anterior dislocation of shoulder with severe osseous deficiency with 3-5 years follow-up

    Institute of Scientific and Technical Information of China (English)

    杨国勇; 向明; 陈杭; 胡晓川; 唐浩琛

    2014-01-01

    after surgery,there was no evidence of fixation failure or graft resorption in the shoulders.No one underwent revision surgery.Overall,most of the patients had satisfactory pain relief and daily living activities postoperatively at the time of the latest follow-up.Conclusions The anterior dislocation of the shoulder in the epileptic patients is really uncommon.The treatment of the secondary recurrent anterior dislocations of the shoulder associated with severe osseous deficiency is quite difficult,due to the unacceptably high rate of re-dislocation after the open or arthroscopic reconstruction surgery of the Bankart lesion.Our study assessed the effects of Latarjet procedure on the radiological and clinical results in seven cases with severe glenoid osseous deficiency accompanied with epileptic seizure disorders and recurrent anterior dislocation of shoulder.The results suggested that when treating patients with an epileptic seizure disorder and recurrent anterior glenohumeral instability,effective control of the epileptic seizures is one of the most important methods to reduce the incidence of post-operative recurrent dislocation,because a compliant patient was very important for a successful clinical outcome.The Latarjet procedure can provide a satisfied reconstruction of shoulder stability,but the possibility of re-dislocation and osteoarthritis should be also noticed.We recommend a high index of suspicion when treating patients with a seizure disorder who have anterior shoulder instability,and we recommend making a preoperative CT scan,if there is a strong likelihood that a coracoid transfer will be used at surgery.This enables the diagnosis of a coracoid fracture nonunion to be made prior to surgery and helps to determine whether there is sufficient bone to allow a Latarjet procedure to be performed.However,it needs further investment to choose an appropriate surgery procedure for the untreated epileptic patients.

  11. Optical imaging of visual cortex epileptic foci and propagation pathways.

    Science.gov (United States)

    Haglund, Michael M

    2012-06-01

    Precise localization of neocortical epileptic foci is a complex problem that usually requires ictal video-electroencephalography (EEG) recordings; high-resolution magnetic resonance imaging (MRI), positron emission tomography (PET), and single photon emission computed tomography (SPECT) studies; and/or invasive monitoring with implanted grid array electrodes. The exact ictal-onset site must be identified and removed to obtain the best opportunity for a seizure-free outcome. The goal of this study was to determine if high-resolution optical imaging could precisely identify neocortical epileptic foci and what role underlying neuroanatomic pathways played in the seizure propagation. Small acute epileptic foci (0.5 × 0.5 mm(2) ) were created in the primate visual neocortex and single-unit and surface EEG recordings were combined with optical imaging of voltage-sensitive dye changes. Brief visual stimulation was used to evoke interictal bursts. In addition, different visually evoked epileptiform bursts were analyzed to determine the location of the epileptic focus. Spike-triggered averaging of the optical images associated with the surface EEG interictal bursts were analyzed to determine the exact location of the epileptic focus. Specific orientations of brief visual stimulation evoked different intensity optical changes and precisely localized the epileptic focus. Optical imaging identified individual epileptic foci that were <3 mm apart. The development of individual epileptic focus was monitored with optical imaging, which demonstrated excitatory activity at the focus with a surrounding zone of inhibitory-like activity. Propagation pathways outside of the inhibitory-like surround demonstrated alternating bands of excitation and inhibition with a pattern orthogonal to the ocular dominance columns. This experimental study demonstrates that optical imaging can precisely localize an epileptic focus, and provides excellent spatial resolution of the changes that

  12. Comparative Study of Early Maladaptive Schemas in Rheumatoid Arthrits Patients and Normal Adults

    OpenAIRE

    Fatemeh Rezaei; Hamid Taher Neshat Dost; Hosein Molavi; Mohamad Reza Abedi; Mansor Karimi Far

    2014-01-01

    Early maladaptive schemas (EMSs) designed to ases early distres. EMSs are at he core of personality pathology and psychological distres. The main objective of this study was to find out he diferences betwen rheumatoid arthrits (RA) patients and normal adults on EMSs. 10 RA patients and 10 normal adults completed Young’s Schema Questionaire developed by Jefery Young (198). The results showed that data was subjected to statistical analysis; T- test showed that the RA patients reported a sign...

  13. Results of Non-contrast Brain Computed Tomography Scans of 1-18 Year Old Epileptic Children

    Directory of Open Access Journals (Sweden)

    Razieh FALLAH

    2012-09-01

    evaluationof the adult patient who presents with a first-time seizure.Emerg Med Clin North Am 2011; 29(1:41-9.Camfield PR, Camfield CS. Pediatric epilepsy. In:Swaiman KF, Ashwal S, Ferriero D M. Pediatric Neurology: principles & practice. (4th ed. Philadelphia:Mosby Elsevier, 2006.P. 983.Gaillard WD, Chiron C, Cross JH, Harvey AS, Kuzniecky R, Hertz-Pannier L, Vezina LG; ILAE, Committee for Neuroimaging, Subcommittee for Pediatric. Guidelines for imaging infants and children with recent-onset epilepsy. Epilepsia 2009; 50(9:2147-53.Soto-Ares G, Jissendi Tchofo P, Szurhaj W, Trehan G,Leclerc X. Management of patients after a first seizure. J Neuroradiol 2004; 31(4:281-8. (in FrenchHirtz D, Ashwal S, Berg A, et al. Practice parameter:evaluating a first nonfebrile seizure in children: report of the quality standards subcommittee of the American Academy of Neurology, the Child Neurology Society, and the American Epilepsy Society. Neurology 2000; 55:616– 623.Kuzniecky RI. Neuroimaging in pediatric epilepsy.Epilepsia 1996; 37, Suppl 1:S10-21.Adamsbaum C, Rolland Y, Husson B. Pediatric neuroimaging emergencies. J Neuroradiol 2004;31(4:272-80. (in FrenchProposal for revised classification of epilepsies and epileptic syndromes. Commission on Classification and Terminology of the International League Against Epilepsy. Epilepsia 1989; 30:389–399.Hsieh DT, Chang T, Tsuchida TN, et al. New-onset afebrile seizures in infants: role of neuroimaging.Neurology 2010;12:74(2:150-6.Khodapanahandeh F, Hadizadeh H. Neuroimaging inchildren with first afebrile seizures: to order or not toorder? Arch Iran Med 2006;9(2:156-8.Berg AT, Testa FM, Levy SR, Shinnar S. Neuroimaging in children with newly diagnosed epilepsy: A community based study. Pediatrics 2000; 106(3:527-32.Maytal J, Krauss JM, Novak G, Nagelberg J, Patel M. Therole of brain computed tomography in evaluating children with new onset of seizures in the emergency department.Epilepsia 2000; 41(8:950-4.Kumar R, Navjivan S, Kohli N, Sharma B

  14. Mandibular fractures: a comparative analysis between young and adult patients in the southeast region of Turkey

    Directory of Open Access Journals (Sweden)

    Serhat Atilgan

    2010-02-01

    Full Text Available OBJECTIVE: The purpose of this study was to review and compare the differences between mandibular fractures in young and adult patients. MATERIAL AND METHODS: Patients treated at the Oral and Maxillofacial Department of Dicle University during a five-year period between 2000 and 2005 were retrospectively evaluated with respect to age groups, gender, etiology, localization and type of fractures, treatment methods and complications. RESULTS: 532 patients were included in the study, 370 (70% males and 162 (30% females, with a total of 744 mandibular fractures. The mean age of young patients was 10, with a male-female ratio of 2:1. The mean age of adult patients was 28, with a male-female ratio of 3:1. The most common causes of injury were falls (65% in young patients and traffic accidents (38% in adults. The most common fracture sites were the symphysis (35% and condyle (36% in young patients, and the symphysis in adults (36%. Mandibular fractures were generally treated by arch bar and maxillomandibular fixation in both young (67% and adult (39% patients, and 43% of the adult patients were treated by open reduction and internal fixation. CONCLUSION: There was a similar gender, monthly and type of treatment distribution in both young and adult patients in the southeast region of Turkey. However, there were differences regarding age, etiology and fracture site. These findings between young and adult patients are broadly similar to those from other studies. Analysis of small differences may be an important factor in assessing educational and socioeconomic environments.

  15. Anxiety and depression in adult patients with celiac disease on a gluten-free diet

    Institute of Scientific and Technical Information of China (English)

    Winfried; Huser; Karl-Heinz; Janke; Bodo; Klump; Michael; Gregor; Andreas; Hinz

    2010-01-01

    AIM: To compare anxiety and depression levels in adult patients with celiac disease (CD) on a gluten-free diet (GFD) with controls.METHODS: The levels of anxiety, depression and of a probable anxiety or depressive disorder were assessed by the Hospital Anxiety and Depression Scale in 441 adult patients with CD recruited by the German Celiac Society, in 235 age-and sex-matched patients with inflammatory bowel disease (IBD) in remission or with slight disease activity, and in 441 adult persons of a representa...

  16. Prospective Safety Surveillance of GH-Deficient Adults: Comparison of GH-Treated vs Untreated Patients.

    OpenAIRE

    Hartman, Mark L.; Xu, Rong; Crowe, Brenda J; Robison, Leslie L.; Erfurth, Eva Marie; Kleinberg, David L; Zimmermann, Alan G.; Woodmansee, Whitney W.; Cutler, Gordon B.; Chipman, John J; Melmed, Shlomo

    2013-01-01

    Context: In clinical practice, the safety profile of GH replacement therapy for GH-deficient adults compared with no replacement therapy is unknown. Objective: The objective of this study was to compare adverse events (AEs) in GH-deficient adults who were GH-treated with those in GH-deficient adults who did not receive GH replacement. Design and Setting: This was a prospective observational study in the setting of US clinical practices. Patients and Outcome Measures: AEs were compared between...

  17. A DIAGNOSTIC PRACTICE STUDY USING INTERNATIONAL CLASSIFICATION OF EPILEPSIES AND EPILEPTIC SYNDROMES IN 302 CASES

    Institute of Scientific and Technical Information of China (English)

    吴立文; MarkL,Scheuer

    1995-01-01

    We attempted to classify.accprding to the International Classification of Epilepaies and Epileptic Syndromes (1989),302 patients at a tertiary epilepsy referral center,Proportion in categories as defined by the International League Against Epilepsy (ILAE) were as follows: localization-related epilepsies:62.9%,generalized epilepsies:22.2%,epilepsies undetermined whether focal or generalized:14.2%,special syndromes:0.7%.Only 26.8% cases were definitely classified in single diagnostic ILAE categories based on ictal CCTV/EEG recordings.The distribution of epileptic syndromes was different from the previous reports due to various methods of case ascertainment and inclusion criteria.Use of specific criteria for the reliability study of international classification has been proposed.

  18. Behavioural epileptic seizures: a clinical and intracranial EEG study in 8 children with frontal lobe epilepsy.

    Science.gov (United States)

    Fohlen, M; Bulteau, C; Jalin, C; Jambaque, I; Delalande, O

    2004-12-01

    We report on eight children who underwent prolonged invasive video-EEG recording (IC-EEG) for intractable frontal lobe epilepsy and whose seizures consisted of behaviour changes. Seizures were recorded on a BMSI computer with 128 channels connected to the Gotman software of a stellate system; their identification was made both clinically and by automatic detection of paroxysmal electrical events. Behavioural epileptic seizures (BES) consisted of various clinical signs comprising mood change, sudden agitation, unexpected quietness, and subtle change of awareness or awakening. In 2 patients, seizures consisted in repetitive movements that we referred to as epileptic stereotypes. BES came from the prefrontal areas of the brain. Most of them were overlooked or misdiagnosed as behavioural manifestations, especially in children with mental deficiency and autistic features. Given the improvement of behaviour and mental functions following surgery, we assume that BES may contribute to generate mental and behavioural dysfunction. PMID:15627941

  19. [A study of 95 families having at least two epileptic children (author's transl)].

    Science.gov (United States)

    Sternberg, B; Patry, G

    1979-01-01

    This report concerns a study of 95 families in which at least two of the children had epilepsy (a total of 210 cases). A total of 45 p. 100 of the patients were from 60 p. 100 of the families and had an intellectual level below the average, and 32 p. 100 of them had an IQ below 70. The family history was the same whether the children were mentally deficient or not. There was no family history of mental deficiency in those families where the epileptic children had a normal IQ but there was a positive family history in 25 p. 100 of families having at least one mentally deficient and epileptic child. The persistence of seizures after 5 years of treatment is seen much more frequently in mentally deficient children than in those with normal intelligence. Finally, the position of the child within the family has no influence and epilepsy may be found in any of the children. PMID:115068

  20. The correlation of small spikes in Rolandic area and epileptic seizures

    Directory of Open Access Journals (Sweden)

    KUANG Xiao-jun

    2013-07-01

    Full Text Available The correlation between small spikes in Rolandic area and epileptic seizures was investigated. In this thesis, small spikes in Rolandic area were found in 118 cases recorded by video electroencephalogram (VEEG monitoring. And the 118 patients were chose to be studied in our research. Among the 118 cases, 62 were male and 56 were female. The youngest was only 3-month-old, and the eldest was 4 years and 5 months old. Eighty-five cases were between 3 months and 2 years old which accounted for 72.03%. There were 101 patients (85.59% having seizures: 42 cases (35.59% of febrile convulsion, 35 (29.66% of benign infantile convulsions with mild gastroenteritis (BICG and 24 (20.34% of epilepsy; 17 cases (14.41% of non-epileptic seizures. Hence, there is high correlation between infantile small spikes in Rolandic area and epileptic seizures. But it does not indicate any specificity. Whether small spikes in Rolandic area can be used as certain evidence to diagnose epilepsy and locate the onset of lesions requires further study to confirm.

  1. Sleep-related epileptic behaviors and non-REM-related parasomnias: Insights from stereo-EEG.

    Science.gov (United States)

    Gibbs, Steve A; Proserpio, Paola; Terzaghi, Michele; Pigorini, Andrea; Sarasso, Simone; Lo Russo, Giorgio; Tassi, Laura; Nobili, Lino

    2016-02-01

    During the last decade, many clinical and pathophysiological aspects of sleep-related epileptic and non-epileptic paroxysmal behaviors have been clarified. Advances have been achieved in part through the use of intracerebral recording methods such as stereo-electroencephalography (S-EEG), which has allowed a unique "in vivo" neurophysiological insight into focal epilepsy. Using S-EEG, the local features of physiological and pathological EEG activity in different cortical and subcortical structures have been better defined during the entire sleep-wake spectrum. For example, S-EEG has contributed to clarify the semiology of sleep-related seizures as well as highlight the specific epileptogenic networks involved during ictal activity. Moreover, intracerebral EEG recordings derived from patients with epilepsy have been valuable to study sleep physiology and specific sleep disorders. The occasional co-occurrence of NREM-related parasomnias in epileptic patients undergoing S-EEG investigation has permitted the recordings of such events, highlighting the presence of local electrophysiological dissociated states and clarifying the underlying pathophysiological substrate of such NREM sleep disorders. Based on these recent advances, the authors review and summarize the current and relevant S-EEG literature on sleep-related hypermotor epilepsies and NREM-related parasomnias. Finally, novel data and future research hypothesis will be discussed. PMID:26164370

  2. Latanoprost systemic exposure in pediatric and adult patients with glaucoma

    DEFF Research Database (Denmark)

    Raber, Susan; Courtney, Rachel; Maeda-Chubachi, Tomoko;

    2011-01-01

    To evaluate short-term safety and steady-state systemic pharmacokinetics (PK) of latanoprost acid in pediatric subjects with glaucoma or ocular hypertension who received the adult latanoprost dose....

  3. Computer-aided diagnosis of interictal 18F-FDG PET images for presurgical evaluation of epileptic foci in extratemporal lobe epilepsy

    International Nuclear Information System (INIS)

    Interictal 18F-FDG PET is beneficial to patients with epilepsy to define the epileptic foci before operation, especially to decide the laterality of temporal lobe epilepsy (TLE). However usefulness has not been clearly established in extra TLE. We retrospectively applied Z-score analysis to interictal preoperative 18F-FDG PET images for detection of the epileptic foci in order to achieve better performance. Seventeen epileptic patients (women/men; 8/9, age; 11-55 yrs) underwent resection of epileptic foci with good outcome (Engel's stage of I or II) even after more than a year from operation. Presurgical 18F-FDG PET images were spatially normalized using statistical parametric mapping 99 (SPM99) with an original Japanese template for 18F-FDG and compared with normal database constructed from 31 healthy volunteers (women/men; 14/17, age; 19-59 yrs). A software program, easy Z-score imaging system (eZIS), for analysis of patient data was developed by calculating Z-score in each voxel and visualizing the score in a standardized stereotactic space; Z-score=(normal mean-patient's value)/a standard deviation of normal data. Detectability of epileptic foci for this computer-aided analysis was compared with visual inspection of original 18F-FDG PET images by five radiologists without any clinical information. In all cases, there was significant reduction of glucose metabolism in the operated area. The sensitivities of the detection of epileptic foci obtained from visual inspection were 47-59%. In contrast to, computer analysis by eZIS showed 71% sensitivity when we defined the highest Z-score in the cerebrum to be the focus diagnosed by eZIS. Computer-aided diagnosis with eZIS for 18F-FDG PET study is useful for detecting epileptic foci in extra TLE. (author)

  4. Quantitative analysis of surface electromyography during epileptic and nonepileptic convulsive seizures

    DEFF Research Database (Denmark)

    Beniczky, Sándor; Conradsen, Isa; Moldovan, Mihai;

    2014-01-01

    tonic-clonic seizures (GTCS) from 14 patients with epilepsy, and 18 convulsive PNES from 12 patients (one patient had both GTCS and PNES). The healthy controls were simulating GTCS. To quantitatively characterize the signals we calculated the following parameters: root mean square (RMS) of the amplitude...... seizure, and separation between the tonic and the clonic phases distinguished at group-level but not at individual level between convulsive PNES and GTCS. RMS, temporal dynamics of the HF/LF ratio, and the evolution of the silent periods differentiated between epileptic and nonepileptic convulsive...

  5. Hypoperfusion in baseline and cognitively activated brain SPECT imaging of adult and elderly patients with depression

    International Nuclear Information System (INIS)

    Objective: To evaluate the rCBF abnormalities of the baseline and cognitively activated rCBF imaging in unmedicated adult and elderly patients with depression. Methods: The subjects were divided into four groups: depressed adults, normal adult controls, depressed elders and normal elderly controls. All depressed patients were unmedicated and the diagnoses (depression of moderate degree with accompanying somatization) were confirmed by the ICD-10 criteria. Age range of the 39 depressed adult patients was 17 - 55 years. 17 age-matched normal adult controls (age range 21 - 50 years) were studied under identical conditions. The age range of 18 depressed elderly patients was 62 - 76 years. 21 age-matched normal elderly controls (age range 60 - 72 years) were studied under identical conditions. Baseline and cognitively activated 99Tcm-ECD SPECT were performed on 25 of the 39 adult patients with depression and 17 normal adult controls. Baseline 99Tcm-ECD SPECT only was performed on the remaining 14 patients with depression. Baseline and cognitively activated 99Tcm-ECD SPECT were performed on 12 of the 18 elderly patients with depression and 18 of the 21 normal elderly controls. Baseline 99Tcm-ECD SPECT only was performed on the remaining elderly patients and 3 normal elderly controls. Results: 1) The characteristic abnormalities of baseline and cognitively activated brain SPECT imaging of depression in adults: the baseline rCBF values of frontal and temporal lobe decreased significantly and the activated rCBF values of frontal, temporal lobe decreased more evidently than that in the baseline imaging and additionally decreased activated rCBF values in parietal lobe were found. 2) The characteristic abnormalities of baseline and cognitively activated brain SPECT imaging of elderly patients with depression: the baseline rCBF values of frontal, temporal lobe and right basal ganglia decreased significantly and the activated rCBF values of frontal, temporal, right parietal lobe

  6. Epileptic Seizures: Quakes of the brain?

    CERN Document Server

    Osorio, Ivan; Sornette, Didier; Milton, John; Lai, Ying-Cheng

    2007-01-01

    The concept of universality proposes that dynamical systems with the same power law behaviors are equivalent at large scales. We test this hypothesis on the Earth's crust and the epileptic brain, and discover that power laws also govern the distributions of seizure energies and recurrence times. This robust correspondence is extended over seven statistics, including the direct and inverse Omori laws. We also verify in an animal seizure model the earthquake-driven hypothesis that power law statistics co-exist with characteristic scales, as coupling between constitutive elements increases towards the synchronization regime. These observations point to the universality of the dynamics of coupled threshold oscillators for systems even as diverse as Earth and brain and suggest a general strategy for forecasting seizures, one of neurosciences' grails.

  7. Epileptic Seizure Forewarning by Nonlinear Techniques

    International Nuclear Information System (INIS)

    Nicolet Biomedical Inc. (NBI) is collaborating with Oak Ridge National Laboratory (ORNL) under a Cooperative Research and Development Agreement (CRADA) to convert ORNL's patented technology for forewarning of epileptic seizures to a clinical prototype. This technical report describes the highlights of the first year's effort. The software requirements for the clinical device were specified from which the hardware specifications were obtained. ORNL's research-class FORTRAN was converted to run under a graphical user interface (GUI) that was custom-built for this application by NBI. The resulting software package was cloned to desktop computers that are being tested in five different clinical sites. Two hundred electroencephalogram (EEG) datasets from those clinical sites were provided to ORNL for detailed analysis and improvement of the forewarning methodology. Effort under this CRADA is continuing into the second year as planned

  8. Patient-Reported Outcomes in Adult Survivors with Single-Ventricle Physiology

    DEFF Research Database (Denmark)

    Overgaard, Dorthe; Schrader, Anne-Marie Voss; Lisby, Karen H;

    2011-01-01

    Objectives: Data on patient-reported outcomes (PROs) in patients with single-ventricle physiology (SVP) are scarce. We sought (1) to describe the perceived health status, quality of life, symptoms of anxiety and depression, and sense of coherence in adult survivors with SVP, (2) to compare PROs...... across functional classes, and (3) to compare PROs between patients and controls. Methods: A case-control study in two adult congenital heart programmes with 62 adult survivors with SVP were matched to 172 healthy controls. A wide range of PROs were measured using validated questionnaires. The treating...... physician classified patients according to the Ability Index. Results: Patients with SVP have a good functional status. Patients in Ability Index class I consistently reported the best scores, similar to those of healthy controls. Negative associations were found between functional class and outcomes...

  9. Patient-reported outcomes in adult survivors with single-ventricle physiology

    DEFF Research Database (Denmark)

    Overgaard, Dorthe; Schrader, Anne-Marie; Lisby, Karen H;

    2011-01-01

    Objectives: Data on patient-reported outcomes (PROs) in patients with single-ventricle physiology (SVP) are scarce. We sought (1) to describe the perceived health status, quality of life, symptoms of anxiety and depression, and sense of coherence in adult survivors with SVP, (2) to compare PROs...... across functional classes, and (3) to compare PROs between patients and controls. Methods: A case-control study in two adult congenital heart programmes with 62 adult survivors with SVP were matched to 172 healthy controls. A wide range of PROs were measured using validated questionnaires. The treating...... physician classified patients according to the Ability Index. Results: Patients with SVP have a good functional status. Patients in Ability Index class I consistently reported the best scores, similar to those of healthy controls. Negative associations were found between functional class and outcomes...

  10. Quality of life related to urinary continence in adult spina bifida patients

    OpenAIRE

    Liu, Joceline S.; Dong, Caroline; Casey, Jessica T.; Greiman, Alyssa; Mukherjee, Shubhra; Kielb, Stephanie J.

    2015-01-01

    Introduction To analyze the correlations of bladder management technique, ambulatory status and urologic reconstruction on quality of life (QOL) as affected by urinary symptoms in adult spina bifida (SB) patients. Material and methods Sixty–six adult SB patients completed the RAND 36–Item Health Survey (mSF–36) and Incontinence Quality of Life (I–QOL). Demographic information, history of urinary reconstruction, and bladder management techniques were reviewed and analyzed with respect to surve...

  11. Childhood trauma and adult interpersonal relationship problems in patients with depression and anxiety disorders

    OpenAIRE

    Huh, Hyu Jung; Kim, Sun-Young; Yu, Jeong Jin; Chae, Jeong-Ho

    2014-01-01

    Introduction Although a plethora of studies have delineated the relationship between childhood trauma and onset, symptom severity, and course of depression and anxiety disorders, there has been little evidence that childhood trauma may lead to interpersonal problems among adult patients with depression and anxiety disorders. Given the lack of prior research in this area, we aimed to investigate characteristics of interpersonal problems in adult patients who had suffered various types of abuse...

  12. Interictal brain SPECT in patients with medically refractory temporal lobe epilepsy

    International Nuclear Information System (INIS)

    The brain single photon emission computed tomography (SPECT) is s functional neuroimaging method that can detect localized changes in cerebral blood flow. The temporal lobe epilepsy (TLE) is the most common epileptic syndrome in adults, and more than 50% are medically refractory. The SPECT can contribute to investigation of epileptogenic focus and is one of the methods of pre-surgical evaluation of these patients. (author)

  13. Cardiovascular effects of growth hormone in adult hemodialysis patients: results from a randomized controlled trial

    DEFF Research Database (Denmark)

    Køber, Lars; Rustom, Rana; Wiedmann, Jonas; Kappelgaard, Anne-Marie; El Nahas, Meguid; Feldt-Rasmussen, Bo

    2010-01-01

    The high morbidity and mortality rates in hemodialysis (HD) patients are due, at least in part, to their increased risk for cardiovascular diseases (CVD). This prospective study evaluated the effect of growth hormone (GH) on a number of CVD risk markers in adult patients on HD.......The high morbidity and mortality rates in hemodialysis (HD) patients are due, at least in part, to their increased risk for cardiovascular diseases (CVD). This prospective study evaluated the effect of growth hormone (GH) on a number of CVD risk markers in adult patients on HD....

  14. The adult cystic fibrosis patient with abdominal pain: what the radiologist needs to know

    Energy Technology Data Exchange (ETDEWEB)

    Liong, S.Y.; Awad, D. [Department of Radiology, University Hospital of South Manchester, Wythenshawe Hospital, Manchester (United Kingdom); Jones, A.M. [Department of Respiratory Medicine, University Hospital of South Manchester, Wythenshawe Hospital, Manchester (United Kingdom); Manchester Academic Health Science Centre, University of Manchester, Manchester (United Kingdom); Sukumar, S.A., E-mail: Sathi.Sukumar@uhsm.nhs.u [Department of Radiology, University Hospital of South Manchester, Wythenshawe Hospital, Manchester (United Kingdom)

    2011-02-15

    As the life expectancy of cystic fibrosis (CF) patients continues to increase, abdominal manifestations of CF are increasingly being encountered by clinicians and radiologists. Imaging plays an important role in the evaluation of adult CF patients with abdominal pain as a cause is often not discernable clinically. Accurate diagnosis is crucial in these patients as some causes may be managed conservatively, whilst others may require surgical intervention. In this review, we describe clinical presentation, imaging findings, and management of adult CF patients presenting with abdominal pain.

  15. The adult cystic fibrosis patient with abdominal pain: what the radiologist needs to know

    International Nuclear Information System (INIS)

    As the life expectancy of cystic fibrosis (CF) patients continues to increase, abdominal manifestations of CF are increasingly being encountered by clinicians and radiologists. Imaging plays an important role in the evaluation of adult CF patients with abdominal pain as a cause is often not discernable clinically. Accurate diagnosis is crucial in these patients as some causes may be managed conservatively, whilst others may require surgical intervention. In this review, we describe clinical presentation, imaging findings, and management of adult CF patients presenting with abdominal pain.

  16. Ontology and Knowledge Management System on Epilepsy and Epileptic Seizures

    CERN Document Server

    Almeida, Pedro; Sales, Francisco; Nogueira, Ana; Dourado, António

    2010-01-01

    A Knowledge Management System developed for supporting creation, capture, storage and dissemination of information about Epilepsy and Epileptic Seizures is presented. We present an Ontology on Epilepsy and a Web-based prototype that together create the KMS.

  17. EPILEPTIC ENCEPHALOPATHY WITH CONTINUOUS SPIKES-WAVES ACTIVITY DURING SLEEP

    Directory of Open Access Journals (Sweden)

    E. D. Belousova

    2012-01-01

    Full Text Available The author represents the review and discussion of current scientific literature devoted to epileptic encephalopathy with continuous spikes-waves activity during sleep — the special form of partly reversible age-dependent epileptic encephalopathy, characterized by triad of symptoms: continuous prolonged epileptiform (spike-wave activity on EEG in sleep, epileptic seizures and cognitive disorders. The author describes the aspects of classification, pathogenesis and etiology, prevalence, clinical picture and diagnostics of this disorder, including the peculiar anomalies on EEG. The especial attention is given to approaches to the treatment of epileptic encephalopathy with continuous spikeswaves activity during sleep. Efficacy of valproates, corticosteroid hormones and antiepileptic drugs of other groups is considered. The author represents own experience of treatment this disorder with corticosteroids, scheme of therapy and assessment of efficacy.

  18. Neurogenesis in a young dog with epileptic seizures.

    Science.gov (United States)

    Borschensky, C M; Woolley, J S; Kipar, A; Herden, C

    2012-09-01

    Epileptic seizures can lead to various reactions in the brain, ranging from neuronal necrosis and glial cell activation to focal structural disorganization. Furthermore, increased hippocampal neurogenesis has been documented in rodent models of acute convulsions. This is a report of hippocampal neurogenesis in a dog with spontaneous epileptic seizures. A 16-week-old epileptic German Shepherd Dog had marked neuronal cell proliferation (up to 5 mitotic figures per high-power field and increased immunohistochemical expression of proliferative cell nuclear antigen) in the dentate gyrus accompanied by microglial and astroglial activation. Some granule cells expressed doublecortin, a marker of immature neurons; mitotically active cells expressed neuronal nuclear antigen. No mitotic figures were found in the brain of age-matched control dogs. Whether increased neurogenesis represents a general reaction pattern of young epileptic dogs should be investigated. PMID:22194355

  19. Correlation Dimension Maps of EEG from Epileptic Absences

    CERN Document Server

    Silva, C; Andrade, A; Foreid, J P; Ducla-Soares, E

    1999-01-01

    Purpose: The understanding of brain activity, and in particular events such as epileptic seizures, lies on the characterisation of the dynamics of the neural networks. The theory of non-linear dynamics provides signal analysis techniques which may give new information on the behaviour of such networks. Methods: We calculated correlation dimension maps for 19-channel EEG data from 3 patients with a total of 7 absence seizures. The signals were analysed before, during and after the seizures. Phase randomised surrogate data was used to test chaos. Results: In the seizures of two patients we could distinguish two dynamical regions on the cerebral cortex, one that seemed to exhibit chaos whereas the other seemed to exhibit noise. The pattern shown is essentially the same for seizures triggered by hyperventilation, but differ for seizures triggered by light flashes. The chaotic dynamics that one seems to observe is determined by a small number of variables and has low complexity. On the other hand, in the seizures ...

