Biomedical subjects

T Bacia

Publications and source records attributed to T Bacia.

At least 19 recordsLinked to original sources

PubMed1992

The results of the surgical treatment of occipital lobe epilepsy.

Out of 502 patients with surgically treated drug-resistant chronic epilepsy (tumour cases excluded) in 12 (2%) a clear occipital focus was found. The pattern of seizures was in most cases nonspecific and polymorphic. EEG examination and neuroradiological findings led to proper localization of the epileptogenic focus. Partial or total occipital lobectomy was performed. Follow-up from 4 to 20 years revealed a satisfactory result in 11 of the surgical cases. One patient was lost to follow-up. Brain scarring was found in the histological examination of specimens in 9 out of 12 patients. The results of the surgical treatment of occipital lobe epilepsy are much better than in other localizations of epileptogenic foci.

Adolescent↗

PubMed1984

Somatomotor manifestations in temporal lobe seizures.

Some authors include somatomotor manifestations (SMM) among the clinical features of temporal lobe seizures in man; however, data are limited and conflicting. This study describes 101 seizures recorded during stereo-EEG explorations in 50 patients, selected on the basis of the demonstration of onset in temporal lobe structures (stereo-EEG) and the presence of lateralized SMM and/or secondary generalization (SG). SMM and SG were present in about 20% of our population of patients with temporal seizures explored with stereo-EEG, and were only rarely observed during the first 10 s (early SMM) of the seizures (less than 10%). Seizures characterized by early SMM were generally induced by electrical stimulation or chemical activation and only exceptionally spontaneous. In all cases the ictal electrical discharge also involved at an early stage extratemporal structures such as the rolandic operculum, the parietal lobe, or contralateral temporal structures. In most cases (greater than 90%) SMM represented a late (greater than 10 s) event in the ictal symptomatology. The face and the upper limb were by far the most frequently involved segments. Thirty-eight percent of seizures ended up in SG. The associated ictal symptomatology was rather poor and differed from our previous findings in temporal lobe seizures: oroalimentary automatisms were relatively rare, whereas an impairment of consciousness was observed in more than 50% of seizures. The critical electrical discharge had a long duration and always involved extratemporal structures in one or both hemispheres. The involvement of the central region could be demonstrated in all patients with deep electrodes in that region. In conclusion, SMM are not characteristic of temporal lobe seizures, and their presence indicates spreading of the critical discharge beyond the temporal lobe.

Adolescent↗

PubMed1982

[Motor and postural manifestations of temporal lobe epilepsy seizure].

This study reports on 73 epileptic seizures (in 36 patients) originating in the temporal lobe (stereo-EEG) presenting motor or postural signs. Motor symptoms occur rarely in the early phase of seizures (less than 10% of our series) and they are exceptional during spontaneous seizures. The critical electrical discharge always affects extra-temporal structures such as the rolandic operculum, the cingulate gyrus, etc. The occurrence of motor symptoms during the late phase of seizures is associated with a long duration of the critical discharge and, again, with the involvement of extra-temporal structures. The characteristics of the associated clinical signs (e.g., frequent loss of contact with the environment, relatively rare oroalimentary automatic activities), together with the high frequency of secondary 'generalizations' are consistent with the stereo-EEG findings and indicate that these seizures also affect extra-temporal regions.

Adolescent↗

PubMed1981

Late results of operation in temporal lobe epilepsy in adults and children.

In our clinic at the Medical Academy in Warsaw 282 patients with temporal lobe epilepsy were treated surgically. The causes of the illness were trauma in 43.2%, including birth trauma in 19.5%, infections diseases in early life in 19.8%, and microtumours in 6.8%. In 30% the aetiology was unknown. Fifty per cent had fits before 10 years and 75% before 20 years of age. The period of conservative treatment was on average nine years. Serial and stereo-EEG recordings including activation by ketamine, as well as intracarotid sodium amytal tests were performed routinely. The interictal EEG epileptiform abnormalities were found most frequently in both temporal lobes (154 cases). The operation was carried out according to Penfield's technique, with electrocorticography and resection of the temporal lobe extending for 6 to 10 cm in the nondominant hemisphere and for 4 to 5 cm in the dominant hemisphere using suction technique. In 75% microscopical changes in the hippocampus were found, in 20% so-called hamartomas and in 6.8% small gliomas. Two patients died and in 13 patients there was a hemiparesis which was transient in 10. The authors present the analysis of late results of 262 cases with a follow-up from 2 to 22 years after operation. Very good results were obtained in 127 cases (48.5%) - no attacks since leaving the clinic. Good results were observed in 42 patients (16%) - not more than 1-2 attacks a year. Thus, the operation resulted in freedom from attacks, or nearly so, in 169 cases (64.5%). In an additional 47 patients (18%) there was a significant reduction (at least 50%) in seizures without complete freedom from attacks, and in 44 cases (16.8%) no improvement was observed. The analysis of our series suggests that the best results may be obtained in patients with unilateral temporal EEG changes. The existence of an additional focus in parts of the other temporal lobe does not impair the operative results when the dominant epileptic focus has been removed. Among 24 cases with equally pronounced bitemporal EEG abnormalities the stereo-EEG studies allowed detection of the epileptic focus in 13 patients (54%). Detailed analysis of the results, obtained in 51 children below 15 years of age, led to the conclusion that temporal lobe epilepsy should be operated upon even in young children, provided that the epileptic focus can be clearly identified.

Adolescent↗

PubMed1980

Clonazepam in the treatment of drug-resistant epilepsy: a clinical short and long term follow-up study.

One hundred sixty one epileptic patients, resistant to standard antiepileptic medication, were treatecd with clonazepam. In 19 cases clonazepam was given during the epileptic status. In 17 cases the status was stopped. In the remaining 142 patients clonazepam was given orally. The short term effect of the drug was analysed after 3 months of observation and the long term effect after a period of more than 1 year of observation. The authors compare the relationship between the clinical form of epilepsy, the EEG changes and the duration of disease with the long and short term therapeutic effect of clonazepam. The results obtained suggest: short term therapy is more successful than long term therapy, poor results or intolerance at the beginning of the treatment occur in about 20% of patients. The influence of clonazepam on epilepsy with focal seizures is relatively better than on generalized forms of epilepsy. "Old" cases of epilepsy are significantly more resistant to clonazepam medication. The same is true for diffuse brain damage.

Adult↗

PubMed1980