Presentation
The clinical presentations, imaging studies and initial pathology studies can mimic lymphocytic hypophysitis. Here we report additional clinical clues in differentiating these two conditions. [ncbi.nlm.nih.gov]
Entire Body System
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Pain
Parietal (pah-RIE-eh-tal) lobe- Controls sense of touch, response to pain and temperature, and understanding of language. Occipital (ok-SIP-eh-tal) lobe- Controls vision. Temporal (TEM-por-al) lobe- Controls hearing and memory. [nationwidechildrens.org]
Autonomic Seizures Section These seizures are accompanied by autonomic symptoms or signs, such as abdominal discomfort or nausea which may rise into the throat (epigastric rising), stomach pain, the rumbling sounds of gas moving in the intestines (borborygmi [epilepsyontario.org]
[…] at clothes or lip smacking Eyes moving from side to side Abnormal sensations, such as numbness, tingling, crawling sensation (like ants crawling on the skin) Hallucinations, seeing, smelling, or sometimes hearing things that are not there Abdominal pain [medlineplus.gov]
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Unconsciousness
After a brief period of restlessness, there is unconsciousness, generalized muscular activity, excessive salivation, chewing activity, opisthotonos, running movements, and often urination and defecation. [medical-dictionary.thefreedictionary.com]
Or, in some severe cases, it may cause unconsciousness and convulsions, when your body shakes uncontrollably. Seizures usually come on suddenly. How long and severe they are can vary. A seizure can happen to you just once, or over and over. [webmd.com]
If a focal seizure spreads from one hemisphere to the other side of the brain, this will give rise to a focal to bilateral seizure. [5] [6] The person will become unconscious and may well have a tonic clonic seizure. [en.wikipedia.org]
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Asymptomatic
This inflammation only resulted in a partial depletion of vasopressin which was asymptomatic and normal range of urine osmolarity was preserved. [bmcendocrdisord.biomedcentral.com]
Gastrointestinal
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Nausea
A complex seizure can last for a minute or two, and you may feel a warning sign such as a feeling of uneasiness or nausea before the seizure. You may feel sleepy and confused after the seizure. [healthline.com]
The child may also experience sweating, nausea, or become pale. Complex-partial seizures Complex-partieal seizures commonly occur in the temporal lobe of the brain, which is the area of the brain that controls emotion and memory function. [chp.edu]
Seizures arising from the midline region of the temporal lobe can cause sensations of fear, sensations in the tummy, pallor and nausea. [epilepsyqueensland.com.au]
Autonomic Seizures Section These seizures are accompanied by autonomic symptoms or signs, such as abdominal discomfort or nausea which may rise into the throat (epigastric rising), stomach pain, the rumbling sounds of gas moving in the intestines (borborygmi [epilepsyontario.org]
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Flatulence
Section These seizures are accompanied by autonomic symptoms or signs, such as abdominal discomfort or nausea which may rise into the throat (epigastric rising), stomach pain, the rumbling sounds of gas moving in the intestines (borborygmi), belching, flatulence [epilepsyontario.org]
Face, Head & Neck
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Malar Rash
She had erythematous malar rash along with reticulating pattern of rash over her both upper extremities. Parvovirus infection was suspected due to the characteristic erythematous malar rash. [ncbi.nlm.nih.gov]
Neurologic
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Focal Seizure
Metabolic disturbances, including hyperglycemia, mild hyperosmolality, hyponatremia, and lack of ketoacidosis contribute to the development of partial focal seizures. [ncbi.nlm.nih.gov]
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Paresthesia
Symptoms vary with different lesion locations and may include but not limited to the motor (e.g. rhythmic muscle contractions in one area of the body), somatosensory and sensory alterations manifested by abnormal numbness, paresthesias or other hallucinations [fpnotebook.com]
For example, paresthesias, flashing lights or smells may be perceived if the postcentral gyrus, calcarine cortex or uncus regions are involved in the seizure activity. [dartmouth.edu]
Other symptoms include funny feelings in the skin, known as paresthesias, or absence of sensation, called numbness. Dizziness or a sensation of movement can also occur, as can rapid to and fro movements of the eyes, known as nystagmus. [childneurologyfoundation.org]
Auras may consist of motor activity or sensory, autonomic, or psychic sensations (eg, paresthesias, a rising epigastric sensation, abnormal smells, a sensation of fear, a déjà vu or jamais vu sensation). [msdmanuals.com]
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Nystagmus
Dizziness or a sensation of movement can also occur, as can rapid to and fro movements of the eyes, known as nystagmus. [childneurologyfoundation.org]
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Monoplegia
Arbitrary divisions may be made, speaking of range only. (1) Terminal paralysis, as of a hand; (2) monoplegia, as of an arm; (3) hemiplegia; and (4) a range, which is not generally admitted—some degree of slight universal paralysis. [medlink.com]
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Recurrent Headache
headache Pred 15 mg/day, then taper/reescalation and suspend until 1.3 years, improved headache but hypopituitarism Caputo, 2014 [ 27 ] M 40 y, Vietnamese Lacrimal gland mass, diabetes insipidus, panhypopituitarism with mass (Lymphocytic hypophysitis [bmcendocrdisord.biomedcentral.com]