  20. De novo loss- or gain-of-function mutations in KCNA2 cause epileptic encephalopathy.

    Science.gov (United States)

    Syrbe, Steffen; Hedrich, Ulrike B S; Riesch, Erik; Djémié, Tania; Müller, Stephan; Møller, Rikke S; Maher, Bridget; Hernandez-Hernandez, Laura; Synofzik, Matthis; Caglayan, Hande S; Arslan, Mutluay; Serratosa, José M; Nothnagel, Michael; May, Patrick; Krause, Roland; Löffler, Heidrun; Detert, Katja; Dorn, Thomas; Vogt, Heinrich; Krämer, Günter; Schöls, Ludger; Mullis, Primus E; Linnankivi, Tarja; Lehesjoki, Anna-Elina; Sterbova, Katalin; Craiu, Dana C; Hoffman-Zacharska, Dorota; Korff, Christian M; Weber, Yvonne G; Steinlin, Maja; Gallati, Sabina; Bertsche, Astrid; Bernhard, Matthias K; Merkenschlager, Andreas; Kiess, Wieland; Gonzalez, Michael; Züchner, Stephan; Palotie, Aarno; Suls, Arvid; De Jonghe, Peter; Helbig, Ingo; Biskup, Saskia; Wolff, Markus; Maljevic, Snezana; Schüle, Rebecca; Sisodiya, Sanjay M; Weckhuysen, Sarah; Lerche, Holger; Lemke, Johannes R

    2015-04-01

    Epileptic encephalopathies are a phenotypically and genetically heterogeneous group of severe epilepsies accompanied by intellectual disability and other neurodevelopmental features. Using next-generation sequencing, we identified four different de novo mutations in KCNA2, encoding the potassium channel KV1.2, in six isolated patients with epileptic encephalopathy (one mutation recurred three times independently). Four individuals presented with febrile and multiple afebrile, often focal seizure types, multifocal epileptiform discharges strongly activated by sleep, mild to moderate intellectual disability, delayed speech development and sometimes ataxia. Functional studies of the two mutations associated with this phenotype showed almost complete loss of function with a dominant-negative effect. Two further individuals presented with a different and more severe epileptic encephalopathy phenotype. They carried mutations inducing a drastic gain-of-function effect leading to permanently open channels. These results establish KCNA2 as a new gene involved in human neurodevelopmental disorders through two different mechanisms, predicting either hyperexcitability or electrical silencing of KV1.2-expressing neurons. PMID:25751627

  1. Screening for coeliac disease in adult patients with type 1 diabetes mellitus: myths, facts and controversy.

    Science.gov (United States)

    Bakker, Sjoerd F; Tushuizen, Maarten E; von Blomberg, Boudewina M E; Bontkes, Hetty J; Mulder, Chris J; Simsek, Suat

    2016-01-01

    This review aims at summarizing the present knowledge on the clinical consequences of concomitant coeliac disease (CD) in adult patients with type 1 diabetes mellitus (T1DM). The cause of the increased prevalence of CD in T1DM patients is a combination of genetic and environmental factors. Current screening guidelines for CD in adult T1DM patients are not uniform. Based on the current evidence of effects of CD on bone mineral density, diabetic complications, quality of life, morbidity and mortality in patients with T1DM, we advise periodic screening for CD in adult T1DM patients to prevent delay in CD diagnosis and subsequent CD and/or T1DM related complications. PMID:27478507

  2. Strengthening the effectiveness of patient education: applying principles of adult education.

    Science.gov (United States)

    Padberg, R M; Padberg, L F

    1990-01-01

    In spite of the recognized significance of patient education, many factors contribute to difficulties in providing effective patient teaching: diminished time from reduced hospital stays, the shortage of nursing personnel, and often, the patient's compromised physical and emotional status. With these constraints, teaching must be effective and efficient. In reviewing the literature, primary emphasis was found on providing sound clinical information with little attention to the techniques of effective methods for teaching adults. This article draws upon the principles of andragogy--the methods of teaching adults delineated by Malcolm Knowles--to provide a conceptual framework for developing effective patient education practice. Examples of both effective and ineffective practice are provided from the nursing literature. The information provided should assist nurses in understanding how adults learn and provide them with a structure to use in tailoring their teaching to meet the individual needs of their patients. PMID:2300506

  3. Frequency of Worry and Anxiety in Epileptic Children's Mothers

    OpenAIRE

    Bagheri-Galeh S.; AA Kolahi

    2013-01-01

    Background and Objectives: Adverse effect of children's epilepsy on family members, especially mothers, is an issue that has been less considered. One of these effects is anxiety increase in mothers. This study has been done with the purpose of determining frequency of worry and anxiety in epileptic children's mothers and recognizing the factors affecting it.Methods: This descriptive cross-sectional study has been done with the participation of epileptic children's mothers referred to Mofid N...

  4. Enhanced susceptibility to spontaneous seizures of noda epileptic rats by loss of synaptic zn(2+.

    Directory of Open Access Journals (Sweden)

    Atsushi Takeda

    Full Text Available Zinc homeostasis in the brain is associated with the etiology and manifestation of epileptic seizures. Adult Noda epileptic rats (NER, >12-week-old exhibit spontaneously generalized tonic-clonic convulsion about once a day. To pursue the involvement of synaptic Zn(2+ signal in susceptibility to spontaneous seizures, in the present study, the effect of zinc chelators on epileptogenesis was examined using adult NER. Clioquinol (CQ and TPEN are lipophilic zinc chelotors, transported into the brain and reduce the levels of synaptic Zn(2+. The incidence of tonic-clonic convulsion was markedly increased after i.p. injection of CQ (30-100 mg/kg and TPEN (1 mg/kg. The basal levels of extracellular Zn(2+ measured by ZnAF-2 were decreased before tonic-clonic convulsion was induced with zinc chelators. The hippocampal electroencephalograms during CQ (30 mg/kg-induced convulsions were similar to those during sound-induced convulsions in NER reported previously. Exocytosis of hippocampal mossy fibers, which was measured with FM4-64, was significantly increased in hippocampal slices from CQ-injected NER that did not show tonic-clonic convulsion yet. These results indicate that the abnormal excitability of mossy fibers is induced prior to epileptic seizures by injection of zinc chelators into NER. The incidence of tonic-clonic convulsion induced with CQ (30 mg/kg was significantly reduced by co-injection with aminooxyacetic acid (5-10 mg/kg, an anticonvulsant drug enhancing GABAergic activity, which did not affect locomotor activity. The present paper demonstrates that the abnormal excitability in the brain, especially in mossy fibers, which is potentially associated with the insufficient GABAergic neuron activity, may be a factor to reduce the threshold for epileptogenesis in NER.

  5. Enhanced susceptibility to spontaneous seizures of noda epileptic rats by loss of synaptic zn(2+).

    Science.gov (United States)

    Takeda, Atsushi; Iida, Masashi; Ando, Masaki; Nakamura, Masatoshi; Tamano, Haruna; Oku, Naoto

    2013-01-01

    Zinc homeostasis in the brain is associated with the etiology and manifestation of epileptic seizures. Adult Noda epileptic rats (NER, >12-week-old) exhibit spontaneously generalized tonic-clonic convulsion about once a day. To pursue the involvement of synaptic Zn(2+) signal in susceptibility to spontaneous seizures, in the present study, the effect of zinc chelators on epileptogenesis was examined using adult NER. Clioquinol (CQ) and TPEN are lipophilic zinc chelotors, transported into the brain and reduce the levels of synaptic Zn(2+). The incidence of tonic-clonic convulsion was markedly increased after i.p. injection of CQ (30-100 mg/kg) and TPEN (1 mg/kg). The basal levels of extracellular Zn(2+) measured by ZnAF-2 were decreased before tonic-clonic convulsion was induced with zinc chelators. The hippocampal electroencephalograms during CQ (30 mg/kg)-induced convulsions were similar to those during sound-induced convulsions in NER reported previously. Exocytosis of hippocampal mossy fibers, which was measured with FM4-64, was significantly increased in hippocampal slices from CQ-injected NER that did not show tonic-clonic convulsion yet. These results indicate that the abnormal excitability of mossy fibers is induced prior to epileptic seizures by injection of zinc chelators into NER. The incidence of tonic-clonic convulsion induced with CQ (30 mg/kg) was significantly reduced by co-injection with aminooxyacetic acid (5-10 mg/kg), an anticonvulsant drug enhancing GABAergic activity, which did not affect locomotor activity. The present paper demonstrates that the abnormal excitability in the brain, especially in mossy fibers, which is potentially associated with the insufficient GABAergic neuron activity, may be a factor to reduce the threshold for epileptogenesis in NER. PMID:23951148

  6. NEUROPSYCHOLOGICAL CHARACTERIZATION OF ADULT PATIENTS UNDER DIALYSIS IN A SPECIALIZED INSTITUTIONIN MEDELLIN, COLOMBIA

    OpenAIRE

    ANA DUARTE; LUZ GÓMEZ; DANIEL AGUIRRE; DAVID PINEDA

    2006-01-01

    Introduction: Patients with chronic renal failure (CRF) have cognitive impairments and intellectual deficiencies comparedwith normal people. Objective: To analyze the neuropsychological characteristics in adult patients (18 to 65 years old),belonging to a dialysis program in the Instituto del Riñón [Kidney Institute] of Medellín-Colombia. Subjects andMethods: A non-randomized sample of 59 patients, aged between 23 to 64 years old, a neuropsychological tests batterywas applied to patients, whi...

  7. Incidence of diabetes mellitus type 2 complications among Saudi adult patients at primary health care center

    OpenAIRE

    Alsenany, Samira; Al Saif, Amer

    2015-01-01

    [Purpose] This study analyzed type 2 diabetes and its role in complications among adult Saudi patients. [Subjects] Patients attending four primary health care centers in Jeddah were enrolled. [Methods] A cross-sectional design study among Saudi patients attending Ministry of Health primary health care centers in Jeddah was selected for use by the Primary Health Care administration. Patients were interviewed with structured questionnaires to determine the presence of diabetes and risk factors ...

  8. Nutrition in adult patients with inflammatory bowel disease.

    Science.gov (United States)

    Hebuterne, Xavier; Filippi, Jerome; Schneider, Stephane M

    2014-01-01

    Seventy five percent of hospitalized patients with Crohn's disease suffer from malnutrition. One third of Crohn's disease patients have a body mass index below 20. Sixty percent of Crohn's disease patients have sarcopenia. However some inflammatory bowel disease (IBD) patients are obese or suffer from sarcopenic-obesity. IBD patients have many vitamin and nutrient deficiencies, which can lead to important consequences such as hyperhomocysteinemia, which is associated with a higher risk of thromboembolic disease. Nutritional deficiencies in IBD patients are the result of insufficient intake, malabsorption and protein-losing enteropathy as well as metabolic disturbances directly induced by the chronic disease and its treatments, in particular corticosteroids. Screening for nutritional deficiencies in chronic disease patients is warranted. Managing the deficiencies involves simple nutritional guidelines, vitamin supplements, and nutritional support in the worst cases. PMID:25266810

  9. Recurrent prolonged fugue states as the sole manifestation of epileptic seizures

    OpenAIRE

    Geeta A Khwaja; Ashish Duggal; Amit Kulkarni; Neera Chaudhry; Meena Gupta; Debashish Chowdhury; Vikram Bohra

    2013-01-01

    A fugue state is defined as an altered state of consciousness with varying degrees of motor activity and amnesia for the event. It may last for hours to days and may be psychogenic or organic in nature. Epileptic fugue states can be encountered in patients with absence or complex partial nonconvulsive status epilepticus or may occur as a postictal phenomenon in patients with generalized seizures. ′′absence status epilepticus′′ (AS) is rare and seen in only 2.6% of the cases with ′′childhood a...

  10. Comparison of biological characteristics of marrow mesenchymal stem cells in hepatitis B patients and normal adults

    Institute of Scientific and Technical Information of China (English)

    Liang Peng; Hua Li; Lin Gu; Xiao-Mou Peng; Yang-Su Huang; Zhi-Liang Gao

    2007-01-01

    AIM: To establish a culture system of marrow mesenchymal stem cells (MSCs) from hepatitis B patients and normal adults and to compare their biological characteristics.METHODS: MSCs were isolated from bone marrow in 34 male hepatitis B patients and 15 male normal adults and cultivated in vitro. Their biological characteristics including surface markers, shapes and appearances, growth curves, first passage time and passage generations were compared.RESULTS: Cultivation achievement ratio of hepatitis B patients was lower than that of normal adults, no statistical significance (82.35% vs 100%, P >0.05). Compared with MSCs of normal adults, MSCs of hepatitis B patients presented a statistical lower growth curve, longer first passage time (13.0 ± 1.6 d vs 11.4 ± 1.5 d, P < 0.05), fewer passaging generation numbers (10.5 ± 1.4 generations vs 12.3±1.7 generations, P < 0.05), though both shared same appearances, shapes and surface markers. MSCs in hepatitis B patients would expand, spread out and age more easily and there were more refractive particles in the cytoplasm.CONCLUSION: MSCs from hepatitis B patients can be cultured in vitro. Although their appearance, shape and surface marker are similar to those of MSCs from normal adults, there are differences in their biological characteristics.

  11. Temporal Cytokine Profiles in Severely Burned Patients: A Comparison of Adults and Children

    Science.gov (United States)

    Finnerty, Celeste C; Jeschke, Marc G; Herndon, David N; Gamelli, Richard; Gibran, Nicole; Klein, Matthew; Silver, Geoff; Arnoldo, Brett; Remick, Daniel; Tompkins, Ronald G

    2008-01-01

    A severe burn leads to hypermetabolism and catabolism resulting in compromised function and structural changes of essential organs. The release of cytokines has been implicated in this hypermetabolic response. The severity of the hypermetabolic response following burn injury increases with age, as does the mortality rate. Due to the relationship between the hypermetabolic and inflammatory responses, we sought to compare the plasma cytokine profiles following a severe burn in adults and in children. We enrolled 25 adults and 24 children who survived a flame burn covering more than 20% of total body surface area (TBSA). The concentrations of 22 cytokines were measured using the Linco multiplex array system (St. Charles, MO, USA). Large perturbations in the expression of pro- and anti-inflammatory cytokines were seen following thermal injury. During the first week following burn injury, IFN-γ, IL-10, IL-17, IL-4, IL-6, and IL-8 were detected at significantly higher levels in adults compared with children, P < 0.05. Significant differences were measured during the second week post-burn for IL-1β (higher in children) and IL-5 (higher in adults), P < 0.05. IL-18 was more abundant in children compared with adults during the third week post-burn, P < 0.05. Between post-burn d 21 and d 66, IL-1α was detected at higher concentrations in pediatric compared with adult patients, P < 0.05. Only GM-CSF expression was significantly different at all time points; it was detected at lower levels in pediatric patients, P < 0.05. Eotaxin, G-CSF, IL-13, IL-15, IP-10, MCP-1, and MIP-1α were detected at significantly different concentrations in adult compared with pediatric patients at multiple time points, P < 0.05. There were no differences in IL-12, IL-2, IL-7, or TNF levels in adult compared with pediatric burn patients at any of these time points. Following severe flame burns, the cytokine profiles in pediatric patients differ compared with those in adult patients, which may

  12. Thyroid Function Test Imbalance in Epileptic Children Under Anticonvulsive Therapy

    Directory of Open Access Journals (Sweden)

    Mohammad TORKAMAN

    2012-03-01

    Full Text Available How to Cite this Article: Ravi Torkaman M, Amirsalari S, Saburi A. Thyroid Function Test Imbalance in Epileptic ChildrenUnder Anticonvulsive Therapy. Iranian Journal of Child Neurology 2012;6(1:43-44. Dear Editor,There have been many studies regarding the impact of antiepileptic drugs(AEDs on thyroid function. There are some challenging scopes which must beconsidered for conducting the study adressing the focused question. “Which oneof the thyroid hormones is related to the AEDs consumption?”. Some studiesdemonstrated that there may be alterations in all thyroid function tests (T3, T4 andTSH after antiepileptic therapy in children (1. Some studies concluded that longtermprescription of anticonvulsive medications resulted in a decline in serum T4levels, although it had no effect on serum TSH levels. However, changes in serumT3 level was challenging and it must be investigated further (2.There were some confounding factors which may interfere with the conclusion.One of them is the type of the study. There are various study plans for this purposesuch as cross-sectional, case-control, experimental, self-controlled cohort anddouble-blind randomized clinical trial studies. It seems that the proper protocol ofstudy for this propose is a double-blind randomized clinical trial study. By usingother designs, the authors cannot interpret the effect of AEDs on thyroid function;however, they can discuss the prevalence of thyroid hormone imbalance and thecoordination among T3, T4 and TSH.Moreover, one of the confounding factors is the thyroid binding globulin (TBGeffect. It has appeared that some of the AEDs may change the amount of TBGand in this way may affect the amount of thyroid hormones (3. Clonazepamand valproic acid do not have any enzyme inducing effects, but phenobarbital,carbamazepine, phenytoin and primidone may induce the hepatic enzyme (4-6. Therefore, it seems necessary to analyze each group of patients based on thetype of drug which is

  13. Aplastic crisis caused by parvovirus B19 in an adult patient with sickle-cell disease

    OpenAIRE

    Setúbal Sérgio; Gabriel Adelmo H.D.; Nascimento Jussara P.; Oliveira Solange A.

    2000-01-01

    We describe a case of aplastic crisis caused by parvovirus B19 in an adult sickle-cell patient presenting with paleness, tiredness, fainting and dyspnea. The absence of reticulocytes lead to the diagnosis. Anti-B19 IgM and IgG were detected. Reticulocytopenia in patients with hereditary hemolytic anemia suggests B19 infection.

  14. Histopathological Characteristics of Distal Middle Cerebral Artery in Adult and Pediatric Patients with Moyamoya Disease.

    Science.gov (United States)

    Takagi, Yasushi; Hermanto, Yulius; Takahashi, Jun C; Funaki, Takeshi; Kikuchi, Takayuki; Mineharu, Yohei; Yoshida, Kazumichi; Miyamoto, Susumu

    2016-06-15

    Moyamoya disease (MMD) is a unique progressive steno-occlusive disease of the distal ends of bilateral internal arteries and their proximal branches. The difference in clinical symptoms between adult and children MMD patients has been well recognized. In this study, we sought to investigate the phenomenon through histopathological study. Fifty-one patients underwent surgical procedures for treatment of standard indications of MMD at Kyoto University Hospital. Fifty-nine specimens of MCA were obtained from MMD patients during the surgical procedures. Five MCA samples were also obtained in the same way from control patients. The samples were analyzed by histopathological methods. In this study, MCA specimens from MMD patients had significantly thinner media and thicker intima than control specimens. In subsequent analysis, adult (≥ 20 years) patients had thicker intima of MCA compared to pediatric (media occurs in both adult and pediatric patients. However, the MMD feature in tunica intima of MCA is more prominent in adult patients. Further analysis from MCA specimens and other researches are necessary to elucidate the pathophysiology of MMD. PMID:27087193

  15. Higher psychic dysfunctions in adult patients with epilepsy: role of antiepileptic therapy

    Directory of Open Access Journals (Sweden)

    Kira Vladimirovna Voronkova

    2012-03-01

    Full Text Available The paper reviews the data available in the literature on higher psychic dysfunctions in adult patients with epilepsy. It considers the factors influencing the development of higher psychic dysfunctions, including the use of antiepileptic drugs. Possible correction options are given for higher psychic sphere impairments in patients with epilepsy.

  16. Effects of neurofeedback on adult patients with psychiatric disorders in a naturalistic setting.

    Science.gov (United States)

    Cheon, Eun-Jin; Koo, Bon-Hoon; Seo, Wan-Seok; Lee, Jun-Yeob; Choi, Joong-Hyeon; Song, Shin-Ho

    2015-03-01

    Few well-controlled studies have considered neurofeedback treatment in adult psychiatric patients. In this regard, the present study investigates the characteristics and effects of neurofeedback on adult psychiatric patients in a naturalistic setting. A total of 77 adult patients with psychiatric disorders participated in this study. Demographic data and neurofeedback states were retrospectively analyzed, and the effects of neurofeedback were evaluated using clinical global impression (CGI) and subjective self-rating scales. Depressive disorders were the most common psychiatric disorders (19; 24.7 %), followed by anxiety disorders (18; 23.4 %). A total of 69 patients (89.6 %) took medicine, and the average frequency of neurofeedback was 17.39 ± 16.64. Neurofeedback was applied to a total of 39 patients (50.6 %) more than 10 times, and 48 patients (62.3 %) received both β/SMR and α/θ training. The discontinuation rate was 33.8 % (26 patients). There was significant difference between pretreatment and posttreatment CGI scores (anxiety, and inattention (<.001). This is a naturalistic study in a clinical setting, and has several limitations, including the absence of a control group and a heterogenous sample. Despite these limitations, the study demonstrates the potential of neurofeedback as an effective complimentary treatment for adult patients with psychiatric disorders. PMID:25740085

  17. Severe Hypercapnia in Critically Ill Adult Cystic Fibrosis Patients

    OpenAIRE

    Sheikh, Hassan S.; Tiangco, Noel Dexter; Harrell, Christopher; Vender, Robert L.

    2011-01-01

    Background Cystic fibrosis (CF) is a monogenetic autosomal recessive multi-organ disease affecting approximately 50,000 patients worldwide. Overall median survival is continually increasing but pulmonary disease remains the most common cause of death. Guidelines have been published in relation to the outpatient maintenance of lung health for CF patients and treatment of acute lung exacerbations but little information exists about the management of the critically ill CF patient. Invasive mecha...

  18. Assessment of oral side effects of Antiepileptic drugs and traumatic oro-facial injuries encountered in Epileptic children

    OpenAIRE

    Ghafoor, P A Fazal; Rafeeq, Mohammed; Dubey, Alok

    2014-01-01

    Background: Epilepsy is a chronic disorder with unpredictably recurring seizure. Uncontrolled attacks can put patients at risk of suffering oro-facial trauma. Antiepileptic drugs (AED) provide satisfactory control of seizures in most of the patients with epilepsy. However use of AED has been found to cause many side effects inclusive of side effects in the oral cavity also. Materials & Methods: This study was conducted on 150 epileptic children, who were on anti epi...

  19. Interplay between interictal spikes and behavioral seizures in young, but not aged pilocarpine-treated epileptic rats.

    Science.gov (United States)

    Bajorat, Rika; Goerss, Doreen; Brenndörfer, Linda; Schwabe, Lars; Köhling, Rüdiger; Kirschstein, Timo

    2016-04-01

    Interictal spike activity is commonly observed in the EEG of patients with epilepsy, but the causal interrelationship between interictal spikes and behavioral seizures is poorly understood. We performed long-term video-EEG monitoring of 16 epileptic rats after pilocarpine-induced status epilepticus and five control animals. To quantify the interplay between periods of spikes and seizures, we calculated the time spent with spikes as well as the time spent with seizures for each animal. Within a given subject, we found a significant correlation between these two measures in 7/11 young epileptic rats (aged pilocarpine-treated animals exhibited significant correlation coefficients between spike periods and seizures (>600days, Paged epileptic rats showed a prominent predominance for either spike periods or seizures, which might explain the absence of significant correlation in this population. We found that there is a significant interplay between interictal periods of spikes and behavioral seizures in young epileptic animals, but this association is absent during aging. PMID:26926072

  20. Computing sources of epileptic discharges using the novel BMA approach: comparison with other distributed inverse solution methods.

    Science.gov (United States)

    Bravo, Elena Cuspineda; Martínez-Montes, Eduardo; Farach-Fumero, Miguel; Machado-Curbelo, Calixto

    2013-01-01

    Electroencephalography (EEG) source localization in epileptology continues to be a challenge for neuroscientists. A number of inverse solution (IS) methodologies have been proposed to solve this problem, and their advantages and limitations have been described. In the present work, a previously developed IS approach called Bayesian model averaging (BMA) is introduced in clinical practice in order to improve the localization accuracy of epileptic discharge sources. For this study, 31 patients with the diagnosis of partial epilepsies were studied: 14 had benign childhood epilepsy with centrotemporal spikes and 17 had temporal lobe epilepsy (TLE). The underlying epileptic sources were localized using the BMA approach, and the results were compared with those expected from the clinical diagnosis. Additional comparisons with results obtained from 3 of the most commonly used distributed IS methods for these purposes (minimum norm [MN], weighted minimum norm [WMN], and low-resolution electromagnetic tomography [LORETA]) were carried out in terms of source localization accuracy and spatial resolutions. The BMA approach estimated discharge sources that were consistent with the clinical diagnosis, and this method outperformed LORETA, MN, and WMN in terms of both localization accuracy and spatial resolution. The BMA was able to localize deeper generators with high accuracy. In conclusion, the BMA methodology has a great potential for the noninvasive accurate localization of epileptic sources, even those located in deeper structures. Therefore, it could be a promising tool for clinical practice in epileptology, although additional studies in other types of epileptic syndromes are necessary. PMID:23248336

  1. Radiology findings in adult patients with vocal fold paralysis

    Energy Technology Data Exchange (ETDEWEB)

    Robinson, S. [Helsinki Medical Imaging Centre, University of Helsinki, Haartmaninkatu, Helsinki (Finland)]. E-mail: s.robinson@dzu.at; Pitkaeranta, A. [Department of Otorhinolaryngology, Haartmaninkatu, Helsinki (Finland)

    2006-10-15

    Aim: To compile imaging findings in patients with vocal fold paralysis. Materials and methods: A retrospective analysis of the medical charts of 100 consecutive patients, admitted to our department with vocal fold paralysis was undertaken. After laryngoscopy, patients were referred for radiological work-up depending on their clinical history and clinical findings. Ultrasound of the neck and/or contrast-enhanced spiral computed tomography (CT) of the neck and mediastinum was performed, extending to include the whole chest if necessary. In one patient, CT of the brain and in two patients, magnetic resonance angiography was undertaken. Analysis of the clinical and radiological data was performed to assess the most frequent causes for vocal fold paralysis. Results: In 66% of patients, the paralysis was related to previous surgery. Thirty-four percent of cases were labelled idiopathic after clinical examination. After imaging and follow-up, only 8% remained unexplained. Nine patients suffered from neoplasms, four from vascular disease, and 12 from infections. One patient developed encephalomyelitis disseminata on follow-up. Conclusion: Thorough radiological work-up helps to reduce the amount of idiopathic cases of vocal fold paralysis and guides appropriate therapy.

  2. Radiology findings in adult patients with vocal fold paralysis

    International Nuclear Information System (INIS)

    Aim: To compile imaging findings in patients with vocal fold paralysis. Materials and methods: A retrospective analysis of the medical charts of 100 consecutive patients, admitted to our department with vocal fold paralysis was undertaken. After laryngoscopy, patients were referred for radiological work-up depending on their clinical history and clinical findings. Ultrasound of the neck and/or contrast-enhanced spiral computed tomography (CT) of the neck and mediastinum was performed, extending to include the whole chest if necessary. In one patient, CT of the brain and in two patients, magnetic resonance angiography was undertaken. Analysis of the clinical and radiological data was performed to assess the most frequent causes for vocal fold paralysis. Results: In 66% of patients, the paralysis was related to previous surgery. Thirty-four percent of cases were labelled idiopathic after clinical examination. After imaging and follow-up, only 8% remained unexplained. Nine patients suffered from neoplasms, four from vascular disease, and 12 from infections. One patient developed encephalomyelitis disseminata on follow-up. Conclusion: Thorough radiological work-up helps to reduce the amount of idiopathic cases of vocal fold paralysis and guides appropriate therapy

  3. Management of asthma in adults: do the patients get what they need--and want?

    DEFF Research Database (Denmark)

    Backer, V; Ulrik, Charlotte Suppli; Harving, H; Lange, Peter; Søes-Petersen, U; Plaschke, PP

    2007-01-01

    conclusion, this study of adult asthmatic patients revealed an important deficit in patient education, little use of lung function measurements, and poor compliance with guidelines for asthma management. Furthermore, asthmatic patients want more education, although they do not use it when provided by their......Suboptimal asthma control may be caused by a combination of factors, such as nonadherence to guidelines, lack of compliance, and poor asthma education. The aim was to assess patients' knowledge of asthma and different management strategies, including patients' attitudes toward involvement in...... treatment decisions. The participants (n=509) were recruited from all parts of Denmark through a web-based panel (Zapera Danmarkspanel). A questionnaire concerning asthma knowledge, compliance, and treatment was fulfilled through the Internet. Among the participating adult asthmatic patients, signs of...

  4. Music and its association with epileptic disorders.

    Science.gov (United States)

    Maguire, Melissa

    2015-01-01

    The association between music and epileptic seizures is complex and intriguing. Musical processing within the human brain recruits a network which involves many cortical areas that could activate as part of a temporal lobe seizure or become hyperexcitable on musical exposure as in the case of musicogenic epilepsy. The dichotomous effect of music on seizures may be explained by modification of dopaminergic circuitry or counteractive cognitive and sensory input in ictogenesis. Research has explored the utility of music as a therapy in epilepsy and while limited studies show some evidence of an effect on seizure activity; further work is required to ascertain its clinical potential. Sodium channel-blocking antiepileptic drugs, e.g., carbamazepine and oxcarbazepine, appear to effect pitch perception particularly in native-born Japanese, a rare but important adverse effect, particularly if a professional musician. Temporal lobe surgery for right lateralizing epilepsy has the capacity to effect all facets of musical processing, although risk and correlation to resection area need further research. There is a need for the development of investigative tools of musical processing that could be utilized along the surgical pathway. Similarly, work is also required in devising a musical paradigm as part of electroencephalography to improve surveillance of musicogenic seizures. These clinical applications could aid the management of epilepsy and preservation of musical ability. PMID:25725912

  5. Electroencephalographic features of familial spontaneous epileptic cats.

    Science.gov (United States)

    Hasegawa, Daisuke; Mizoguchi, Shunta; Kuwabara, Takayuki; Hamamoto, Yuji; Ogawa, Fukie; Matsuki, Naoaki; Uchida, Kazuyuki; Fujita, Michio

    2014-08-01

    A feline strain of familial spontaneous epileptic cats (FSECs) with typical limbic seizures was identified in 2010, and have been maintained as a novel animal model of genetic epilepsy. In this study, we characterized the electroencephalographic (EEG) features of FSECs. On scalp EEG under sedation, FSECs showed sporadic, but comparatively frequent interictal discharges dominantly in the uni- or bilateral temporal region. Bemegride activation was performed in order to evaluate the predisposition of epileptogenicity of FSECs. The threshold doses of the first paroxysmal discharge, clinical myoclonus and generalized convulsion in FSECs were significantly lower than those in control cats. Chronic video-intracranial EEG monitoring revealed subclinical or clinical focal seizures with secondarily generalization onset from the unilateral amygdala and/or hippocampus. Clinical generalized seizures were also recorded, but we were unable to detect the onset site. The results of the present study show that FSECs resemble not only feline kindling or the kainic acid model and El mouse, but also human familial or sporadic mesial temporal lobe epilepsy. In addition, our results indicate that FSECs are a natural and valuable model of mesial temporal lobe epilepsy. PMID:24893833

  6. Epileptic discharges affect the default mode network--FMRI and intracerebral EEG evidence.

    Directory of Open Access Journals (Sweden)

    Firas Fahoum

    Full Text Available Functional neuroimaging studies of epilepsy patients often show, at the time of epileptic activity, deactivation in default mode network (DMN regions, which is hypothesized to reflect altered consciousness. We aimed to study the metabolic and electrophysiological correlates of these changes in the DMN regions. We studied six epilepsy patients that underwent scalp EEG-fMRI and later stereotaxic intracerebral EEG (SEEG sampling regions of DMN (posterior cingulate cortex, Pre-cuneus, inferior parietal lobule, medial prefrontal cortex and dorsolateral frontal cortex as well as non-DMN regions. SEEG recordings were subject to frequency analyses comparing sections with interictal epileptic discharges (IED to IED-free baselines in the IED-generating region, DMN and non-DMN regions. EEG-fMRI and SEEG were obtained at rest. During IEDs, EEG-fMRI demonstrated deactivation in various DMN nodes in 5 of 6 patients, most frequently the pre-cuneus and inferior parietal lobule, and less frequently the other DMN nodes. SEEG analyses demonstrated decrease in gamma power (50-150 Hz, and increase in the power of lower frequencies (<30 Hz at times of IEDs, in at least one DMN node in all patients. These changes were not apparent in the non-DMN regions. We demonstrate that, at the time of IEDs, DMN regions decrease their metabolic demand and undergo an EEG change consisting of decreased gamma and increased lower frequencies. These findings, specific to DMN regions, confirm in a pathological condition a direct relationship between DMN BOLD activity and EEG activity. They indicate that epileptic activity affects the DMN, and therefore may momentarily reduce the consciousness level and cognitive reserve.

