the value of different forms of treatment. This paper seeks to analyze the incidence of and recovery from neurological deficit and seizures in patients who have been treated in the MCNN from 1954 to 1981, inclusive, together with an additional four cases treated at the Birmingham Children's Hospital. Summary of Cases Clinical Material A diagnosis of acute subdural empyema was made in 89 patients at the MCNN from 1954 to 1981, inclusive. Some of these patients have been the subject of other reports. 2, 3, 13 Patients who developed postoperative or
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Douglas S. Cohen, Geoffrey P. Zubay, and Robert R. Goodman
C avernous malformations or angiomas come to clinical attention in a variety of ways. Seizures, intracranial hemorrhage, and expansile mass lesion are all possible manifestations of this vascular anomaly. 11, 28, 30 In recent reviews of series, seizures have been cited as the most common mode of presentation of these benign vascular abnormalities. 23 Over 50% of all patients harboring cavernous malformations and over 60% with supratentorial lesions may be expected to have at least one seizure during the course of their illness. 6, 23, 24 Seizure morbidity
Wishwa N. Kapoor and Peter J. Jannetta
S yncope , seizures, and cardiac arrest are well described in association with glossopharyngeal neuralgia, 3 but have not previously been reported with neuralgia affecting other cranial or peripheral nerves. We report a patient who had trigeminal neuralgia associated with syncope and seizures due to bradycardia and asystole. The episodes of loss of consciousness did not recur after a pacemaker was inserted. The neuralgia and bradycardia later resolved with microvascular decompression of the fifth cranial nerve. Case Report This 60-year-old man was in
Adrian L. Rabinowicz, David L. Ginsburg, Christopher M. DeGiorgio, Peggy S. Gott, and Steven L. Giannotta
T he incidence of postoperative epilepsy following craniotomy has been reported to range between 8% and 50%, and the risk of seizures following ruptured aneurysms ranges from 3% to 26%. 1–3, 11–13 Nevertheless, the risk of seizures after surgery for unruptured aneurysms is not well known. It would be expected that this risk would be low, given the lack of preoperative hemorrhage, modern microsurgical techniques, and limited cortical resection. If indeed the risk for seizures is very low, then prophylactic anticonvulsant agents would be contraindicated, given
Kimball S. Fuiks, Allen R. Wyler, Bruce P. Hermann, and Grant Somes
C orpus callosotomy is a surgical option for patients with medically uncontrolled seizures who do not have a unilateral, restricted epileptogenic focus. Callosotomy was first introduced in 1940 by Van Wagenen and Herren. 20 Since then, numerous refinements in operative technique have reduced the morbidity and mortality initially associated with the procedure; 3–5, 8, 10, 13, 17–19, 25 however, several issues remain controversial. First, what extent of callosotomy is sufficient for acceptable seizure outcome? Second, if complete callosotomy is elected
Tzu-Ming Yang, Wei-Che Lin, Wen-Neng Chang, Jih-Tsun Ho, Hung-Chen Wang, Nai-Wen Tsai, Yi-Ting Shih, and Cheng-Hsien Lu
S pontaneous ICH has long been recognized as a risk factor for the development of seizures and epilepsy. 5 The authors of most large studies of seizures after stroke have focused either on ischemic and hemorrhagic stroke together or hemorrhagic stroke exclusively. 1 , 4–6 However, few researchers have examined the clinical features of seizures in patients who have had spontaneous ICH. 3 , 9 , 14 , 15 , 19 The majority of previous studies have included relatively few patients, 9 , 14 less strict selection, and included seizures that occurred only in the
Douglas A. Hardesty, Matthew R. Sanborn, Whitney E. Parker, and Phillip B. Storm
S eizures are a common problem among adult and pediatric patients with brain tumors. As many as 30%–50% of these adult patients and approximately 15% of these pediatric patients will experience seizures. 2 , 10 , 11 , 15 , 23 , 24 , 27 Approximately 12% of brain tumors in pediatric patients become evident with the development of seizures. 29 The use of AEDs in brain tumor patients who present with seizures is completely warranted, but AED prophylaxis in newly diagnosed seizure-free patients is the subject of some controversy. In 2000, the AAN recommended
David G. Piepgras, Thoralf M. Sundt Jr., Ashvin T. Ragoonwansi, and Lorna Stevens
neurological deficits versus the benefit of the elimination of future hemorrhage, but also the risk of inducing or aggravating a seizure disorder and the benefit of eliminating or significantly improving seizures that exist secondary to the AVM. The results of surgical treatment for AVM's and subsequent long-term seizure follow-up study have been only sparsely documented. The conclusions regarding the efficacy of this operation for seizures are mixed. 1, 4–8, 10–15, 19–23 Since we found it difficult to determine the prognosis for new seizure development or improved
Hwa-shain Yeh, John M. Tew Jr., and Maureen Gartner
seizure onset; the duration of seizure history varied from a few months to 27 years. Eighteen patients had simple partial seizures, 34 had complex partial seizures, six had generalized seizures without aura or focal symptom, and 22 had partial seizures with secondary generalization ( Table 2 ). Twenty-two patients suffered two types of seizures and two patients had three types of seizures. TABLE 1 Age at surgery in 54 patients with cerebral arteriovenous malformations Age Range (yrs) No. of Cases Sex Male Female 11
Ching-Jen Chen, Srinivas Chivukula, Dale Ding, Robert M. Starke, Cheng-Chia Lee, Chun-Po Yen, Zhiyuan Xu, and Jason P. Sheehan
C erebral arteriovenous malformations (AVMs) are congenital vascular anomalies that have an estimated incidence of approximately 1 in 100,000 persons. 3 , 9 , 30 , 35 Patients often present by the 3rd decade of life with hemorrhage, seizure, or neurological deficit. 8 , 50 The most common presentation in patients harboring such vascular anomalies is hemorrhage, with the estimated risks ranging from 2% to 4% annually. 11 , 27 Due to the significant morbidity and mortality associated with AVM rupture, the majority of AVM treatments and studies have
