Seizures in Klinefelter's syndrome.

This study describes the clinical spectrum of patients with Klinefelter's syndrome and seizures. Klinefelter's syndrome is a sex chromosomal abnormality and the most common cause of male hypogonadism. It is characterized by cognitive dysfunction, hypogonadism, and abnormalities of physical maturation.

Epileptic pseudodementia.

Dementia is a frequent cause of memory loss with aging. The incidence of complex partial seizures sharply rises after age 60. Complex partial seizures that occur with subtle clinical signs or loss of awareness, or occur during sleep may defy identification.

Interictal single-photon emission computed tomography in partial epilepsy. Accuracy in localization and prediction of outcome.

The role of interictal brain single-photon emission computed tomography (SPECT) was examined using (99mTc)- labeled hexamethylpropyleneamine oxime (HMPAO) in refractory partial epilepsy. The accuracy with which SPECT localized an epileptic focus and whether it predicted long-term postoperative seizure relief were assessed. Twenty patients were evaluated, 14 of whom ultimately had anterior temporal lobectomy with follow-up ranging from 41 to 56 months.

Gabapentin treatment of seizures in acute intermittent porphyria.

Most antiepileptic drugs (AEDs) available have demonstrated porphyrogenicity in hepatic porphyrias. Gabapentin is a new AED not appreciably metabolized by the liver in humans. We report two patients with acute intermittent porphyria successfully treated with gabapentin without its inducing porphyric crisis.

Technetium-99m-HMPAO SPECT in partial status epilepticus.

Unlabelled: In this paper we correlate the findings on 99mTc-HMPAO brain SPECT with the results of clinical examinations and electroencephalography to determine the utility of SPECT in the evaluation of patients with suspected status epilepticus.

Methods: Thirteen patients with suspected status epilepticus underwent serial neurologic examinations, serial electroencephalograms, CT/MRI scanning and 99mTc-HMPAO SPECT. Seven patients were diagnosed with status epilepticus and six patients received other neurological diagnoses.

Epileptic palatal myoclonus.

Palatal myoclonus (PM) is usually caused by lesions of the brainstem. We report a case of PM of focal cortical origin in a patient with epilepsia partialis continua. The PM sometimes occurred in isolation, and at other times was accompanied by unilateral face, neck, and arm twitching.

The open opercular sign: diagnosis and significance.

Four children with varying clinical manifestations, but with the unifying feature of severe developmental delay, had bilateral enlargement of the sylvian fissure confirmed by magnetic resonance imaging (MRI). Subsequently, we examined 125 consecutive MRI scans of the heads of pediatric patients, looking for this insular exposure, and did not find it. Pathological correlation in 1 child revealed arhinencephaly and abnormal gyral formation; another is known to have migrational abnormalities.

Akinetic mutism: pharmacologic probe of the dopaminergic mesencephalofrontal activating system.

Four children who exhibited akinetic mutism during the course of their neurologic diseases were treated with bromocriptine. Reversal of the akinetic mute states was evident in all patients. Pathways of the dopaminergic neurons are reviewed and a clinically useful mechanism which causes akinetic mutism is postulated.

Effect of anti-inflammatory drug administration in patients with rheumatoid arthritis. An endoscopic assessment.

A prospective endoscopic study was carried out in 65 patients with rheumatoid arthritis to assess the prevalence of gastroduodenal lesions on aspirin alone or aspirin plus another anti-inflammatory drug (n = 26). All patients were taking greater than or equal to 8 tablets aspirin/day for greater than or equal to 3 months. Drug therapy consisted of regular, buffered or enteric-coated aspirin +/- one other non-steroidal anti-inflammatory drug or less than or equal to 10 mg prednisone/day.