  7. Assessment of adult patients with hypernatremia: A single center experience

    Directory of Open Access Journals (Sweden)

    Ercan Gündüz

    2015-09-01

    Full Text Available Objective: In the present study, determination of symptoms, clinical characteristics, prevalence and recovery rates was aimed in patients who applied to the emergency service and diagnosed with hypernatremia. Methods: Patients who applied to Dicle University Medical School Emergency Service during January 2013-December 2014 and whose serum Na>148 mEq/L were included in the study. The study was conducted retrospectively. Results: Hypernatremia prevalence was determined as 0.21% in the cases who applied to the emergency service. The average age in all patients was 69±22 and the median age was 72 years. The average hospitalization period was 13.3±10.9 days. The mortality rate was 75.7% and male gender domination (56% was determined in patients who developed mortality. When mortality and recovery groups were compared statistically; significant difference was determined (p<0.05 in terms of hospitalization period, glucose, urea, creatinine and calcium averages. The complaints of our patients who applied to the emergency service were changes in consciousness (92.7%, oral intake disorder (83.4% and fever (48.6% based on frequency order. The accompanying comorbid states were cerebrovascular illness (36.9%, Dementia/Alzheimer (32.4% and hypertension (28.9% based on frequency order. Conclusion: Consequently, hypernatremia is a fluid-electrolyte disorder progressing with high mortality and could be observed in older patients and in patients whose oral intake is defective and who have cerebrovascular illness and dementia.

  8. Making the Hospital Safer for Older Adult Patients: A Focus on the Indwelling Urinary Catheter

    OpenAIRE

    Lee, Eric A.; Malatt, Camille

    2011-01-01

    The needs of hospitalized geriatric patients differ from the needs of hospitalized younger adults. In an attempt to improve systems of care for the older adult, the Centers for Medicare and Medicaid Services classified urinary tract infections related to the use of indwelling urinary catheters (IUC) as one of eight “never events.” The insertion of an IUC is a commonly performed procedure that can cause an array of iatrogenic complications. In addition, the placement of an IUC without medical ...

  9. Psychometric evaluation of the Sheehan Disability Scale in adult patients with attention-deficit/hyperactivity disorder

    OpenAIRE

    Coles T; Coon C; DeMuro C; McLeod L; Gnanasakthy A

    2014-01-01

    Theresa Coles,1 Cheryl Coon,1 Carla DeMuro,1 Lori McLeod,1 Ari Gnanasakthy21Patient-Reported Outcomes, RTI Health Solutions, Research Triangle Park, NC, 2Novartis Pharmaceuticals, East Hanover, NJ, USAAbstract: Inattention and impulsivity symptoms are common among adults with attention-deficit/hyperactivity disorder (ADHD), which can lead to difficulty concentrating, restlessness, difficulty completing tasks, disorganization, impatience, and impulsiveness. Many adults with ADHD find it diffic...

  10. Translating Personality Psychology to Help Personalize Preventive Medicine for Young-Adult Patients

    OpenAIRE

    Israel, Salomon; Moffitt, Terrie E.; Belsky, Daniel W.; Hancox, Robert J; Poulton, Richie; Roberts, Brent; Thomson, W Murray; Caspi, Avshalom

    2014-01-01

    The rising number of newly insured young adults brought on by healthcare reform will soon increase demands on primary-care physicians. Physicians will face more young-adult patients which presents an opportunity for more prevention-oriented care. In the current study, we evaluated whether brief observer reports of young adults’ personality traits could predict which individuals would be at greater risk for poor health as they entered midlife. Following the Dunedin Study cohort of 1,000 indivi...

  11. From pediatric to adult care: strategic evaluation of a transition program for patients with osteogenesis imperfecta

    OpenAIRE

    Dogba, Maman Joyce; Rauch, Frank; Wong, Trudy; Ruck, Joanne; Glorieux, Francis H; Bedos, Christophe

    2014-01-01

    Background Achieving a successful transition from pediatric to adult care for young adults with special needs, especially rare genetic diseases such as osteogenesis imperfecta (OI), is a prominent issue in healthcare research. This transition represents a challenge for patients with OI, their families, clinicians and healthcare managers because of the complex nature of the process and the lack of evaluation of existing transition programs. We evaluated a transition program for adolescents and...

  12. Association between patterns of leisure time physical activity and asthma control in adult patients

    OpenAIRE

    Simon L Bacon; Lemiere, Catherine; Moullec, Gregory; Ninot, Gregory; Pepin, Véronique; Kim L. Lavoie

    2015-01-01

    Background Physical activity has been shown to have various health benefits in patients with asthma, especially in children. However, there are still limited data on the nature of the association between physical activity and asthma control in adults. Objective The objective of the current study was to determine the nature of the association between physical activity and asthma control, with particular emphasis on the intensity of the activity and seasonal variations. Methods 643 adult patien...

  13. Ingestion and Pharyngeal Trauma Causing Secondary Retropharyngeal Abscess in Five Adult Patients

    Directory of Open Access Journals (Sweden)

    Sudhir B. Sharma

    2012-01-01

    Full Text Available Retropharyngeal abscess most commonly occurs in children. When present in adults the clinical features may not be typical, and associated immunosuppression or local trauma can be part of the presentation. We present a case series of five adult patients who developed foreign body ingestion trauma associated retropharyngeal abscess. The unusual pearls of each case, along with their outcomes, are discussed. Pertinent information for the emergency medicine physician regarding retropharyngeal abscess is presented as well.

  14. Clinical next generation sequencing of pediatric-type malignancies in adult patients identifies novel somatic aberrations

    OpenAIRE

    Silva, Jorge Galvez; Corrales-Medina, Fernando F.; Maher, Ossama M.; Tannir, Nizar; Huh, Winston W; Rytting, Michael E.; Subbiah, Vivek

    2015-01-01

    Pediatric malignancies in adults, in contrast to the same diseases in children are clinically more aggressive, resistant to chemotherapeutics, and carry a higher risk of relapse. Molecular profiling of tumor sample using next generation sequencing (NGS) has recently become clinically available. We report the results of targeted exome sequencing of six adult patients with pediatric-type malignancies : Wilms tumor(n=2), medulloblastoma(n=2), Ewing's sarcoma( n=1) and desmoplastic small round ce...

  15. Long-Term Consumption of Oats in Adult Celiac Disease Patients

    OpenAIRE

    Kaukinen, Katri; Collin, Pekka; Huhtala, Heini; Mäki, Markku

    2013-01-01

    Many celiac disease patients tolerate oats, but limited data are available on its long-term consumption. This was evaluated in the present study, focusing on small-bowel mucosal histology and gastrointestinal symptoms in celiac adults maintaining a strict gluten-free diet with or without oats. Altogether 106 long-term treated celiac adults were enrolled for this cross-sectional follow-up study. Daily consumption of oats and fiber was assessed, and small-bowel mucosal morphology and densities ...

  16. Preoperative corneal astigmatism among adult patients with cataract in Northern Nigeria

    OpenAIRE

    Mohammed Isyaku; Ali, Syed A.; Sadiq Hassan

    2014-01-01

    The prevalence and nature of corneal astigmatism among patients with cataract has not been well-documented in the resident African population. This retrospective study was undertaken to investigate preexisting corneal astigmatism in adult patients with cataract. We analyzed keratometric readings acquired by manual Javal-Schiotz keratometry before surgery between January 1, 2011 and December 31, 2011. There were 3,169 patients (3286 eyes) aged between 16 and 110 years involved with a Male to f...

  17. Prevalence of sapovirus infection among infant and adult patients with acute gastroenteritis in Tehran, Iran

    OpenAIRE

    Romani, Sara; Azimzadeh, Pedram; Mohebbi, Seyed Reza; Bozorgi, Sajad Majidizadeh; Zali, Narges; JADALI, Farzaneh

    2012-01-01

    Aim This study investigated the prevalence of sapovirus infections in patient with acute gastroenteritis in Tehran, Iran. Background Sapovirus, a member of the family Caliciviridae is one of the major causative agents of viral gastroenteritis affecting both children and adult individuals. There isn't enough data about prevalence and genotypes of sapovirus infection in Tehran, the capital city of Iran. Patients and methods A total of 42 fecal samples were collected from patients with acute gas...

  18. Optimal Positioning for an Adult Athetoid Cerebral Palsy Patient in a Wheelchair

    OpenAIRE

    Shimizu, Michele Eisemann; Tanaka, Sachiko; Takamagari, Hironobu; Honda, Katsuhiko; Shimizu, Hajime; Nakamura, Shigenobu

    1994-01-01

    The purpose of this case study was specifically to reinforce the necessity for proper positioning in a wheelchair for an adult athetoid cerebral palsy patient. A 36-year old female with cerebral palsy sat in the wheelchair with pelvic sliding, uneven weight distribution on the hips, hip adduction, and right lateral trunk tilt and rotation. The abnormal posture observed was first corrected by seating the patient well back in the wheelchair with the patient's weight evenly distributed between b...

  19. Extrathoracic investigation in adult patients with isolated pulmonary langerhans cell histiocytosis

    OpenAIRE

    Tazi, Abdellatif; de Margerie-Mellon, Constance; Vercellino, Laetitia; Naccache, Jean Marc; Fry, Stéphanie; Dominique, Stéphane; Jouneau, Stéphane; Lorillon, Gwenaël; Bugnet, Emmanuelle; Chiron, Raphael; Wallaert, Benoit; Valeyre, Dominique; Chevret, Sylvie

    2016-01-01

    Background An important objective on diagnosis of patients with Langerhans cell histiocytosis (LCH) is to determine the extent of disease. However, whether systematic extrathoracic investigation is needed in adult patients with clinically isolated pulmonary LCH (PLCH) has not been evaluated. Methods In this prospective, multicentre study, 54 consecutive patients with newly diagnosed clinically isolated PLCH were systematically evaluated at inclusion by bone imaging and blood laboratory testin...

  20. Introduction of a Venous Thromboembolism Prophylaxis Protocol for Older Adult Psychiatric Patients.

    OpenAIRE

    Croxford, Anna; Clare, Adam; McCurdy, Kathleen

    2015-01-01

    Hospital-Acquired venous thromboembolism (VTE) is a common cause of morbidity and mortality in older adults. In psychiatric patients these risks are increased due to multiple factors including poor mobility, restraint, catatonia, sedation, and conventional antipsychotic use. Diagnosis and treatment of psychiatric patients presenting with signs and symptoms of a VTE can be delayed due to a patient's communication difficulties, non-compliance, or attribution of symptoms to a psychosomatic cause...

  1. Yoga in adult cancer: an exploratory, qualitative analysis of the patient experience

    OpenAIRE

    McCall, Marcy; Thorne, Sally; Ward, Alison; Heneghan, Carl

    2015-01-01

    Background Some patients receiving treatment in conventional health care systems access therapeutic yoga outside their mainstream care to improve cancer symptoms. Given the current knowledge gap around patient preferences and documented experiences of yoga in adult cancer, this study aimed to describe patient-reported benefits, barriers and characteristics of programming for yoga practice during conventional treatment. Methods In depth semi-structured interviews (n = 10) were conducted in men...

  2. Mandibular fractures: a comparative analysis between young and adult patients in the southeast region of Turkey

    OpenAIRE

    Serhat Atilgan; Behçet Erol; Ferhan Yaman; Nezih Yilmaz; Musa Can Ucan

    2010-01-01

    OBJECTIVE: The purpose of this study was to review and compare the differences between mandibular fractures in young and adult patients. MATERIAL AND METHODS: Patients treated at the Oral and Maxillofacial Department of Dicle University during a five-year period between 2000 and 2005 were retrospectively evaluated with respect to age groups, gender, etiology, localization and type of fractures, treatment methods and complications. RESULTS: 532 patients were included in the study, 370 (70%) ma...

  3. Regionally specific expression of high-voltage-activated calcium channels in thalamic nuclei of epileptic and non-epileptic rats.

    Science.gov (United States)

    Kanyshkova, Tatyana; Ehling, Petra; Cerina, Manuela; Meuth, Patrick; Zobeiri, Mehrnoush; Meuth, Sven G; Pape, Hans-Christian; Budde, Thomas

    2014-07-01

    The polygenic origin of generalized absence epilepsy results in dysfunction of ion channels that allows the switch from physiological asynchronous to pathophysiological highly synchronous network activity. Evidence from rat and mouse models of absence epilepsy indicates that altered Ca(2+) channel activity contributes to cellular and network alterations that lead to seizure activity. Under physiological circumstances, high voltage-activated (HVA) Ca(2+) channels are important in determining the thalamic firing profile. Here, we investigated a possible contribution of HVA channels to the epileptic phenotype using a rodent genetic model of absence epilepsy. In this study, HVA Ca(2+) currents were recorded from neurons of three different thalamic nuclei that are involved in both sensory signal transmission and rhythmic-synchronized activity during epileptic spike-and-wave discharges (SWD), namely the dorsal part of the lateral geniculate nucleus (dLGN), the ventrobasal thalamic complex (VB) and the reticular thalamic nucleus (NRT) of epileptic Wistar Albino Glaxo rats from Rijswijk (WAG/Rij) and non-epileptic August Copenhagen Irish (ACI) rats. HVA Ca(2+) current densities in dLGN neurons were significantly increased in epileptic rats compared with non-epileptic controls while other thalamic regions revealed no differences between the strains. Application of specific channel blockers revealed that the increased current was carried by L-type Ca(2+) channels. Electrophysiological evidence of increased L-type current correlated with up-regulated mRNA and protein expression of a particular L-type channel, namely Cav1.3, in dLGN of epileptic rats. No significant changes were found for other HVA Ca(2+) channels. Moreover, pharmacological inactivation of L-type Ca(2+) channels results in altered firing profiles of thalamocortical relay (TC) neurons from non-epileptic rather than from epileptic rats. While HVA Ca(2+) channels influence tonic and burst firing in ACI and WAG

  4. Congenital tracheoesophageal fistula: A rare and late presentation in adult patient

    Directory of Open Access Journals (Sweden)

    Waseem M Hajjar

    2012-01-01

    Full Text Available Congenital H-type tracheoesophageal fistula (TEF in adults is a rare presentation and can test the diagnostic acumen of a surgeon, endoscopist, and the radiologist. These undetected fistulas may present as chronic lung disease of unknown origin because repeated aspirations can lead to recurrent lung infections and bronchiectasis. Congenital TEFs should be considered in the diagnosis of infants and young adults with recurrent respiratory distress and/or infections. Here, we present the successful management of this rare case in an adult patient.

  5. Factors affecting ventriculoperitoneal shunt survival in adult patients

    Directory of Open Access Journals (Sweden)

    Farid Khan

    2015-01-01

    Conclusions: Patients with increased age, prolonged hospital stay, GCS score of less than 13, extra-ventricular drains in situ, or excision of brain tumors were more likely to experience early shunt malfunction.

  6. Medico-ethical analysis of problems in epileptic population and its impacts on the living quality of patients%从医学伦理学视角剖析癫痫患者群体存在的问题及对其生活质量的影响

    Institute of Scientific and Technical Information of China (English)

    郑晓瑛; 张蕾; 纪颖; 范向华

    2005-01-01

    ,balance and justice. Since some epileptic patients lack in the knowledge of epilepsy and proper treatment and suffer from discrimination in the health care, more untreated and non-proper treatment, doctors and nursing persons should take the attitude of being beneficial to the patients. Medication for the epileptics, especially the female patients at the first period of pregnancy, the incidence of the deformed children was high. Should the principle of beneficence be applied to mothers or children? The number of the operative treatment was more and more in patients with epilepsy, while surgery itself is a risk behavior .If there is no better method to choose, and all the available choices have their advantage and disadvantages. Physicians can only choose the better one from the two kinds of harm, trying to make the patientssuffer the least harm with the largest effect. Aggressive behaviors can be observed during seizure or unconsciousness state. Controlling the moving range of the patients with epilepsy consciously is in accord with the general ethical behavior, on the contrary, confinement disobeys the morals and the curative effect is not good. The extreme behavior of the patients with epilepsy is suicide and occurred more in unemployed, unmarried and living alone, male, and patients with mental disorders in epilepsy. The direct reasons of suicide are unemployment, low social status, and little understanding and care from their communities, families and friends.The sensible ethical principle for epileptics is to treat the patients as normal people in the society.CONCLUSION: Epileptic crowd need care from the society, family and other factors. Proper considering ethical principle in treating the population is the humane solicitude and to help the patients regain health and improve the life quality.

  7. Patient satisfaction and ethnic identity among American Indian older adults.

    Science.gov (United States)

    Garroutte, Eva Marie; Kunovich, Robert M; Jacobsen, Clemma; Goldberg, Jack

    2004-12-01

    Work in the field of culturally competent medical care draws on studies showing that minority Americans often report lower satisfaction with care than White Americans and recommends that providers should adapt care to patients' cultural needs. However, empirical evidence in support of cultural competence models is limited by reliance upon measurements of racial rather than ethnic identity and also by a near-total neglect of American Indians. This project explored the relationship between ethnic identity and satisfaction using survey data collected from 115 chronically ill American Indian patients >or=50 years at a Cherokee Nation clinic. Satisfaction scores were high overall and comparable to those found in the general population. Nevertheless, analysis using hierarchical linear modeling showed that patients' self-rated American Indian ethnic identity was significantly associated with satisfaction. Specifically, patients who rated themselves high on the measure of American Indian ethnic identity reported reduced scores on satisfaction with health care providers' social skill and attentiveness, as compared to those who rated themselves lower. Significant associations remained after controlling for patients' sex, age, education, marital status, self-reported health, wait time, and number of previous visits. There were no significant associations between patients' American Indian ethnic identity and satisfaction with provider's technical skill and shared decision-making. Likewise, there were no significant associations between satisfaction and a separate measure of White American ethnic identity, although a suggestive trend was observed for satisfaction with provider's social skill. Our findings demonstrate the importance of including measures of ethnic identity in studies of medical satisfaction in racial minority populations. They support the importance of adapting care to patient's cultural needs, and they highlight the particular significance of interpersonal

  8. Assessment of adult patients with hypernatremia: A single center experience

    OpenAIRE

    Ercan Gündüz; Yılmaz Zengin; Mustafa İçer; Hasan Mansur Durgun; Recep Dursun; Ahmet Gündüzalp; Mustafa İpek; Cahfer Güloğlu

    2015-01-01

    Objective: In the present study, determination of symptoms, clinical characteristics, prevalence and recovery rates was aimed in patients who applied to the emergency service and diagnosed with hypernatremia.Methods: Patients who applied to Dicle University Medical School Emergency Service during January 2013-December 2014 and whose serum Na>148 mEq/L were included in the study. The study was conducted retrospectively.Results: Hypernatremia prevalence was determined as 0.21% in the cases w...

  9. Connectivity differences between adult male and female patients with attention deficit hyperactivity disorder according to resting-state functional MRI

    OpenAIRE

    Bo-yong Park; Hyunjin Park

    2016-01-01

    Attention deficit hyperactivity disorder (ADHD) is a pervasive psychiatric disorder that affects both children and adults. Adult male and female patients with ADHD are differentially affected, but few studies have explored the differences. The purpose of this study was to quantify differences between adult male and female patients with ADHD based on neuroimaging and connectivity analysis. Resting-state functional magnetic resonance imaging scans were obtained and preprocessed in 82 patients. ...

  10. Clinical evaluation and MRI findings in early infantile epileptic encephalopathy with suppression-burst

    International Nuclear Information System (INIS)

    The clinical courses and a follow-up study on the MRI findings in four cases with early infantile epileptic encephalopathy (EIEE) are reported. The patients consisted of one male and three females. The age at onset was before 15 days on life and the etiology was unknown in all cases. EEG improvement and a decrease in seizure frequency were seen after treatment with ACTH and anticonvulsants in three of the four patients, while no treatment was effective in the other patient who developed Lennox-Gastaut syndrome through West syndrome. Psychomotor development of all patients was severely retarded, and it was impossible for three cases to gain head control until 12 months old. MRI findings revealed dysmyelination of white matter in the cerebrum in three patients and asymmetrical myelination in the other patient. These results suggested that EIEE is based on brain immaturity combined with dysmyelination. (author)

  11. Percutaneous Endovascular Treatment of Hepatic Artery Stenosis in Adult and Pediatric Patients After Liver Transplantation

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate the efficacy of percutaneous endovascular techniques for the treatment of hepatic artery stenosis (HAS) occurring after liver transplantation (LT) in adult and pediatrics patients. From February 2003 to March 2009, 25 patients (15 adults and 10 children) whose developed HAS after LT were referred to our interventional radiology unit. Technical success was achieved in 96% (24 of 25) of patients. Percutaneous transluminal angioplasty (PTA) was performed in 13 patients (7 children), and stenting was performed in 11 patients (2 children). After the procedure, all patients were followed-up with liver function tests, Doppler ultrasound, and/or computed tomography. Mean follow-up was 15.8 months (range 5 days to 58 months). Acute hepatic artery thrombosis occurred immediately after stent deployment in 2 patients and was successfully treated with local thrombolysis. One patient developed severe HA spasm, which reverted after 24 h. After the procedure, mean trans-stenotic pressure gradient decreased from 30.5 to 6.2 mmHg. Kaplan-Meyer curve of HA primary patency was 77% at 1 and 2 years. During the follow-up period, 5 patients (20%) had recurrent stenosis, and 2 patients (8.3%) had late thrombosis. Two of 7 patients with stenosis/thrombosis underwent surgical revascularization (n = 1) and liver retransplantation (n = 1). Six (25%) patients died during follow-up, but overall mortality was not significantly different when comparing patients having patent hepatic arteries with those having recurrent stenosis/thrombosis. There were no significant differences in recurrent stenosis/thrombosis and mortality comparing patients treated by PTA versus stenting and comparing adult versus pediatric status. Percutaneous interventional treatment of HAS in LT recipients is safe and effective and decreases the need for surgical revascularization and liver retransplantation. However, the beneficial effects for survival are not clear, probably because

  12. A Novel Dynamic Update Framework for Epileptic Seizure Prediction

    Directory of Open Access Journals (Sweden)

    Min Han

    2014-01-01

    Full Text Available Epileptic seizure prediction is a difficult problem in clinical applications, and it has the potential to significantly improve the patients’ daily lives whose seizures cannot be controlled by either drugs or surgery. However, most current studies of epileptic seizure prediction focus on high sensitivity and low false-positive rate only and lack the flexibility for a variety of epileptic seizures and patients’ physical conditions. Therefore, a novel dynamic update framework for epileptic seizure prediction is proposed in this paper. In this framework, two basic sample pools are constructed and updated dynamically. Furthermore, the prediction model can be updated to be the most appropriate one for the prediction of seizures’ arrival. Mahalanobis distance is introduced in this part to solve the problem of side information, measuring the distance between two data sets. In addition, a multichannel feature extraction method based on Hilbert-Huang transform and extreme learning machine is utilized to extract the features of a patient’s preseizure state against the normal state. At last, a dynamic update epileptic seizure prediction system is built up. Simulations on Freiburg database show that the proposed system has a better performance than the one without update. The research of this paper is significantly helpful for clinical applications, especially for the exploitation of online portable devices.

  13. The level of specialist assessment of adult asthma is influenced by patient age

    DEFF Research Database (Denmark)

    Porsbjerg, C; Sverrild, A; Stensen, L;

    2014-01-01

    adults, and were more frequently smokers. However, a regression analysis showed that older age was associated with a lower likelihood of diagnostic assessment with a reversibility test, a bronchial challenge test, or measurement of exhaled NO, independently of a known diagnosis of asthma, smoking habits......BACKGROUND: Late onset asthma is associated with more severe disease and higher morbidity than in younger asthma patients. This may in part relate to under recognition of asthma in older adults, but evidence on the impact of patient age on diagnostic assessment of asthma in a specialist setting is...... sparse. AIM: To examine the impact of patient age on the type and proportion of diagnostic tests performed in patients undergoing specialist assessment for asthma. METHODS: Data from a clinical population consisting of all patients consecutively referred over a 12 months period to a specialist clinic for...

  14. Expression of human epileptic temporal lobe neurotransmitter receptors in Xenopus oocytes: An innovative approach to study epilepsy

    Science.gov (United States)

    Palma, Eleonora; Esposito, Vincenzo; Mileo, Anna Maria; Di Gennaro, Giancarlo; Quarato, Pierpaolo; Giangaspero, Felice; Scoppetta, Ciriaco; Onorati, Paolo; Trettel, Flavia; Miledi, Ricardo; Eusebi, Fabrizio

    2002-01-01

    Poly(A+) RNA was extracted from the temporal lobe (TL) of medically intractable epileptic patients which underwent surgical TL resection. Injection of this mRNA into Xenopus oocytes led to the expression of ionotropic receptors for γ-aminobutyric acid (GABA), kainate (KAI) and α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA). Membrane currents elicited by GABA inverted polarity at −15 mV, close to the oocyte's chloride equilibrium potential, were inhibited by bicuculline, and were potentiated by pentobarbital and flunitrazepam. These basic characteristics were also displayed by GABA currents elicited in oocytes injected with mRNAs isolated from human TL glioma (TLG) or from mouse TL. However, the GABA receptors expressed by the epileptic TL mRNA exhibited some unusual properties, consisting in a rapid current run-down after repetitive GABA applications and a large EC50 (125 μM). AMPA alone evoked very small or nil currents, whereas KAI induced larger currents. Nevertheless, upon cyclothiazide treatment, AMPA elicited substantial currents that, like the KAI currents, were inhibited by 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX). Furthermore, the glutamate receptor 5 (GluR5) agonist, ATPA, failed to evoke an obvious current although both RT-PCR and Western blot analyses showed GluR5 expression in the epileptic TL. Oocytes injected with mouse TL or human TLG mRNAs generated KAI and AMPA currents similar to those evoked in oocytes injected with epileptic TL mRNA but, in contrast to these, the mouse TL and human TLG oocytes were also responsive to ATPA. Our findings are in accord with the concept that both a depression of GABA inhibition and a dysfunction of the KAI-receptor system maintain a high neuronal excitability that results in epileptic seizures. PMID:12409614

  15. The T-type calcium channel antagonist Z944 disrupts prepulse inhibition in both epileptic and non-epileptic rats.

    Science.gov (United States)

    Marks, Wendie N; Greba, Quentin; Cain, Stuart M; Snutch, Terrance P; Howland, John G

    2016-09-22

    The role of T-type calcium channels in brain diseases such as absence epilepsy and neuropathic pain has been studied extensively. However, less is known regarding the involvement of T-type channels in cognition and behavior. Prepulse inhibition (PPI) is a measure of sensorimotor gating which is a basic process whereby the brain filters incoming stimuli to enable appropriate responding in sensory rich environments. The regulation of PPI involves a network of limbic, cortical, striatal, pallidal and pontine brain areas, many of which show high levels of T-type calcium channel expression. Therefore, we tested the effects of blocking T-type calcium channels on PPI with the potent and selective T-type antagonist Z944 (0.3, 1, 3, 10mg/kg; i.p.) in adult Wistar rats and two related strains, the Genetic Absence Epilepsy Rats from Strasbourg (GAERS) and Non-Epileptic Control (NEC). PPI was tested using a protocol that varied prepulse intensity (3, 6, and 12dB above background) and prepulse-pulse interval (30, 50, 80, 140ms). Z944 decreased startle in the Wistar strain at the highest dose relative to lower doses. Z944 dose-dependently disrupted PPI in the Wistar and GAERS strains with the most potent effect observed with the higher doses. These findings suggest that T-type calcium channels contribute to normal patterns of brain activity that regulate PPI. Given that PPI is disrupted in psychiatric disorders, future experiments that test the specific brain regions involved in the regulation of PPI by T-type calcium channels may help inform therapeutic development for those suffering from sensorimotor gating impairments. PMID:27365170

  16. Kidney transplantation in an adult patient with VACTERL association.

    Science.gov (United States)

    Cimen, Sertac; Nantais, Jordan; Guler, Sanem; Lawen, Joseph

    2015-01-01

    The vertebral, anal, cardiac, tracheoesophageal, renal, and limb birth defects (VACTERL) association is a rare, non-random constellation of congenital abnormalities among which urinary tract anomalies can be included. In the presence of these anomalies, patients are suspected to have a higher rate of renal failure than average. We report a case of a 22-year-old woman with VACTERL association and consequent end stage renal failure. A live-related kidney transplant was carried out successfully and the postoperative course was uncomplicated. The patient had immediate graft function. Risk factors that may complicate kidney transplant surgery in this patient population as well as considerations relevant to peritransplant management are discussed. PMID:26106170

  17. A snapshot of the adult spina bifida patient – high incidence of urologic procedures

    Science.gov (United States)

    Liu, Joceline S.; Greiman, Alyssa; Casey, Jessica T.; Mukherjee, Shubhra

    2016-01-01

    Introduction To describe the urologic outcomes of contemporary adult spina bifida patients managed in a multidisciplinary clinic. Material and methods A retrospective chart review of patients seen in our adult spina bifida clinic from January 2004 to November 2011 was performed to identify urologic management, urologic surgeries, and co-morbidities. Results 225 patients were identified (57.8% female, 42.2% male). Current median age was 30 years (IQR 27, 36) with a median age at first visit of 25 years (IQR 22, 30). The majority (70.7%) utilized clean intermittent catheterization, and 111 patients (49.3%) were prescribed anticholinergic medications. 65.8% had urodynamics performed at least once, and 56% obtained appropriate upper tract imaging at least every other year while under our care. 101 patients (44.9%) underwent at least one urologic surgical procedure during their lifetime, with a total of 191 procedures being performed, of which stone procedures (n = 51, 26.7%) were the most common. Other common procedures included continence procedures (n = 35, 18.3%) and augmentation cystoplasty (n = 29, 15.2%). Only 3.6% had a documented diagnosis of chronic kidney disease and 0.9% with end-stage renal disease. Conclusions Most adult spina bifida patient continue on anticholinergic medications and clean intermittent catheterization. A large percentage of patients required urologic procedures in adulthood. Patients should be encouraged to utilize conservative and effective bladder management strategies to reduce their risk of renal compromise. PMID:27123330

  18. Complementary Therapies Used Among Adult Patients with Type 2 Diabetes Mellitus in Aceh, Indonesia

    OpenAIRE

    Niswah Niswah; Chinnawong T; Manasurakarn J

    2014-01-01

    Purpose: This study aimed to reveal Complementary Therapies (CT) use among adult patients with type 2 diabetes mellitus (T2DM) in Aceh, Indonesia, and to determine the reasons of using the CT.Methods: A descriptive, cross-sectional study was undertaken using a self-reported questionnaire. One hundred and fifty four adult patients with T2DM has been completed the questionnaire. Descriptive statistics was used to analyze the data.Results: Herbs as a part of biological based therapies were the m...

