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PubMed1975

[Alterations in several cerebral metabolic indices in patients with epilepsy].

The paper pertains to studies of some metabolic indices in the brain of 106 epileptic patients where fits were of a traumatical and inflammatory etiology and with the duration of the disease from 1-10 years. The examination revealed disorders of the reductive-oxidative processes and carbohydrate metabolism in the brain which were not related to the etiology of epilepsy. A disorder of reductive-oxidative processes were more expressed in focal nonconvulsive fits characteristic for temporal epilepsy. The authors point to a certain correlation between changes in biochemical indices and the duration of the disease.

Adolescent↗
PubMed1975

[Brain damage and epilepsy in childhood (author's transl)].

Among the 1100 patients with convulsive disorders attending out-patient paediatric clinics of the Universities of Vienna and Graz, there are 14 cases of postnatal posttraumatic epilepsy. The characteristic features of this condition, as evidenced even by this small group of patients are focal epilepsy with focal paroxysms in the EEG, often combined with neurological defects and psychological abnormalities, but more seldom with defects of intelligence; resistance to anticonvulsive drugs is a frequent observation. In a retrospective study such as this, the criteria which could predict the development of epilepsy following posttraumatic brain damage are not sufficiently accurately definable; prospective serial studies on brain-damaged children would be of greater prognostic value. The following parameters seem to be important: the kind of brain damage, the duration of unconsciousness, the frequency of initial convulsive attacks and the persistance of the progression of the EEG changes.

Adolescent↗
PubMed1976

Posttraumatic subepicranial varix.

Two cases of subepicranial varix following injury are reported. They were associated with depressed skull fractures. Subepicranial varix is a rare and benign scalp mass, and should be differentiated from vascular anomalies of the scalp and cystic masses of the scalp communicating with the cerebrospinal space. The relationship between subepicranial varix and sinus pericranii is discussed.

Adolescent↗
PubMed1976

[Posttraumatic epilepsy. Clinical aspects and electrophysiological foundations].

The review of the syndrome is centered on time course, prognosis and prophylaxis. Prophylactic anticonvulsive treatment depends on the prognosis. The latter is dependent on the risk to develop epilepsy after a certain type of head injury. Treatment should begin in the high risk group of patients before seizures become overt. In order to avoid preventive treatment in unselected posttraumatic cases, predicting the risk in each case is most important. Therefore the literature was reviewed selecting injuries and complications of high risk. Knowledge on pathophysiologic mechanisms in the epileptogenic focus to a large extent stems from animal experiments using a model of chronic recurrent seizures. Basic electrophysiologic mechanisms responsible for focal electroencephalographic changes were studied by recording from single cells. Profound abnormalities in patterns of neuronal discharge were found as well as morphological and functional changes of glia in the epileptogenic scar. It appears that glia is important in generating focal electroencephalographic spiking. By controlling intercellular potassium transport glia modulates neuronal activity.

Animals↗
PubMed1978

Posttraumatic epilepsy and CT scan.

Among 83 head-trauma cases examined by CT scan in a later year, 41 were included in a seizure group of those who clinically showed late epilepsy and who obviously showed epileptic discharge such as spike or spike and wave in EEG after trauma, and 42 were included in a nonseizure group of those who had some sequelae such as abnormal findings in EEG or neurologic defects: the CT findings of these 83 cases were collected and compared with clinical findings, EEG, and other data. The CT findings of these cases were divided into five groups: (A) a normal group; (B) a group showing partial or unilateral ventricular dilatation; (C) a group showing porencephaly in the cerebral parenchyma; (D) a group suspected of cortical atrophy; (E) a group of other cases. Group D contained 44.3% of the cases, and was the largest group; the frequency of seizure was highest in Group C. The CT classification reveals the contradiction of the conventional definition of posttraumatic epilepsy and also poses some problems concerning the disease. CT scan is mostly applied to head trauma in the acute stage, and as for trauma in the chronic stage there are a few reports on chronic subdural hematoma and post-traumatic hydrocephalus. We noticed posttraumatic epilepsy among the sequelae of trauma, and then analyzed CT findings of the epilepsy: the results are reported here.

Adolescent↗
PubMed1976

Brain damage in National Hunt jockeys.

Five National Hunt jockeys have been found to have post-traumatic encephalopathy- three with epilepsy and two with significant intellectual and psychological deterioration. Closer supervision is needed.

Adult↗
PubMedDate not supplied

[Negative aspects of pharmacological prevention of epilepsy].

Pharmacological prevention of epilepsy, especially in cases of past cranial trauma, arose as one of the problems connected with this disease. Attention has been called, however, ever more frequently to the neurotoxic effects of antiepileptic drugs symptoms and signs of with brain damage. Drug-induced encephalopathy or neuropathy occur particularly in patients with disorders of anticonvulsant drug metabolism in liver diseases or due to inborn enzymatic defects. Teratogenic and even epileptogenic side effects has been described in cases treated with therapeutic doses of anticonvulsants. The author discusses in this aspect the indications to pharmacological prevention of epilepsy quoting cases observed by her in which cranial trauma was followed by one or several seizures in early post-traumatic period and presence of seizure potentials was found in EEG. During follow-up observations of severel years duration the seizures were not repeated and EEG has returned to normal.

