Clinical seizures

Electroencephalograph (EEG) should be obtained immediately and once clinical seizures are controlled... 

In discussing schizophrenia, we have restricted our attention to the rule of neuromodulation. A second general rule concerns the excitability of the brain with special reference to phasic activity of the sort that drives the REM sleep process (on the one hand), and clinical seizures (on the other). In chapter 9, I pointed out some of the phenomenological and physiological processes that REM sleep and epilepsy share, and emphasized the importance to both of temporal lobe activation. 

Ronen GM, Richards JE, Cunningham C, Secord M, Rosenbloom D. Can sodium valproate improve learning in children with epileptiform bursts but without clinical seizures Dev Med Child Neurol 2000 42(ll) 751-5. 

The numerical diversity of Na channel genes and their variable expression patterns increase the probabihty that the anticipated channel subunit mutations will generate multiple CNS excitability profiles finked to distinct clinical seizure types. Each of these selective excitability increases in specific axonal pathways may act to synchronize large neuronal populations by synaptic or non-synaptic mechanisms. This review considers the anatomical aspects of Na channel involvement in epileptogenesis, namely, how the site of expression of the Na channel gene, both within the neuron and within specific brain pathways, acts as an important phenotypic determinant of the disorder. 

Interestingly, the establishment of the Commission on Classification and Terminology of the International League Against Epilepsy in the year 1981 eame up with an altogether new proposal. In reality this proposal, advocates a elassifieation of epileptic seizures exclusively based on two cardinal clinical seizure variants commonly observed in patients, namely ... 

Epilepsy is a disorder characterized by recurrent spontaneous electrical discharges within the brain which are manifested by clinical seizures. Four million patients in the United States are afflicted with this ailment 20% of these have seizures that cannot be controlled sufficiently with existing medications to permit normal activities of everyday life. The market for anticonvulsants is substantial a historical growth rate of 10 to 12% is expected to be sustained thereafter. Epileptic seizures can be classified as primary epilepsies (35%) or partial epilepsies (65%). Primary epilepsies (generalized convulsions) can be controlled with valproate (Depakote), carbamazepine (Tegretol), phenytoin (Dilantin), or phenobarbi-tol. Most partial epilepsies have resisted control with chemotherapeutic agents. 

To evaluate the antiepileptic effects of SAHCS on temporal lobe epileptogenesis, the number and type of clinical seizures/day and the number of interictal negative EEG spikes at the epileptic focus/10 sec was... 

Velasco, F., Velasco, M., Velasco, A.L., and Jimenez, F. Effect of chronic electrical stimulation of the centromedian thalamic nuclei on various intractable seizure patterns I. Clinical seizures and paroxysmal EEG activity. Epilepsia 1993a, 34 1052-1064. 

Phenytoin versus levetiracetam In a retrospective review of 500 consecutive patients with glioma, who were treated from 2001 to 2008, who had had at least one clinical seizure, and who had been followed for at least 6 months, 76 were identified, 25 taking phenytoin and 51 levetiracetam [9 ]. The incidence of adverse reactions with levetiracetam was 6% versus 20% with phenytoin. In addition, 36% of the... 

It appears that lidocaine injected into the carotid sinus may have accidentally entered the cerebral arterial circulation and caused the clinical seizure. 

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