  19. CT findings of perforated appendicitis: comparison of child and adult patient

    International Nuclear Information System (INIS)

    To evaluate the CT findings of patients with surgically confirmed perforated appendicitis and to compare the characteristics between children and adults. Patients in whom complicated appendicitis was clinically suspected underwent contrast enhanced CT scanning. The scans of 50 patients (19 children and 31 adults) with surgically confirmed perforated appendicitis were analysed. Without knowledge of operative findings, we retrospectively analyzed the CT findings with regard to:1) the detection of the appendiceal wall thickening;2) the presence of appendicolith;3) the size, features, and location of periappendical abscess;4) mesenteric fat infiltration and lymphadenopathy;5) wall thickening of the cecum and terminal ileum; and 6) ascites and free air. Appendiceal wall thickening was detected in seven children (37%) and 13 adults (42%) (p>0.05). Appendicolith was detected in 21 patients (42%) and was more frequent in children (13 cases, 68%) than in adults (8 cases, 26%). There were statistically significant differences between the two groups (p0.05). Periappendiceal abscess with well-defined cyst was more frequent in children (17/19, 89%) than in adults (13/31, 42%) (p<0.05). The most commonly involved site was the midabdomen and pelvis in children (9/19, 47%), and the right lower quadrant in adults (18/31, 58%), (p<.05). Mesenteric lymph nodes were commonly detected in children, and cecal wall thickening in adults. The CT findings of perforated appendicitis included appendiceal wall thickening, appendicolith, periappendiceal abscess, mesenteric fat infiltration and enlargement of mesenteric lymph nodes, and thickening of the cecum wall Periappendiceal abscess with well-defined cyst in the midabdomen or pelvis was more frequent in children, as were appendicolith and enlargement of mesenteric lymph nodes.=20

  20. Interictal brain SPECT in patients with medically refractory temporal lobe epilepsy; SPECT cerebral interictal em pacientes com epilepsia do lobo temporal de dificil controle

    Energy Technology Data Exchange (ETDEWEB)

    Andraus, Maria Emilia Cosenza

    2000-06-01

    The brain single photon emission computed tomography (SPECT) is s functional neuroimaging method that can detect localized changes in cerebral blood flow. The temporal lobe epilepsy (TLE) is the most common epileptic syndrome in adults, and more than 50% are medically refractory. The SPECT can contribute to investigation of epileptogenic focus and is one of the methods of pre-surgical evaluation of these patients. (author)

  1. 3D stereotaxis for epileptic foci through integrating MR imaging with neurological electrophysiology data

    International Nuclear Information System (INIS)

    Objective: To improve the accuracy of the epilepsy diagnoses by integrating MR image from PACS with data from neurological electrophysiology. The integration is also very important for transmiting diagnostic information to 3D TPS of radiotherapy. Methods: The electroencephalogram was redisplayed by EEG workstation, while MR image was reconstructed by Brainvoyager software. 3D model of patient brain was built up by combining reconstructed images with electroencephalogram data in Base 2000. 30 epileptic patients (18 males and 12 females) with their age ranged from 12 to 54 years were confirmed by using the integrated MR images and the data from neurological electrophysiology and their 3D stereolocating. Results: The corresponding data in 3D model could show the real situation of patients' brain and visually locate the precise position of the focus. The suddessful rate of 3D guided operation was greatly improved, and the number of epileptic onset was markedly decreased. The epilepsy was stopped for 6 months in 8 of the 30 patients. Conclusion: The integration of MR image and information of neurological electrophysiology can improve the diagnostic level for epilepsy, and it is crucial for imp roving the successful rate of manipulations and the epilepsy analysis. (authors)

  2. Management of Adult Jehovah's Witness Patients with Acute Bleeding

    NARCIS (Netherlands)

    K. Berend; M. Levi

    2009-01-01

    Because of the firm refusal of transfusion of blood and blood components by Jehovah's Witnesses, the management of Jehovah's Witness patients with severe bleeding is often complicated by medical, ethical, and legal concerns. Because of a rapidly growing and worldwide membership, physicians working i

  3. Modern treatment of adult short bowel syndrome patients

    DEFF Research Database (Denmark)

    Efsen, E; Jeppesen, P B

    2011-01-01

    By definition, intestinal failure prevails when oral compensation is no longer feasible and parenteral support is necessary to maintain nutritional equilibrium. In the past, conventional treatment has mainly focused on "making the most of what the short bowel syndrome patient still had" by...

  4. Treatment of adult short bowel syndrome patients with teduglutide

    DEFF Research Database (Denmark)

    Nørholk, Lærke Marijke; Holst, Jens Juul; Jeppesen, Palle Bekker

    2012-01-01

    INTRODUCTION: Parenteral support is lifesaving in short bowel syndrome patients with intestinal failure (SBS-IF), who are unable to compensate for their malabsorption by metabolic or pharmacologic adaptation. Mutually, the symptoms of SBS-IF and the inconveniences and complications in relation to...

  5. Relationship among eye condition sensitivities,photosensitivity and epileptic syndromes

    Institute of Scientific and Technical Information of China (English)

    YANG Zhi-xian; CAI Xiang; LIU Xiao-yan; QIN Jiong

    2008-01-01

    Background Electroencephalogram(EEG)activity in normal subjects and epileptic patients is often closely related to the eye's status such as eye opened(EO),eye closure(ECL)and eyes closed(EC).ECL is the period immediately after closing of the eyes and only Iasts for Jess than 3 seconds if the eyes remain closed.EC is the pened as long as the eyes are closed.Epileptiform changes on EEG induced by ECL or EC are called the changes of ECL sensitivity(ECLS)or EC sensitivity (ECS).ECLS occurs mainly but not exclusively in photosensitive patients and ECS has been seen rarely in photosensitive patients.This study aimed to investigate the relationships among ECLS,ECS.photosensitivity and epilepsy syndromes in children.Methods EEG records from child patients in the EEG Department of Peking University First Hospital dudng the period of May 2005 to Mav 2007 were examined for the presence of ECLS or ECS.Open-close eye tests and intermittent photic stimulations were carried out during video-EEG monitoring for examining ECLS.ECS and photosensitivity.Results Based on ECLS and ECS on their EEGs,30 patients were divided into ECLS group (16 cases)and ECS group (14 cases).There were more boys than girls in the two groups.The mean age of initial detection of ECLS and ECS was 10 years.and the average onset age of seizures was 9 years.The epilepsy syndromes in the ECLS group included idiopathic photosensitive occipital lobe epilepsy,Panayiotopoulos syndrome,symptomatic occipital lobe epilepsy,juvenile myoclonic epilepsy,juvenile absence epilepsy,eyelid myoclonia with absences,epilepsy with grand mal on awakening and pure photosensitive epilepsy with mainly generalized tonic clonic seizures.Those in the ECS group were iuvenile myoclonic epilepsy,idiopathic photosensitive occipital Iobe epilepsy,Panayiotopoulos syndrome and Gastaut type-idiclpathic children occipital epilepsy.Photosensitivity was detected in 88%of Patients with ECLS and 29%of patients with ECS.Conclusions ECLS and ECS are

  6. Cyclic Vomiting Syndrome in 41 adults: the illness, the patients, and problems of management

    Directory of Open Access Journals (Sweden)

    Burch Richard

    2005-12-01

    Full Text Available Abstract Background Cyclic Vomiting Syndrome (CVS is a disorder characterized by recurrent, stereotypic episodes of incapacitating nausea, vomiting and other symptoms, separated by intervals of comparative wellness. This report describes the clinical features, co-morbidities and problems encountered in management of 41 adult patients who met the diagnostic criteria for CVS. Methods This is a retrospective study of adults with CVS seen between 1994 and 2003. Follow-up data were obtained by mailed questionnaires. Results Age of onset ranged from 2 to 49 years. The duration of CVS at the time of consultation ranged from less than 1 year to 49 years. CVS episodes were stereotypic in respect of their hours of onset, symptomatology and length. Ninety-three percent of patients had recognizable prodromes. Half of the patients experienced a constellation of symptoms consisting of CVS episodes, migraine diathesis, inter-episodic dyspeptic nausea and a history of panic attacks. Deterioration in the course of CVS is indicated by coalescence of episodes in time. The prognosis of CVS is favorable in the majority of patients. Conclusion CVS is a disabling disorder affecting adults as well as children. Because its occurrence in adults is little known, patients experience delayed or mis-diagnosis and ineffectual, sometimes inappropriately invasive management.

  7. Comparative study of behavioural problems among epileptic children treated with phenobarbital with epileptic children treated with phenytoin

    Directory of Open Access Journals (Sweden)

    Mohsen Javadzadeh

    2011-01-01

    Full Text Available Background: Phenobarbital is recommended by WHO as the first line drug for the treatment of partial and generalized tonic clonic epilepsies in developing countries, however several clinical trials have recorded higher frequencies of behavioural problems associated with Phenobarbital than with other drugs or no treatment. We compared the frequency of behavioural problems among epileptic children treated with phenobarbital with epileptic children treated with phenytoin. Materials and Method: We conducted a case-control study to comparing of epileptic children treatment with neurological with epileptic children treated with phenytoin. Between November 2006 to March 2007, 74 children referred from child neurologic clinic who treated with phenobarbital or phenytoin for more than 2 months in Zahedan, assessed consecutively by the Rutters behaviour scale for children aged 6 years and older and by the preschool behaviour questionnaire for those 2-5 years.Results: The mean scores on the behaviour scales did not differ significantly between the phenobarbital and phenytoin groups in children aged 6 years and older. Irretability, attention deficit, disobedience and lack of energy in phenobarbital group more than phenytoin group in 2-5 years old children. Conclusion: Several clinical trials have recorded higher frequencies (20-60% of behavioural problems associated with phenobarbital than with other drugs but in our study evidence supports the acceptability of phenobarbital for epileptic children in developing countries

  8. Epilepsy, anti-epileptic medication use and risk of cancer

    DEFF Research Database (Denmark)

    Kaae, Jeanette; Carstensen, Lisbeth; Wohlfahrt, Jan;

    2014-01-01

    Whether the powerful medications used to treat epilepsy increase the risk of cancer has been debated for decades, but until now no study could disentangle the contributions of anti-epileptic medications and epilepsy itself to cancer risk. Using a cohort comprising all Danish residents ≥ 16 years...... old at some point during the period 1996-2010 (>56 million person-years of follow-up) and information from national health registers, we examined associations between anti-epileptic medication use and cancer rates in persons with and without epilepsy, and between epilepsy and cancer rates in treated...... and untreated individuals. Associations were expressed as incidence rate ratios (IRRs) estimated using Poisson regression. Among persons without epilepsy, use of anti-epileptic medication increased the rates of most cancers little or not at all, although we observed moderately increased rates of liver...

  9. Acute transient deafness representing a negative epileptic phenomenon.

    Science.gov (United States)

    Shahar, Eli; Ravid, Sarit; Genizi, Jacob; Schif, Aharon

    2010-07-01

    We report herein 2 children who presented with acute deafness heralding an epileptic event manifesting thereafter by loss of consciousness and tonic generalized posturing, possibly reflecting a negative epileptic phenomenon. The first previously healthy male had 2 paroxysmal episodes 7 months apart, starting with acute deafness lasting for a few minutes followed by loss of consciousness and generalized tonic posturing for 10 minutes. Electroencephalography (EEG) during the second episodes demonstrated generalized epileptiform discharges. The second with previously controlled partial complex seizures presented with episodes of complete deafness lasting for a few minutes followed by loss of consciousness and focal tonic posturing lasting 10 minutes. Such acute deafness represented an aura of a focal seizure substantiated by right focal temporal epileptic discharges within the region of the primary auditory cortex. Therefore, EEG should be performed in any case of acute transient deafness, even in the absence of accompanying overt clinical seizures. PMID:20042694

  10. Automatic classification of penicillin-induced epileptic EEG spikes.

    Science.gov (United States)

    Kortelainen, Jukka; Silfverhuth, Minna; Suominen, Kalervo; Sonkajarvi, Eila; Alahuhta, Seppo; Jantti, Ville; Seppanen, Tapio

    2010-01-01

    Penicillin-induced focal epilepsy is a well-known model in epilepsy research. In this model, epileptic activity is generated by delivering penicillin focally to the cortex. The drug induces interictal electroencephalographic (EEG) spikes which evolve in time and may later change to ictal discharges. This paper proposes a method for automatic classification of these interictal epileptic spikes using iterative K-means clustering. The method is shown to be able to detect different spike waveforms and describe their characteristic occurrence in time during penicillin-induced focal epilepsy. The study offers potential for future research by providing a method to objectively and quantitatively analyze the time sequence of interictal epileptic activity. PMID:21096740

  11. Effectiveness of Sulpiride in Adult Patients With Schizophrenia

    OpenAIRE

    Lai, Edward Chia-Cheng; Chang, Chia-Hsien; Kao Yang, Yea-Huei; Lin, Swu-Jane; Lin, Chia-Yin

    2012-01-01

    The objective of this study is to compare the effectiveness among sulpiride, risperidone, olanzapine, and haloperidol by evaluating the persistence of drug use. A retrospective cohort study was conducted by analyzing the National Health Insurance Research Database of Taiwan. Patients with schizophrenia aged 18–65 years and newly prescribed with a single oral antipsychotic medication between years 2003 and 2008 were included. The primary outcome was the persistence of antipsychotic agents by c...

  12. Relationship between perceived sleep and polysomnography in older adult patients

    OpenAIRE

    dos Santos Silva, Mayra; Bazzana, Caroline Moreira; de Souza, Altay Lino; Ramos, Luiz Roberto; Tufik, Sergio; Lucchesi, Lígia M.; Lopes, Guiomar Silva

    2015-01-01

    Background and aims Aging is a multifactorial process that elicits changes in the duration and quality of sleep. Polysomnography is considered to be the standard examination for the analysis of sleep and consists of the simultaneous recording of selected physiological variables during sleep. Objective The objective of this study was to use polysomnography to compare sleep reported by senior citizens. Methods We selected 40 patients, both male and female, with ages ranging from 64 to 89 years ...

  13. A manometric study of the esophagus in adult patients

    International Nuclear Information System (INIS)

    112 patients over 65 with an average age of 71.6 years old were studied. 65 of them were females and 47 were males. A manometric study of the esophagus was conducted in all cases and the results were compared with those of a groups of 48 sound individuals, 38 males and 10 females with an average age of 28.7 years old. The manometric diagnosis in 61.6 % of the cases was unspecific motor disorder; in 31.2 %, hiatus hernia; in 26.7 %, esophageal achalasia; and only 5.3 % presented a normal manometric study. It was proved that the resting pressure of the upper esophageal sphincter, the intensity and duration of the primary wave in the upper esophagus, and the lenght and percentage of relaxation of the lower esophageal sphincter were significantly inferior, for a p < 0.05 in elderly patients compared with the control group. The duration of the primary wave in the middle and lower esophagus was augmented, for a p < 0.05 in our studied group. Morphological alterations of the primary wave were found, where as tertiary and non-peristaltic waves were also observed, which is attributed to the progressive deterioration of the esophageal function with aging. These results confirm the presence of specific manometric alterations in the third age that must be known in order to improve the attention and treatment of these patients

  14. Comparison of the Phenotype and Approach to Pediatric vs Adult Patients With Nonalcoholic Fatty Liver Disease.

    Science.gov (United States)

    Nobili, Valerio; Alisi, Anna; Newton, Kimberly P; Schwimmer, Jeffrey B

    2016-06-01

    Nonalcoholic fatty liver disease (NAFLD) is one of the main chronic noncommunicable diseases in Westernized societies; its worldwide prevalence has doubled during the last 20 years. NAFLD has serious health implications not only for adults, but also for children. However, pediatric NAFLD is not only an important global problem in itself, but it is likely to be associated with increases in comorbidities, such as metabolic syndrome and cardiovascular diseases. There are several differences between NAFLD in children and adults, and it is not clear whether the disease observed in children is the initial phase of a process that progresses with age. The increasing prevalence of pediatric NAFLD has serious implications for the future adult population requiring appropriate action. Studies of NAFLD progression, pathogenesis, and management should evaluate disease phenotypes in children and follow these over the patient's lifetime. We review the similarities and differences of NAFLD between children and adults. PMID:27003600

  15. Attentional disorders in patients with complex partial epilepsy Distúrbios de atenção em pacientes com crises parciais complexas

    Directory of Open Access Journals (Sweden)

    Florindo Stella

    2003-06-01

    Full Text Available A study of concentrated attention patterns in epileptic patients was conducted with the objectives: characterization of the patients' epileptic condition; assessment of the concentrated attention levels in epileptic and nonepileptic individuals; comparison of the attention levels of the two groups. An evaluation was performed of 50 adult outpatients with complex partial seizures and 20 non-epileptic individuals (comparative group at the Neuroepilepsy Ambulatory Unit, State University of Campinas SP, Brazil. METHOD: characterization of seizure types, frequency and duration; concentrated attention assessment (Concentrated Attention Test - Toulouse-Piéron; comparison of the epileptic with non-epileptic individuals. RESULTS: A statistically significant difference was observed between the groups with regard to Correct Response, Wrong Response and No Response. A difference was observed in relation to Time, but it was statistically insignificant. The epileptic patients presented inferior cognitive performance in relation to concentrated attention when compared with the non-epileptic individuals, findings compatible with the clinical complaints.Estudou-se o padrão da atenção concentrada em pacientes epilépticos, com o objetivo de se caracterizar a condição epiléptica, avaliar os níveis de atenção concentrada em epilépticos e em sujeitos não-epilépticos e comparar esses níveis entre os grupos. Foram avaliados 50 pacientes adultos com crises parciais complexas em atendimento no Ambulatório de Neuroepilepsia da Universidade Estadual de Campinas SP, Brasil. Também foram estudados 20 sujeitos sem epilepsia, para efeito comparativo. MÉTODO: caracterização tipológica, freqüência e duração das crises; avaliação da atenção concentrada (Teste de Atenção Concentrada - Toulouse-Piéron; e comparação dos resultados dos pacientes dos pacientes com os sujeitos não-epilépticos. RESULTADOS: Houve diferença estatisticamente

  16. A novel genetic programming approach for epileptic seizure detection.

    Science.gov (United States)

    Bhardwaj, Arpit; Tiwari, Aruna; Krishna, Ramesh; Varma, Vishaal

    2016-02-01

    The human brain is a delicate mix of neurons (brain cells), electrical impulses and chemicals, known as neurotransmitters. Any damage has the potential to disrupt the workings of the brain and cause seizures. These epileptic seizures are the manifestations of epilepsy. The electroencephalograph (EEG) signals register average neuronal activity from the cerebral cortex and label changes in activity over large areas. A detailed analysis of these electroencephalograph (EEG) signals provides valuable insights into the mechanisms instigating epileptic disorders. Moreover, the detection of interictal spikes and epileptic seizures in an EEG signal plays an important role in the diagnosis of epilepsy. Automatic seizure detection methods are required, as these epileptic seizures are volatile and unpredictable. This paper deals with an automated detection of epileptic seizures in EEG signals using empirical mode decomposition (EMD) for feature extraction and proposes a novel genetic programming (GP) approach for classifying the EEG signals. Improvements in the standard GP approach are made using a Constructive Genetic Programming (CGP) in which constructive crossover and constructive subtree mutation operators are introduced. A hill climbing search is integrated in crossover and mutation operators to remove the destructive nature of these operators. A new concept of selecting the Globally Prime offspring is also presented to select the best fitness offspring generated during crossover. To decrease the time complexity of GP, a new dynamic fitness value computation (DFVC) is employed to increase the computational speed. We conducted five different sets of experiments to evaluate the performance of the proposed model in the classification of different mixtures of normal, interictal and ictal signals, and the accuracies achieved are outstandingly high. The experimental results are compared with the existing methods on same datasets, and these results affirm the potential use of

  17. Increased phase synchronization of spontaneous calcium oscillations in epileptic human versus normal rat astrocyte cultures

    Science.gov (United States)

    Balázsi, Gábor; Cornell-Bell, Ann H.; Moss, Frank

    2003-06-01

    Stochastic synchronization analysis is applied to intracellular calcium oscillations in astrocyte cultures prepared from epileptic human temporal lobe. The same methods are applied to astrocyte cultures prepared from normal rat hippocampus. Our results indicate that phase-repulsive coupling in epileptic human astrocyte cultures is stronger, leading to an increased synchronization in epileptic human compared to normal rat astrocyte cultures.

  18. Comparative Study of Early Maladaptive Schemas in Rheumatoid Arthrits Patients and Normal Adults

    Directory of Open Access Journals (Sweden)

    Fatemeh Rezaei

    2014-01-01

    Full Text Available Early maladaptive schemas (EMSs designed to ases early distres. EMSs are at he core of personality pathology and psychological distres. The main objective of this study was to find out he diferences betwen rheumatoid arthrits (RA patients and normal adults on EMSs. 10 RA patients and 10 normal adults completed Young’s Schema Questionaire developed by Jefery Young (198. The results showed that data was subjected to statistical analysis; T- test showed that the RA patients reported a signifcantly greater severity of early maladaptive schemata than the normal subjects. This study sugested that a remarkable amount of RA patients may sufer from EMSs which have an efect on their pain situation. These findings confirm those pieces of evidence indicating the psychological treatments included in multidisciplinary programs for this disorder.

  19. Design Considerations for Patient Portal Adoption by Low-Income, Older Adults

    Science.gov (United States)

    Latulipe, Celine; Gatto, Amy; Nguyen, Ha T.; Miller, David P.; Quandt, Sara A.; Bertoni, Alain G.; Smith, Alden; Arcury, Thomas A.

    2016-01-01

    This paper describes the results of an interview study investigating facilitators and barriers to adoption of patient portals among low-income, older adults in rural and urban populations in the southeastern United States. We describe attitudes of this population of older adults and their current level of technology use and patient portal use. From qualitative analysis of 36 patient interviews and 16 caregiver interviews within these communities, we derive themes related to benefits of portals, barriers to use, concerns and desired features. Based on our initial findings, we present a set of considerations for designing the patient portal user experience, aimed at helping healthcare clinics to meet U.S. federally-mandated ‘meaningful use’ requirements. PMID:27077140

  20. Innovative Strategies Designed to Improve Adult Pneumococcal Immunizations in Safety Net Patient-Centered Medical Homes.

    Science.gov (United States)

    Park, Nina J; Sklaroff, Laura Myerchin; Gross-Schulman, Sandra; Hoang, Khathy; Tran, Helen; Campa, David; Scheib, Geoffrey; Guterman, Jeffrey J

    2016-08-01

    Streptococcus pneumoniae is a principal cause of serious illness, including bacteremia, meningitis, and pneumonia, worldwide. Pneumococcal immunization is proven to reduce morbidity and mortality in high-risk adult and elderly populations. Current pneumococcal vaccination practices are suboptimal in part because of recommendation complexity, the high cost of provider-driven immunization interventions, and outreach methods that are not patient-centric. These barriers are amplified within the safety net. This paper identifies efforts by the Los Angeles County Department of Health Services to increase pneumococcal immunization rates for adult indigent patient populations. A 4-part approach will be used to increase vaccination rates: (1) protocol driven care, (2) staff education, (3) electronic identification of eligible patients, and (4) automated patient outreach and scheduling. The proposed analytics plan and potential for scalability are described. (Population Health Management 2016;19:240-247). PMID:26824148

  1. Treatment of Acute Myeloid Leukemia in Adolescent and Young Adult Patients

    Directory of Open Access Journals (Sweden)

    Guldane Cengiz Seval

    2015-03-01

    Full Text Available The objectives of this review were to discuss standard and investigational treatment strategies for adolescent and young adult with acute myeloid leukemia, excluding acute promyelocytic leukemia. Acute myeloid leukemia (AML in adolescent and young adult patients (AYAs may need a different type of therapy than those currently used in children and older patients. As soon as AML is diagnosed, AYA patient should be offered to participate in well-designed clinical trials. The standard treatment approach for AYAs with AML is remission induction chemotherapy with an anthracycline/cytarabine combination, followed by either consolidation chemotherapy or stem cell transplantation, depending on the ability of the patient to tolerate intensive treatment and cytogenetic features. Presently, continuing progress of novel drugs targeting specific pathways in acute leukemia may bring AML treatment into a new era.

  2. Patient Reported Delays in Seeking Treatment for Tuberculosis among Adult and Pediatric TB Patients and TB Patients Co-Infected with HIV in Lima, Peru: A Qualitative Study

    OpenAIRE

    Valerie A Paz-Soldan; Alban, Rebecca E; Dimos Jones, Christy; Powell, Amy R.; Oberhelman, Richard A.

    2014-01-01

    Introduction: Tuberculosis (TB) remains a significant public health challenge worldwide, and particularly in Peru with one of the highest incidence rates in Latin America. TB patient behavior has a direct influence on whether a patient will receive timely diagnosis and successful treatment of their illness. Objectives: The objective was to understand the complex factors that can impact TB patient health seeking behavior. Methods: In-depth interviews were conducted with adult and parents...

  3. The contribution of radiotherapy in the adult patients with a medulloblastoma: a long mono-institutional experience; Le role de la radiotherapie chez les patients adultes atteints d'un medulloblastome: une longue experience monoinstitutionelle

    Energy Technology Data Exchange (ETDEWEB)

    Bari, B. de [Centre Hospitalier Lyon-Sud, Service de Radiotherapie Oncologie, 69 - Pierre-Benite (France); Balducci, M.; Manfrida, S.; Chiesa, S.; Frascino, V.; Valentini, V. [Cattedra di Radioterapia, Dipt. di Bioimmagini e Scienze Radiologiche UCSC, Rome (Italy); Anile, C. [Istituto di Neurochirurgia, UCSC, Rome (Italy)

    2009-10-15

    The medulloblastoma is rare among adults (1% of primitive cerebral tumors). currently, the surgery constitutes the initial therapy approach, followed by the radiotherapy. This summary presents the update of a retrospective analysis in a population of adult patients (>18 years) suffering of a medulloblastoma presented in 2006 at the national congress of the Italian association of oncological radiotherapy. It confirms the efficiency of radiotherapy to treat the adult patients suffering of a medulloblastoma. (N.C.)

  4. Clinical next generation sequencing of pediatric-type malignancies in adult patients identifies novel somatic aberrations.

    Science.gov (United States)

    Silva, Jorge Galvez; Corrales-Medina, Fernando F; Maher, Ossama M; Tannir, Nizar; Huh, Winston W; Rytting, Michael E; Subbiah, Vivek

    2015-01-01

    Pediatric malignancies in adults, in contrast to the same diseases in children are clinically more aggressive, resistant to chemotherapeutics, and carry a higher risk of relapse. Molecular profiling of tumor sample using next generation sequencing (NGS) has recently become clinically available. We report the results of targeted exome sequencing of six adult patients with pediatric-type malignancies : Wilms tumor(n=2), medulloblastoma(n=2), Ewing's sarcoma( n=1) and desmoplastic small round cell tumor (n=1) with a median age of 28.8 years. Detection of druggable somatic aberrations in tumors is feasible. However, identification of actionable target therapies in these rare adult patients with pediatric-type malignancies is challenging. Continuous efforts to establish a rare disease registry are warranted. PMID:25859559

  5. Clinical characteristics and outcomes of Mycobacterium tuberculosis disease in adult patients with hematological malignancies

    Directory of Open Access Journals (Sweden)

    Chen Chien-Yuan

    2011-11-01

    Full Text Available Abstract Background Diseases caused by Mycobacterium tuberculosis (TB among adult patients with hematological malignancies have rarely been investigated. Methods Adult patients with hematological malignancies at National Taiwan University Hospital between 1996 and 2009 were retrospectively reviewed. Patients with positive serology for HIV were excluded. TB disease is diagnosed by positive culture(s in the presence of compatible symptoms and signs. The demographics, laboratory and, microbiological features, were analyzed in the context of clinical outcomes. Results Fifty-three of 2984 patients (1.78% were diagnosed with TB disease. The estimated incidence was 120 per 100,000 adult patients with hematological malignancies. Patients with acute myeloid leukemia had a significantly higher incidence of TB disease than other subtypes of hematological malignancies (2.87% vs. 1.21%, p = 0.002, odds ratio, 2.40; 95% confidence interval, 1.39-4.41. Thirty-eight patients (72% with non-disseminated pulmonary TB disease presented typically with mediastinal lymphadenopathy (53%, pleural effusion (47% and fibrocalcific lesions (43% on chest imaging. The 15 (28% patients with extra-pulmonary disease had lower rates of defervescence within 72 h of empirical antimicrobial therapy (13% vs 45%, p = 0.03 and a higher 30-day in-hospital mortality (20% vs. 0%, p = 0.004 compared to those with disease confined to the lungs. Conclusions TB disease is not uncommon among patients with hematological malignancies in Taiwan. Patients who received a diagnosis of extra-pulmonary TB suffered higher mortality than those with pulmonary TB alone. Clinicians should consider TB in the differential diagnoses of prolonged fever in patients with hematological malignancies, particularly in regions of high endemicity.

  6. Orthodontic Treatment in Adult Patient with Reduced Periodontium: A Case Report.

    Science.gov (United States)

    Shintcovsk, Ricardo Lima; Knop, Luegya Amorim Henriques; Pinto, Ary Santos; Gandini, Luiz Gonzaga; Martins, Lídia Parsekian

    2015-01-01

    Patients presenting reduced periodontium represent a major concern for orthodontists. The purpose of this article is to present the clinical case of an adult patient who presented sequel of periodontal disease (diastemas) compromising her dental aesthetics. She was subjected to an orthodontic treatment with the application of light forces distant from the teeth with reduced periodontium. A periodontal support therapy was successfully implemented. The final stage of the treatment indicated satisfactory occlusal and periodontal characteristics. PMID:27029099

  7. Increased Mortality in Adult Trauma Patients Transfused with Blood Components Compared with Whole Blood

    OpenAIRE

    Jones, Allison R.; Frazier, Susan K

    2014-01-01

    Hemorrhage is a preventable cause of death among trauma patients, and management often includes transfusion, either whole blood or a combination of blood components (packed red blood cells, platelets, fresh frozen plasma). We used the 2009 National Trauma Data Bank to evaluate the relationship between transfusion type and mortality in adult major trauma patients (n = 1745). Logistic regression analysis identified three independent predictors of mortality: Injury Severity Score, emergency tran...

  8. The Level of Dental Anxiety and Dental Status in Adult Patients

    OpenAIRE

    Dobros, Katarzyna; Hajto-Bryk, Justyna; Wnek, Anna; Zarzecka, Joanna; Rzepka, Dominik

    2014-01-01

    Background: The present study aimed to assess potential correlation between dental anxiety and overall dental status in adult patients, in consideration of the frequency of dental appointments and individual dental hygiene practices. Materials and Methods: Individual dental anxiety levels were assessed with the aid of the Corah’s dental anxiety scale (DAS). The study embraced 112 patients of the University Dental Clinic, Kraków. Following clinical and X-ray exams, r...

  9. Three cases of pulmonary aspergilloma in adult patients with cystic fibrosis.

    OpenAIRE

    Maguire, C. P.; Hayes, J. P.; Hayes, M.; Masterson, J.; FitzGerald, M X

    1995-01-01

    Pulmonary aspergillomas usually occur when Aspergillus fungi colonise lung tissue previously damaged by disease. Pulmonary aspergillomas in three adult patients with cystic fibrosis are reported--an association not previously described. At the time of diagnosis all three patients had previous long term colonisation with Aspergillus fumigatus and severe advanced destructive lung disease with lung function less than 25% of the predicted normal values. It is likely that, with increasing survival...

  10. Transitions at the end of life for older adults - patient, carer and professional perspectives

    OpenAIRE

    Hanratty, Barbara; Lowson, Elizabeth; Grande, Gunn; Payne, Sheila; Addington-Hall, Julia; Valtorta, Nicole; Seymour, Jane

    2014-01-01

    Background The end of life may be a time of high service utilisation for older adults. Transitions between care settings occur frequently, but may produce little improvement in symptom control or quality of life for patients. Ensuring that patients experience co-ordinated care, and moves occur because of individual needs rather than system imperatives, is crucial to patients’ well-being and to containing health-care costs. Objective The aim of this study was to understand the expe...

  11. Post-transplant lymphoproliferative disorder presented as small bowel intussusception in adult liver transplant patient

    OpenAIRE

    Joo, Sun Hyung; Acun, Zeki; Stefanovic, Alexandra; Blieden, Clifford R.; Ikpatt, Offiong F.; Moon, Jang

    2011-01-01

    Intestinal obstruction after liver transplant is a rare complication, with diverse clinical manifestations. Intestinal adhesion is the most common cause. However, internal hernia, abdominal wall hernia, and neoplasm are also reported. Intussusception is another rare cause of intestinal obstruction, which has been reported primarily in pediatric patients. Herein, we report a case of intestinal obstruction from intussusception in an adult liver transplant patient associated with post-transplant...

