Changes In Serum Prolactin With Brain Stimulation

The first recognition of episodic hyperprolactinemia induced by seizures were the observations of investigators (11) who were seeking endocrine profiles to predict which patients would benefit from a full course of electrocon-vulsive therapy (ECT). Although endocrine changes did not predict the likelihood of successful ECT in women with depression, reproducible elevations in serum PRL followed ECT. ECT produces similar endocrine changes in schizophrenics (12,13). Subsequent to the ECT reports,...

Harold Morris Supplimentary Motor Seizures

Gelastic Seizures And Brain View

Baltimore Johns Hopkins Press, 1945. 2. Jackson JH, ed. Selected Writings of John Hughlings Jackson. Reprinted in 1931 ed. London Staples Press, 1874. 3. Gowers WR. Epilepsy and Other Chronic Convulsive Diseases Their Causes, Symptoms and Treatment. London J & A Churchill, 1881. 4. Ajmone-Marsan C, Ralston BL. The Epileptic Seizure. Its Functional Morphology and Diagnostic Significance. Springfield, Illinois Charles C Thomas, 1957. 5. Jackson JH, ed. Case of a...

Gastroesophageal Reflux

Much has been written about gastroesophageal reflux in infants, but cinematographic or videorecording or full polygraphic registration of a reflux-associated episode that might be described as a seizure has not been reported, though a true reflux episode associated with an epileptic seizure has been described 60 . Nonetheless, there is a persuasively recognizable condition, the awake apnea syndrome 61 . Having been fed within the previous hour, often following an imposed change of posture, the...

Migraine

EEG changes may occur during and after migraine attacks. Unfortunately, the literature is beset with frequent imperfections that may mislead the unsuspecting reader. This consists of the grouping of dissimilar patients, the lack of adequate controls, and vague definitions of what constitutes an EEG abnormality. Phenomena consistent with spreading depression and alterations of cerebral blood flow underlie the acute-appearing EEG abnormalities that occur principally, if not exclusively, in...

Affective Seizures

Any emotion can be expressed during the course of an epileptic seizure 2.2.2.1 . Irritability, anxiety, and anger can occur from amygdalar seizures or stimulation 46,48 . Fear is commonly a component of hippocam-pal seizures 90 . It is often without content and thus takes on the perception of unreality 91 . An affectless expression of fear can occur with cingulate seizures, as can a feeling of happiness 64,71 . Auras may involve the sudden onset of overwhelming fear without dependence on the...

Rem Behavior Disorder

The second sleep disorder that may mimic convulsive epileptic seizures is REM behavior disorder RBD 58,59 . RBD is characterized by recurrent episodes of vigorous motor activity occurring during REM sleep, movements that often awaken the patient or spouse. The primary presenting complaints are interrupted sleep or injuries during sleep. RBD is more common in older adults, usually beginning after the age of 50. It is two to five times more common in men than in women. It is possible that rare...

Sleep Wake Transition Disorders

Rhythmic movement disorders such as nocturnal head banging jactatio capitis nocturna , body rocking, and head rolling typically occur in infants and toddlers as they are trying to fall asleep. They can be present in deep sleep and in wakefulness. They are more common in children with learning disabilities. They typically remit by 5 years of age, but may persist into adult life. Management relies on good sleep hygiene and padding the headboard so the rest of the house is not wakened. Rhythmic...

Sandifer Syndrome

Infants with gastroesophageal reflux may have intermittent paroxysmal spells of generalized stiffening and opisthotonic posturing. These spells may also be associated with apnea, staring, and minimal jerking of the extremities. A careful history will reveal that these spells are associated with feedings, often occurring within 30 minutes of a feed. Sandifer syndrome can be seen in neurologically normal children as well as children with hypotonia and tracheomalacia, which may predispose the...

Visual Seizures

Because most of the occipital lobe is involved in visual function, occipital lobe seizures are frequently preceded by a visual aura. Visual auras include ictal amaurosis or hemianopsia, elementary or complex visual hallucinations, and visual illusions 85,94 . Ictal amaurosis describes ictal blindness and is uncommon. It may be preceded by ictal hemianopsia. If hemianopsia occurs, it has lateralizing significance to the contralateral occipital lobe. Ictal amaurosis lasts seconds to minutes and...