Workup
Routine workup for all patients should include EEG and MRI of the brain; most of the time, the results will be normal. [emedicine.medscape.com]
This requires extensive workup with detailed brain imaging and EEGs. A neurosurgeon will then surgically remove the area of the brain that is causing the seizures. This is called epilepsy surgery. [childneurologyfoundation.org]
EEG
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Focal Delta Activity
Among the 35 patients, tumor was more common when intelligence and results of neurological examination were each normal, a plausible cause for uncontrolled seizures was lacking, and persistent focal delta activity occurred in a majority of electroencephalograms [ncbi.nlm.nih.gov]
Microbiology
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Human Parvovirus B19
Serum human parvovirus B19 DNA polymerase chain reaction was positive which was consistent with acute parvovirus infection. [ncbi.nlm.nih.gov]
Treatment
An additional analysis was performed to determine whether a shift from more severe focal seizure subtypes to less severe occurred upon treatment with lacosamide. [ncbi.nlm.nih.gov]
Treatment For all types of epilepsy, the goal of treatment is to attain seizure freedom. 7 Many options are available to treat partial-onset seizures, either as monotherapy or as an adjunct to another treatment. [uspharmacist.com]
[…] as needed Counselling about the risks of valproate treatment and the need for effective contraception throughout treatment A review of ongoing treatment by a specialist at least annually A risk acknowledgement form that patients and prescribers will [bestpractice.bmj.com]
UCB Pharma SA assumes no responsibility of the views expressed and recommended treatments in these volumes. [epilepsy.com]
Prognosis
Defining the type of epilepsy should now be considered mandatory as it offers the best guide to both management and prognosis. Most epileptic syndromes and diseases are well defined and easy to diagnose. [epilepsy.com]
Prognosis If you have epilepsy and it is not caused by a treatable condition, such as infection, your tendency to have seizures may be life-long and may require long-term treatment with medicines. [drugs.com]
Abstract OBJECTIVE: To document the effect of unprovoked status epilepticus (SE) on the prognosis for otherwise normal children with focal epilepsy. [pediatrics.aappublications.org]
They are primarily characterised by the outward symptoms of the epileptic seizures, but also by the cause, the course of the disease, its prognosis (the probable outcome of the disease) and by the EEG findings (EEG: electroencephalography). [epilepsiemuseum.de]
Etiology
If an infectious or a metabolic etiology is suspected, laboratory tests can also be helpful. [amboss.com]
No differences were found between groups regarding sex, age, age at epilepsy onset, duration of epilepsy, frequency of seizures, and etiology. Temporal lobe epilepsies were significantly more activated than frontal lobe epilepsies. [ncbi.nlm.nih.gov]
Etiology is variable, ranging from genetic, metabolic, or any type of focal structural lesions. Rolandic epilepsy is a common idiopathic syndrome with focal clonic seizures. [medlink.com]
Epidemiology
Thurman DJ, Beghi E, Begley CE, et al; ILAE Commission on Epidemiology. Standards for epidemiologic studies and surveillance of epilepsy. Epilepsia. 2011;52(suppl 7):2-26. 3. Taylor RS, Sander JW, Taylor RJ, Baker GA. [uspharmacist.com]
[…] brain can result in SPS, including the following: Developmental abnormalities Vascular lesions Meningitis/focal encephalitis Trauma Tumors Hypoxic insults Postsurgical changes Metabolic and electrolyte shifts Endocrine disorders Medications and toxins Epidemiology [emedicine.medscape.com]
Descriptive epidemiology of epilepsy: Contributions of population-based studies from Rochester, Minnesota. Mayo Clinic Proceedings, 71(6). 576-586. [epilepsyaustralia.net]
The natural history of epilepsy: An epidemiological view. J Neurol Neurosurg Psychiatry 2004;75:1376-81. 3. Cockerell OC, Johnson AL, Sander JW, Shorvon SD. [neurologyindia.com]
Pathophysiology
As the pathophysiological characteristics of this phenomenon remain unclear, this case implies that the posterior parietal cortex is a possible anatomical localization of the central integrator of visual extra-personal orientation. [ncbi.nlm.nih.gov]
In: Lueders HO, Noachtar S (eds) Epilepsy seizures: pathophysiology and clinical semiology. Churchill Livingstone, Philadelphia, pp 237–242 Google Scholar Ebner A, Kerdar MS (2000) Olfactory and gustatory auras. [link.springer.com]
Elucidating this issue is of paramount importance both for understanding the pathophysiology of focal epilepsies and for the development of new pharmacological strategies for drug-resistant forms of these disorders. [sciencedaily.com]
In this updated article, the author details the historical aspects, classification, clinical manifestations, pathophysiology, EEG, differential diagnosis, and management of patients with focal clonic seizures. [medlink.com]
Pathophysiology Any structural lesion of the brain that causes an electrical variation in the surrounding tissue can provide an adequate substrate for epileptogenesis. [emedicine.medscape.com]
Prevention
Prevention If you have epilepsy, the best way to prevent seizures is to take prescribed seizure medicines without missing doses. You should also get enough sleep each night, don't fast and avoid drinking too much alcohol. [drugs.com]
You can’t always prevent seizures, but you can control them with medications. If you’re on a medication for this purpose, take it as instructed by your doctor and don’t miss doses. [healthline.com]
How Can You Prevent Focal Seizures You can’t really prevent a focal seizure without addressing the root cause. [doctorshealthpress.com]