  12. Volumetric localization of epileptic activities in tuberous sclerosis using synthetic aperture magnetometry

    Energy Technology Data Exchange (ETDEWEB)

    Xiao, Zheng [Hospital for Sick Children, Research Institute, Toronto (Canada); Hospital for Sick Children, Department of Diagnostic Imaging, Toronto (Canada); Xiang, Jing [Hospital for Sick Children, Research Institute, Toronto (Canada); Hospital for Sick Children, Department of Diagnostic Imaging, Toronto (Canada); Holowka, Stephanie; Chuang, Sylvester [Hospital for Sick Children, Department of Diagnostic Imaging, Toronto (Canada); Hunjan, Amrita; Sharma, Rohit; Otsubo, Hiroshi [Hospital for Sick Children, Division of Neurology, Toronto (Canada)

    2006-01-01

    Magnetoencephalography (MEG) is a novel noninvasive technique for localizing epileptic zones. Tuberous sclerosis complex (TSC) is often associated with medically refractory epilepsy with multiple epileptic zones. Surgical treatment of TSC requires accurate localization of epileptogenic tubers. The objective of this study was to introduce a new MEG technique, synthetic aperture magnetometry (SAM), to volumetrically localize irritable zones and clarify the correlations between SAM, dipole modeling and anatomical tubers. Eight pediatric patients with TSC confirmed by clinical and neuroimaging findings were retrospectively studied. MEG data were recorded using a whole-cortex CTF OMEGA system. Sleep deprivation was employed to provoke epileptiform activity. Irritable zones were localized using both dipole modeling and SAM. MRI detected 42 tubers in the eight patients. Dipole modeling localized 28 irritable zones, and 19 out of the 28 zones were near tubers (19/42, 45%). SAM found 51 irritable zones, and 31 out of the 51 zones were near tubers (31/42, 74%). Among the 51 irritable zones determined by SAM, thirty-five zones were in 1-35 Hz, nine zones were in 35-60 Hz, and seven zones were in 60-120 Hz. The new method, SAM, yielded very plausible equivalent sources for patients who showed anatomical tubers on MRI. Compared to conventional dipole modeling, SAM appeared to offer increased detection of irritable zones and beneficial volumetric and frequency descriptions. (orig.)

  13. Ecstatic epileptic seizures: a glimpse into the multiple roles of the insula

    Directory of Open Access Journals (Sweden)

    Markus eGschwind

    2016-02-01

    Full Text Available Ecstatic epileptic seizures are a rare but compelling epileptic entity. During the first seconds of these seizures, ecstatic auras provoke feelings of well-being, intense serenity, bliss, and enhanced self-awareness. They are associated with the impression of time dilation, and can be described as a mystic experience by some patients. The functional neuroanatomy of ecstatic seizures is still debated. During recent years several patients presenting with ecstatic auras have been reported by others and us (in total n=49; a few of them in the setting of presurgical evaluation including electrical brain stimulation. According to the recently recognized functions of the insula, and the results of nuclear brain imaging and electrical stimulation, the ecstatic symptoms in these patients seem to localize to a functional network centered around the anterior insular cortex, where we thus propose to locate this rare ictal phenomenon. Here we summarize the role of the multiple sensory, autonomic, affective and cognitive functions of the insular cortex, which are integrated into the creation of self-awareness, and we suggest how this system may become dysfunctional on several levels during ecstatic aura.

  14. Volumetric localization of epileptic activities in tuberous sclerosis using synthetic aperture magnetometry

    International Nuclear Information System (INIS)

    Magnetoencephalography (MEG) is a novel noninvasive technique for localizing epileptic zones. Tuberous sclerosis complex (TSC) is often associated with medically refractory epilepsy with multiple epileptic zones. Surgical treatment of TSC requires accurate localization of epileptogenic tubers. The objective of this study was to introduce a new MEG technique, synthetic aperture magnetometry (SAM), to volumetrically localize irritable zones and clarify the correlations between SAM, dipole modeling and anatomical tubers. Eight pediatric patients with TSC confirmed by clinical and neuroimaging findings were retrospectively studied. MEG data were recorded using a whole-cortex CTF OMEGA system. Sleep deprivation was employed to provoke epileptiform activity. Irritable zones were localized using both dipole modeling and SAM. MRI detected 42 tubers in the eight patients. Dipole modeling localized 28 irritable zones, and 19 out of the 28 zones were near tubers (19/42, 45%). SAM found 51 irritable zones, and 31 out of the 51 zones were near tubers (31/42, 74%). Among the 51 irritable zones determined by SAM, thirty-five zones were in 1-35 Hz, nine zones were in 35-60 Hz, and seven zones were in 60-120 Hz. The new method, SAM, yielded very plausible equivalent sources for patients who showed anatomical tubers on MRI. Compared to conventional dipole modeling, SAM appeared to offer increased detection of irritable zones and beneficial volumetric and frequency descriptions. (orig.)

  15. Epidemiology of adult-onset hydrocephalus: institutional experience with 2001 patients.

    Science.gov (United States)

    Bir, Shyamal C; Patra, Devi Prasad; Maiti, Tanmoy K; Sun, Hai; Guthikonda, Bharat; Notarianni, Christina; Nanda, Anil

    2016-09-01

    OBJECTIVE Adult-onset hydrocephalus is not commonly discussed in the literature, especially regarding its demographic distribution. In contrast to pediatric hydrocephalus, which is related to a primary CSF pathway defect, its development in adults is often secondary to other pathologies. In this study, the authors investigated the epidemiology of adult-onset hydrocephalus as it pertains to different etiologies and in reference to age, sex, and race distributions. METHODS The authors retrospectively reviewed the clinical notes of 2001 patients with adult-onset hydrocephalus who presented to Louisiana State University Health Sciences Center within a 25-year span. Significant differences between the groups were analyzed by a chi-square test; p < 0.05 was considered significant. RESULTS The overall mean (± SEM) incidence of adult hydrocephalus in this population was 77 ± 30 per year, with a significant increase in incidence in the past decade (55 ± 3 [1990-2003] vs 102 ± 6 [2004-2015]; p < 0.0001). Hydrocephalus in a majority of the patients had a vascular etiology (45.5%) or was a result of a tumor (30.2%). The incidence of hydrocephalus in different age groups varied according to various pathologies. The incidence was significantly higher in males with normal-pressure hydrocephalus (p = 0.03) or head injury (p = 0.01) and higher in females with pseudotumor cerebri (p < 0.0001). In addition, the overall incidence of hydrocephalus was significantly higher in Caucasian patients (p = 0.0002) than in those of any other race. CONCLUSIONS Knowledge of the demographic variations in adult-onset hydrocephalus is helpful in achieving better risk stratification and better managing the disease in patients. For general applicability, these results should be validated in a large-scale meta-analysis based on a national population database. PMID:27581317

  16. Clinical effectiveness of first and repeat influenza vaccination in adult and elderly diabetic patients

    NARCIS (Netherlands)

    Looijmans-Van den Akker, I.; Verheij, T.J.M.; Buskens, E.; Nichol, K.L.; Rutten, G.E.H.M.; Hak, E.

    2006-01-01

    OBJECTIVE: Influenza vaccine uptake remains low among the high-risk group of patients with diabetes, partly because of conflicting evidence regarding its potential benefits. We assessed the clinical effectiveness of influenza vaccination in adults with diabetes and specifically examined potential mo

  17. An Examination of Intimate Partner Violence and Psychological Stressors in Adult Abortion Patients

    Science.gov (United States)

    Ely, Gretchen E.; Otis, Melanie D.

    2011-01-01

    The purpose of this article is to describe an exploratory study examining the relationship between intimate partner violence and psychological stressors in a sample of 188 adult abortion patients. Results indicate the almost 15% of respondents report a history of abuse by the coconceiving partner. In addition, women who reported having had one or…

  18. Evaluation of doses received by pediatric and adult patients undergoing to CT exams

    International Nuclear Information System (INIS)

    This paper aims to evaluated the dose to adult and pediatric patients due to the execution of tests CT scan of head, chest and abdomen, as well as establish a comparative analysis between these results and protocols involving employees to begin a process optimization in the practice

  19. Guiding Hypertensive Adult Patients : A Literature Review of Evidence- Based Nursing

    OpenAIRE

    Afolabi, Joshua; Guo, Haochuan

    2014-01-01

    Abstract of Thesis LAPLAND UNIVERSITY OF APPLIED SCIENCES Health Care And Social Services Degree Programme in Nursing Bachelor’s Thesis________________________________________ Authors Guo Haochuan And Joshua Afolabi Year 2014 Advisors Mirja Anttila And Seppo Kilpiäinen Title Guiding Hypertensive Adult Patients Pages 47pages________________________________________ This thesis dealt with the guida...

  20. Intensive patient education and treatment program for young adults with atopic dermatitis

    NARCIS (Netherlands)

    Coenraads, PJ; Span, L; Jaspers, JPC; Fidler, [No Value

    2001-01-01

    Background and Objective. By means of a 2-week intensive multidisciplinary training & treatment course in small groups (ISBP), young adults with atopic dermatitis may be able to achieve better self-management of their disease and reduce their number of doctor visits. Methods. Patients aged 18-35 wit

  1. Adults Living with Limited Literacy and Chronic Illness: Patient Education Experiences

    Science.gov (United States)

    King, Judy; Taylor, Maurice C.

    2010-01-01

    The purpose of this study was to investigate how Canadian adults living with limited literacy and chronic illness made meaning of their patient education experiences. The study used a hermeneutic phenomenological research design and employed three data sources over a nine-month period. Data was interpreted and analyzed as it was collected,…

  2. Infliximab dependency is related to decreased surgical rates in adult Crohn's disease patients

    DEFF Research Database (Denmark)

    Pedersen, N.; Duricova, D.; Lenicek, M.;

    2010-01-01

    Background Infliximab dependency in children with Crohn's disease (CD) has recently been described and found to be associated with a decreased surgery rate. Aim To assess infliximab dependency of adult CD patients, evaluate the impact on surgery, and search for possible clinical and genetic...

  3. 18F-FDG PET Reveals Fronto-temporal Dysfunction in Children with Fever-Induced Refractory Epileptic Encephalopathy

    International Nuclear Information System (INIS)

    Fever-induced refractory epileptic encephalopathy in school-age children (FIRES) is a recently described epileptic entity whose etiology remains unknown. Brain abnormalities shown by MRI are usually limited to mesial-temporal structures and do not account for the catastrophic neuro-psychologic findings. Methods: We conducted FIRES studies in 8 patients, aged 6-13 y, using 18F-FDG PET to disclose eventual neo-cortical dysfunction. Voxel-based analyses of cerebral glucose metabolism were performed using statistical parametric mapping and an age-matched control group. Results: Group analysis revealed a widespread inter-ictal hypo-metabolic network including the temporo-parietal and orbito-frontal cortices bilaterally. The individual analyses in patients identified hypo-metabolic areas corresponding to the predominant electroencephalograph foci and neuro-psychologic deficits involving language, behavior, and memory. Conclusion: Despite clinical heterogeneity, 18F-FDG PET reveals a common network dysfunction in patients with sequelae due to fever-induced refractory epileptic encephalopathy. (authors)

  4. Characterization of language and phonological working memory in patients with myoclonic astatic epileptic syndrome Caracterização da linguagem e memória de trabalho em pacientes com síndrome epiléptica mioclônica astática

    Directory of Open Access Journals (Sweden)

    Marisa Tomoe Hebihara Fukuda

    2010-02-01

    Full Text Available The course of myoclonic astatic epileptic syndrome (MAES is variable and little information is available about cortical functions in the presence of the disease. The objective of the present study was to assess the phonological working memory (PWM and the verbal language of six patients between 8 and 18 years old, on treatment for at least 5 years, and good control of seizures, diagnosed in the Service of Epilepsy of Hospital of Clinics of Ribeirão Preto, São Paulo University in Brazil. The Test of Repetition of Meaningless Words was used to assess PWM. Video-recorded of language samples were collected during spontaneous and directed activities for the study of verbal language and pragmatics. A qualitative analysis showed that all patients presented deficits in the execution of the PWM test and only one patient showed poor mastery of all aspects studied. These finds contribute to strategies of treatment for language problems of patients with MAES, focusing on PWA.A evolução da síndrome epiléptica mioclônica astática (SEMA é variável e há poucas informações sobre funções corticais. Este estudo pretendeu avaliar a memória de trabalho fonológica (MTF e a linguagem verbal de pacientes com SEMA. Foram avaliados seis pacientes entre 8 e 18 anos em tratamento há mais de 5 anos e bom controle das crises, do Serviço de Epilepsia do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo. A Prova de Repetição de Palavras Sem Significado foi utilizada para MTF, e coletaram-se amostras de linguagem, gravadas em vídeo, durante atividades espontâneas e dirigidas para estudo da linguagem verbal e pragmática. Análise qualitativa mostrou que todos apresentaram deficiência na MTF e, exceto um, mostraram domínio dos aspectos verbais estudados. Os achados contribuem para estratégias de tratamento de problemas de linguagem de pacientes com SEMA, com maior enfoque na MTF.

  5. The Influence of Adult Attachment on Patient Self-Management in Primary Care - The Need for a Personalized Approach and Patient-Centred Care

    OpenAIRE

    Katja Brenk-Franz; Bernhard Strauss; Fabian Tiesler; Christian Fleischhauer; Paul Ciechanowski; Nico Schneider; Jochen Gensichen

    2015-01-01

    Objective Self-management strategies are essential elements of evidence-based treatment in patients with chronic conditions in primary care. Our objective was to analyse different self-management skills and behaviours and their association to adult attachment in primary care patients with multiple chronic conditions. Methods In the apricare study (Adult Attachment in Primary Care) we used a prospective longitudinal design to examine the association between adult attachment and self-management...

  6. Psychiatric stigma in treatment seeking adults with personality problems: evidence from a sample of 214 patients.

    Directory of Open Access Journals (Sweden)

    Kirsten eCatthoor

    2015-07-01

    Full Text Available Stigmatization is a major hindrance in adult psychiatric patients with Axis-I diagnoses, as shown consistently in most studies. Significantly fewer studies on the emergence of psychiatric stigma in adult patients with personality disorders exist, although the resulting evidence is conclusive. Some authors consider patients with personality disorders at risk for severe stigmatization because of intense difficulties during interpersonal contact, even in a psychotherapeutic relationship. The aim of this study was primarily the assessment of pre-existing stigma in patients referred for intensive treatment for personality disorders. The study enrolled 214 patients admitted to the adult department of a highly specialized mental health care institute offering psychotherapy for patients with severe and complex personality pathology. All patients underwent a standard assessment with self-report questionnaires and a semi-structured interview to measure Axis II personality disorders. The Stigma Consciousness Questionnaire (SCQ and the Perceived Devaluation-Discrimination Questionnaire (DDQ, both validated instruments, were used to measure perceived and actual experiences of stigma. Independent sample t-tests were used to investigate differences in the mean total stigma scores for patients both with and without a personality disorder. One-way ANOVA’s were performed to assess the differences between having a borderline personality disorder, another personality disorder, or no personality disorder diagnosis.Multiple regression main effect analyses were conducted in order to explore the impact of the different personality disorder diagnosis on the level of stigma. The mean scores across all patient groups were consistent with rather low stigma. No differences were found for patients with or without a personality disorder diagnosis. Level of stigma in general was not associated with an accumulating number of personality disorders.

  7. A 5-year retrospective study of rampant dental caries among adult patients in a Nigerian Teaching Hospital

    OpenAIRE

    M Ajayi Deborah; M F Abiodun-Solanke Iyabode; O Gbadebo Shakeerah

    2015-01-01

    Background: Rampant caries in adults has not been a focus of many researches unlike the childhood form of the disease. The disease is an interesting finding in an adult patient. When the condition occurs in children, it has been described as nursing bottle caries, baby bottle tooth decay, and the most recently adopted term, "early childhood caries". Aim: The aim was to determine the prevalence of rampant caries among adult patients. Materials and Methods: Cases of rampant caries were id...

  8. A Spectral Based Forecasting Tool of Epileptic Seizures

    Directory of Open Access Journals (Sweden)

    Hedi Khammari

    2012-05-01

    Full Text Available A new approach to recognize and predict succedent epileptic seizure by using single channel electroencephalogram (EEG analysis is proposed. Spectral analysis of a brain time series of the left frontal FP1-F7 (LF scalp location signal is devoted for seizure prediction and analysis. Important findings showing the presence of preictal spectral changes in studied brain signal are described. Spectral features occurring during the preictal epoch are extracted from the application of sliding spectral windows of raw EEG at different moments in time preceding the seizure onset. The same method is then applied to a couple of Intrinsic Mode Functions (IMF1 and IMF2 of the raw EEG (FP1-F7 decomposed by the algorithm of empirical mode decomposition. The main prediction features are derived from the changes of amplitudes, frequency and the number of spikes which are of diagnostic values. The sliding spectral windows were computed to trace the amplitude changes of higher harmonics during time interval preceding the seizure onset. Choosing different moments in time aims to identify the best prediction time of seizure onset. Obviously an early prediction time is always desirable but the seizure may result from an abrupt change and so the spectral 'signs of an imminent seizure occur during a very short prediction time. From another viewpoint, it may be advantageous to consider a successive prediction times showing the increase of spike numbers and the predominance of certain waves rather than others when approaching seizure onset. The common prediction features extracted from the analysis of FP1-F7 signal for both patients were mainly the increasing number of spikes of low frequency waves namely delta and theta waves.

  9. Modulation of epileptic activity by deep brain stimulation: a model-based study of frequency-dependent effects

    Directory of Open Access Journals (Sweden)

    Faten eMina

    2013-07-01

    Full Text Available A number of studies showed that deep brain stimulation (DBS can modulate the activity in the epileptic brain and that a decrease of seizures can be achieved in responding patients. In most of these studies, the choice of stimulation parameters is critical to obtain desired clinical effects. In particular, the stimulation frequency is a key parameter that is difficult to tune. A reason is that our knowledge about the frequency-dependant mechanisms according to which DBS indirectly impacts the dynamics of pathological neuronal systems located in the neocortex is still limited. We address this issue using both computational modeling and intracerebral EEG (iEEG data.We developed a macroscopic (neural mass model of the thalamocortical network. In line with already-existing models, it includes interconnected neocortical pyramidal cells and interneurons, thalamocortical cells and reticular neurons. The novelty was to introduce, in the thalamic compartment, the biophysical effects of direct stimulation. Regarding clinical data, we used a quite unique data set recorded in a patient (drug-resistant epilepsy with a focal cortical dysplasia (FCD. In this patient, DBS strongly reduced the sustained epileptic activity of the FCD for low-frequency (LFS, < 2 Hz and high-frequency stimulation (HFS, > 70 Hz while intermediate-frequency stimulation (IFS, around 50 Hz had no effect.Signal processing, clustering and optimization techniques allowed us to identify the necessary conditions for reproducing, in the model, the observed frequency-dependent stimulation effects. Key elements which explain the suppression of epileptic activity in the FCD include a feed-forward inhibition and synaptic short-term depression of thalamocortical connections at LFS, and b inhibition of the thalamic output at HFS. Conversely, modeling results indicate that IFS favors thalamic oscillations and entrains epileptic dynamics.

  10. QL-04FACTORS ASSOCIATED WITH SUICIDAL IDEATION IN CLINICALLY DISTRESSED ADULT GLIOMA PATIENTS

    Science.gov (United States)

    Banerjee, Pia; Cloughesy, Timothy; Cervantes, Sandra; Pham, Jennifer; Nghiemphu, Phioanh; Lai, Albert; Wellisch, David

    2014-01-01

    OBJECTIVE: During patient care, it is critical to identify the glioma patients who are experiencing suicidal ideation among those who present with elevated levels of psychological distress, so appropriate interventions can be implemented. The aim of this study was to determine the factors that differentiated adult glioma patients with possible suicidal ideation from those without suicidal ideation among patients experiencing psychological distress. METHODS: 317 adult patients with WHO Grade II-IV glioma completed a psychosocial questionnaire comprised of several measures: Brief Symptom Inventory-18 (BSI-18) on general psychological distress, Patient Health Questionnaire-9 on depressive symptoms, General Anxiety Disorder-7 on anxiety symptoms, Revised Schwartz Cancer Fatigue Scale on fatigue, and CCSS Neurocognitive Questionnaire on cognitive symptoms. Patients with clinically elevated levels of psychological distress were identified, as determined by a BSI-18 Total T Score ≥ 50 (per Recklitis, 2007). Possible suicidal ideation was identified by endorsement of a positive response to BSI-18 item "thoughts of ending your life.“ T-tests, chi-square tests, and regression were utilized to identify the factors that distinguished the patients who endorsed possible suicidal ideation from those who did not, among the subset of patients with clinically elevated distress levels. RESULTS: 116 patients (36.6%) endorsed clinically significant distress levels. Of these, 17 patients (14.7%) endorsed possible suicidal ideation. Significantly higher levels of depression, anxiety, overall fatigue, emotional fatigue, emotional lability, task inefficiency, and memory concerns (p < .01) distinguished the patients with suicidal ideation. No medical characteristics (e.g., tumor location, grade, KPS, chemotherapy) or demographics (e.g., age, gender) significantly differentiated those with suicidal ideation from those without. CONCLUSION: The rates of clinically elevated psychological

  11. Subclinical anaemia of chronic disease in adult patients with cystic fibrosis.

    LENUS (Irish Health Repository)

    O'connor, T M

    2012-02-03

    Patients with chronic hypoxaemia develop secondary polycythaemia that improves oxygen-carrying capacity. Therefore, normal haemoglobin and haematocrit values in the presence of chronic arterial hypoxaemia in cystic fibrosis constitute \\'relative anaemia\\'. We sought to determine the cause of this relative anaemia in patients with cystic fibrosis. We studied haematological indices and oxygen saturation in healthy volunteers (n=17) and in adult patients with cystic fibrosis (n=15). Patients with cystic fibrosis had lower resting arterial oxygen saturation when compared with normal volunteers (P<0.0001), and exercise led to a greater reduction in arterial oxygen saturation (P<0.0001). However, haemoglobin and haematocrit values in patients with cystic fibrosis did not significantly differ from normal volunteers. Serum iron (P=0.002), transferrin (P=0.02), and total iron-binding capacity (P=0.01) were lower in patients with cystic fibrosis. There were no significant differences in serum ferritin, percentage iron saturation, serum erythropoietin or red cell volume between the groups. The data presented demonstrate a characteristic picture of anaemia of chronic disease in adult patients with cystic fibrosis, except for normal haemoglobin and haematocrit values. Normal haemoglobin and haematocrit values in patients with cystic fibrosis appear to represent a combination of the effects of arterial hypoxaemia promoting polycythaemia, counterbalanced by chronic inflammation promoting anaemia of chronic disease.

  12. Bronchoscopic removal of foreign bodies in adults: experience with 62 patients from 1974-1998.

    Science.gov (United States)

    Debeljak, A; Sorli, J; Music, E; Kecelj, P

    1999-10-01

    The authors reviewed their experience with therapeutic bronchoscopy for removal of tracheobronchial foreign bodies in the adult. Bronchoscopy records and collection of foreign bodies in the endoscopic department were retrospectively examined. Among 37,466 bronchoscopies performed between 1974-1998, 62 (0.2%) were performed for the removal of tracheobronchial foreign bodies. Medical history was suggestive of foreign body aspiration in 33 patients and the chest radiograph was suggestive in 10 patients. The procedure was performed with the flexible bronchoscope in 42 patients (68%), rigid bronchoscope in 4 (6%), and with both in 16 (26%) patients. Foreign bodies were found in the right bronchial tree on 42 occasions, in the left on 20 and in the trachea once. In 39 patients, inflammatory granulations were found around the foreign body. The origins of the foreign bodies included: bone fragments (n=31), vegetable (n=10), broncholith (n=8), a part of dental prosthesis (n=7), endodontic needle (n=2), a metallic (n=2), or plastic (n=1) particle, a tracheostomy tube (n=1) and a match (n=1). In one patient, 2 foreign bodies were found. The foreign bodies were successfully removed in all but 2 patients (3%). The most useful instruments for removal were alligator forceps and the wire basket. Foreign bodies in the tracheobronchial system are rare in adults. They can be successfully removed in the majority of patients under either flexible or rigid bronchoscopy. PMID:10573222

  13. Novel management options for adult patients with progressive acute lymphoblastic leukemia: introduction.

    Science.gov (United States)

    Wang, Eunice S

    2015-06-01

    Acute lymphoblastic leukemia (ALL) is a heterogeneous hematologic malignancy characterized by highly proliferative immature lymphoid cells in the bone marrow and peripheral blood. In adults, ALL accounts for approximately 20% of all adult leukemias. ALL carries a poor prognosis in adults. The 5-year overall survival is 24% in patients ages 40 to 59 years and 18% in patients ages 60 to 69 years. ALL can be grouped into different categories according to its cell lineage (B cell or T cell), the presence or absence of the Philadelphia chromosome, and various cytogenetic and molecular classifications. A main goal of treatment is to allow the patient to achieve a complete remission and to consolidate this remission with either a maintenance regimen or an allogeneic stem cell transplant. Although the overall rate of complete remission following frontline therapy for newly diagnosed ALL is high, the majority of patients experience a disease relapse. In general, the duration of initial complete remission impacts the patient’s prognosis and response to further therapies. Subsequent treatments must balance the goal of achieving a remission with the need for the patient to maintain or improve quality of life. Recently approved agents, such as blinatumomab and vincristine sulfate liposome injection, offer the promise of a second remission that can serve as a bridge to allogeneic stem cell transplant while still maintaining quality of life. A novel approach using adoptive cellular immunotherapy with chimeric antigen receptor (CAR) T cells is associated with extremely robust responses. PMID:26431322

  14. THE MEANING OF INSULIN PUMPE THERAPY TO ADULT PATIENTS WITH TYPE 1 DIABETES

    DEFF Research Database (Denmark)

    Nissen, Heidi; Aagaard, Hanne

    Background: Insulin pump therapy is an increasing field. Studies have documented a clinical relevant decrease in HbA1c, especially among adults type 1 diabetes patients with initial high HbA1c. However, only few studies investigate the lived experience with and the meaning of the insulin pump...... therapy in adulthood. Aim: The study explore the lived experiences and the meaning of insulin pump therapy in adulthood. Method: The study is based on a phenomenological – hermeneutic approach. Four adult type 1 diabetes patients were interviewed about their insulin pump therapy. The interviews were based...... meaningfulness in relation to diabetes self-care and self-management. The bolus guide, as a rather new feature, seem to play an important role. Conclusion: Based on The Shifting Perspectives Model of Chronic Illness, we concluded that a well established insulin pump therapy lead to changing the patients...

  15. MRI in adult patients with aortic coarctation: diagnosis and follow-up

    International Nuclear Information System (INIS)

    Aortic coarctation is a disease that usually presents in infancy; however, a proportion of patients present for the first time in adulthood. These lesions generally require repair with either surgery or interventional techniques. The success of these techniques means that increasing numbers of patients are presenting for follow-up imaging in adulthood, whether their coarctation was initially repaired in infancy or as adults. Thus, the adult presenting to the radiologist for assessment of possible coarctation or follow-up of coarctation repair is not an uncommon scenario. In this review, we present details of the MRI protocols and MRI findings in these patients so that a confident and accurate assessment can be made

  16. Combined duplication of the colon and vermiform appendix in an adult patient

    Institute of Scientific and Technical Information of China (English)

    Sahin Kabay; Mehmet Yucel; Faik Yaylak; Alper Hacioglu; Mustafa C Algin; Esra G Olgun; Levent Sahin; Tayfun Aydin

    2008-01-01

    Combined duplication of the colon and vermiform appendix is one of the rare congenital anomalities of the alimentary tract. Only a few cases have been reported in the adult population. A 28-year-old man presented to the clinic with a mass in the right flank. Imaging showed only a hydronephrotic atrophic kidney. The final diagnosis was only available at exploration. Combined duplication of the tubular colon and vermiform appendix was confirmed histopathologically. The patient was treated with nephrectomy and complete resection of the duplicated colon and vermiform appendix. The patient recovered uneventfully, and has done well for the past year. This is believed to be one of the first reports of combined duplication of the tubular colon and vermiform appendix as a cause of hydronephrotic atrophic kidney in an adult patient.

  17. A Case of Bone Aspiration Mimicking Asthma in an Adult Patient

    Directory of Open Access Journals (Sweden)

    Servet Kayhan

    2014-03-01

    Full Text Available Foreign body aspiration is an urgent condition that requires immediate diagnosis and intervention. It is generally seen in children and in elderly patients with neurological problems and rarely seen in healthy adults. There may be some clinical signs and symptoms in patients with foreign body aspiration from mild to severe; such as cough, shortness of breath and respiratory arrest. A 52-year-old woman applied to our clinic with the complaints of cough and shortness of breath, and she was misdiagnosed and treated as asthma for three months. The chest radiograph showed heterogenous opacity in the right paracardiac region, computerized tomography revealed the foreign body aspiration in right main bronchus and peripheric pneumonia. Flexible bronchoscopy examination was processed and the foreign body was excluded safely with the aim of crocodile forceps. Foreign body aspiration should be kept in the mind in a adult patient with a sudden onset of asthma like disorder.  

  18. Combined treatment with sitagliptin and vitamin D in a patient with latent autoimmune diabetes in adults

    Science.gov (United States)

    Rapti, E; Karras, S; Grammatiki, M; Mousiolis, A; Tsekmekidou, X; Potolidis, E; Zebekakis, P; Daniilidis, M

    2016-01-01

    Summary Latent autoimmune diabetes in adults (LADA) is a relatively new type of diabetes with a clinical phenotype of type 2 diabetes (T2D) and an immunological milieu characterized by high titers of islet autoantibodies, resembling the immunological profile of type 1 diabetes (T1D). Herein, we report a case of a young male, diagnosed with LADA based on both clinical presentation and positive anti-glutamic acid decarboxylase antibodies (GAD-abs), which were normalized after combined treatment with a dipeptidyl peptidase-4 inhibitor (DPP-4) (sitagliptin) and cholecalciferol. Learning points Anti-glutamic acid decarboxylase antibodies (GAD-abs) titers in young patients being previously diagnosed as type 2 diabetes (T2D) may help establish the diagnosis of latent autoimmune diabetes in adults (LADA). Sitagliptin administration in patients with LADA might prolong the insulin-free period. Vitamin D administration in patients with LADA might have a protective effect on the progression of the disease.

  19. The epileptic amygdala: Toward the development of a neural prosthesis by temporally coded electrical stimulation.

    Science.gov (United States)

    Cota, Vinícius Rosa; Drabowski, Bruna Marcela Bacellar; de Oliveira, Jasiara Carla; Moraes, Márcio Flávio Dutra

    2016-06-01

    Many patients with epilepsy do not obtain proper control of their seizures through conventional treatment. We review aspects of the pathophysiology underlying epileptic phenomena, with a special interest in the role of the amygdala, stressing the importance of hypersynchronism in both ictogenesis and epileptogenesis. We then review experimental studies on electrical stimulation of mesiotemporal epileptogenic areas, the amygdala included, as a means to treat medically refractory epilepsy. Regular high-frequency stimulation (HFS) commonly has anticonvulsant effects and sparse antiepileptogenic properties. On the other hand, HFS is related to acute and long-term increases in excitability related to direct neuronal activation, long-term potentiation, and kindling, raising concerns regarding its safety and jeopardizing in-depth understanding of its mechanisms. In turn, the safer regular low-frequency stimulation (LFS) has a robust antiepileptogenic effect, but its pro- or anticonvulsant effect seems to vary at random among studies. As an alternative, studies by our group on the development and investigation of temporally unstructured electrical stimulation applied to the amygdala have shown that nonperiodic stimulation (NPS), which is a nonstandard form of LFS, is capable of suppressing both acute and chronic spontaneous seizures. We hypothesize two noncompetitive mechanisms for the therapeutic role of amygdala in NPS, 1) a direct desynchronization of epileptic circuitry in the forebrain and brainstem and 2) an indirect desynchronization/inhibition through nucleus accumbens activation. We conclude by reintroducing the idea that hypersynchronism, rather than hyperexcitability, may be the key for epileptic phenomena and epilepsy treatment. © 2016 Wiley Periodicals, Inc. PMID:27091311

  20. Interictal functional connectivity of human epileptic networks assessed by intracerebral EEG and BOLD signal fluctuations.

