Seizure occurrence in patients with chronic renal insufficiency in regular hemodialysis program

Hemodialysis-associated seizure is a complication of hemodialysis. This report describes the occurrence of seizures in patients with end stage renal disease on dialysis therapy at the Nephrology Institute of Mogi das Cruzes, São Paulo State, Brazil. A retrospective medical history of 189 patients was reviewed to investigate the occurrence of convulsive seizures during dialytic program. Seven patients with history of seizures were selected but five of them were included in our study. Three patients presented generalized tonic-clonic seizures, one had partial seizure with secondary generalization, and one presented unclassified seizure. Three patients presented seizure just during the dialysis (unique seizure) and one of them presented convulsive status epilepticus. The two other patients had already presented seizures prior the beginning of dialysis. We conclude that seizures in renal failure could be considered as occasional events that do not usually become chronic.

Convulsões durante o tratamento dialítico podem constituir uma complicação da hemodiálise. Esse artigo descreve a ocorrência de crises em pacientes em estágio final de insuficiência renal crônica sob tratamento dialítico no Instituto de Nefrologia de Mogi das Cruzes, São Paulo, Brasil. Foram revistos os prontuários de 189 pacientes, com o objetivo de investigar a ocorrência de crises convulsivas durante o tratamento dialítico. Dos sete pacientes selecionados com história de crises, cinco concordaram em participar de nosso estudo. Três pacientes apresentaram crises generalizadas tônico-clônicas, um apresentou crise parcial com generalização subseqüente e um apresentou crise inclassificada. Três pacientes apresentaram crises apenas durante o processo dialítico (crise única) sendo que um deles apresentou status epilepticus convulsivo. Os outros dois pacientes já haviam apresentado crises antes do início do tratamento dialítico. Nós concluímos que as crises convulsivas que ocorrem em pacientes com falência renal podem ser consideradas como eventos ocasionais e que usualmente não se tornam crônicas.

Alveolar soft-part sarcoma presenting with multiple intracranial metastases.

A 28-year-old man presented with history of raised intracranial pressure and one episode of generalized tonic clonic seizures. Computed Tomogram revealed multiple contrast enhancing intracranial lesions. Biopsy of one of the lesions was reported as metastatic alveolar soft part sarcoma. He was advised whole brain radiotherapy.

Primary fibrosarcoma of brain.

This is a case presentation of a young patient with an intracranial space-occupying lesion following multiple episodes of generalised tonic clonic seizures for the last 20 years. Such a long latency period between the onset of fits and the discovery of an intracranial lesion is highly unusual in malignant brain tumours. This lesion was excised completely and proved to be a primary lesion of the brain - fibrosarcoma. These rare tumours of mesenchymal origin in the central nervous system are very rare.

Síndrome del niño sacudido / Shaked baby syndrome

Una niña de 8 meses de edad ingresó al hospital por crisis convulsivas tónico clónicas generalizadas, sopor, irritabilidad, hemorragias retinales y disyunción epifisiaria de los huesos. La lactante era frecuentemente sacudida por su madre -soltera, adolescente- entre los brazos de ésta, con el objeto de silenciar su llanto. En el examen de los fondos de ojo había atrofia de ambas papilas ópticas y en la tomografía axial del cráneo se comprobó un derrame subdural frontal bilateral que obligó a drenarlo quirúrgicamente. A la edad de 2 años y 3 meses la paciente tiene retardo psicomotor severo y ceguera bilateral. El síndrome del lactante sacudido es una de las formas mas graves de maltrato físico infantil y es difícil de reconocer por cuanto suele no presentar manifestaciones externas de la agresión, por lo que es importante tenerlo presente

Epilepsia dependiente a la piridoxina a propósito de un caso / Pyruloxine dependent epilepsy

Se describe un caso de dependencia a la piridoxina (Vit. B6) en una adolescencia de 13 años de edad con retardo mental. Hija de padres consanguíneos. Las convulsiones fueron observadas desde el período neonatal, siendo controladas con la administración diaria de piridoxina