Population And What Tests Best Distinguish One Disorder From Another

Episodic neurologic dysfunction in the elderly has a wide differential diagnosis, certain conditions being much more strongly represented among older than younger patients. Disorders that can in some instances be difficult to distinguish from seizures include syncope, TIAs, migraine, sleep disorders, paroxysmal toxic-metabolic abnormalities, movement disorders, and psychiatric conditions.42 Syncope in the elderly is particularly important to recognize because it becomes both more common and...

Are Any Other Hormonal Systems Clinically Affected By Partial Seizures

The function of the hypothalamo-pituitary-adrenal axis may be altered chronically as well as acutely in seizure patients.39,60 Cortisol has been shown to be elevated interictally in some studies61 but not in others.31 Corticotropin is also elevated interictally in patients with temporal lobe seizures,61 a finding that appears to be related specifically to abnormal functioning of the anterior temporal lobe,61 where the amygdala is located, and to be limited to TLE that involves the amygdala. For...

Can Hormones Be Used To Treat Epilepsy

Endocrine treatment of seizures may rationally be aimed at those endocrino-logic aspects of seizures that act either to exacerbate or to ameliorate them. As already discussed, progesterone may have an anticonvulsant effect, whereas estrogen, CRH, and Cortisol may have proconvulsant effects. Thus, treatment with progesterone, estrogen antagonists, and medications that suppress the activity of the hypothalamo-pituitary-adrenal axis may prove to be useful adjunctive treatments in appropriate...

What Other Psychiatric Symptoms May Develop In Epilepsy

Anxiety is an important and common condition associated with epilepsy and can have various causes. In addition to the direct anxiety produced by a seizure during the ictal phase, anxiety symptoms can develop during the postictal and interictal periods. Seizures can produce autonomic effects resulting in symptoms that mimic anxiety or panic, including increased heart rate, increased blood pressure, and flushing. In patients with epilepsy, anxiety may also develop as a response to anticipating a...

How Do Psychiatric Or Behavioral Symptoms Vary In Patients With Simple As Opposed To Complex Partial Seizures

Focal seizures can produce a wide range of symptoms and experiences, including motor, sensory, autonomic, psychiatric, behavioral, and cognitive events. Maintenance of consciousness during the event separates a simple partial from a complex partial seizure. In a simple partial seizure, the seizure focus is localized, the patient maintains awareness of the environment and memory for events occurring during the seizure, and specific ictal symptoms can be experienced and recalled for the duration...

What Are The Types Of Generalized Seizures

There is rarely any difficulty in correctly diagnosing generalized tonic-clonic (GTC) seizures (formerly termed grand mal seizures). The only caution is that toddlers with breath-holding attacks and adults and children with syncope may have brief generalized tonic-clonic seizures at the end of the attack.7 Those brief seizures should not be treated with antiepileptic drugs. Some patients may have a simple partial seizure (aura) preceding the loss of consciousness. As previously described, this...

What Complications Can Occur With Convulsive Status Epilepticus

Convulsive SE can cause numerous complications (Table 8.3).9'10 Autonomic changes, which can be severe, include hypertension, tachycardia, arrhythmias, diaphoresis, hyperthermia, and vomiting. Many changes are caused by increased circulating catecholamines. Hyperthermia may result from excessive convulsive muscle contractions as well as from hypothalamic effects. The electrocardiogram (ECG) may show conduction abnormalities or ischemic patterns.11 Autonomic dysfunction and cardiac arrhythmias...