    Directory of Open Access Journals (Sweden)

    Gaelle Bettus

    Full Text Available In this study, we aimed to demonstrate whether spontaneous fluctuations in the blood oxygen level dependent (BOLD signal derived from resting state functional magnetic resonance imaging (fMRI reflect spontaneous neuronal activity in pathological brain regions as well as in regions spared by epileptiform discharges. This is a crucial issue as coherent fluctuations of fMRI signals between remote brain areas are now widely used to define functional connectivity in physiology and in pathophysiology. We quantified functional connectivity using non-linear measures of cross-correlation between signals obtained from intracerebral EEG (iEEG and resting-state functional MRI (fMRI in 5 patients suffering from intractable temporal lobe epilepsy (TLE. Functional connectivity was quantified with both modalities in areas exhibiting different electrophysiological states (epileptic and non affected regions during the interictal period. Functional connectivity as measured from the iEEG signal was higher in regions affected by electrical epileptiform abnormalities relative to non-affected areas, whereas an opposite pattern was found for functional connectivity measured from the BOLD signal. Significant negative correlations were found between the functional connectivities of iEEG and BOLD signal when considering all pairs of signals (theta, alpha, beta and broadband and when considering pairs of signals in regions spared by epileptiform discharges (in broadband signal. This suggests differential effects of epileptic phenomena on electrophysiological and hemodynamic signals and/or an alteration of the neurovascular coupling secondary to pathological plasticity in TLE even in regions spared by epileptiform discharges. In addition, indices of directionality calculated from both modalities were consistent showing that the epileptogenic regions exert a significant influence onto the non epileptic areas during the interictal period. This study shows that functional

  1. Sleep deprivation and spike-wave discharges in epileptic rats

    NARCIS (Netherlands)

    Drinkenburg, W.H.I.M.; Coenen, A.M.L.; Vossen, J.M.H.; Luijtelaar, E.L.J.M. van

    1995-01-01

    The effects of sleep deprivation were studied on the occurrence of spike-wave discharges in the electroencephalogram of rats of the epileptic WAG/Rij strain, a model for absence epilepsy. This was done before, during and after a period of 12 hours of near total sleep deprivation. A substantial incre

  2. Pathophysiology of Tonic Muscle Activation During Epileptic Seizures

    DEFF Research Database (Denmark)

    Beniczky, S.; Conradsen, Isa; Wolf, P.; Sams, Thomas; Sørensen, Helge Bjarup Dissing

    Tonic seizures and the tonic phase of tonic-clonic epileptic seizures are defined as a “sustained tonic” muscle contraction. Visual inspection of the surface electromyograms (sEMG) during seizures significantly contributed to a better understanding and diagnosis of several seizure types. However,...

  3. Switching to generic anti-epileptic medicines : A regulatory perspective

    NARCIS (Netherlands)

    Maliepaard, Marc; Hekster, Yechiel A.; Kappelle, Arnoud; Van Puijenbroek, Eugène P.; Elferink, André J.; Welink, Jan; Gispen-de Wied, Christine C.; Lekkerkerker, Frits J.F.

    2010-01-01

    Introduction: Currently, there is a lot of discussion about whether generic substitution of anti-epileptic drugs (AEDs) with the same active moiety but from different manufacturers can take place safely. Many AEDs are considered to have a narrow therapeutic index, and the consequences of an epilepti

  4. Epileptic neuronal networks: methods of identification and clinical relevance

    NARCIS (Netherlands)

    H. Stefan; F.H. Lopes da Silva

    2013-01-01

    The main objective of this paper is to examine evidence for the concept that epileptic activity should be envisaged in terms of functional connectivity and dynamics of neuronal networks. Basic concepts regarding structure and dynamics of neuronal networks are briefly described. Particular attention

  5. Relationships between interictal epileptic spikes and ripples in surface EEG

    NARCIS (Netherlands)

    Van Klink, Nicole; Frauscher, Birgit; Zijlmans, Maeike; Gotman, Jean

    2016-01-01

    Objective: Ripples (80-250. Hz) have been shown to be a more specific biomarker for the epileptogenic zone than epileptic spikes in intracranial EEG and even surface EEG. Ripples often co-occur with spikes. We investigated the spatiotemporal relation between spikes and ripples, and differences betwe

  6. Preictal Dynamics of EEG Complexity in Intracranially Recorded Epileptic Seizure

    Czech Academy of Sciences Publication Activity Database

    Bob, P.; Roman, R.; Světlák, M.; Kukleta, M.; Chládek, Jan; Brázdil, M.

    2014-01-01

    Roč. 93, č. 23 (2014), el151:1-4. ISSN 0025-7974 R&D Projects: GA MŠk(CZ) LO1212 Institutional support: RVO:68081731 Keywords : EEG * epileptic Seizure Subject RIV: FS - Medical Facilities ; Equipment Impact factor: 5.723, year: 2014

  7. Acute respiratory distress syndrome in an adult patient with a myelodysplastic disorder.

    Science.gov (United States)

    Pentimone, F; Cini, G; Meola, N; Ferrannini, E

    1983-01-01

    A 58-year-old man was diagnosed to have refractory anaemia with excessive blasts. After 3 1/2 years of relative control on periodic blood transfusions, the patient developed an acute leukaemia. Although the blastic crisis was not extreme (WBC counts less than 100 X 10(9)/l), a severe, intractable respiratory distress syndrome set in and brought the patient to the exitus in a few days. Overt signs of septic shock were absent, as was evidence of any other known cause of adult respiratory distress. Acute pulmonary failure can be the cause of death in leukaemic patients even in the absence of overwhelming sepsis or hyperleucocytosis. PMID:6404107

  8. Nebulised dornase alfa versus placebo or hypertonic saline in adult critically ill patients

    DEFF Research Database (Denmark)

    Claudius, Casper; Perner, Anders; Møller, Morten Hylander

    2015-01-01

    BACKGROUND: Nebulised dornase alfa is used off-label in critically ill patients. We aimed to assess the benefits and harms of nebulised dornase alfa versus placebo, no prophylaxis, or hypertonic saline on patient-important outcome measures in adult critically ill patients. METHODS: We performed a...... systematic review with meta-analysis and trial sequential analysis (TSA) using the Cochrane Collaboration methodology. Eligible trials were randomised clinical trials comparing nebulised dornase alfa with placebo, no prophylaxis, or hypertonic saline. The predefined outcome measures were all-cause mortality...

  9. Recurrent prolonged fugue states as the sole manifestation of epileptic seizures.

    Science.gov (United States)

    Khwaja, Geeta A; Duggal, Ashish; Kulkarni, Amit; Chaudhry, Neera; Gupta, Meena; Chowdhury, Debashish; Bohra, Vikram

    2013-10-01

    A fugue state is defined as an altered state of consciousness with varying degrees of motor activity and amnesia for the event. It may last for hours to days and may be psychogenic or organic in nature. Epileptic fugue states can be encountered in patients with absence or complex partial nonconvulsive status epilepticus or may occur as a postictal phenomenon in patients with generalized seizures. "absence status epilepticus" (AS) is rare and seen in only 2.6% of the cases with "childhood absence epilepsy" (CAE). The diagnosis of AS can be elusive, but sudden onset and termination of the fugue state, classical electroencephalogram (EEG) features, and response to a therapeutic trial of benzodiazepines helps in confirming the diagnosis and differentiating it from nonepileptic fugue states. We report a childhood onset case, with a 10 years history of recurrent episodes of prolonged fugue state lasting for up to 24 h, as the sole manifestation of epileptic seizures. The EEG features were suggestive of an AS, but there was no history of typical absences, myoclonus, or generalized tonic clonic seizures. This unusual and rare case cannot be categorized into one of the defined epilepsy syndromes like CAE but belongs to a recently identified syndrome of idiopathic generalized epilepsy known as "Absence status epilepsy" in which AS is the sole or the predominant seizure type. PMID:24339579

  10. Epileptic qualia and self-awareness: a third dimension for consciousness.

    Science.gov (United States)

    Hanoğlu, Lütfü; Özkara, Çiğdem; Yalçiner, Betül; Nani, Andrea; Cavanna, Andrea E

    2014-01-01

    Over the last few decades, there has been increasing awareness among epileptologists about the need to refine our understanding and assessment of ictal consciousness, focusing on both subjective and behavioral aspects of seizures. Specifically, there have been suggestions that both the internal and external milieux - the former related to the phenomenal qualia of experience, the latter related to behavior - must be taken into account for a better understanding of altered states of consciousness in epilepsy. It has been proposed that clinical and experimental data from patients experiencing alterations of consciousness during epileptic seizures could be better understood within a bidimensional model, in which any manifestation of conscious experience can be plotted according to the level and contents of consciousness. The 'level' axis measures the degree of alertness/arousal, whereas the 'contents' axis measures the vividness of specific experiential phenomena reported by the patient. We argue that certain seizure types might require more rigorous conceptual models for their characterization, and we highlight the potential usefulness of a more refined framework which includes a further dimension related to the 'self', in addition to those of 'level' and 'contents'. This model could be visualized in a three-dimensional space to allow fine-grained distinctions between epileptic seizures. PMID:24100248

  11. Recurrent prolonged fugue states as the sole manifestation of epileptic seizures

    Directory of Open Access Journals (Sweden)

    Geeta A Khwaja

    2013-01-01

    Full Text Available A fugue state is defined as an altered state of consciousness with varying degrees of motor activity and amnesia for the event. It may last for hours to days and may be psychogenic or organic in nature. Epileptic fugue states can be encountered in patients with absence or complex partial nonconvulsive status epilepticus or may occur as a postictal phenomenon in patients with generalized seizures. ′′absence status epilepticus′′ (AS is rare and seen in only 2.6% of the cases with ′′childhood absence epilepsy′′ (CAE. The diagnosis of AS can be elusive, but sudden onset and termination of the fugue state, classical electroencephalogram (EEG features, and response to a therapeutic trial of benzodiazepines helps in confirming the diagnosis and differentiating it from nonepileptic fugue states. We report a childhood onset case, with a 10 years history of recurrent episodes of prolonged fugue state lasting for up to 24 h, as the sole manifestation of epileptic seizures. The EEG features were suggestive of an AS, but there was no history of typical absences, myoclonus, or generalized tonic clonic seizures. This unusual and rare case cannot be categorized into one of the defined epilepsy syndromes like CAE but belongs to a recently identified syndrome of idiopathic generalized epilepsy known as ′′Absence status epilepsy′′ in which AS is the sole or the predominant seizure type.

  12. Differential Effect of Neuropeptides on Excitatory Synaptic Transmission in Human Epileptic Hippocampus.

    Science.gov (United States)

    Ledri, Marco; Sørensen, Andreas T; Madsen, Marita G; Christiansen, Søren H; Ledri, Litsa Nikitidou; Cifra, Alessandra; Bengzon, Johan; Lindberg, Eva; Pinborg, Lars H; Jespersen, Bo; Gøtzsche, Casper R; Woldbye, David P D; Andersson, My; Kokaia, Merab

    2015-07-01

    Development of novel disease-modifying treatment strategies for neurological disorders, which at present have no cure, represents a major challenge for today's neurology. Translation of findings from animal models to humans represents an unresolved gap in most of the preclinical studies. Gene therapy is an evolving innovative approach that may prove useful for clinical applications. In animal models of temporal lobe epilepsy (TLE), gene therapy treatments based on viral vectors encoding NPY or galanin have been shown to effectively suppress seizures. However, how this translates to human TLE remains unknown. A unique possibility to validate these animal studies is provided by a surgical therapeutic approach, whereby resected epileptic tissue from temporal lobes of pharmacoresistant patients are available for neurophysiological studies in vitro. To test whether NPY and galanin have antiepileptic actions in human epileptic tissue as well, we applied these neuropeptides directly to human hippocampal slices in vitro. NPY strongly decreased stimulation-induced EPSPs in dentate gyrus and CA1 (up to 30 and 55%, respectively) via Y2 receptors, while galanin had no significant effect. Receptor autoradiographic binding revealed the presence of both NPY and galanin receptors, while functional receptor binding was only detected for NPY, suggesting that galanin receptor signaling may be impaired. These results underline the importance of validating findings from animal studies in human brain tissue, and advocate for NPY as a more appropriate candidate than galanin for future gene therapy trials in pharmacoresistant TLE patients. PMID:26134645

  13. Brain morphological changes in adolescent and adult patients with anorexia nervosa.

    Science.gov (United States)

    Seitz, J; Herpertz-Dahlmann, B; Konrad, K

    2016-08-01

    Gray matter (GM) and white matter (WM) volume loss occur in the brains of patients with acute anorexia nervosa (AN) and improve again upon weight restoration. Adolescence is an important time period for AN to begin. However, little is known about the differences between brain changes in adolescents vs adults. We used a meta-analysis and a qualitative review of all MRI studies regarding acute structural brain volume changes and their recovery in adolescents and adults with AN. 29 studies with 473 acute, 121 short-term weight-recovered and 255 long-term recovered patients with AN were included in the meta-analysis. In acute AN, GM and WM were reduced compared to healthy controls. Acute adolescent patients showed a significantly greater GM reduction than adults (-8.4 vs -3.1 %), the difference in WM (-4.0 vs -2.1 %) did not reach significance. Short-term weight-recovered patients showed a remaining GM deficit of 3.6 % and a non-significant WM reduction of 0.9 % with no age differences. Following 1.5-8 years of remission, GM and WM were no longer significantly reduced in adults (GM -0.4 %, WM -0.7 %); long-term studies for adolescents were scarce. The qualitative review showed that GM volume loss was correlated with cognitive deficits and three studies found GM regions, cerebellar deficits and WM to be predictive of outcome. GM and WM are strongly reduced in acute AN and even more pronounced in adolescence. Long-term recovery appears to be complete for adults while no conclusions can be drawn for adolescents, thus caution remains. PMID:27188331

  14. Hypothalamic hamartomas and ictal laughter: evolution of a characteristic epileptic syndrome and diagnostic value of magnetic resonance imaging.

    Science.gov (United States)

    Berkovic, S F; Andermann, F; Melanson, D; Ethier, R E; Feindel, W; Gloor, P

    1988-05-01

    Detailed study of 4 patients and review of the literature allowed us to delineate further the epileptic syndrome associated with hypothalamic hamartomas, which characteristically begins in infancy with laughing seizures. Because early childhood psychomotor development is usually normal, the condition appears benign and may not even be recognized. The episodes of laughter are brief, frequent, and mechanical in nature. These features distinguish it from other forms of epileptic laughter, particularly that which occurs in temporal lobe epilepsy. Subsequently, the seizures become longer, other seizure types appear, and between the ages of 4 and 10 years, the clinical and electroencephalographic features of secondary generalized epilepsy develop. Cognitive deterioration occurs and severe behavior problems are frequent. Prognosis for seizure control and social adjustment is poor. Cortical abnormality occurs in association with the hypothalamic hamartoma. The lesions are best detected by magnetic resonance imaging but may be difficult to identify by computed tomographic scanning. PMID:3389755

  15. An integrative view of mechanisms underlying generalized spike-and-wave epileptic seizures and its implication on optimal therapeutic treatments.

    Directory of Open Access Journals (Sweden)

    Boyuan Yan

    Full Text Available Many types of epileptic seizures are characterized by generalized spike-and-wave discharges. In the past, notable effort has been devoted to understanding seizure dynamics and various hypotheses have been proposed to explain the underlying mechanisms. In this paper, by taking an integrative view of the underlying mechanisms, we demonstrate that epileptic seizures can be generated by many different combinations of synaptic strengths and intrinsic membrane properties. This integrative view has important medical implications: the specific state of a patient characterized by a set of biophysical characteristics ultimately determines the optimal therapeutic treatment. Through the same view, we further demonstrate the potentiation effect of rational polypharmacy in the treatment of epilepsy and provide a new angle to resolve the debate on polypharmacy. Our results underscore the need for personalized medicine and demonstrate that computer modeling and simulation may play an important role in assisting the clinicians in selecting the optimal treatment on an individual basis.

  16. International veterinary epilepsy task force recommendations for systematic sampling and processing of brains from epileptic dogs and cats

    DEFF Research Database (Denmark)

    Matiasek, Kaspar; Pumarola I Batlle, Martí; Rosati, Marco;

    2015-01-01

    to add substantial data on patients with complete clinical work-up. This may be due to sparse training in epilepsy pathology and or due to lack of neuropathological guidelines for companion animals.The protocols introduced herein shall facilitate systematic sampling and processing of epileptic brains......Traditionally, histological investigations of the epileptic brain are required to identify epileptogenic brain lesions, to evaluate the impact of seizure activity, to search for mechanisms of drug-resistance and to look for comorbidities. For many instances, however, neuropathological studies fail...... and therefore increase the efficacy, reliability and reproducibility of morphological studies in animals suffering from seizures.Brain dissection protocols of two neuropathological centres with research focus in epilepsy have been optimised with regards to their diagnostic yield and accuracy, their...

  17. Clinical and microbiological characteristics of perianal infections in adult patients with acute leukemia.

    Directory of Open Access Journals (Sweden)

    Chien-Yuan Chen

    Full Text Available BACKGROUND: Perianal infection is a common problem for patients with acute leukemia. However, neutropenia and bleeding tendency are relatively contraindicated to surgical intervention. The epidemiology, microbiology, clinical manifestations and outcomes of perianal infection in leukemic patients are also rarely discussed. METHOD: The medical records of 1102 adult patients with acute leukemia at a tertiary medical center in Taiwan between 2001 and 2010 were retrospectively reviewed and analyzed. RESULT: The prevalence of perianal infection was 6.7% (74 of 1102 in adult patients with acute leukemia. Twenty-three (31% of the 74 patients had recurrent episodes of perianal infections. Patients with acute myeloid leukemia had higher recurrent rates than acute lymphoblastic leukemia patients (p = 0.028. More than half (n = 61, 53% of the perianal infections were caused by gram-negative bacilli, followed by gram-positive cocci (n = 36, 31%, anaerobes (n = 18, 15% and Candida (n = 1, 1% from pus culture. Eighteen patients experienced bacteremia (n = 24 or candidemia (n = 1. Overall 41 (68% of 60 patients had polymicrobial infection. Escherichia coli (25% was the most common micro-organism isolated, followed by Enterococcus species (22%, Klebsiella pneumoniae (13%, and Bacteroides species (11%. Twenty-five (34% of 74 patients received surgical intervention. Acute leukemia patients with surgically managed anal fistulas tended to have fewer recurrences (p = 0.067. Four (5% patients died within 30 days after diagnosis of perianal infection. Univariate analysis of 30-day survival revealed the elderly (≧ 65 years (p = 0.015 and patients with shock (p<0.001 had worse outcome. Multivariate analysis showed septic shock to be the independent predictive factor of 30-day crude mortality of perianal infections (p = 0.016. CONCLUSION: Perianal infections were common and had high recurrence rate in adult patients with acute

  18. Etiological prevalence of epilepsy and epileptic seizures in hospitalized elderly in a Brazilian tertiary center – Salvador - Brazil

    Directory of Open Access Journals (Sweden)

    Telma Rocha de Assis

    2015-02-01

    Full Text Available Epilepsy in the elderly has high incidence and prevalence and is often underecognized. Objective To describe etiological prevalence of epilepsy and epileptic seizures in elderly inpatients. Methods Retrospective analysis was performed on elderly patients who had epilepsy or epileptic seizures during hospitalization, from January 2009 to December 2010. One hundred and twenty patients were enrolled. They were divided into two age subgroups (median 75 years with the purpose to compare etiologies. Results The most common etiology was ischemic stroke (36.7%, followed by neoplasias (13.3%, hemorrhagic stroke (11.7%, dementias (11.4% and metabolic disturbances (5.5%. The analysis of etiological association showed that ischemic stroke was predominant in the younger subgroup (45% vs 30%, and dementias in the older one (18.9% vs 3.8%, but with no statistical significance (p = 0.23. Conclusion This study suggests that epilepsy and epileptic seizures in the elderly inpatients have etiological association with stroke, neoplasias and dementias.

  19. Prevalence, clinical presentation and treatment outcome of cryptosporidiosis in immunocompetent adult patients presenting with acute diarrhoea

    International Nuclear Information System (INIS)

    Objective: To document the prevalence, clinical presentation and treatment outcome of cryptosporidiosis in immunocompetent adult patients presenting with acute diarrhoea. Methods: This prospective cohort study was conducted at the Sindh Institute of Urology and Transplantation Karachi from February 1, till September 30, 2012. All immunocompetent adult patients who presented with acute diarrhoea to the gastroenterology clinic at SIUT were included. Data collection sheet was filled and stool studies sent. Modified acid fast stain of stool was performed for cryptosporidium. SPSS 20 was used for statistical analysis. Results: There were 105 patients with acute diarrhoea. Fifty three (50.4%) were males. The mean age was 34+-8.4 years. Of 105, 58 (55%) patients had cryptosporidium isolated in stool studies. Patients with cryptosporidiosis had statistically significant greater stool frequency per day (p<0.001,OR=12.7; CI [4.4-37.1]), abdominal pain (p<0.001, OR= 19.8 [6.1-64.1]), vomiting (p<0.001, OR=7.3 [2.7-19.9]), low grade fever (p<0.001, OR=8.5 [3.5-20.8]), fatigue (p<0.001, OR=8.4 [3.2-21.6]) and dehydration and a shorter duration of illness with more watery diarrhoea. All 58 patients reported resolution of diarrhoea after 7 days of treatment with nitazoxanide. However, 40 (70.1%) patients reported recurrence of diarrhoea within 6 weeks of treatment. Conclusion: Our study demonstrates a high prevalence of cryptosporidiosis in immunocompetent adult patients. Nitazoxanide is the recommended antimicrobial drug for cryptosporidiosis. (author)

  20. Adjuvant chemotherapy in adult medulloblastoma: is it an option for average-risk patients?

    Science.gov (United States)

    Franceschi, E; Bartolotti, M; Paccapelo, A; Marucci, G; Agati, R; Volpin, L; Danieli, D; Ghimenton, C; Gardiman, M P; Sturiale, C; Poggi, R; Mascarin, M; Balestrini, D; Masotto, B; Brandes, A A

    2016-06-01

    The standard treatment in children with average-risk medulloblastoma (MB) is reduced-dose radiotherapy (RT) followed by chemotherapy. However, in adults, there is no agreement on the use of adjuvant chemotherapy. We performed a retrospective analysis of adult MB patients with average-risk disease, defined as no postsurgical residual (or ≤1.5 cm(2)) and no metastatic disease (M0). Main inclusion criteria were: age >16 years, post-surgical treatment with craniospinal irradiation with or without adjuvant chemotherapy (cisplatin and etoposide ± cyclophosphamide). From 1988 to 2012 were accrued 43 average-risk MB patients treated with surgery and adjuvant RT. Fifteen (34.9 %) patients received also chemotherapy: 7 before RT, 5 after RT, and 3 before and after RT. Reasons to administer chemotherapy were presence of residual disease (even if ≤1.5 cm) and delay in RT. After a median follow up time of 10 years (range: 8-13), median survival was 18 years (95 % CI 9-28) in patients who receive RT alone, and was not reached in patients treated with RT plus chemotherapy. The survival rates at 5, 10 and 15 years were 100 %, 78.6 % (95 % CI 60.0-97.2 %) and 60.2 % (95 % CI 36.9-83.5 %), in patients treated with RT alone, and 100, 100 and 100 %, in patients treated with RT plus chemotherapy (p = 0.079). Our findings suggest a role for adjuvant chemotherapy in the treatment of average-risk MB adult patients. Further improvements might drive to add chemotherapy in average-risk setting with less favourable biological signatures (i.e., non-WNT group). PMID:26940908

  1. Predictors of health-related quality of life in adult ambulatory independence neuromuscular disease patients

    International Nuclear Information System (INIS)

    To evaluate the health related quality of life (HRQoL) of totally independent ambulatory neuromuscular disease (NMD) patients in comparison with age matched healthy control subjects, and to assess associations between socio demographic variables and HRQoL in totally independent NMD patients. Ninety-nine adult patients with a diagnosis of NMD referred to the Physical Therapy Department of the Health Sciences Faculty of Hacettepe University, Ankara, Turkey between 2007 and 2009 were included in the study. The Functional Independence Measurement and the Nottingham Health Profile (NHP) were the main outcomes to assess independence level in activities of daily living and quality of life. The HRQoL score as measured by NHP was high (worse) in patients than healthy controls, and the difference between the 2 groups was significant for energy, physical mobility, and total score. Employed NMD patients scored significantly lower (better) than those unemployed in the majority of NHP domains. The genders and duration of illness displayed no significant difference in all dimension scores. All NMD patients had a poorer HRQoL than with healthy subjects with respect to energy, physical mobility dimensions, and total score. Furthermore, occupation was found to be a main factor that affects HRQoL in adult ambulatory NMD patients. (author)

  2. Prevalence of celiac disease in adult type 1 patients with diabetes

    Science.gov (United States)

    Dogan, Burcu; Oner, Can; Bayramicli, Oya Uygur; Yorulmaz, Elif; Feyizoglu, Guneş; Oguz, Aytekin

    2015-01-01

    Objectives: Celiac disease, an autoimmune disease, is related to immune mediated intolerance to gluten. Some studies suggest that Celiac Disease was 20 times more frequent in type 1 patients with diabetes. The objective of our study was to evaluate the prevalence of celiac disease in hospital based type 1 diabetic adults. Methods: Our study was carried out retrospectively in Medeniyet University Goztepe Training and Educational Hospital in Istanbul between 2012–2013. The cohort comprised 482 type 1 patients with diabetes attending the diabetes outpatient clinic. The data were analyzed by SPSS 10.5 package program. Student’s t tests is used for comparative analyses. A p-value less than 0.05 was considered statistically significant. Results: The cohort included 482 type 1 patients with diabetes. Fifty seven of them were not evaluated for Endomysium antibody positivity. Fifteen of the remaining 425 patients were positive for anti endomysial antibody (3.5%). The prevalence of biopsy proven celiac disease was 2.3% (10/425). There was no significant difference between Endomysial antibody positive and negative groups in regard of age, sex, or duration of the disease. Conclusion: This study confirms that the celiac disease is common in type 1 diabetic patients. Since a small proportion of celiac patients are symptomatic this disorder should be screened in all adult type 1 patients with diabetes by antiendomysium antibody. PMID:26430419

  3. Dyspnea, pulmonary function and exercise capacity in adult Saudi patients with sickle cell disease

    International Nuclear Information System (INIS)

    Objective was to examine pulmonary function, dyspnea, and exercise capacity in adult Saudi patients with sickle cell disease (SCD) patients. The patients were recruited from the hematology clinic at King Khalid University Hospital in Riyadh from January to December 2005. The study involved 39 patients with stable SCD 20 women and 19 men, with a mean age of 22.7+/- 7.1 years, hemoglobin level of 95.5+/-14.6g/L and hemoglobin F level of 13.7+/08.6. Patients underwent pulmonary function tests PFT forced expiratory volume in first second [FEV1], forced vital capacity [FVC], and diffusion capacity of carbon monoxide [DLco] data are presented as a percentage of the normal prediction, a 6- minute walk test 6MWT and echocardiography. Dyspnea was assessed using the Borg score. The 6MWT data were compared to body mass index matched healthy controls. Forty-one percent of SCD patients had mild dyspnea at rest and this increased to 61% at the end of the 6MWT. Pulmonary function tests were abnormal in 51%, 36% of patients had a restrictive pattern, 10% had isolated decrease in DLco and 5% had a mixed restrictive-obstrutive pattern. The 6MWD was shorter in SCD patients compared to the controls 368+/-67 versus 407+/-47m, p=0.005. No hematological variables correlated with outcome variables. Chronic pulmonary complications in adult Saudi SCD patients are relatively mild but common. Pulmonary function in these patients differs from that published for African-origin SCD patients. The difference may reflect a different natural history of SCD in the 2 populations. (author)

  4. Lipids for intravenous nutrition in hospitalised adult patients: a multiple choice of options.

    Science.gov (United States)

    Calder, Philip C

    2013-08-01

    Lipids used in parenteral nutrition provide energy, building blocks and essential fatty acids. Traditionally, these lipids have been based on n-6 PUFA-rich vegetable oils particularly soyabean oil. This may not be optimal because soyabean oil may present an excessive supply of linoleic acid. Alternatives to use of soyabean oil include its partial replacement by medium-chain TAG, olive oil or fish oil, either alone or in combination. Lipid emulsions containing these alternatives are well tolerated without adverse effects in a wide range of hospitalised adult patients. Lipid emulsions that include fish oil have been used in parenteral nutrition in adult patients' post-surgery (mainly gastrointestinal). This has been associated with alterations in patterns of inflammatory mediators and in immune function and, in some studies, a reduction in length of intensive care unit and hospital stay. These benefits are emphasised through recent meta-analyses. Perioperative administration of fish oil may be superior to post-operative administration. Parenteral fish oil has been used in critically ill adults. Here, the influence on inflammatory processes, immune function and clinical endpoints is not clear, since there are too few studies and those that are available report contradictory findings. However, some studies found reduced inflammation, improved gas exchange and shorter length of hospital stay in critically ill patients if they receive fish oil. More and better trials are needed in patient groups in which parenteral nutrition is used and where fish oil may offer benefits. PMID:23663322

  5. Visual and SPM analysis of regional cerebral glucose metabolism in adult patients with neurofibromatosis

    International Nuclear Information System (INIS)

    We evaluated the regional cerebral glucose metabolism in adult patients with neurofibromatosis (NF) using visual and SPM analysis, and compared with MRI findings. A total of 11 adult patients with NF type I were prospectively included in the study. All patients underwent F-18 FDG PET and brain MRI within 2 month of each other. All hypometabolic areas on PET were determined visually by 2 nuclear medicine physician and compared with MRI findings. SPM analysis was done using 42 normal controls with p = 0.005. Seven of 11 PET images showed 10 hypometabolic areas and 4 of 11 MRIs showed 6 areas of signal change brain parenchyma. Hypometabolic areas were bilateral thalamus (n=5), left temporal cortex (n=4) and dentate nucleus (n=1). In only 2 lesions (thalamus and dentate nucleus), hypometabolic foci were consistently related to signal change on MRI. SPM analysis revealed significantly decreased area in bilateral thalamus and left temporal cortex. F-18 FDG PET revealed significant hypometabolism in bilateral thalamus and left temporal cortex in adult patients with NF, and it might be helpful in understanding developmental abnormality of NF

  6. Visual and SPM analysis of regional cerebral glucose metabolism in adult patients with neurofibromatosis

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Joon Kee; An, Young Sil; Hong, Seon Pyo; Joh, Chul Woo; Yoon, Seok Nam [Ajou University, School of Medicine, Suwon (Korea, Republic of)

    2005-07-01

    We evaluated the regional cerebral glucose metabolism in adult patients with neurofibromatosis (NF) using visual and SPM analysis, and compared with MRI findings. A total of 11 adult patients with NF type I were prospectively included in the study. All patients underwent F-18 FDG PET and brain MRI within 2 month of each other. All hypometabolic areas on PET were determined visually by 2 nuclear medicine physician and compared with MRI findings. SPM analysis was done using 42 normal controls with p = 0.005. Seven of 11 PET images showed 10 hypometabolic areas and 4 of 11 MRIs showed 6 areas of signal change brain parenchyma. Hypometabolic areas were bilateral thalamus (n=5), left temporal cortex (n=4) and dentate nucleus (n=1). In only 2 lesions (thalamus and dentate nucleus), hypometabolic foci were consistently related to signal change on MRI. SPM analysis revealed significantly decreased area in bilateral thalamus and left temporal cortex. F-18 FDG PET revealed significant hypometabolism in bilateral thalamus and left temporal cortex in adult patients with NF, and it might be helpful in understanding developmental abnormality of NF.