Anticonvulsants↗
PubMed1976

[Study of epilepsy by computer controlled transverse axial tomography of the brain].

The value of computerized azial tomography of the encephalon is considered:--Firstly, in relation to the different electro-clinical varieties of epilepsy (essentially primary, secondary and partial) where it provides information of a high degree of precision concerning the topography, frequency and size of morphological abnormalties of the encephalon.--Secondly, in relation to the various aetiological possibilities (tumour, post-traumatic, post-ischaemic, post-infective, et cetera). This new method is of considerable to specify an aetiology almost unknown up to the present time: post-ischaemic occipital porencephaly secondary to perinatal or infantile occlusion of the posterior cerebral artery.

Adult↗
PubMed1978

Transient global amnesia--a review of 213 cases from the literature.

TGA is a clearly recognisable clinical syndrome with many and varied aetiologies, the most ubiquitous being transient cerebral ischaemia. This entity is probably much more common than the literature suggests, many patients not coming to the attention of a physician due to the transient nature of the isolated memory defect and the risk of recurrence being low, it is of interest that many of the original patients described tended to be the more prominent members of the community, e.g. physicians and relatives of physicians, perhaps suggesting that the occurrence of TGA in such a person is less likely to pass unnoticed. In the differential diagnosis one should include the following: transient cerebral ischaemia, epilepsy, migraine, temporal lobe encephalitis, psychogenic fugues, post-traumatic, and rarely cerebral neoplasms.

Adult↗
PubMedDate not supplied

[Etiological diagnosis of epilepsy: value of computerized axial tomography (C.A.T.) (author's transl)].

The authors appraise the value of CAT in the study of epilepsy from their personal experience and from the few published works that are available. The CAT confirms and supports a large number of already acquired facts:--the almost complete absence of cerebral lesions in "functional" epilepsies (primary generalized epilepsies and benign childhood epilepsy with rolandic paroxysms);--the large number of abnormalities in the secondary generalized epilepsies (West syndrome, Lennox-Gastaut syndrome) where the majority of patients present a bilateral fronto-temporal atrophy;--the high percentage of cerebral lesions in partial epilepsies. In this case, the CAT is especially notable in revealing etiologies in 63 p. 100 of cases. They include: tumors, abcesses, empyemas, angiomas, cerebral infarctions, cerebral atrophies, post-traumatic lesions, etc... From this study, it can be concluded that positive diagnosis of epilepsy is still made on the basis of clinical and electroencephalographic data, with the CAT used to facilitate the etiological diagnosis.

Adolescent↗
PubMed1979

[Neuroradiological findings in epilepsies without consideration of cranial computerized tomography and radioactive brain scanning (author's transl)].

This paper gives a detailed summary of neuroradiological findings (X-rays of the skull, pneumoencephalograms and angiograms) in epilepsies and epileptic seizures, that is based on 902 patients, which have been treated in the Neuro-Psychiatric university hospital of Mainz during 1960 and 1975. First the different pathological findings and their frequency in relation to the single types of epilepsy are described. Then it is tried to draw conclusions from the neuroradiological findings to the etiology of the particular seizure-classes. In further passages important etiologies are chosen and the appearing different seizures with their neuroradiological findings are presented. Epilepsies due to unknown causes, due to brain damage in early childhood, post-traumatically, alcohologenic and caused by brain-tumors are considered. As no similar classification was found in the literature, our data could only be compared with those of different papers, each dealing with some aspects. In the absence of recent publications with statistical data we also had to refer to older papers. Differences between our results and those of the literature are discussed.

Brain↗
PubMed1979

[Computerized tomography in post-traumatic cerebral lesions (author's transl)].

A review of 108 cases of cranial injury, dating back for more than three months, and having had computerized tomography examinations, revealed 96 abnormalities in the results. These included overall, 65 times, and localized, 20 times, ventricular dilatations, generalized atrophy 27 times, porencephaly 27 times, enlargement of the sylvian fossa 28 times, chronic subdural hematomas 8 times, intracranial calcification 3 times, meningiomas 3 times, and a cerebral abscess in 1 patient. The computerized tomography results were normal in 12 patients. Very good correlations were found between clinical and computerized tomography results in patients with psychic disturbances and disorders of the higher centers. They were variable in cases of epilepsy and neurological deficiency states. The greatest number of normal results was found in so-called subjective syndromes.

Brain Diseases↗
PubMedDate not supplied

Benign post-traumatic encephalopathy in young people and its relation to migraine.

Thirteen children and adolescents between ages 4 and 19 years developed transient nonconvulsive neurological symptoms and signs within a few hours apparently trivial head injuries. Some became quite seriously ill, but all made rapid and complete recoveries. Some of these young people are known to have suffered from migraine before and/or after this episode, and in all but one of the others a family history of migraine was elicited. With these patients are compared five younger children who developed epileptic fits after equally slight trauma. A diagnosis of migraine should be considered in children who develop delayed impairment of consciousness after head trauma, with or without convulsive phenomena or focal neurological deficits, and in whom specialized investigations reveal no sign of a mass lesion or of intracranial hemorrhage.

Adolescent↗