The aim of this study was the assessment of detection rate on MRI and description of MRI findings in patients with medically intractable epilepsy. Seventy-three patients with medically intractable epilepsy between the ages of 0 and 68 years old were evaluated by MRI, on three planes with spin-echo T1, fast spin-echo T2, and fluid-attenuated inversion recovery sequences, and, if necessary, with contrast-enhanced SE T1 sequences. Cerebral infarct regions with atrophy and gliosis in 8 patients, cerebral tumors in 5 patients, hippocampal sclerosis in 16 patients, radial microbrain in 1 patient, cortical dysplasia in 3 patients, pachygyria in 2 patients, subcortical heterotopia in 2 patients, schizencephaly in 3 patients, cerebral hemiatrophy in 2 patients, tuberous sclerosis in 1 patient, herpes encephalitis in 2 patients, Rasmussen's encephalitis in 1 patient, vascular malformations in 5 patients, and no abnormality in 22 patients were detected. Magnetic resonance imaging has a high success rate in detecting structural brain abnormalities, of both temporal and extratemporal locations, associated with medically intractable epilepsy syndromes. So MRI plays a primary role in planning of the treatment, primarily surgical therapy, by detecting structural epileptogenic lesions.
The prevalence of headache and the prevalence of migraine, which are considered to be pathogenetically linked to epilepsy, were not different in epilepsy patients as compared to that of the general population. Different outcomes and percentages in other studies suggest that pathogenesis of headache is multifactorial and that different diagnostic criteria might have been taken into consideration.
We report an uncommon case of 53-year-old female patient with partial seizure induced by forced voluntary eye closure due to non-ketotic hyperglycemia. The initial laboratory tests showed an elevated blood glucose level of 550 mg/dL but no evidence of ketosis. Brain magnetic resonance imaging was normal. When the blood glucose levels decreased slowly to about 150 mg/dL in five days, the seizures ended completely. No anticonvulsants were used. Since seizures are generally refractory to antiepileptic medication, control of blood glucose is essential.
Introduction: Paroxysmal atrial fibrillation (PAF) has a similar risk with persistent AF for ischemic stroke. Holter monitorization (HM) and other long-term monitorization methods increased the detection of PAF and short-lasting runs of tachyarrhythmias. Their classification as PAF and roles in the etiology of ischemic stroke is controversial. In this study, we aimed to investigate the frequency of any duration of PAF and clinical characteristics of the patients with acute ischemic stroke who have undergone 24-hrs HM.Methods: Patients with acute ischemic stroke and transient ischemic attack (TIA) hospitalized in the Neurology ward and undergone 24-hrs of HM during their hospital stay were included in the study. HM reports, clinical, and laboratory characteristics were analyzed, retrospectively. Patients were grouped into three based on HM: 1st group, without PAF; 2nd group, PAF >30 seconds (s) and 3rd group, PAF<30s.Results: PAF of any duration was detected in 18.8% (n=49) of 261 patients. The duration of PAF was <30s in 16.1% (n=42) and >30s in 2.7% (n=7) of the patients. The mean age, left atrium diameter and CHA2DS2-VASc scores of the second group were significantly higher than the first group (p<0.001, p<0.001 and p=0.007; respectively). The mean age, left atrium diameter, modified Rankin Scores (mRS), and CHA2DS2-VASc scores of the third group were significantly higher than the first group (p<0.001; for all). There was no difference between the second and the third groups in means of mean age, left atrial diameter, MRS, and CHA2DS2-VASc scores (p<0.017, for all).
Conclusion:In this study, 24-hrs HM in the early period of acute ischemic stroke results yielded a high frequency of PAF<30s and predictive features were in parallel with the literature.
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