  7. Use of Complementary and Alternative Medicine for Epileptic Children in Tehran: A Cross-Sectional Study (2009-2011

    Directory of Open Access Journals (Sweden)

    Seyed Hassan TONEKABONI

    2014-01-01

    Full Text Available How to Cite This Article: Tonekaboni Sh, Jafari Naeini S, Khajeh A, Yaghini O, Ghazavi A, Abdollah Gorji F. Use of Complementary and Alternative Medicine for Epileptic Children in Tehran: A Cross-Sectional Study (2009-2011. Iran J Child Neurol. 2014 Winter; 8(1:26-31.ObjectiveAlthough the use of Complementary and Alternative Medicine (CAM has been evaluated globally, there are few studies in our country on this subject. The purpose of this study was to determine the prevalence, pattern of use, parental sources of information, and benefits of CAM in epileptic children in Tehran.Materials & MethodsOne hundred thirty-three parents or relatives of epileptic children who were referred to outpatient clinics or admitted in neurologic ward of four major hospitals in Tehran, were interviewed by our researcher based on a structured questionnaire; from 2009 to 2010. The information obtained comprised the demographic data of patients and their parents, frequency and morphology of convulsions, the type and sources of CAM and finally, the benefits and adverseeffects of this practice.ResultsForty-four percent of the respondents had used CAM methods either alone or in combination with other methods. The most frequently used CAM was written prayers followed by oral herbs and special diets. CAM was mainly introduced to them by relatives. Only 16.7% of these parents had discussed this matter with their children’s physicians. No efficacy to control seizure was observed for most of these methods.ConclusionThis study showed that use of CAM in our study group is relatively common and may have a potentially hazardous role in the treatment process. So, it is necessary for physicians to have enough information about CAM practice in their patients. References:National Institutes of health. More than one third of US adults use complementary and alternative medicine, according to new government survey. [Serial online] 2004 (cited 2004 May 27. Available

  8. Iron Overload Assessment in Adult Thalassaemic Patients Using MRI T2

    Directory of Open Access Journals (Sweden)

    Azita Azarkeivan

    2009-01-01

    Full Text Available "nd anemia in our country. Blood transfusion is the continual treatment of this disease. But transfusion causes a serious side effect which is iron overload in vital organs such as the heart, liver and the endocrine system. Accumulated iron in these organs may cause high risk secondary problems which threaten the patients' life. Early assessment of the iron overload in vital organs and applying for early treatment can be beneficial for increasing life quality in these patients. Assessment of cardiac and hepatic iron overload using MRI T2 technique and comparing it with serum ferritin level was the goal of this study. "nMaterials and Methods: The referred thalassaemic patients to Zafar adult thalassaemia clinic were the population of this study. Serum ferritin test was carried out for all these patients. Cardiac and hepatic iron overload assessment of these patients was performed in Noor medical imaging center using MRI T2 technique. The iron overload results of all patients were classified as normal, mild, moderate and severe. We compared them with the patients’ clinical parameters, especially the serum ferritin level. Results were analyzed by SPSS software. "nResults: 700 adult patients with the mean age of 25.76 (SD±10.4 were studied in this research project. There were 360 males (51.4% and 340 (48.6% females enrolled in this study. Among them, there were 502 (71.7% major thalassaemia, 158 (22.6% intermediate thalassaemia, 7 alpha thalassaemia, 9 sickle cell anemia and 10 hemochromatosis patients. The mean of serum ferritin level was 2327.6 mg/dl (SD±2095.8. Classified results of cardiac iron overload assessment were normal in 366 (66.5% patients, mild in 44 (8% patients, moderate in 64 (11.6% patients, and severe in 76 (13.8%patients. The classified results of hepatic iron overload assessment were: normal in 122 (22.2% patients, mild in 137 (25% patients, moderate in 235 (42.8% patients and severe in 55 (10% patients. Iron overload

  9. A systematic review of music therapy practice and outcomes with acute adult psychiatric in-patients.

    Directory of Open Access Journals (Sweden)

    Catherine Carr

    Full Text Available There is an emerging evidence base for the use of music therapy in the treatment of severe mental illness. Whilst different models of music therapy have been developed in mental health care, none have specifically accounted for the features and context of acute in-patient settings. This review aimed to identify how music therapy is provided for acute adult psychiatric in-patients and what outcomes have been reported.A systematic review using medical, psychological and music therapy databases. Papers describing music therapy with acute adult psychiatric in-patients were included. Analysis utilised narrative synthesis.98 papers were identified, of which 35 reported research findings. Open group work and active music making for nonverbal expression alongside verbal reflection was emphasised. Aims were engagement, communication and interpersonal relationships focusing upon immediate areas of need rather than longer term insight. The short stay, patient diversity and institutional structure influenced delivery and resulted in a focus on single sessions, high session frequency, more therapist direction, flexible use of musical activities, predictable musical structures, and clear realistic goals. Outcome studies suggested effectiveness in addressing a range of symptoms, but were limited by methodological shortcomings and small sample sizes. Studies with significant positive effects all used active musical participation with a degree of structure and were delivered in four or more sessions.No single clearly defined model exists for music therapy with adults in acute psychiatric in-patient settings, and described models are not conclusive. Greater frequency of therapy, active structured music making with verbal discussion, consistency of contact and boundaries, an emphasis on building a therapeutic relationship and building patient resources may be of particular importance. Further research is required to develop specific music therapy models for this

  10. Campylobacter enteritis in adult patients with acute diarrhea from 2005 to 2009 in Beijing, China

    Institute of Scientific and Technical Information of China (English)

    CHEN Jie; SUN Xin-ting; ZENG Zheng; YU Yan-yan

    2011-01-01

    Background There has been a marked global increase in the incidence of human Campylobacter enteritis in recent years. This study investigated the epidemiological and clinical features of Campylobacter enteritis in adult patients suffering from acute diarrhea.Methods This was a retrospective review of Campylobacter enteritis in adult patients with acute diarrhea presenting at Beijing University First Hospital, Beijing, China, in the summer and autumn (April to October) of 2005 to 2009. The data collected included the species of campylobacter identified, and the age, gender, clinical manifestations and results of laboratory test on stool samples collected from the patients. Campylobacter sensitivity tests to various antimicrobial agents were conducted on 80 specimens. Chi-square tests were applied using SPSS13.0 software and a two-sided P value of <0.05 was considered statistically significant.Results Campylobacter spp. isolated from the stool specimens of 142 patients with diarrhea represented 14.9% of all the cases examined. C. jejuni was identified in 127 patients (89.4%) and C. coli in 15 others (10.6%). The infection incidence was highest in the age range of 21-30 years which comprised 21.7% of the total cases examined. Most cases of diarrhea (46 patients) occurred in June. Watery diarrhea (97.2%), abdominal pain (72.5%) and fever (64.8%) were the most common manifestations of enteric campylobacteriosis. Only four patients (2.8%) had bloody diarrhea. The antimicrobial resistance rates were: cefoperazone (100%), levofloxacin (61.3%), gentamicin (12.5%), erythromycin (6.3%), and azithromycin (2.5%).Conclusions Campylobacter was prevalent among adults with acute diarrhea from 2005 to 2009 in Beijing, China. The large number of those afflicted by the disease warrants the commission of a large multicenter study to determine the extent of enteric campylobacteriosis in this region.

  11. The complexity of ADHD: diagnosis and treatment of the adult patient with comorbidities.

    Science.gov (United States)

    Newcorn, Jeffrey H; Weiss, Margaret; Stein, Mark A

    2007-08-01

    Attention-deficit/hyperactivity disorder (ADHD) is an impairing but usually treatable condition. Popular culture propagates the myth that ADHD recedes with age; this is not the case. Although it is common, problems, and learning disabilities. However, symptoms that result from ADHD, such as mood symptoms or lability, are often mistaken for comorbid disorders. Comorbidity with ADHD impacts treatment compliance, treatment response, and patient insight. Insufficient data on the interaction between ADHD and comorbidities impedes proper diagnosis and treatment. Better clinical tools for assessing these conditions are needed. Food and Drug Administration-approved pharmacologic treatments for adult ADHD include stimulants, dexmethylphenidate, and the nonstimulant atomoxetine. Effect sizes of approved medicines at approved doses are half those seen in children. Adults may also need longer duration of medication effects than children. Short-acting stimulants are likely to result in poorer adherence and have a higher risk for diversion or abuse. Risk of abuse is a major concern; stimulant treatments are controlled substances, and children with ADHD show increased risk of substance abuse. Psychosocial interventions may be beneficial in treating both ADHD and comorbidities.In this expert roundtable supplement, Margaret Weiss, MD, PhD, presents a comprehensive overview of complications surrounding differential diagnosis in adults with ADHD. Next, Mark A. Stein, PhD, reviews evaluation, comorbidity, and development of a treatment plan in this population. Finally, Jeffrey H. Newcorn, MD, provides a discussion on the pharmacologic options available for adults with ADHD, considering dosages specific to adults and common comorbidities. PMID:17667893

  12. Optimising radiographic bitewing examination to adult and juvenile patients through the use of anthropomorphic phantoms

    International Nuclear Information System (INIS)

    Four anthropomorphic phantoms (an adult male, an adult female, a 10-y-old child and a 5-y-old child) were exposed to bitewing radiographs at film and digital settings using both rectangular and round collimation. Optically stimulated dosemeters were used. For children, average organ doses were <40 μGy and the organs with the highest doses were the salivary glands, parotid, oral mucosa, skin and extrathoracic airway. For adults, average organ doses were <200 μGy. Highest adult doses were to the salivary glands, oral mucosa and skin. Effective doses ranged from 1.5 to 1.8 μSv for children and from 2.6 to 3.6 μSv for adults when optimised technique factors were employed, including digital receptors, rectangular collimation, size-appropriate exposure times and proper clinical judgment. Optimised doses were a fraction of the natural daily background exposure. Therefore, predictions of hypothetical cancer incidence or detriment in patient populations exposed to such low doses are highly speculative and should be discouraged. (authors)

  13. Molecular detection and characterization of Aichivirus A in adult patients with diarrhea in Thailand.

    Science.gov (United States)

    Saikruang, Wilaiporn; Khamrin, Pattara; Suantai, Boonpa; Ushijima, Hiroshi; Maneekarn, Niwat

    2014-06-01

    Viral gastroenteritis is a common public health problem that causes morbidity and mortality worldwide. Recently, new viruses causing gastroenteritis have been identified. Among these, Aichivirus has also been proposed as a causative agent of gastroenteritis in human. Most studies have been conducted in infants and children, the information in adults is limited. Therefore, the purpose of this study was to investigate the epidemiology and molecular characterization of Aichivirus in adult patients with diarrhea. A total of 332 fecal specimens collected from January to December 2008 were screened for the presence of Aichivirus by reverse transcription-PCR (RT-PCR) method. Out of 332 fecal specimens tested, Aichivirus was detected with the prevalence of 0.9% (3/332). The data indicate that the prevalence of Aichivirus in adults was as low as those reported in children in Thailand. Phylogenetic analysis of the VP1 sequence revealed that one Aichivirus belonged to genotype A, while other two Aichiviruses were genotype B. In conclusion, this study provided the molecular epidemiological data of Aichivirus circulating in adult patients with diarrhea at low prevalence and the viruses were genetically variable as both genotypes A and B were found in this population. PMID:24536026

  14. Clinical and hepatic evaluation in adult dengue patients: a prospective two-month cohort study

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    Ricardo Tristão-Sá

    2012-12-01

    Full Text Available INTRODUCTION: To analyze the liver dysfunction and evolution of signs and symptoms in adult dengue patients during a two-month follow-up period. METHODS: A prospective cohort study was conducted in Campos dos Goytacazes, Rio de Janeiro, Brazil, from January to July, 2008. The evolution of laboratory and clinical manifestations of 90 adult dengue patients was evaluated in five scheduled visits within a two-month follow-up period. Twenty controls were enrolled for the analysis of liver function. Patients with hepatitis B, hepatitis C, those known to be human immunodeficiency virus (HIV seropositive and pregnant women were excluded from the study. RESULTS: At the end of the second month following diagnosis, we observed that symptoms persisted in 33.3% (30/90 of dengue patients. We also observed that, 57.7% (15/26 of the symptoms persisted at the end of the second month. The most persistent symptoms were arthralgia, fatigue, weakness, adynamia, anorexia, taste alteration, and hair loss. Prior dengue virus (DENV infection did not predispose patients to a longer duration of symptoms. Among hepatic functions, transaminases had the most remarkable elevation and in some cases remained elevated up to the second month after the disease onset. Alanine aminotransferase (ALT levels overcame aspartate aminotransferase (AST during the convalescent period. Male patients were more severely affected than females. CONCLUSIONS: Dengue fever may present a wide number of symptoms and elevated liver transaminases at the end of the second month.

  15. Wandering spleen with gastric volvulus and intestinal non-rotation in an adult male patient

    International Nuclear Information System (INIS)

    We report an extremely rare case of wandering spleen (WS) complicated with gastric volvulus and intestinal non-rotation in a male adult. A 22-year-old man who had been previously treated for Wilson disease was admitted with severe abdominal pain. Radiological findings showed WS in the midline of the pelvic area. The stomach was mesenteroaxially twisted and intestinal non-rotation was observed. Radiology results did not show any evidence of splenic or gastrointestinal (GI) infarction. Elective emergency laparoscopy confirmed WS and intestinal non-rotation; however, gastric volvulus was not observed. It was suspected that the stomach had untwisted when gastric and laparoscopic tubes were inserted. Surgery is strongly recommended for WS because of the high risk of serious complications; however, some asymptomatic adult patients are still treated conservatively, such as the patient in this study. The present case is reported with reference to the literature

  16. Temporomandibular disorders and psychological status in adult patients with a deep bite

    DEFF Research Database (Denmark)

    Sonnesen, Liselotte; Svensson, Peter

    2008-01-01

    Temporomandibular disorders (TMDs) and psychological status were examined in adult patients with a deep bite and compared with an adult age- and gender-matched control group with neutral occlusion. The deep bite group consisted of 20 females (mean age 30.3 years) and 10 males (mean age 33.1 years......). The control group comprised 20 females (mean age 29.4 years) and 10 males (mean age 34.2 years). TMD examination, according to the Research Diagnostic Criteria for TMD (RDC/TMD), cephalometric lateral radiographs, registration of occlusion, and bite force were performed. To test the mean differences between...... craniofacial morphology, bite force, the occurrence of RDC/TMD diagnostic groups, and headache between the two groups, unpaired t-test, Fisher's exact test, Mann-Whitney U test, and multiple logistic regression analyses were performed. Deep bite patients more frequently reported nocturnal and diurnal clenching...

  17. Comparative studies of '18F-FDG PET/CT brain imaging and EEG in preoperative localization of temporal lobe epileptic focus

    International Nuclear Information System (INIS)

    Objective: To compare the value of 18F-FDG PET/CT brain imaging and EEG in preoperative localization of the epileptic focus at the temporal lobe. Methods: A total of 152 patients (108 males, 44 females, age ranged from 3 to 59 years old) with past history of temporal lobe epilepsy were included.All patients underwent 18F-FDG PET/CT brain imaging and long-range or video EEG, and 29 patients underwent intracranial electrode EEG due to the failure to localize the disease focus by non-invasive methods.Histopathologic findings after operative treatment were considered the gold standard for disease localization. All patients were followed up for at least six months after the operation. The accuracy of the 18F-FDG PET/CT brain imaging and long-range or video EEG examination were compared using χ2 test. Results: The accuracy of locating the epileptic focus was 80.92% (123/152) for 18F-FDG PET/CT brain imaging and 43.42% (66/152) for long-range or video EEG (χ2=22.72, P<0.01). The accuracy of locating the epileptic focus for the 29 cases with intracranial electrode EEG was 100%. Conclusions: Interictal 18F-FDG PET/CT brain imaging is a sensitive and effective method to locate the temporal lobe epileptic focus and is better than long-range or video EEG. The combination of 18F-FDG PET/CT brain imaging and intracranial electrode EEG examination can further improve the accuracy of locating the epileptic focus. (authors)

  18. Attention in schizophrenia and in epileptic psychosis

    Directory of Open Access Journals (Sweden)

    I.C.J Kairalla

    2008-01-01

    Full Text Available The adaptive behavior of human beings is usually supported by rapid monitoring of outstanding events in the environment. Some investigators have suggested that a primary attention deficit might trigger symptoms of schizophrenia. In addition, researchers have long discussed the relationship between schizophrenia and the schizophrenia-like psychosis of epilepsy (SLPE. On the basis of these considerations, the objective of the present study was to investigate attention performance of patients with both disorders. Patient age was 18 to 60 years, and all patients had received formal schooling for at least four years. Patients were excluded if they had any systemic disease with neurologic or psychiatric comorbidity, or a history of brain surgery. The computer-assisted TAVIS-2R test was applied to all patients and to a control group to evaluate and discriminate between selective, alternating and sustained attention. The TAVIS-2R test is divided into three parts: one for selective attention (5 min, the second for alternating attention (5 min, and the third for the evaluation of vigilance or sustained attention (10 min. The same computer software was used for statistical analysis of reaction time, omission errors, and commission errors. The sample consisted of 36 patients with schizophrenia, 28 with interictal SLPE, and 47 healthy controls. The results of the selective attention tests for both patient groups were significantly lower than that for controls. The patients with schizophrenia and SLPE performed differently in the alternating and sustained attention tests: patients with SLPE had alternating attention deficits, whereas patients with schizophrenia showed deficits in sustained attention. These quantitative results confirmed the qualitative clinical observations for both patient groups, that is, that patients with schizophrenia had difficulties in focusing attention, whereas those with epilepsy showed perseveration in attention focus.

  19. Role of cranial imaging in epileptic status

    International Nuclear Information System (INIS)

    Introduction: There is paucity of studies evaluating the role of cranial imaging in the management of status epilepticus (SE); therefore this study evaluates the role of imaging in predicting the outcome of SE. Methods: Consecutive patients with SE were prospectively evaluated. Clinical evaluation, blood counts, serum chemistry and cerebrospinal fluid (CSF) were carried out. Cranial CT scan was performed on a spiral CT and MRI on a 1.5 T scanner. Patients were treated with IV sodium valproate, phenytoin and benzodiazepines as per fixed protocol. Outcome was defined as seizure control at 1 h and mortality. Various clinical and radiological parameters were correlated. Results: There were 99 patients with SE whose mean age was 35 (1-78) years, 40 females and 17 were below 12 years of age. Fifty six patients had central nervous system (CNS) infections, 15 strokes, 13 metabolic encephalopathy, 5 drug default and in the remaining 10 patients various acute symptomatic causes were present. Cranial imaging was abnormal in 59% patients. CT was abnormal in 21 (47.7%) out of 44 patients whereas MRI was abnormal in 26 (63.4%) out of 41 patients. Both MRI and CT were carried out in 14 patients and 12 revealed abnormalities; 2 had abnormality only on MRI. Imaging revealed cortical lesions in 10, subcortical in 19 and both cortical as well as subcortical in 30 patients. One hour seizure control was achieved in 60, seizures recurred within 24 h in 38 and 27 patients died during hospital stay. Seizure type, duration of SE, seizure control at 1 h and mortality did not correlate with radiological abnormalities. Conclusion: Cranial imaging reveals structural abnormality in 59% patients with SE and was not related to SE control and mortality.

  20. Population pharmacokinetics of topiramate in adult patients with epilepsy using nonlinear mixed effects modelling

    OpenAIRE

    Vučičević, Katarina; Jovanović, Marija; Vovk, Tomaž; Miljković, Branislava; Sokić, Dragoslav; Grabnar, Iztok; Prostran, Milica

    2015-01-01

    The objective of the study was to develop population pharmacokinetic model of topiramate (TPM) using nonlinear mixed effects modelling approach. Data were collected from 78 adult epilepsy patients on mono- or co-therapy of TPM and other antiepileptic drugs, such as carbamazepine (CBZ), valproic acid, lamotrigine, levetiracetam, phenobarbital and pregabalin. Steady-state TPM concentrations were determined in blood samples by high performance liquid chromatography with fluorescence detection. A...

  1. Socioeconomic status and glycemic control in adult patients with type 2 diabetes: a mediation analysis

    OpenAIRE

    Houle, Janie; Lauzier-Jobin, François; Beaulieu, Marie-Dominique; MEUNIER, Sophie; Coulombe, Simon; Côté, José; Lespérance, François; Chiasson, Jean-Louis; Bherer, Louis; Lambert, Jean

    2016-01-01

    Objective The purpose of this study is to examine the contribution of health behaviors (self-management and coping), quality of care, and individual characteristics (depressive symptoms, self-efficacy, illness representations) as mediators in the relationship between socioeconomic status (SES) and glycemic control. Methods A sample of 295 adult patients with type 2 diabetes was recruited at the end of a diabetes education course. Glycemic control was evaluated through glycosylated hemoglobin ...

  2. Anesthetic experience of an adult patient with an unrecognized tracheal bronchus -A case report-

    OpenAIRE

    Choi, Yong Seon; Kwak, Young Lan; Choi, Hong Gyu; Oh, Se Young; Lee, Jong Wha

    2010-01-01

    We present a case of problematic tracheal intubation in an adult patient with an unrecognized tracheal bronchus. Immediately after tracheal intubation and position change to prone, bilateral breath sounds were almost absent, and there was a diminished tidal volume. In order to resolve the ventilatory difficulty, the wire-reinforced tube was replaced with a conventional tube, and proper positioning of the tube was completed under fiberoptic guidance. A tracheal bronchus (originating about 1.2 ...

  3. Laparoscopic treatment of ileal intussusception due to heterotopic gastric mucosa in an adult patient

    OpenAIRE

    Yılmaz, Tonguç Utku; Güneş, Abdullah; Pösteki, Gökhan; Güler, Sertaç Ata

    2014-01-01

    Adult intussusception, which is a rare condition, generally requires surgical treatment. A 25-year-old-male with abdominal pain was diagnosed as ileal intussusception with computerized tomography. The patient underwent diagnostic laparoscopy, laparoscopic small bowel resection and anastomosis. The pathologic evaluation revealed heterotopic gastric mucosa. Heterotopic gastric mucosa is rarely seen in ileum and is difficult to diagnose preoperatively. Excision is the choice of treatment. Laparo...

  4. Incidence of surgical site infection following adult spinal deformity surgery: an analysis of patient risk

    OpenAIRE

    Pull ter Gunne, Albert F.; Laarhoven, C.J.H.M. van; Cohen, David B.

    2010-01-01

    Surgical site infection (SSI) following spinal surgery is a frequent complication and results in higher morbidity, mortality and healthcare costs. Patients undergoing surgery for spinal deformity (scoliosis/kyphosis) have longer surgeries, involving more spinal levels and larger blood losses than typical spinal procedures. Previous research has identified risk factors for SSI in spinal surgery, but few studies have looked at adult deformity surgeries. We retrospectively performed a large case...

  5. Closure of Huge Palatal Fistula in an Adult Patient with Isolated Cleft Palate: A Technical Note

    OpenAIRE

    Amin Rahpeyma, DDS; Saeedeh Khajehahmadi, DDS

    2015-01-01

    Summary: Closure of huge palatal fistula surrounded by fully erupted permanent dentition in the adult patients with cleft is a challenge. Posteriorly based buccinator myomucosal flap is a neurovascular pedicled flap, with inherent nature of thin thickness, saliva secretion, and axial pattern blood supply. Vicinity of donor site to the palate and low donor-site morbidity are the other advantages. It is an ideal choice in such situation. In this article, the details of surgical technique and th...

  6. Jarcho-Levin syndrome with diastematomyelia: Case report of an adult patient and review of literature

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Seon; Lee, Ji Hae; Kang, Mi Jin; Baek Kyung Eun; Kim, Jae Hyung; Jeong, Myeong Ja; Kim, Soung Hee; Kim, Ji Young; Kim, Soo Hyun; Lee, Han Bee [Dept. of Radiology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)

    2015-01-15

    Jarcho-Levin syndrome (JLS) is a rare congenital dysostosis characterized by multiple vertebral and costal anomalies. The combination of JLS and neural tube defect is rare. Only six cases of JLS accompanying diastematomyelia have been reported; all were in infants or children. We present the case of a 37-year-old female patient with JLS who also had diastematomyelia in lumbar vertebral level. This is the seventh case of JLS with diastematomyelia, and the first adult case.

  7. Personality-Related Risk and Resilience Factors in Coping with Daily Stress among Adult Cancer Patients

    OpenAIRE

    Diehl, Manfred; Hay, Elizabeth L.

    2013-01-01

    We employed a diary design to study personality-related risk and resilience factors in adult cancer patients coping with daily stress. We focused on individuals’ self-concept incoherence (SCI) as a personality-related risk factor and on psychological well-being (PWB) at baseline and daily beliefs of control as resilience factors. Reactivity to daily stress was assessed in terms of negative daily mood. Multilevel modeling analyses yielded significant main effects of daily stress, PWB at baseli...

  8. HAG regimen improves survival in adult patients with hypocellular acute myeloid leukemia

    OpenAIRE

    Hu, Xiaoxia; Fu, Weijun; Wang, Libing; Gao, Lei; Lü, Shuqin; Xi, Hao; Qiu, Huiying; Chen, Li; Chen, Jie; Ni, Xiong; Xu, Xiaoqian; Zhang, Weiping; Yang, Jianmin; Wang, Jianmin; Song, Xianmin

    2015-01-01

    Background Hypocellular acute myeloid leukemia (Hypo-AML) is a rare disease entity. Studies investigating the biological characteristics of hypo-AML have been largely lacking. We examined the clinical and biological characteristics, as well as treatment outcomes of hypo-AML in our institutes over a seven years period. Design and Methods We retrospectively analyzed data on 631 adult AML patients diagnosed according to the French-American-British (FAB) classification and WHO classification of t...

  9. Role of surgery in the management of the adult patient with coarctation of the aorta

    OpenAIRE

    Ramnarine, I

    2005-01-01

    Adult patients with coarctation of the aorta have a range of clinical presentations. These include the presence of additional cardiovascular anomalies (predominantly aortic valve abnormality) and presentation with complications after coarctation repair in childhood (such as recurrent coarctation or aneurysm formation). Developments in endovascular technology over the past decade may potentially reduce the morbidity from open surgical repair. However, some cases are unsuitable for endovascular...

  10. PSORIASIS AND PSORIATIC ARTHRITIS: CHARACTERISTICS AND RISK FACTORS AMONG ADULT PATIENTS IN EGYPT

    OpenAIRE

    Essam A. El-Moselhy, Ibrahim Saad Nada, Hamed O. Khalifa,

    2012-01-01

    Background: Psoriasis and psoriatic arthritis are common, chronic, immune mediated disease of the skin and joints. Interaction between genes and environment are important in disease causation. Objectives: The aim of the present study was to determine the socioemographic and clinical characters of adult patients with psoriasis and those with psoriatic arthritis, to define psoriasis and psoriatic arthritis etiological risk factors, and to define the relationship between psoriasis severity and t...

  11. Tumor disembrioplástico neuroepitelial: un caso de muerte súbita en un paciente joven epiléptico Dysembryoplastic neuroepithelial tumor: a case of sudden death in a young epileptic patient

    Directory of Open Access Journals (Sweden)

    B. Biritxinaga

    2010-12-01

    Full Text Available Las muertes súbitas por tumores intracraneales no diagnosticados en vida son muy raras. En el presente artículo se presenta el caso de un paciente joven que es hallado muerto durante el sueño. Como único antecedente de interés destaca la presencia desde la infancia de crisis epilépticas de difícil control medicamentoso. Las pruebas de imagen no habían mostrado en vida alteraciones reseñables. En la autopsia se evidencia un tumor de 0,5 x 1 cm en la corteza cerebral del lóbulo parietal izquierdo, sin efecto masa. A la vista de los hallazgos del estudio histopatológico e inmunohistoquímico se realiza el diagnóstico de tumor disembrioplástico neuroepitelial (TDN simple. Se establece como causa de la muerte el trastorno epiléptico orgánico secundario al tumor. El TDN es un tumor cerebral de muy baja frecuencia (0,2-1% de los tumores cerebrales y normalmente se asocia a crisis epilépticas fármaco-resistentes. Este caso demuestra que ante una muerte súbita e inexplicada asociada a epilepsia es fundamental la realización de una autopsia médico-legal a fin de reconocer la causa y los factores de riesgo relacionados con la epilepsia y la muerte.Sudden deaths due to intracranial tumors that have not been diagnosed in life are very rare. In this paper we present the case of a young patient who died during sleep. The only medical antecedent was drug-resistant epilepsy suffered since childhood. Neuroimage techniques did not show any alteration prior to death. The autopsy showed in the cerebral cortex of the left parietal lobe the presence of a tumor of 0.5 x 1 cm without mass effect. In view of the findings of histopathological and immunohistochemical studies a diagnosis of dysembryoplastic neuroepithelial tumor (DNT simple was made. The cause of sudden death was attributed to an organic seizure disorder secondary to the tumor. DNT is very infrequent (0.2-1% of brain tumors and it is usually associated with drug-resistant seizures. This

  12. NAPB - a novel SNARE-associated protein for early-onset epileptic encephalopathy.

    Science.gov (United States)

    Conroy, J; Allen, N M; Gorman, K M; Shahwan, A; Ennis, S; Lynch, S A; King, M D

    2016-02-01

    Next-generation sequencing has accelerated the identification of disease genes in many rare genetic disorders including early-onset epileptic encephalopathies (EOEEs). While many of these disorders are caused by neuronal channelopathies, the role of synaptic and related neuronal proteins are increasingly being described. Here, we report a 6-year-old girl with unexplained EOEE characterized by multifocal seizures and profound global developmental delay. Recessive inheritance was considered due to parental consanguinity and Irish Traveller descent. Exome sequencing was performed. Variant prioritization identified a homozygous nonsense variant in the N-ethylmaleimide-sensitive factor attachment protein, beta (NAPB) gene resulting in a premature stop codon and 46% loss of the protein. NAPB plays a role in soluble N-ethylmaleimide-sensitive fusion attachment protein receptor (SNARE)-complex dissociation and recycling (synaptic vesicle docking). Knockout mouse models of the murine ortholog Napb have been previously reported. These mice develop recurrent post-natal epileptic seizures in the absence of structural brain changes. The identification of a disease-causing variant in NAPB further recognizes the importance of the SNARE complex in the development of epilepsy and suggests that this gene should be considered in patients with unexplained EOEE. PMID:26235277

  13. ENT1 inhibition attenuates epileptic seizure severity via regulation of glutamatergic neurotransmission.

    Science.gov (United States)

    Xu, Zucai; Xu, Ping; Chen, Yalan; Liu, Jing; Zhang, Yanke; Lv, Yaodong; Luo, Jing; Fang, Min; Zhang, Jun; Wang, Jing; Wang, Kewei; Wang, Xuefeng; Chen, Guojun

    2015-03-01

    Type 1 equilibrative nucleoside transporter (ENT1) promotes glutamate release by inhibition of adenosine signaling. However, whether ENT1 plays a role in epileptic seizure that involves elevated glutamatergic neurotransmission is unknown. Here, we report that both seizure rats and patients show increased expression of ENT1. Intrahippocampal injection of a specific inhibitor of ENT1, nitrobenzylthioinosine (NBTI), attenuates seizure severity and prolongs onset latency. In order to examine whether NBTI would be effective as antiepileptic after peripheral application, we injected NBTI intraperitoneally, and the results were similar to those obtained after intrahippocampal injection. NBTI administration leads to suppressed neuronal firing in seizure rats. In addition, increased mEPSC in seizure are inhibited by NBTI. Finally, NBTI results in deactivation of phosphorylated cAMP-response element-binding protein in the seizure rats. These results indicate that ENT1 plays an important role in the development of seizure. Inhibition of ENT1 might provide a novel therapeutic approach toward the control of epileptic seizure. PMID:25490964

  14. CACNA1A haploinsufficiency causes cognitive impairment, autism and epileptic encephalopathy with mild cerebellar symptoms.