NonREM Partial Arousal Disorders Arousal Parasomnias Night Terrors

Brief nocturnal arousals are normal in children. They occur typically in stage 4 non-REM sleep, 1 to 2 hours after sleep onset. They vary from normal events such as mumbling, chewing, sitting up, and staring to arousals that can be thought of as abnormal because of the disruption they cause the family. These include calm and agitated sleepwalking, and a spectrum from confusional arousals to night terrors or pavor nocturnus. The child may exhibit automatic behavior, but the events are not truly...

Slow Delta Wave Activity Hepatic Encephalopathy

Triphasic Sharp Wave Complexes

___ he diagnosis of paroxysmal events in I the elderly presents particular difficulties, especially when contrasted with the problem presented by younger patients. In the first instance, the history is often difficult to obtain, vague, or not available at all. A second problem, common in the elderly, is the coexistence of multiple medical and or neurological problems that complicate the analysis of intercurrent paroxysmal symptoms. A third factor involves the confounding results of diagnostic...

Discussion

Syncope is usually defined as a transient loss of consciousness accompanied by a loss of postural tone 9-11 . This definition, emphasizing two common clinical features of syncope, allows one to develop a differential diagnosis and to pursue a work-up based on the observed phenomena. On the other hand, Lempert defines syncope as a transient loss of consciousness and upright posture due to global cerebral ischemia 12 . There are two major advantages to Lempert's definition i it limits syncope to...

References

Blume WT, Luders HO, Mizrahi E, et al. ILAE Commission report. Glossary of descriptive terminology for ictal semeiology Report of the ILAE task force on classification and terminology. 2001 Epilepsia 42 9 1212-18. 2. Rufo-Campos M, Gonzalez M-L A, Rangel-Pineda C. Cerebral seizures in neonatal period semeiology, evolution and factors of influence. Rev Neurol 2000 31 4 301-6. 3. Liporace J, Sperling M. Simple autonomic seizures. In Engel J, Pedley TA eds. Epilepsy a Comprehensive Textbook....

Hyperventilation Syncope

Hyperventilation in any human induces various organic symptoms that may in certain individuals stimulate further hyperventilation and exacerbation of the original symptoms. A degree of panic may be so engendered. Asking the child to hyperventilate whether by getting the child to repeatedly blow out a candle, blow soap bubbles, blow a tissue, or to directly hyperventilate may induce symptoms similar to those of which the child complains. Continuation of hyperventilation once the directed...

Hyperkinetic Seizures

Epileptic Seizures

Video-EEG has familiarized most neurologists with the fencing or M2e postures of supplementary motor The figure demonstrates a young girl who loses motor control of her right hand during seizures reproduced from video . The EEG of the event indicated at vertical line did not show a clear ictal build-up but demonstrated epileptiform potentials at Cz-Pz arrow during the event. On this and subsequent EEG figures, the calibration bar indicates 50 V, the green vertical line corresponds to the time...

Paroxysmal Torticollis

Torticollis is an abnormal sustained posture of the head and neck in which the head tilts to one side and the face rotates to the opposite side. In paroxysmal torticollis, the events begin and end suddenly. The attacks can be brief or prolonged. The child is alert and responsive during an attack although the patient may appear uncomfortable and irritable. The EEG is normal during the event. The etiology of the attacks is unknown, although both a focal dystonia and labyrinth dysfunction have...

Contributors

Montreal Neurological Institute and Hospital Professor of Neurology and Pediatrics Montreal Neurological Institute and Hospital Associate Professor of Clinical Neurology Columbia University College of Physicians and Surgeons Director, Clinical Anticonvulsant Drug Trials Assistant Professor Department of Neurology Emory University School of Medicine Atlanta, GA Department of Clinical Neurological Sciences The University of Western Ontario London Health Sciences Centre London, Ontario Canada...

Autonomic Seizures

Autonomic epileptic seizures non-motor, autonomic -2.2.1.8 and 3.0 - autonomic events are probably the most common of the seizures that don't look like seizures. Fortunately these phenomena usually occur during the course of a complex partial seizure or as a prelude to a generalized tonic-clonic seizure. The pathways involved can be afferent or efferent 33 . Once more, in the absence of another etiology, any isolated, recurring, paradoxical autonomic complaint should be investigated as a...

Periodic Limb Movements Of Sleep

In addition to the nonepileptic conditions previously discussed, two sleep related conditions can occasionally be confused with convulsive epileptic seizures. These are periodic limb movements of sleep PLMS and REM sleep behavior disorder RBD see also Chapter 16 . PLMS is characterized by recurrent muscle contractions, primarily of the lower extremities, during sleep 50-53 . Simultaneous movements of the upper extremities may occur. The movements tend to occur in clusters, each movement...