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8 results

  • Chapter 14 - Disorders of the Central Nervous System in Pregnancy

  • Edited by David R. Gambling, University of California, San Diego, M. Joanne Douglas, University of British Columbia, Vancouver, Grace Lim, University of Pittsburgh
  • Book:
    Obstetric Anesthesia and Uncommon Disorders
    Published online:
    26 January 2024
    Print publication:
    01 February 2024, pp 206-230

  • Summary

    Disorders of the central nervous system (CNS) in pregnancy continue to be a common reason for morbidity and mortality in mothers. Common CNS diseases during pregnancy and their anesthetic management are described in our chapter. Some disorders of central nervous system preexist pregnancy, like epilepsy, Parkinson disease, multiple sclerosis, intracranial lesions, benign intracranial hypertension, or migraine. Others may have an increased incidence in pregnancy, for example cerebrovascular disorders, including hemorrhagic or ischemic strokes. Experience in treating these CNS diseases is limited, thus management is largely based on isolated case reports, case series, and some review articles. A high suspicion for uncommon CNS conditions is vital since timely and intense treatment significantly affects the outcome. Important aspects of consideration for the care of the parturient with a CNS disorder are the pathophysiology of the lesion, effects of pregnancy on the lesion, and effects of lesion on pregnancy. Other important considerations in management are the effect of medical management, monitoring, and surgery on fetus, maternal versus fetal priority regarding surgical plan, timing, and route of delivery. Most importantly communication and coordination among the patient, her family, and the medical team (neurologist, neurosurgeon, obstetrician, anesthesiologist, medical consultants, and nursing staff) is paramount in the optimal management of mother and fetus.

  • Metaphors in the description of seizure experiences: Common expressions and differential diagnosis

  • Leendert Plug, Basil Sharrack, Markus Reuber
  • Journal:
    Language and Cognition / Volume 3 / Issue 2 / June 2011
    Published online by Cambridge University Press:
    11 March 2014, pp. 209-233

  • This paper explores the use of metaphorical expressions in the description of seizure experiences by patients with epilepsy and patients with psychogenic non-epileptic seizures. The paper addresses two main questions. First, what is the range of metaphorical expressions which patients use to describe their seizure experiences, and can these be related to conventional metaphors used by healthy individuals? Second, is the difference in the underlying cause of our patients' seizure experiences in any way reflected in their use of metaphorical expressions? The paper suggests that the answer to both of these questions is affirmative, which strengthens the embodiment hypothesis. Implications for our understanding of patients' experiences of seizures and of the difference between epileptic and non-epileptic seizures are also discussed.

  • Chapter 7 - Peri-ictal psychiatric phenomena

  • Edited by Michael R. Trimble, Institute of Neurology, London, Bettina Schmitz
  • Book:
    The Neuropsychiatry of Epilepsy
    Published online:
    07 October 2011
    Print publication:
    09 June 2011, pp 57-66

  • Summary

    This introduction presents an overview of the concepts discussed in this book The Neuropsychiatry of Epilepsy. In the intervening years, there has been a clear appreciation in biological psychiatry of the neurobiological bases of psychopathologies as major depressive disorder, obsessive-compulsive disorder and other anxiety-related conditions, and there has been further development of psychotropic and anticonvulsant drugs (AEDs). The second edition starts with epidemiology, which has become a prominent discipline in research attempting to disentangle the extent and variety of psychiatric comorbidities in epilepsy. The clinical presentations and the wide spectrum of peri-ictal disorders are then discussed. Depression in epilepsy may not be quite like depression in the absence of epilepsy, the neuroanatomy giving a special stamp on the phenomenology. The book concludes with a discussion on the brain mechanisms of consciousness as may be revealed through investigations of patients with seizure disorders.

  • Chapter 16 - Postmenopausal bleeding and endometrial cancer

  • from Section 3 - Genitourinary concerns
  • Edited by Jo Ann Rosenfeld, The Johns Hopkins University School of Medicine
  • Book:
    Handbook of Women's Health
    Published online:
    26 December 2009
    Print publication:
    22 October 2009, pp 181-186

  • Summary

    Incorporating preconception care into primary care of young women enhances the preventive aspects of care and may improve pregnancy outcomes. The preconception approach to medical care includes optimization of chronic health problems and risks that may impact negatively on pregnancy. Specific preconception issues regarding common chronic disorders are addressed along with antepartum medical care in this chapter. Preconception care of type I diabetic women results in earlier prenatal care, lower glycosylated hemoglobin levels, fewer antepartum hospitalizations and fewer hospital days, and decreased intensity and length of stay for newborns. Perinatal consultation may be helpful as a preconception event in a number of high risk medical conditions and in women with an unexplained history of poor reproductive outcomes. A growing list of metabolic problems and hematological disorders are associated with preeclampsia, growth retardation, abruption, and other complications in late pregnancy.

