Epileptic seizures in cerebral arterial occlusive disease.

Abstract

CSF SEROTONIN IN RUPTURED ANEURYSM/ Voldby et al. 189ruptured cerebral aneurysm. J Neurol Neurosurg Psychiat 27: 198-199, 1964 2124The growing attention focused on transient ischemic attacks (TIAs) seems to have fostered an increasing disregard of the relationship between epilepsy and cerebral ischemia, and the two diagnoses have even been considered as mutually exclusive. 26Seizures in obstructions of the middle cerebral artery (MCA) have not been regarded as an outstanding feature of the clinical picture, being included among second-order symptoms.6, '• 10,12,26,27 The obvious inference is that epileptic attacks are more frequent in carotid than in MCA occlusive disease. Indeed, their actual incidence is difficult to assess on the basis of data so far available. In the carotid group, epilepsy was the presenting symptom in 6.7% of patients, whereas no MCA patient had seizures prior to the appearance of a neurological deficit. Since epileptic seizures may complicate an otherwise asymptomatic carotid obstruction, angiography should be performed whenever the other standard investigations, including CT-scan, fail to reveal the cause of a late-onset epilepsy.

Association between antiphospholipid antibodies and epilepsy in patients with systemic lupus erythematosus

“…Inzelberg and Korczyn (13) proposed that seizures in aPL-positive patients are the expression of ischemic events occurring as a result of hypercoagulability. In fact, seizures are a well-known symptom of cerebral ischemia (20), and the coexistence of other vascular disorders in a high percentage (42.9%) of our epileptic patients with positive aPL provides evidence that this association may be clinically significant. Finally, it is of interest that all patients with abnormal features found on CT and/or MRI scanning had positive aPL (P = 0.03).…”

Exames subsidiários preditivos de crises epilépticas após acidente vascular cerebral isquêmico

“…Cocito et al 7 comparando também dois grupos de pacientes, um com doença cerebrovascular oclusiva com crises epilépticas e outro sem crises epilépticas, não obtiveram diferença entre os grupos para a presença de dislipidemia e de hiperglicemia.…”

Características das crises epilépticas após acidente vascular cerebral isquêmico

“…Sung e Chu 45 relatam 56% de crises do tipo parcial simples, 24% de crises do tipo parcial complexa, 4% do tipo generalizado e 16% de crises inclassificáveis, em uma das maiores casuísticas de crises epilépticas secundárias a AVCI do tipo trombótico. Os achados de Cocito et al 9 a respeito do tipo de crise são semelhantes aos encontrados pelos autores acima, isto é, 82% de crises do tipo parcial e 18% do tipo generalizado. Gupta et al 25 , discordando, relataram 58% de crises do tipo generalizado, contra 42% do tipo parcial, em estudo de 90 pacientes com AVCI.…”

“…Gupta et al 25 encontraram estado de mal epiléptico em 8% dos 90 pacientes com AVCI. Há, no entanto, relatos discrepantes, como por exemplo o de Cocito et al 9 que, estudando 22 casos de oclusão da artéria carótida ou da cerebral média, encontraram estado de mal epiléptico em 8 (36%). Barolin 2 relacionou estado de mal epiléptico com mau prognóstico do AVC quanto a presença de seqüelas motoras, porque acredita que um cérebro com doença cerebrovascular raramente seja capaz de sustentar descargas adicionais de sintomas epilépticos contínuos, levando à ampliação da área lesada.…”