    Science.gov (United States)

    Damaj, Lena; Lupien-Meilleur, Alexis; Lortie, Anne; Riou, Émilie; Ospina, Luis H; Gagnon, Louise; Vanasse, Catherine; Rossignol, Elsa

    2015-11-01

    CACNA1A loss-of-function mutations classically present as episodic ataxia type 2 (EA2), with brief episodes of ataxia and nystagmus, or with progressive spinocerebellar ataxia (SCA6). A minority of patients carrying CACNA1A mutations develops epilepsy. Non-motor symptoms associated with these mutations are often overlooked. In this study, we report 16 affected individuals from four unrelated families presenting with a spectrum of cognitive impairment including intellectual deficiency, executive dysfunction, ADHD and/or autism, as well as childhood-onset epileptic encephalopathy with refractory absence epilepsy, febrile seizures, downbeat nystagmus and episodic ataxia. Sequencing revealed one CACNA1A gene deletion, two deleterious CACNA1A point mutations including one known stop-gain and one new frameshift variant and a new splice-site variant. This report illustrates the phenotypic heterogeneity of CACNA1A loss-of-function mutations and stresses the cognitive and epileptic manifestations caused by the loss of CaV2.1 channels function, presumably affecting cerebellar, cortical and limbic networks. PMID:25735478

  15. Reduced transcription of TCOF1 in adult cells of Treacher Collins syndrome patients

    Directory of Open Access Journals (Sweden)

    Camargo Anamaria A

    2009-12-01

    Full Text Available Abstract Background Treacher Collins syndrome (TCS is an autosomal dominant craniofacial disorder caused by frameshift deletions or duplications in the TCOF1 gene. These mutations cause premature termination codons, which are predicted to lead to mRNA degradation by nonsense mediated mRNA decay (NMD. Haploinsufficiency of the gene product (treacle during embryonic development is the proposed molecular mechanism underlying TCS. However, it is still unknown if TCOF1 expression levels are decreased in post-embryonic human cells. Methods We have estimated TCOF1 transcript levels through real time PCR in mRNA obtained from leucocytes and mesenchymal cells of TCS patients (n = 23 and controls (n = 18. Mutational screening and analysis of NMD were performed by direct sequencing of gDNA and cDNA, respectively. Results All the 23 patients had typical clinical features of the syndrome and pathogenic mutations were detected in 19 of them. We demonstrated that the expression level of TCOF1 is 18-31% lower in patients than in controls (p , even if we exclude the patients in whom we did not detect the pathogenic mutation. We also observed that the mutant allele is usually less abundant than the wild type one in mesenchymal cells. Conclusions This is the first study to report decreased expression levels of TCOF1 in TCS adult human cells, but it is still unknown if this finding is associated to any phenotype in adulthood. In addition, as we demonstrated that alleles harboring the pathogenic mutations have lower expression, we herein corroborate the current hypothesis of NMD of the mutant transcript as the explanation for diminished levels of TCOF1 expression. Further, considering that TCOF1 deficiency in adult cells could be associated to pathologic clinical findings, it will be important to verify if TCS patients have an impairment in adult stem cell properties, as this can reduce the efficiency of plastic surgery results during rehabilitation of these

  16. Marital Status and Fertility in Adult Iranian Patients with β-Thalassemia Major.

    Science.gov (United States)

    Miri-Aliabad, Ghasem; Fadaee, Mahsoumeh; Khajeh, Ali; Naderi, Majid

    2016-03-01

    Expecting a family is an important component and a great goal for better quality of life for most of adults with β-thalassemia major. The aim of the present study was to examine the marital status of adults with β-thalassemia major. This cross-sectional study examined the marital status of patients with transfusion-dependent β-thalassemia aged over 15 years. Patients' demographic characteristics including age, gender, marital status, duration of marriage, divorce, having or not having children and spouse's health status were recorded. Information about the disease including cardiac and endocrine complications, ferritin level, splenectomy and viral hepatitis were also recorded. Of 228 patients with transfusion-dependent β-thalassemia major aged over 15 years who were treated at this medical center, 32 (14 %) were married. The mean age of married patients was 25.18 ± 4.74 years. Among the married patients, 8 (25 %) were females and 24 (75 %) patients were males. The mean age of marriage was 22.76 ± 4.16 years. The minimum and maximum marriage age was 15 and 33 years, respectively. The median duration of marriage was one year with the range from 3 months to 11 years. Only 8 (25 %) patients (one female and seven males) had children. Therapeutic advances have led to significantly increased survival and improved quality of life and fertility of patients with β-thalassemia major. According to the results, 14 % of patients over 15 years were married which was slightly higher as compared with other similar studies. PMID:26855517

  17. Subtalar Arthroereisis Implant Removal in Adults: A Prospective Study of 100 Patients.

    Science.gov (United States)

    Saxena, Amol; Via, Alessio Giai; Maffulli, Nicola; Chiu, Haywan

    2016-01-01

    Subtalar joint arthroereisis (STA) can be used in the management of adult acquired flatfoot deformity (AAFD), including posterior tibial tendon dysfunction. The procedure is quick and normally causes little morbidity; however, the implant used for STA often needs to be removed because of sinus tarsi pain. The present study evaluated the rate and risk factors for removal of the implant used for STA in adults treated for AAFD/posterior tibial tendon dysfunction, including patient age, implant size, and the use of endoscopic gastrocnemius recession. Patients undergoing STA for adult acquired flatfoot were prospectively studied from 1996 to 2012. The inclusion criteria were an arthroereisis procedure for AAFD/posterior tibial tendon dysfunction, age >18 years, and a follow-up period of ≥2 years. The exclusion criteria were hindfoot arthritis, age recession did not exert any influence on the rate of implant removal (p = .19). After STA for AAFD, 22% of the implants were removed. No significant difference was found in the incidence of removal according to patient age or endoscopic gastrocnemius recession. However, a significant difference was found for implant size, with 11-mm implants explanted most frequently. PMID:26874830

  18. The prognostic significance of minimal residual disease in adult Egyptian patients with precursor acute lymphoblastic leukemia

    International Nuclear Information System (INIS)

    Background: Minimal residual disease (MRD) studies in adult acute lymphoblastic leukemia (ALL) give highly significant prognostic information superior to other standard criteria as Minimal residual disease; age, gender and total leucocytic count (TLC) in distinguishing patients at high and low risk of Flow cytometry relapse. Objectives: We aimed to determine the value of MRD monitoring by flow cytometry (FCM) in predicting outcome in adult Precursor ALL patients. Patients and methods: Bone marrow (BM) samples were analyzed by 4-color FCM collected at diagnosis and after induction therapy (MRD1) to correlate MRD positivity with disease free survival (DFS) and overall survival (OS). Results: Study included 57 adult ALL patients (44 males and 13 females) with a median age of 22 years (18-49). DFS showed no significant difference with age, gender and initial TLC (p = 0.838, 0.888 and 0.743, respectively). Cumulative DFS at 2 years was 34% for B-lineage ALL (n: 35) and 57% for T-lineage ALL (n: 18) (p = 0.057). Cumulative DFS at 2 years was M.A. Samra et al. 136 7% for MRD1 positive (high risk, HR) versus 57% for MRD1 negative patients (Low risk, LR) (p < 0.001). Cumulative DFS at 2 years was 29% for HR patients (n: 26) versus 55% for LR (n: 27) according to GMALL classification (p = 0.064). Cumulative OS did not differ according to age, gender and TLC (p = 0.526, 0.594 and 0.513, respectively). Cumulative OS at 2 years was 36% for B ALL (n: 39) versus 77% for TALL (n: 18) (p = 0.016) and was 49% for Philadelphia chromosome (Ph) negative patients versus 0% for Ph-positive patients (p < 0.001). Regarding MRD1, OS at 2 years was 18% for MRD1 HR (n:17) versus 65% for MRD1 LR (n: 38) (p < 0.001). OS was 35% for high-risk patients (n: 30) and 62% for low-risk patients (n: 27) classified according to GMALL risk stratification (p = 0.017). Conclusion: MRD by FCM is a strong independent predictor of outcome in terms of DFS and OS and is a powerful informative parameter in

  19. Lymphocytic Bronchiolitis as Presenting Disorder in an Undiagnosed Adult Patient with Chronic Granulomatous Disease

    Directory of Open Access Journals (Sweden)

    Payam Tabarsi

    2007-12-01

    Full Text Available Chronic Granulomatous Disease (CGD is a rare primary immunodeficiency disease. Although the most affected patients are diagnosed in childhood, there are several reports of the disease presenting in adult patients. Here we present a 40 years old man who was admitted in hospital due to respiratory symptoms and ground glass pattern in high resolution computed tomography of lung. Open lung biopsy revealed lymphocytic bronchiolitis. Because of past medical history of granulomatous lesion in lung and recurrent abscesses of skin and soft tissue, NBT test was conducted which its result revealed that the disorder was compatible with CGD and then it was confirmed by fluorescent cytometry.

  20. Evaluation and Surgical Management of the Overcorrected Clubfoot Deformity in the Adult Patient.

    Science.gov (United States)

    Burger, Dawid; Aiyer, Amiethab; Myerson, Mark S

    2015-12-01

    Adult patients presenting with an overcorrected clubfoot often have had a posteromedial release. They present later in life and have compensated quite well despite the development of deformity. Minor trauma may lead to the onset of acute symptoms. A spectrum of deformity exists. Key features include a dorsally subluxated navicular, a dorsal bunion from overpull of the tibialis anterior tendon, valgus of the ankle or hindfoot or both, and a flattop talus. This article details the diagnostic approach to the overcorrected clubfoot patient and options for management of the various components of the deformity. PMID:26589080

  1. Severe aortic coarctation in an adult patient with normal brachial blood pressure

    DEFF Research Database (Denmark)

    Leetmaa, Tina H; Nørgaard, Bjarne L; Mølgaard, Henning;

    2014-01-01

    The present case shows that a normal brachial blood pressure (BP) does not exclude severe coarctation and should be considered in normotensive patients presenting with a systolic murmur and/or unexplained severe left ventricular hypertrophy. Congenital coarctation of the aorta is a narrowing of the...... descending aorta, usually located distal to the origin of the subclavian artery, causing hypertension in the upper part of the body. This condition may be undiagnosed until adult life where the clinical presentation most often is high BP in the upper extremities. A 57-year-old patient with severe aortic...

  2. Insulin Resistance in Adult Primary Care Patients With a Surrogate Index, Guadalajara, Mexico, 2012

    OpenAIRE

    Espinel-Bermúdez, María Claudia; Robles-Cervantes, José Antonio; del Sagrario Villarreal-Hernández, Liliana; Villaseñor-Romero, Juan Pablo; Hernández-González, Sandra Ofelia; González-Ortiz, Manuel; Martínez-Abundis, Esperanza; Pérez-Rubio, Karina Griselda

    2015-01-01

    Introduction Insulin resistance (IR) is a key molecular disorder related with diabetes mellitus, obesity, and cardiovascular disease. The objective of this study was to determine IR in adult primary care patients using the triglyceride/glucose (TyG) index [(Ln TG (mg/dL) × FG (mg/dL))/2]. Methods We conducted a cross-sectional secondary analysis and identified IR subjects according to the TyG index. Results There were 1500 patients included. Significant differences were found between the IR g...

  3. An Adult Patient with Ocular Myasthenia and Unusually Long Spontaneous Remission

    Directory of Open Access Journals (Sweden)

    Jasem Al-Hashel

    2014-01-01

    Full Text Available A male patient developed ocular myasthenia gravis (MG at the age of 33. He was anti-acetylcholine receptor antibody (anti-AChR Ab negative. He received cholinesterase blocker for 5 months and went into a complete clinical remission that lasted untreated for 17 years. He relapsed recently with ocular symptoms only. He is now anti-AChR Ab positive and SFEMG is abnormal in a facial muscle. The patient is controlled with steroids. He had one of the longest spontaneous remissions reported in the natural history of MG, particularly unusual for an adult with the disease.

  4. Effects of chondroitin sulfate and glucosamine in adult patients with Kaschin-Beck disease

    DEFF Research Database (Denmark)

    Zhang, Ya-xu; Dong, Wei; Liu, Hui; Cicuttini, Flavia; de Courten, Maximilian; Yang, Jian-bai

    2010-01-01

    The purpose is to investigate the effects of chondroitin sulfate and glucosamine on adult patients with Kaschin-Beck disease (KBD). A total of 80 patients, aged over 40 years, were randomized into two groups receiving either 1,600 mg oral mixture of chondroitin sulfate and glucosamine or placebo...... overall mean change in joint space was significant between the two groups (P <0.0001). Knee joint space of the experimental group narrowed slowly compared to the control group. Therefore, chondroitin sulfate and glucosamine might play a protective role in preserving articular cartilage and provide...

  5. Correction of transverse maxillary deficiency and anterior open bite in an adult Class III skeletal patient

    Directory of Open Access Journals (Sweden)

    Prerna Hoogan Teja

    2016-01-01

    Full Text Available Transverse maxillary deficiency may be associated with sagittal or vertical problems of the maxilla or mandible. It may contribute to unilateral or bilateral posterior crossbite, anterior dental crowding, and unesthetic black buccal corridors on smiling. An adequate transverse dimension is important for stable and proper functional occlusion. Surgically, assisted rapid palatal expansion has been the treatment of choice to resolve posterior crossbite in skeletally mature patients. The following case report presents an adult Class III skeletal patient with an anterior open bite and bilateral posterior crossbite which was treated by surgically assisted rapid maxillary expansion with satisfactory outcomes.

  6. Primary Mature Cystic Teratoma Mimicking As An Adrenal Mass In An Adult Male Patient

    Directory of Open Access Journals (Sweden)

    Emrah Okulu

    2014-03-01

    Teratomas are bizarre neoplasms derived from embryonic tissues that are typically found only in the gonadal and sacrococcygeal regions of adults. Primary retroperitoneal teratomas are rare and present challenging management options. We report a case of unilateral primary retroperitoneal mature cystic teratoma mimicking as an adrenal mass in 54-year-old male patient. Adrenal mass complete resection was performed by flank approach using the 11th rib resection. Because of the risk of malignancy, follow-up radiographic studies were performed to ensure the oncologic efficacy of resection. The patient has been free of recurrence for longer than 12 months.

  7. Endothelin receptor antagonists for pulmonary hypertension in adult patients with sickle cell disease

    OpenAIRE

    Minniti, Caterina P.; Machado, Roberto F.; Coles, Wynona A.; Sachdev, Vandana; Gladwin, Mark T.; Kato, Gregory J.

    2009-01-01

    Pulmonary Hypertension is a serious complication of sickle cell disease (SCD), with a high risk of morbidity and mortality. Endothelin-1, a potent vasoconstrictor peptide known to be elevated in SCD, acts through two receptors: ETR-A and ETR-B. Bosentan and ambrisentan are ETR blockers approved for use in primary pulmonary hypertension. We report on the use of ETR blocking agents in a cohort of 14 high-risk adult patients with SCD and pulmonary hypertension. Patients underwent right heart cat...

  8. Pituitary dysfunction in adult patients after cranial irradiation for head and nasopharyngeal tumours

    International Nuclear Information System (INIS)

    Background: Pituitary insufficiency after radiotherapy in the hypothalamic pituitary region is a well-known complication. However, endocrine assessments are not incorporated in the follow-up after cranial irradiation for head and neck tumours. Aim of the study: To evaluate pituitary function in patients cranially irradiated for non-pituitary tumours. Patients and methods: Evaluation of pituitary function in all available patients treated at our centre with cranial radiotherapy for head and neck tumours. Results: We included 80 patients. Forty patients were treated for cerebral tumours, 15 for nasopharyngeal tumours, and 25 for different tumours like meningioma or cerebral metastasis. Mean age was 47.5 (18.6–89.7) years. Mean radiation dose delivered at the pituitary region was 56.27 Gy (40.0–70.0). Pituitary insufficiency was present in 16 patients within 2 years after irradiation 23/49 patients (47%) after 5 years and 27/45 (60%) after 10 years and 31/35 patients (89%) after 15 years. Conclusion: Pituitary insufficiency is highly prevalent in adult patients treated with cranial radiotherapy for head and nasopharyngeal tumours. These prevalence rates are comparable to those observed after radiotherapy for pituitary tumours. Because hormone replacement of endocrine deficits improves quality of life and prevents potential severe complications, such as Addisonian crises, periodical evaluation of pituitary function is advocated

  9. MRI findings in 100 epileptic children

    International Nuclear Information System (INIS)

    Findings of magnetic resonance imaging (MRI) of the brain were retrospectively reviewed in 100 consecutive pediatric patients with epilepsy in relation to the type of epilepsy and prognosis. There were 65 boys and 35 girls, ranging in age from 3 months to 25 years. Among 100 patients, 67 (a total of 102 lesions) showed abnormal findings on MRI. Morphological abnormalities, including ventricular enlargement, atrophy and malformation, were seen in 54 patients. Periventricular (n=14), frontal (n=3), temporal (n=8) and occipital (n=7) areas were of high signal intensity on T2-weighted images. According to the type of epilepsy, MRI abnormality was seen in 34 (61%) of 56 patients with partial seizures and 33 (76%) of 44 patients with generalized seizures. When associated with cerebral palsy and mental retardation, the incidence of MRI abnormality was high. There was no sigificant correlation between MRI findings and prognosis. (N.K.)

  10. Prevalence of human norovirus and Clostridium difficile coinfections in adult hospitalized patients

    Science.gov (United States)

    Stokely, Janelle N; Niendorf, Sandra; Taube, Stefan; Hoehne, Marina; Young, Vincent B; Rogers, Mary AM; Wobus, Christiane E

    2016-01-01

    Objective Human norovirus (HuNoV) and Clostridium difficile are common causes of infectious gastroenteritis in adults in the US. However, limited information is available regarding HuNoV and C. difficile coinfections. Our study was designed to evaluate the prevalence of HuNoV and C. difficile coinfections among adult patients in a hospital setting and disease symptomatology. Study design and setting For a cross-sectional analysis, 384 fecal samples were tested for the presence of C. difficile toxins from patients (n=290), whom the provider suspected of C. difficile infections. Subsequent testing was then performed for HuNoV genogroups I and II. Multinomial logistic regression was performed to determine symptoms more frequently associated with coinfections. Results The final cohort consisted of the following outcome groups: C. difficile (n=196), C. difficile + HuNoV coinfection (n=40), HuNoV only (n=12), and neither (n=136). Coinfected patients were more likely to develop nausea, gas, and abdominal pain and were more likely to seek treatment in the winter season compared with individuals not infected or infected with either pathogen alone. Conclusion Our study revealed that patients with coinfection are more likely to experience certain gastrointestinal symptoms, in particular abdominal pain, suggesting an increased severity of disease symptomatology in coinfected patients. PMID:27418856

  11. Blueprint for Implementing New Processes in Acute Care: Rescuing Adult Patients With Intraosseous Access.

    Science.gov (United States)

    Chreiman, Kristen M; Kim, Patrick K; Garbovsky, Lyudmila A; Schweickert, William D

    2015-01-01

    The intraosseous (IO) access initiative at an urban university adult level 1 trauma center began from the need for a more expeditious vascular access route to rescue patients in extremis. The goal of this project was a multidisciplinary approach to problem solving to increase access of IO catheters to rescue patients in all care areas. The initiative became a collaborative effort between nursing, physicians, and pharmacy to embark on an acute care endeavor to standardize IO access. This is a descriptive analysis of processes to effectively develop collaborative strategies to navigate hospital systems and successfully implement multilayered initiatives. Administration should empower nurse to advance their practice to include IO for patient rescue. Intraosseous access may expedite resuscitative efforts in patients in extremis who lack venous access or where additional venous access is required for life-saving therapies. Limiting IO dwell time may facilitate timely definitive venous access. Continued education and training by offering IO skill laboratory refreshers and annual e-learning didactic is optimal for maintaining proficiency and knowledge. More research opportunities exist to determine medication safety and efficacy in adult patients in the acute care setting. PMID:26352658

  12. Changes of gluteus medius muscle in the adult patients with unilateral developmental dysplasia of the hip

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    Liu RuiYu

    2012-06-01

    Full Text Available Abstract Background The gluteus medius muscle is essential for gait and hip stability. Changes that occur in the gluteus medius muscles in patients with developmental dysplasia of the hip (DDH are not well understood. A better understanding of DDH related changes will have positive repercussions toward hip soft tissue reconstruction. Methods 19 adult patients with unilateral DDH scheduled for total hip arthroplasty were assessed for: cross-sectional area (CSA, radiological density (RD and the length of gluteus medius using computed tomograhpy(CT (scanned before THA. Hip abductor moment arm and gluteus medius activation angle were also measured via hip anteroposterior radiographs. Results Both CSA and RD of gluteus medius muscle were significantly reduced (p  Conclusions The gluteus medius showed substantial loss of CSA, RD as well as decreased length in patients with DDH in the affected hip. These changes should be considered in both hip reconstruction and postoperative rehabilitation training in patients with DDH.

  13. Increased pulmonary alveolar-capillary permeability in patients at risk for adult respiratory distress syndrome

    International Nuclear Information System (INIS)

    Two methods for predicting adult respiratory distress syndrome (ARDS) were evaluated prospectively in a group of 81 multitrauma and sepsis patients considered at clinical high risk. A popular ARDS risk-scoring method, employing discriminant analysis equations (weighted risk criteria and oxygenation characteristics), yielded a predictive accuracy of 59% and a false-negative rate of 22%. Pulmonary alveolar-capillary permeability (PACP) was determined with a radioaerosol lung-scan technique in 23 of these 81 patients, representing a statistically similar subgroup. Lung scanning achieved a predictive accuracy of 71% (after excluding patients with unilateral pulmonary contusion) and gave no false-negatives. We propose a combination of clinical risk identification and functional determination of PACP to assess a patient's risk of developing ARDS

  14. Endothelin receptor antagonists for pulmonary hypertension in adult patients with sickle cell disease.

    Science.gov (United States)

    Minniti, Caterina P; Machado, Roberto F; Coles, Wynona A; Sachdev, Vandana; Gladwin, Mark T; Kato, Gregory J

    2009-12-01

    Pulmonary Hypertension is a serious complication of sickle cell disease (SCD), with high morbidity and mortality. Endothelin (ET)-1, a potent vasoconstrictor elevated in SCD, acts through the ET receptors (ETR), ETR-A and ETR-B. Bosentan and ambrisentan are ETR blockers used in primary pulmonary hypertension. We report on the use of ETR blocking agents in a cohort of 14 high-risk SCD adult patients with pulmonary hypertension. Patients underwent right heart catheterization, 6-min walk test, echocardiogram, physical examination and blood work-up before starting ETR blockers. Eight patients received ETR blockers as initial therapy; six patients were already taking sildenafil. Over more than 6 months of therapy, sequential measurements of 6-min walk distance increased significantly (baseline 357 +/- 22 to 398 +/- 18 m at 5-6 months, P bosentan and ambrisentan in pulmonary hypertension in SCD. PMID:19775299

  15. Psychometric evaluation of the Sheehan Disability Scale in adult patients with attention-deficit/hyperactivity disorder.

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    Coles, Theresa; Coon, Cheryl; DeMuro, Carla; McLeod, Lori; Gnanasakthy, Ari

    2014-01-01

    Inattention and impulsivity symptoms are common among adults with attention-deficit/hyperactivity disorder (ADHD), which can lead to difficulty concentrating, restlessness, difficulty completing tasks, disorganization, impatience, and impulsiveness. Many adults with ADHD find it difficult to focus and prioritize. Resulting outcomes, such as missed deadlines and forgotten engagements, may ultimately impact the ability to function at work, school, home, or in a social environment. The European Medicines Agency guidelines for evaluating medicinal products for ADHD recommend inclusion of both functional outcomes, such as school, social, or work functioning, and outcomes related to symptoms of ADHD in clinical studies of novel medication primary efficacy endpoints. Due to its performance in other disease areas and the relevance of its items as evidenced by content validity analyses, the Sheehan Disability Scale (SDS) was chosen to assess functional impairment in ADHD. The aim of this study was to investigate the psychometric properties of the SDS, used as a brief measure of functional impairment in a number of psychiatric disorders, in adult patients with ADHD. To the authors' knowledge, this is the first study to evaluate the reliability of the SDS (based on Cronbach's coefficient alpha and test-retest reliability), its validity (construct and known-groups validity), and its ability to detect change in this patient population. This study also established a preliminary responder definition for the SDS in this study population to determine when change can be considered clinically beneficial in a clinical trial setting. The psychometric results support the use of the SDS subscales (items 1-3) and total score (sum of items 1-3) in an ADHD population. In addition, the evaluation provides evidence for a three-point preliminary responder definition for the SDS and further evidence of its responsiveness in adults with ADHD. Altogether, the results indicate that the SDS is a

  16. Frequency of Obstructive Sleep Apnea Syndrome Among Patients with Epilepsy Attending a Tertiary Neurology Clinic

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    Mohammed Al-Abri

    2015-01-01

    Full Text Available Objectives: Epilepsy is a common neurological disorder with a median lifetime prevalence of 14 per 1000 subjects. Sleep disorders could influence epileptic seizure. The most common sleep disorder is obstructive sleep apnea syndrome (OSAS which occurs in 2% of adult women and 4% of adult men in the general population. The aim of this study is to estimate the frequency of OSAS among patients with epilepsy and to study the seizure characteristics among those patients with co-morbid OSAS.  Methods: Patients with a confirmed diagnosis of epilepsy who attended the Sultan Qaboos University Hospital neurology clinic were recruited for the study between June 2011 and April 2012. Patients were screened for OSAS by direct interview using the validated Arabic version of the Berlin questionnaire. Patients identified as high-risk underwent polysomnography.  Results: A total of 100 patients with epilepsy (55 men and 45 women were screened for OSAS. Generalized and focal seizure was found in 67% of male and 27% of female patients. Six percent of the participants had epilepsy of undetermined type. Only 9% of the sample was found to have high risk of OSAS based on the Berlin questionnaire. No significant correlation was found between risk of OSAS, type of epilepsy, and anti-epileptic drugs.  Conclusion: The risk of OSAS was marginally greater in patients with epilepsy compared to the general population with the overall prevalence of 9%.

  17. Mapping the epileptic brain with EEG dynamical connectivity: Established methods and novel approaches

    Science.gov (United States)

    Papadopoulou, Margarita; Vonck, Kristl; Boon, Paul; Marinazzo, Daniele

    2012-11-01

    Several algorithms rooted in statistical physics, mathematics and machine learning are used to analyze neuroimaging data from patients suffering from epilepsy, with the main goals of localizing the brain region where the seizure originates from and of detecting upcoming seizure activity in order to trigger therapeutic neurostimulation devices. Some of these methods explore the dynamical connections between brain regions, exploiting the high temporal resolution of the electroencephalographic signals recorded at the scalp or directly from the cortical surface or in deeper brain areas. In this paper we describe this specific class of algorithms and their clinical application, by reviewing the state of the art and reporting their application on EEG data from an epileptic patient.

  18. Abdominal Tuberculosis: Analysis of Clinical Features and Outcome of Adult Patients in Southern Taiwan

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    Ming-Luen Hu

    2009-10-01

    Full Text Available Background: Abdominal tuberculosis remains a serious health threat. This retrospectivereport aimed to analyze patients after the development of the tuberculosiscontrol program by the Center of Disease Control (Taiwan in January 2000.The study was conducted at the Chang Gung Memorial Hospital-Kaohsiung,Taiwan.Methods: Between January 2000 and December 2006, we evaluated 14 adult patientswith abdominal tuberculosis by reviewing their clinical information, therapeuticmethods and outcomes. Diagnosis of abdominal tuberculosis wasmade based on clinical features of abdominal infection with microbiologicalresults from culture, acid-fast bacilli stain and polymerase chain reaction forMycobacterium tuberculosis and/or histopathological confirmation frombiopsy and ascites.Results: Tuberculous peritonitis and intestinal tuberculosis were the most commontype of infections followed by hepatic tuberculosis, and intra-abdominaltuberculoma. 35.7% of these patients had the coexistence of extra-abdominalinfection. The most common clinical symptoms and signs were abdominalpain, abdominal distension, ascites and body weight loss. Fever was found in35.7% of patients and peritoneal signs were noted in 7.1%. Immunocompromisedstates and old age are relevant to adult abdominal tuberculosis.Overall, patients were diagnosed by bacteriology (35.7%, biopsy materialsfrom laparotomy (42.8%, liver biopsy (14.3%, and biopsy materials fromcolonoscopy (7.2%. Patients were cured after taking antituberculous drugsfor at least 6 months without relapse during regular follow-up for at least 2years. However, three patients died of sepsis and decompensated liver cirrhosisduring treatment.Conclusion: Extra vigilance in dealing with patients who present with unexplainedabdominal conditions is the key to the diagnosis of abdominal tuberculosis.Early diagnosis, early antituberculous therapy and surgical treatment of theassociated complications are essential for the survival of the patient.

  19. Clinical trials of an intravenous oxygenator in patients with adult respiratory distress syndrome.

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    High, K M; Snider, M T; Richard, R; Russell, G B; Stene, J K; Campbell, D B; Aufiero, T X; Thieme, G A

    1992-11-01

    In patients with severe adult respiratory distress syndrome, mechanical ventilation may not be able to ensure gas exchange sufficient to sustain life. We report the use of an intravenous oxygenator (IVOX) in five patients who were suffering from severe adult respiratory distress syndrome as a result of aspiration, fat embolism, or pneumonia. IVOX was used in an attempt to provide supplemental transfer of CO2 and O2 and thereby reduce O2 toxicity and barotrauma. All patients were tracheally intubated, sedated, and chemically paralyzed and had a PaO2 ventilated with an FIO2 = 1.0 and a positive end expiratory pressure of > or = 5 cmH2O. The right common femoral vein was located surgically, and the patient was systemically anticoagulated with heparin. A hollow introducer tube was inserted into the right common femoral vein, and the furled IVOX was passed into the inferior vena cava and advanced until the tip was in the lower portion of the superior vena cava. IVOX use ranged from 2 h to 4 days. In this group of patients, IVOX gas exchange ranged from 21 to 87 ml x min-1 of CO2 and from 28 to 85 ml x min-1 of O2. One of the five patients survived and was discharged from the hospital. The IVOX transferred up to 28% of metabolic gas-exchange requirements. One patient with a small vena cava showed signs of caval obstruction. Three other patients demonstrated signs of a septic syndrome after the device was inserted.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1443737

  20. Clinical characteristics, prognostic factors, and outcomes of adult patients with hemophagocytic lymphohistiocytosis.

    Science.gov (United States)

    Otrock, Zaher K; Eby, Charles S

    2015-03-01

    Hemophagocytic lymphohistiocytosis (HLH) is a rare clinical syndrome characterized by the activation of the mononuclear phagocytic system. The diagnosis of HLH in adults is challenging not only because the majority of the reported data are from pediatric patients, but also because HLH occurs in many disease entities. This study reports the clinical and laboratory findings and prognostic factors of adult HLH in a large cohort managed at a single medical center from 2003 to 2014. Seventy-three patients met the HLH-2004 diagnostic criteria. The median age was 51 years (range, 18-82 years); 41 (56.2%) were male. Patients manifested fever, cytopenias, and elevated ferritin in >85% of cases. Likely causes of HLH were as follows: 30 (41.1%) infections, 21 (28.8%) malignancies, 5 (6.8%) attributed to autoimmune disorders, 1 (1.4%) primary immunodeficiency, 2 (2.7%) post solid organ transplantation, and 13 (17.8%) idiopathic. The median overall survival was 7.67 months. Patients with malignancy-associated HLH had a markedly worse survival compared with patients with non-malignancy-associated HLH (median overall survival 1.13 vs. 46.53 months, respectively; P hazard ratio = 12.22; 95% CI: 2.53-59.02; P = 0.002) correlated with poor survival. Ferritin >50,000 µg/L correlated with 30-day mortality. Survival after a diagnosis of HLH is dismal, especially among those with malignancy-associated HLH. The development of a registry for adults with HLH would improve our understanding of this syndrome, validate diagnostic criteria, and help develop effective treatment strategies. PMID:25469675