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Autonomic seizure

Roisin Bartlam, Rajiv Mohanraj
BACKGROUND: Seizures can lead to cardiac arrhythmias by a number of mechanisms including activation/inhibition of cortical autonomic centers, increase in vagal tone through activation of brainstem reflex centers, and respiratory failure. Ictal asystole (IA) is a potential mechanism underlying sudden unexpected death in epilepsy (SUDEP). We analyzed the clinical features of 5 patients who developed IA requiring pacemaker implantation. METHODS: Patients with ictal arrhythmias were identified from the video-telemetry and ambulatory EEG database at Greater Manchester Neurosciences Centre, as well as an independent epilepsy residential care facility...
October 13, 2016: Epilepsy & Behavior: E&B
M L Mamalyga, L M Mamalyga
Circadian peculiarities of HR regulation and functional capacities of the heart in WAG/Rij rats with genetically determined absence epilepsy are related to spike-wave activity of the brain. The number of spike-wave discharges (SWD) is maximum at night, early morning, and evening time and decreases to minimum at 08.00-16.00. At night, functional capacities of the heart are reduced and stress test at night induces ischemic changes in the myocardium at a lower functional load than in the daytime (low level of SWD activity)...
September 2016: Bulletin of Experimental Biology and Medicine
Mohamed B Abou-Donia, Briana Siracuse, Natasha Gupta, Ashly Sobel Sokol
Sarin (GB, O-isopropyl methylphosphonofluoridate) is a potent organophosphorus (OP) nerve agent that inhibits acetylcholinesterase (AChE) irreversibly. The subsequent build-up of acetylcholine (ACh) in the central nervous system (CNS) provokes seizures and, at sufficient doses, centrally-mediated respiratory arrest. Accumulation of ACh at peripheral autonomic synapses leads to peripheral signs of intoxication and overstimulation of the muscarinic and nicotinic receptors, which is described as "cholinergic crisis" (i...
October 5, 2016: Critical Reviews in Toxicology
Hong-Li Huang, Hao Zhou, Nuan Wang, Chun-Yu Yu
Epilepsy is a common neurodegenerative disease with an increasing morbidity. Clinical treatment of epilepsy includes symptomatic treatment, etiological treatment, surgery and prevention. The aim of the present study was to determine the effects of antiepileptic drugs (AEDs) on serum folate and vitamin B12 in various epileptic patients, and to examine the correlation between these effects and secondary cerebrovascular events. A total of 68 epileptic patients, diagnosed between May 2012 and May 2014, were included in the present study...
October 2016: Biomedical Reports
Gregory S Day, David F Tang-Wai, Michel C F Shamy
We review the case of a young man who developed a constellation of symptoms and signs-bizarre behavior, seizures, abnormal movements, and autonomic instability-that evaded diagnosis at the time of presentation. We use this case to explore the way medical knowledge changes over time. Despite the dramatic advances in our understanding of neurological diseases in recent decades, physicians tend to approach diseases and diagnoses as if they were immutable. Our case reinforces how the diagnosis and treatment of disease are determined by an ever-changing historical context driven by the rapid expansion of medical knowledge...
October 2016: Neurohospitalist
Sook Hui Chaw, Li Lian Foo, Lucy Chan, Kang Kwong Wong, Suhailah Abdullah, Boon Kiong Lim
Anti-N-methyl-d-aspartate receptor encephalitis is a recently described neurological disorder and an increasingly recognized cause of psychosis, movement disorders and autonomic dysfunction. We report 20-year-old Chinese female who presented with generalized tonic-clonic seizures, recent memory loss, visual hallucinations and abnormal behavior. Anti-N-methyl-d-aspartate receptor encephalitis was diagnosed and a computed tomography scan of abdomen reviewed a left adnexal tumor. We describe the first such case report of a patient with anti-N-methyl-d-aspartate receptor encephalitis who was given a bilateral transversus abdominis plane block as the sole anesthetic for removal of ovarian tumor...
September 26, 2016: Revista Brasileira de Anestesiologia
Bekir Enes Demiryürek, Aslı Aksoy Gündogdu, Bilgehan Atılgan Acar, Aybala Neslihan Alagoz
Alien hand syndrome (AHS) is an involuntary and rare neurological disorder emerges at upper extremity. AHS is a disconnection syndrome with the symptoms of losing sense of agency and sense of ownership, and presence of involuntary autonomic motor activity. There are frontal, callosal and posterior types of AHS and each of them occurs depend on the lesions of different of the brain. Posterior variant is a rarely encountered AHS type compared to others. AHS, generally regarded as persistent, but rarely maybe observed as paroxysmal...
