Seizures focal

Predictors of an unfavorable outcome seizures, focal neurologic findings, altered mental status, papilledema, hypotension, septic shock, and pneumococcal meningitis3... 

Collins, R. C., Tearse, R. G. and Lothman, E. W. Functional anatomy of limbic seizures focal discharges from medial entorhinal cortex in rat. Brain Res. 280 25-40,1983. 

Benzodiazepines and barbiturates are used as anticonvulsant drugs in the treatment of epilepsy. Epilepsy, a medical disorder characterized by recurrent seizures, has many different forms. The four most common seizure types are generalized tonic-clonic seizures (old name grand mal seizures), generalized absence seizures (petit mal seizures), complex partial seizures (psychomotor or temporal lobe seizures), and simple partial seizures (focal seizures). 

The terms convulsion and seizure are often used interchangeably and basically have the same meaning. A seizure may be defined as a periodic attack of disturbed cerebral function. A seizure may also be described as an abnormal disturbance in the electrical activity in one or more areas of the brain. Seizures may be classified as partial (focal) or generalized. Each different type of seizure disorder is characterized by a specific pattern of events, as well as a different pattern of motor or sensory manifestation. 

Partial or focal seizures arise from a localized area in the brain and cause specific symptoms. A partial seizure can spread to the entire brain and cause a generalized seizure. Fhrtial seizures include simple seizures in which consciousness is not impaired, jack-sonian seizures (a focal seizure that begins with an uncontrolled stiffening or jerking in one part of the body such as finger, mouth, hand, or foot that may progress to a generalized seizure), and psycho motor seizures. 

It has become clear that drugs which are effective in protecting mice against PTZ are effective in absence seizures while those able to control the tonic response to maximal electroshock are effective in tonic-clonic seizure. Some drugs are effective in only one test and clinical condition whilst a few are active in both (Table 16.1). Experimental focal seizures are indicative of partial seizures. 

Figure 16.3 Changes in neuronal function required for the development of epileptic seizures. The factors that may control or induce the changes in neuronal function that turn a normal neuron into a focal one (A) recruit other neurons (focal epileptogenesis) to produce an interictal EEG spike (B) and ensure the spread of activity (general epileptogenesis) to full ictal activity (C) are discussed in the text. They include alterations to various ion channels, especially those for Na, a reduction in local inhibitory activity or an increase in local excitatory drive. The electrophysiological counterparts of some of the events involved are shown in Fig. 16.2...

AG, a 20-year-old male college student, is seen by his physician 4 days after an apparent seizure during finals week. According to his roommate, he suddenly fell to the floor and had a generalized tonic-clonic seizure. This seizure lasted for 1 to 2 minutes. The patient was incontinent for urine during the seizure. He was sleepy and confused when the paramedics arrived 1 0 minutes later. Due to final examinations he reports being sleep-deprived. His physical exam is completely normal and no focal neurologic deficits were observed. 

Immunocompromised, history of CNS disease, new onset seizure, papilledema, altered consciousness, or focal neurologic deficit or delay in performance of diagnostic lumbar puncture... 

Central nervous system meningoencephalitis, strokes, seizures, and focal paralysis... 

Under physiologic conditions, the balance of membrane lipid metabolism, particularly that of arachidonoyl and docosahexaenoyl chains, favors a very small and tightly controlled cellular pool of free arachidonic acid (AA, 20 4n-3) and docosahexaenoic acid (DHA, 22 6n-3), but levels increase very rapidly upon cell activation, cerebral ischemia, seizures and other types of brain trauma [1, 2], Other free fatty acids (FFAs) in addition to AA, released during cell activation and the initial stages of focal and global cerebral ischemia, are stearic acid (18 0), palmitic acid (16 0) and oleic acid (18 1). 

Obtundation, hallucinations, grand mal seizures, and focal neurologic findings have also been associated with this illness. 

Seizures result from excessive excitation, or from disordered inhibition of a population of neurons. Initially, a small number of neurons fire abnormally. Then normal membrane conductances and inhibitory synaptic currents break down, excitability spreads locally (focal seizure) or more widely (generalized seizure). 

CP seizures may include somatosensory or focal motor features. They are associated with altered consciousness. 

Partial (focal) seizures begin in one hemisphere of the brain and, unless they become secondarily generalized, result in an asymmetric seizure. Partial seizures manifest as alterations in motor functions, sensory or somatosensory symptoms, or automatisms. If there is no loss of consciousness, the seizures are called simple partial. If there is loss of consciousness, they are termed complex partial, and the patients may have automatisms, memory loss, or aberrations of behavior. 

Neuromuscular symptoms include altered mental status, abnormal behavior, seizures, stupor, and coma. Hypercapnia can mimic a stroke or CNS tumor by producing headache, papilledema, focal paresis, and abnormal reflexes. CNS symptoms are caused by increased cerebral blood flow and are variable, depending in part on the acuity of onset. 

The possibility of cerebrovascular action of PCP was raised by the development of focal seizures and hemiparesis in a 6-year-old boy who had ingested what was presumed to be PCP (18). Hypertensive encephalopathy with a blood pressure of260/160 occurred in an 18-year-old woman who used PCP (43). These clinical findings are compatible with in vitro studies indicating that cerebral artery spasms can be produced by PCP as well as by LSD and mescaline (4). Whether such cerebrovascular actions are pertinent to the mental effects of these drugs is questionable. 

The laboratory is the focal point for almost all information regarding a purchase or seizure of drug evidence. This information... 

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