ABSTRACT
Stroke is one of the most frequent causes of acute symptomatic status epilepticus. The aim of this study was to investigate the electroclinical features of status epilepticus in acute ischemic stroke. Nine consecutively admitted patients with status epilepticus during ischemic stroke were examined: five of them had convulsive unilateral or generalized status epilepticus for from 24 hours to 9 days after a large hemispheric infarction, always associated with EEG epileptiform abnormalities; the remaining four had focal motor status epilepticus during the first 24 hours after a small cortical or subcortical infarction, and showed no clear EEG changes. Status epilepticus in acute ischemic stroke may have two distinct electroclinical patterns of different prognostic significance.
Subject(s)
Brain Ischemia/physiopathology , Cerebrovascular Disorders/physiopathology , Status Epilepticus/physiopathology , Aged , Brain Ischemia/complications , Cerebrovascular Disorders/complications , Electroencephalography , Electromyography , Female , Humans , Male , Middle Aged , Status Epilepticus/complicationsABSTRACT
We report two patients who developed focal abnormalities on MRI after partial status epilepticus. Maximum radiological modification occurred in the area of maximal epileptic discharge. Subsequent MRI failed to demonstrate persistent abnormalities. These transient abnormalities on MRI could be an expression of cerebral edema caused by focal epileptic status.
Subject(s)
Status Epilepticus/pathology , Adult , Female , Humans , Magnetic Resonance Imaging , Time FactorsABSTRACT
In order to study the correlation between central nervous system (CNS) involvement and EEG abnormalities in HIV infection we studied 100 consecutive HIV patients. Patients were divided into 4 groups; Group I: 42 neurologically asymptomatic subjects; Group II: 6 patients with peripheral neuropathies; Group III: 28 patients with AIDS Dementia Complex; Group IV: 24 patients with secondary CNS involvement. The results of this study emphasize that abnormal EEGs are correlated with CNS involvement. Neurologically asymptomatic patients showed no abnormal tracings, but the presence of borderline EEGs (33%) in asymptomatic patients should be evaluated prospectively.
Subject(s)
AIDS Dementia Complex/diagnosis , Electroencephalography , Acquired Immunodeficiency Syndrome/physiopathology , Adult , Female , HIV Seropositivity/physiopathology , Humans , Male , Prospective StudiesABSTRACT
Flunarizine plasma concentrations and side effects were evaluated in migraine patients during a 3 month course of prophylactic treatment. Plasma concentrations did not correlate with daily dose (in mg/kg). Mean flunarizine levels were higher in patients showing sleepiness or sedation. Weight gain was independent of plasma concentrations. Future clinical trials of flunarizine should be supported by drug monitoring in order to clarify the relationship between plasma levels and drug effects.
Subject(s)
Flunarizine/blood , Migraine Disorders/blood , Adolescent , Adult , Aged , Child , Dose-Response Relationship, Drug , Female , Flunarizine/adverse effects , Flunarizine/therapeutic use , Humans , Male , Middle Aged , Migraine Disorders/drug therapy , Osmolar ConcentrationABSTRACT
Sixty-one consecutive patients, less than or equal to 40 years old, were hospitalized for cerebral infarction between 1977 and 1985. Evaluation included computed tomographic brain scan, arteriography, echocardiography, and blood tests. A probable migrainous infarction was diagnosed in six patients (10%) (all women with a history of migraine) who survived the initial stroke and were followed-up for an average of four years. In five patients the stroke occurred during a common migraine attack and in one patient during a classic migraine attack. The site of infarction was invariably the occipital lobe. During the follow-up, no subject had a further stroke. All six women had a permanent hemianopic deficit.
Subject(s)
Cerebral Infarction/physiopathology , Cerebrovascular Disorders/physiopathology , Migraine Disorders/physiopathology , Adult , Cerebral Infarction/complications , Cerebrovascular Disorders/complications , Female , Humans , Male , Migraine Disorders/etiology , Prognosis , Smoking/physiopathologySubject(s)
Cerebral Infarction/diagnosis , Magnetic Resonance Imaging , Female , Humans , Mesencephalon , Middle Aged , ThalamusABSTRACT
Treatment of epileptic seizures in patients with hepatic porphyrias is a challenging problem due to enzymatic induction activity of phenobarbital (PB), phenytoin (PHT), carbamazepine (CBZ), and clonazepam (CZP). We present the case of a patient with partial seizures treated with PHT and showing clinical signs and biochemical abnormalities of porphyria cutanea tarda (PCT). We withdrew PHT and treated the patient with sodium valproate (VPA). We followed the patient for 6 months during VPA therapy. During this period, clinical signs of PCT disappeared and biochemical values normalized. Our study shows that VPA is a safe treatment in epileptic patients with PCT.
Subject(s)
Epilepsy, Temporal Lobe/drug therapy , Porphyrias/complications , Skin Diseases/complications , Valproic Acid/therapeutic use , Aged , Epilepsy, Temporal Lobe/complications , Humans , Male , Phenytoin/adverse effects , Porphyrias/chemically induced , Skin Diseases/chemically induced , Valproic Acid/bloodSubject(s)
Migraine Disorders/physiopathology , Adolescent , Amnesia/physiopathology , Confusion/etiology , Consciousness Disorders/etiology , Consciousness Disorders/physiopathology , Electroencephalography , Epilepsy/etiology , Female , Hemiplegia/etiology , Humans , Migraine Disorders/complications , Migraine Disorders/geneticsSubject(s)
Cluster Headache/physiopathology , Vascular Headaches/physiopathology , Adolescent , Adult , Child , Female , Humans , Male , Middle Aged , Time FactorsSubject(s)
Cluster Headache/drug therapy , Nimodipine/therapeutic use , Vascular Headaches/drug therapy , Adult , Female , Humans , Male , Middle AgedABSTRACT
We report the clinical and EEG study of three migraine patients who presented with peculiar clinical phenomena related to migraine attack. The first case is a transient global amnesia that followed a classic migraine status. The second is a confusional state that complicated a classic migraine attack. The third is a complex attack with combined features of migraine and epilepsy.
Subject(s)
Amnesia/etiology , Cognition Disorders/etiology , Consciousness Disorders/etiology , Migraine Disorders/complications , Adolescent , Adult , Amnesia/physiopathology , Consciousness Disorders/physiopathology , Electroencephalography , Epilepsy/etiology , Epilepsy/physiopathology , Female , Humans , Male , Menstrual Cycle , Migraine Disorders/physiopathologySubject(s)
Headache/economics , Absenteeism , Child , Costs and Cost Analysis , Employment , Epidemiologic Methods , Female , Headache/epidemiology , Humans , Male , San MarinoABSTRACT
Ten migraine patients underwent a tilt test both during migraine attack and headache-free interval, and the following parameters were assessed: plasma levels of norepinephrine (NE), and serum dopamine beta hydroxylase (D beta H), systolic and diastolic blood pressure and heart rate (SBP, DBP, HR). SBP during the tilt test showed a fall greater than 30 mmHg in 2 cases in the headache-free interval and in 4 cases during migraine attack. In migraine patients in headache-free interval, tilt test increased NE and D beta H as it did in the control group, while in migraine attack tilt test increased NE and D beta H less than in the control group. This impairment of the sympathetic nervous system during the migraine attack is discussed.