Transient loss of consciousness
Sherif Gonem, Ian Pavord in Diagnosis in Acute Medicine, 2017
Preceding symptoms: – Palpitation suggests cardiac arrhythmia.– Chest pain may occur with myocardial ischaemia, pulmonary embolism, aortic dissection or cardiac arrhythmia.– Anxiety, fast breathing, tingling of the hands or around the mouth, and carpopedal spasm are characteristic of hyperventilation.– Dizziness or light-headedness before loss of consciousness commonly occurs with syncope and hypoglycaemia.– Vertigo is suggestive of brainstem ischaemia.– Absence of preceding symptoms is characteristic of seizure disorders, although in some cases patients may report a variety of curious sensations, particularly with temporal lobe epilepsy.
Psychiatric Diagnosis is Not a Diagnosis of Exclusion
Paul Ian Steinberg in Psychoanalysis in Medicine, 2020
No abnormalities of affect, thought process or content, or sensorium were observed during psychiatric examination of Mr. F. The most appropriate diagnosis appeared to be a transient delirium of unknown etiology, with temporal lobe epilepsy being the psychiatrist’s favored diagnosis. Not satisfied that his symptoms represented a psychiatric disturbance or an adequately diagnosed medical condition, the psychiatrist referred Mr. F to a general internist. The latter initially diagnosed temporal lobe epilepsy. Eventually, however, Mr. F’s episodes were related to a fasting condition, and hyperinsulinemia with hypoglycemia was documented. His paranoid symptoms were replicated in hospital during fasting hypoglycemia. They were relieved by glucose ingestion, fulfilling Whipple’s triadic criteria for insulinoma. No tumor was found by arteriography, ultrasound, or abdominal CT scan. The insulinoma was identified when Mr. F underwent specialized investigation in another country, by transhepatic portal venous sampling, which indicated, employing differential insulin gradients, an insulin-secreting tumor in the pancreas head. A benign islet cell was surgically removed.
Central Nervous System Effects of Essential Oil Compounds
K. Hüsnü Can Başer, Gerhard Buchbauer in Handbook of Essential Oils, 2020
Temporal lobe epilepsy is one of the most common among the “difficult to treat” epilepsies, with almost a third of patients without adequate response to available treatments. In a rat intrahippocampal kainate experimental model of temporal lobe epilepsy, orally given thymoquinone decreased epileptic activity, reducing the increase in malondialdehyde (but not nitrite and nitrate) levels and SOD activity. Of note, 27 attenuated the hippocampal CA1 and CA3 neuronal loss and the signs of damage to the dentate nucleus, possibly suggestive of neuroprotective activity against the epileptic insult. The neuroprotection may be associated with the antioxidant and anti-inflammatory activities observed for this compound in other studies (Dariani et al., 2013).
Sub-chronic boldine treatment exerts anticonvulsant effects in mice
Published in Neurological Research, 2018
Leila Moezi, Siranoush Yahosseini, Akram Jamshidzadeh, Mona Dastgheib, Fateme Pirsalami
Epilepsy is one of the most common neurological disorders characterized by sudden episodes of abnormal neuronal discharge [1]. It affects 50 million people throughout the world [2]. Regardless of advances in epilepsy research, its treatment still remains complicated and challenging. Because present medications are associated with a variety of adverse effects and near one-third of epileptic patients do not response to the conventional drugs, therefore finding new remedies with new mechanisms of actions is necessary to potentiate the effects of antiepileptic drugs and make treatment of epilepsy more effective [3,4]. Temporal lobe epilepsy is the most diffuse epilepsy type in adults frequently associated with hippocampal sclerosis. This form of epilepsy is described by refractoriness to drug treatment, so to require surgical resection of mesial temporal regions involved in seizure beginning. Even this last therapeutic method may fail in giving relief to patients [5].
Design and evaluation of chrysin-loaded nanoemulsion against lithium/pilocarpine-induced status epilepticus in rats; emphasis on formulation, neuronal excitotoxicity, oxidative stress, microglia polarization, and AMPK/SIRT-1/PGC-1α pathway
Published in Expert Opinion on Drug Delivery, 2023
Mina Y. George, Marwa O. El-Derany, Yasmine Ahmed, Malvina Zaher, Caroline Ibrahim, Habiba Waleed, Hajar Khaled, Gehad Khaled, Ahmed Saleh, Huda Alshafei, Rahma Alshafei, Nirmeen Ahmed, Sara Ezz, Nouran Ashraf, Shaimaa S. Ibrahim
Besides, Li/Pilo animal model is also useful in evaluating cognitive impairment seen in epilepsy patients. This was proven by the reduction seen in the spontaneous alternations and probe trial in y maze and Moris water maze tests, respectively in epileptic rats. On the other hand, CH pretreatment enhanced and corrected such cognitive impairment as demonstrated by increased spatial memory functioning in y maze and Moris water maze tests. This finding is in agreement with other studies reporting the ability of CH to counteract cognitive impairment in rats [32,70]. It is worth mentioning that locomotor activity and TAE in y maze test did not change among the groups. Such behavioral changes were further confirmed by histological examination of hippocampus regions; CA1, CA3, and dentate gyrus. Neuronal damage was found to be a common feature of temporal lobe epilepsy patients which may contribute to the process of epileptogenesis. CH pretreatment showed protective effects against such histopathological changes in all studied hippocampal areas. It is worthy to note that CH NE IN administration demonstrated superior protection especially for dentate gyrus region.
Operative variations in temporal lobe epilepsy surgery and seizure and memory outcome in 226 patients suffering from hippocampal sclerosis
Published in Neurological Research, 2021
Karl Roessler, Burkhard S Kasper, Julia Shawarba, Katrin Walther, Roland Coras, Sebastian Brandner, Fabian Winter, Hajo Hamer, Ingmar Blumcke, Michael Buchfelder
All patients underwent extensive epileptological examinations at the certified level 4 epilepsy center before surgery and suffered from verified electro-clinical temporal lobe epilepsy (TLE). Additionally, to evaluate the history and neurological status, prolonged video electroencephalography (EEG) monitoring, high-resolution magneto-resonance-imaging (MRI, according to the epilepsy protocol), and memory testing were performed in all patients. In selected cases, magnetoencephalography (MEG), single-photon emission computed tomography (SPECT), voxel-based morphometry (VBM), and Wada testing were performed. During the follow-up visit conducted at 6 months postoperatively, neuropsychological testing was routinely performed. Visual field testing using a standard automated computer perimeter was performed immediately before and after surgery as well as 6 months after surgery. Additionally, evaluation of peri- and post-operative complications and assessment of effectiveness of antiepileptic drugs before and after surgery were performed. The decision for surgery was confirmed at a multidisciplinary epilepsy conference, where epileptologists, neurosurgeons, neuroradiologists, neuropsychologists, and nuclear medicine physicians carefully weighted all findings and pro and cons of surgery.
Related Knowledge Centers
- Comorbidity
- Electroencephalography
- Memory
- Neuroimaging
- Neurological Disorder
- Temporal Lobe
- Epilepsy
- Anticonvulsant
- Seizure
- Focal Seizure