October 2016: Cognitive Neurodynamics
Shigemi Nagayama, Keiko Tanaka
Recently, the search for diagnostic antibody markers has drawn considerable attention in relation to autoimmune encephalitis. Among the antibody markers, the most frequently detected is the anti-N-methyl-D-aspartate receptor (NMDAR)antibody. Patients with this antibody develop characteristic clinical features. This disease tends to affect young women, and starts with psychiatric symptoms followed by seizures, involuntary movements, autonomic failure, and respiratory failure. Nearly half of these female patients have ovarian teratoma...
September 2016: Brain and Nerve, Shinkei Kenkyū No Shinpo
Vikram A Londhey
SLE (systemic lupus erythematosus) is a multisystem autoimmune disorder of unknown aetiology which can present with myriad clinical presentation. The neurological manifestations of SLE consist of central nervous system (CNS) and peripheral nervous system manifestations (PNS). The CNS manifestations are aseptic meningitis, cerebrovascular accidents (stroke), demyelinating disorders, headache, involuntary movements like chorea, myelopathy, acute confusional states, cognitive dysfunction, mood disorder, seizures, psychosis and cranial nerve palsies...
December 2015: Journal of the Association of Physicians of India
Elaine Wyllie, Ahsan Nv Moosa
We report four children who highlight the potentially under-recognized EEG pattern of bilaterally synchronous occipito-frontal sharp waves, which may occur in children with Panayiotopoulos-type self-limited childhood epilepsy but may be easily confused with the patterns of symptomatic generalized epilepsy. Our patients were young, healthy children who had infrequent, predominantly nocturnal, fairly prolonged seizures characterized by altered consciousness, vomiting, and autonomic features, or in one case nocturnal secondary generalized tonic clonic convulsion...
September 16, 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Piotr Milanowski, Piotr Suffczynski
Complex dynamical systems may exhibit sudden autonomous changes from one state to another. Such changes that occur rapidly in comparison to the regular dynamics have been termed critical transitions. Examples of such phenomena can be found in many complex systems: changes in climate and ocean circulation, changes in wildlife populations, financial crashes, as well as in medical conditions like asthma attacks and depression. It has been recognized that critical transitions, even if they arise in completely different contexts and situations, share several common attributes and also generic early-warning signals that indicate that a critical transition is approaching...
December 2016: International Journal of Neural Systems
Margaret Rozier, Denise Morita, Marta King
BACKGROUND: Anti-N-methyl-D-aspartate receptor encephalitis is an autoimmune disorder characterized by behavioral changes, dyskinesia, and autonomic instability. PATIENT DESCRIPTION: We describe a 14-year-old girl who initially presented with acute behavioral changes and seizures and who over a 2-week period developed high fever, tachycardia, and elevated blood pressures. RESULTS: Because she received multiple medications including anticonvulsants and a neuroleptic, our patient was initially diagnosed with neuroleptic malignant syndrome, a disorder characterized by autonomic dysfunction, hyperthermia, muscle rigidity, and mental status changes usually caused by the use of a neuroleptic agent...
October 2016: Pediatric Neurology
Agnes van Sonderen, Roland D Thijs, Elias C Coenders, Lize C Jiskoot, Esther Sanchez, Marienke A A M de Bruijn, Marleen H van Coevorden-Hameete, Paul W Wirtz, Marco W J Schreurs, Peter A E Sillevis Smitt, Maarten J Titulaer
OBJECTIVE: This nationwide study gives a detailed description of the clinical features and long-term outcome of anti-leucine-rich glioma-inactivated 1 (LGI1) encephalitis. METHODS: We collected patients prospectively from October 2013, and retrospectively from samples sent to our laboratory from January 2007. LGI1 antibodies were confirmed with both cell-based assay and immunohistochemistry. Clinical information was obtained in interviews with patients and their relatives and from medical records...
October 4, 2016: Neurology
Roger Kelsey Halbert
Anti-N-methyl-D-aspartate receptor encephalitis is an autoimmune syndrome that presents with personality changes, autonomic dysfunction, and neurologic deterioration. Most patients with this syndrome progress from psychosis to seizure to catatonia, often associated with abnormal movements, autonomic instability, and hypoventilation. First-line treatment constitutes resection of the associated neoplasm, corticosteroids, intravenous immunoglobulin, and plasma exchange. Second-line treatment includes rituximab and cyclophosphamide...
