Epilepsy clinical presentation

The only clinical use for ethosuximide (Zarontin) is in the treatment of absence epilepsy. If absence attacks are the only seizure disorder present, ethosuximide alone is effective. If other types of epilepsy are present, ethosuximide can be readily combined with other agents. 

Turjman F, Massoud TF, Vinuela F et al. (1994) Aneurysms related to cerebral arteriovenous malformations super-selective andiographic assessment in 58 patients. AJNR Am J Neuroradiol 15 1601-1605 Turjman F, Massoud TF, Vinuela F et al. (1995a) Correlation of the angioarchitectural features of cerebral arteriovenous malformations with clinical presentation of hemorrhage. Neurosurgery 37 856-860 Turjman F, Massoud TF, Sayre JW et al. (1995b) Epilepsy associated with cerebral arteriovenous malformations a... 

Regular monitoring of blood phenytoin levels provides a valuable contribution to the management of patients with epilepsy. The value of determining the blood level of other anticonvulsant drugs is unconfirmed. At present such work should be undertaken only as prospective research procedures combining clinical and biochemical methods of assessment and patient-management. 

A neonatal form of hepatic failure has a rapidly fatal course and frequently includes severe hypotonia, myoclonus epilepsy, and psychomotor retardation [39]. Another type (found in children aged 2-18 months) has a milder clinical course with infrequent fatal outcome [11]. Abnormal histology (steatosis, micro and macro-nodular cirrhosis) and elevated plasma or cerebrospinal fluid (CSF) lactate are consistent features of the disease, regardless of the clinical subtype. The brain is often involved in these presentations, but other organs could also be involved. Dwarfism... 

GAMT deficiency has been known for more than 10 years now and several affected patients have been reported [6]. The severity of clinical symptoms varies widely. Affected patients show developmental delay with absence of active speech and, in older patients, autism with self injury. More severely affected patients present with severe extrapyramidal symptoms and intractable epilepsy. Biochemical diagnosis can be made by analysis of GA in the plasma or urine. 

At present, a multitude of novel sodium channel blockers are in preclinical and clinical development. However, most compounds have been applied to many indications, especially epilepsy and stroke. This review includes only those substances for which activities in pain models have been reported. 

An interesting situation occurs when identical (monozygotic) twins are discordant for epilepsy (one twin has epilepsy and the other twin does not) without any known cause of postnatal injury to one twin. Clinical and MRI analysis of such twins reveals that most of the epileptic twins show either lesions or anatomical anomalies not present in the normal cotwin.21 Since the genomes of the twins are identical, something happened... 

Laudanosine or Af-methyltetrahydropapaverine is a recognized metabolite of atracurium and cisatracurium. Laudanosine decreases the seizure threshold, and thus, it can induce seizures if present at sufficient threshold concentrations however, such concentrations are unlikely to be produced consequent to chemodegradable metabolism of clinically admiiustered doses of cisatracurium or atracurium. Laudanosine also occurs naturally in minute amounts (0.1 %) in opium, from which it was first isolated in 1871. Partial dehydrogenation of laudanosine will lead to papaverine, the alkaloid found in the opium poppy plant (Papaver somniferum). Laudanosine is a benzyltetrahydroisoquinoline alkaloid. It has been shown to interact with GABA receptors, opioid receptors, and ificotinic acetylcholine receptors, but not benzodiazepinergic or muscarinic receptors which are also involved in epilepsy and other types of seizures. 

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