Biomedical subjects

A J Murvin

Publications and source records attributed to A J Murvin.

4 recordsLinked to original sources

PubMed1986

Temporal lobectomy for partial complex seizures: evaluation, results, and 1-year follow-up.

Twenty-six patients were evaluated for temporal lobectomy. Fourteen underwent initial monitoring with electrodes in the amygdala and hippocampus bilaterally. Twelve had initial monitoring with scalp and sphenoidal electrodes. Four had conclusive localization without depth electrodes. Twenty-three patients underwent lobectomy. At 1-year minimum follow-up, 15 were seizure free. Five had greater than 90% reduction in seizure frequency. Complications of depth electrodes were one hemorrhage and one abscess. One patient developed impaired memory following surgery. Temporal lobectomy is effective in well-selected patients. Depth electrodes localize seizure onset from mesial temporal structures. Scalp and sphenoidal recording may be sufficient in some cases.

Adolescent↗

PubMed1984

Misdiagnosis of complex absence seizures.

Video-EEG monitoring disclosed absence seizures in five patients who were treated for partial seizures. Analysis of the historical and video data showed the presence of several potentially misleading ictal manifestations as follows: unidirectional head and/or eye turning, symmetric clonic activity, urinary incontinence, loss of balance causing injuries, focal clonic activity, and de novo automatisms. Without EEG correlation, complex absence seizures may be difficult to differentiate from other types of seizures. When correctly diagnosed, appropriate therapy may improve seizure control.

Adolescent↗

PubMed1982

Pseudoseizures: diagnostic evaluation.

A prospective study of pseudoseizures using prolonged video-electroencephalographic (EEG) recording was carried out in 60 patients. Of 33 patients with episodes of uncertain mechanism, a diagnosis based on recorded episodes was made in 18 (55%). Twelve (36%) had pseudoseizures; 6 (18%) had epileptic seizures. Ten additional patients had epileptiform EEGs compatible with epilepsy. Of 27 patients with presumably uncontrolled epileptic seizures, 4 (15%) had recorded pseudoseizures. Prediction of the nature of the episode by the admitting neurologist was accurate in 67% of cases. Determination from observations of unit personnel and neurologists was correct in less than 80% of episodes. These data suggest that pseudoseizures occur frequently in patients being evaluated for epilepsy or suspected epilepsy. The clinical differentiation between epileptic seizures and pseudoseizures is often inaccurate. This differentiation is facilitated by prolonged video-EEG recording.

Adolescent↗

PubMedDate not supplied

Infantile spasms: ictal phenomena.

Ictal phenomena were studied during three separate six-hour video/polygraphic recording sessions in 10 patients with infantile spasms; 1,079 spasms occurred. Frequency during wakefulness (7.7 spasms/hour) was greater than that during sleep (2.5 spasms/hour); 46.6% of spasms occurred in clusters. Spasms were composed of one or more of three phases: a myoclonic contraction, a tonic contraction, and/or an arrest of activity. The most common types were myoclonic-tonic (40.3%) and myoclonic alone (36.3%). When classified by postural motor phenomena, 41.6% were "flexor", 16.3% "extensor", 39.0% "mixed", and 3.1% "arrest" alone. Electrographic monitoring revealed that myoclonic contractions were associated with an initial paroxysmal event. Tonic contractions and arrests were usually associated with suppression of electroencephalographic activity with or without rhythmic activity. Knowledge of these clinical and electrographic features is important for diagnosis and evaluation of proposed treatments.

Cerebral Cortex↗