October 2016: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
Anouk Van de Vel, Kris Cuppens, Bert Bonroy, Milica Milosevic, Katrien Jansen, Sabine Van Huffel, Bart Vanrumste, Patrick Cras, Lieven Lagae, Berten Ceulemans
PURPOSE: Detection of, and alarming for epileptic seizures is increasingly demanded and researched. Our previous review article provided an overview of non-invasive, non-EEG (electro-encephalography) body signals that can be measured, along with corresponding methods, state of the art research, and commercially available systems. Three years later, many more studies and devices have emerged. Moreover, the boom of smart phones and tablets created a new market for seizure detection applications...
October 2016: Seizure: the Journal of the British Epilepsy Association
Krishnan Ravindran, Kim L Powell, Marian Todaro, Terence J O'Brien
Alterations in cardiac electrophysiology are an established consequence of long-standing drug resistant epilepsy. Patients with chronic epilepsy display abnormalities in both sinoatrial node pacemaker current as well as ventricular repolarizing current that places them at a greater risk of developing life-threatening cardiac arrhythmias. The development of cardiac arrhythmias secondary to drug resistant epilepsy is believed to be a key mechanism underlying the phenomenon of Sudden Unexpected Death in EPilepsy (SUDEP)...
August 11, 2016: Epilepsy Research
Rebecca L Holt, Eric Arehart, Arsen Hunanyan, Nina A Fainberg, Mohamad A Mikati
Several factors, such as epilepsy syndrome, poor compliance, and increased seizure frequency increase the risks of sudden unexpected death in epilepsy (SUDEP). Animal models have revealed that the mechanisms of SUDEP involve initially a primary event, often a seizure of sufficient type and severity, that occurs in a brain, which is vulnerable to SUDEP due to either genetic or antecedent factors. This primary event initiates a cascade of secondary events starting, as some models indicate, with cortical spreading depolarization that propagates to the brainstem where it results in autonomic dysfunction...
May 2016: Seminars in Pediatric Neurology
Isamu Aiba, Xander H T Wehrens, Jeffrey L Noebels
Cardiorespiratory failure is the most common cause of sudden unexplained death in epilepsy (SUDEP). Genetic autopsies have detected "leaky" gain-of-function mutations in the ryanodine receptor-2 (RyR2) gene in both SUDEP and sudden cardiac death cases linked to catecholaminergic polymorphic ventricular tachycardia that feature lethal cardiac arrhythmias without structural abnormality. Here we find that a human leaky RyR2 mutation, R176Q (RQ), alters neurotransmitter release probability in mice and significantly lowers the threshold for spreading depolarization (SD) in dorsal medulla, leading to cardiorespiratory collapse...
August 16, 2016: Proceedings of the National Academy of Sciences of the United States of America
Ricardo Erazo, Jaime González, Consuelo Quintanilla, Claudia Devaud, Consuelo Gayoso, Ximena Toledo, Erna Rauch, Claudia Riffo, Carolina Alvarez, Marne Salazar, Daniela Salvo, Josep Dalmau, Orietta Carmona
INTRODUCTION: Subacute anti-NMDA receptor encephalitis was recognised in 2007 as a clinical entity, and was first described in young women with ovarian teratoma. The first paediatric series unrelated with tumours was reported in 2009. OBJECTIVE: To present the clinical features, treatment, and prognosis of 13 patients with anti-NMDA receptor encephalitis in Chile. PATIENTS AND METHOD: A description is presented of 13 children, 9 males, aged between 1 and 16 years, diagnosed between 2009 and 2016 in 7 hospitals...
July 28, 2016: Revista Chilena de Pediatría
Harald Prüss, Belinda R Lennox
Antibodies against the voltage-gated potassium channel (VGKC) were first recognised as having a potential pathogenic role in disorders of the central nervous system in 2001, with VGKC antibodies described in patients with limbic encephalitis, and the subsequent seminal paper describing the clinical phenotype and immunotherapy treatment responsiveness in 13 patients with VGKC antibodies and limbic encephalitis in 2004. These initial case descriptions were of a progressive neuropsychiatric syndrome with abnormalities of mood, sleep and cognition recognised alongside the neurological symptoms of seizures and autonomic instability...
November 2016: Journal of Neurology, Neurosurgery, and Psychiatry
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