  • Global/local scoring modifications for the Rey-Osterrieth Complex Figure: Relation to unilateral temporal lobe epilepsy patients

  • REGINA MCCONLEY, ROY MARTIN, JAMES BAÑOS, PAUL BLANTON, EDWARD FAUGHT
  • Journal:
    Journal of the International Neuropsychological Society / Volume 12 / Issue 3 / May 2006
    Published online by Cambridge University Press:
    17 May 2006, pp. 383-390

  • Observation of figural reproductions of right temporal lobe epilepsy (RTLE) patients have revealed overall configuration errors, whereas in left temporal lobe epilepsy (LTLE) patients, the global aspect of performance is generally preserved. This study compared performance of individuals with temporal lobe epilepsy (LTLE, n = 83; RTLE, n = 63) on a global/local modification of the Rey-Osterrieth Complex Figure Test (RCFT). In Phase I, neuropsychologists (n = 6) and neuropsychology fellows (n = 3) completed a survey identifying the global and local aspects of the RCFT. Questionnaire responses were used to categorize a list of global and local items (five global, five local) for re-scoring the protocols of TLE patients during study Phase II. Results showed that the RTLE and LTLE groups were not differentiated according to the global or local indices F(1,141) = .385; p = not significant. There were lower local scores for both groups in the copy F(1,142) = 5.23; p = .024, immediate F(1,142) = 445.26; p < .001, and delay trials F(1,142) = 427.82; p < .001, indicating less retention of local information over time. Results suggest general declines in figural memory for local stimulus properties in both unilateral TLE groups. However, this relationship was weakened after controlling for global and local item verbalizability. (JINS, 2006, 12, 383–390.)

  • 8 - Epilepsy in children and adolescents

  • from Part II - Epilepsy diagnosis and treatment
    • By Patricia Crumrine, Department of Neurology, Children's Hospital of Pittsburgh, 3705 5th Avenue at DeSoto Street, Pittsburgh, PA 15213, USA
  • Edited by Martha J. Morrell, Columbia University, New York, Kerry L. Flynn, Columbia-Presbyterian Cancer Center, New York
  • Book:
    Women with Epilepsy
    Published online:
    02 November 2009
    Print publication:
    20 March 2003, pp 77-88

  • Summary

    This chapter deals with epilepsy in girls and young women, and reviews the common epilepsy syndromes, treatment challenges, and educational and social concerns. Some seizure disorders can be grouped together as an epilepsy syndrome. The epileptic syndromes that present in adolescence are juvenile absence epilepsy, juvenile myoclonic epilepsy (JME), and generalized tonic-clonic seizures on awakening. Decisions about treating seizures in children and adolescents involve considerations of when to treat, how long to treat, selection of the best medications to use, supplementation with vitamins, and compliance with the treatment plan. Knowledge of possible drug interactions is important, for the physician, the caretakers, and the girl with epilepsy. Some antiepileptic drugs (AEDs), for example phenytoin, alter the concentration of vitamin D in the body. Children and adolescents who have normal cognitive development include those with febrile seizures, childhood absence epilepsy, benign focal epilepsy (rolandic epilepsy) and JME.

  • 2 - On being a woman with epilepsy

  • from Part I - The woman with epilepsy
  • Edited by Martha J. Morrell, Columbia University, New York, Kerry L. Flynn, Columbia-Presbyterian Cancer Center, New York
  • Book:
    Women with Epilepsy
    Published online:
    02 November 2009
    Print publication:
    20 March 2003, pp 7-16

  • Summary

    In this chapter, the author shares her personal experience and perspective on what it has been like to live with epilepsy. The author explains how she navigated the medical system, the questions she asked and how she become an effective self-advocate. Women who are coping with seizure disorders are making decisions and living their lives without adequate information, sometimes with false information and, all too often, with fear. Everyone who takes medication for epilepsy has concerns about possible side effects. Besides the visible side effects of various antiepileptic drugs (AEDs), there are two areas in which women may have epilepsy-related fears. The first is child-bearing and raising. The second area of concern is that of physical safety, especially the risk of sexual assault during, or just after, a seizure. In the author's view, taking responsibility for one's own well-being is essential to living well as a woman with epilepsy.

  • 27 - Work issues and epilepsy

  • from Part VI - Living well with epilepsy
    • By Jim Troxell, Epilepsy Foundation, 4351 Garden City Drive, Landover, MD 20785, USA
  • Edited by Martha J. Morrell, Columbia University, New York, Kerry L. Flynn, Columbia-Presbyterian Cancer Center, New York
  • Book:
    Women with Epilepsy
    Published online:
    02 November 2009
    Print publication:
    20 March 2003, pp 281-286

  • Summary

    Unique issues for women in the workforce include the need for more high-quality day care, more flexibility with leave time policies from employers, and more job training for women entering employment. Women with epilepsy who are working must confront the realities and dynamics of this contemporary environment while also living with the realities and dynamics of their condition. Before exploring specific facets of employment, this chapter examines factors common to the experience of epilepsy that make the disorder uniquely challenging. Many women with seizure disorders are successfully employed. Having epilepsy does not prevent women from having successful jobs and careers. It is important, however, that careful decisions are made, that support is sought when it would be beneficial, and that qualifications and experience are promoted as the most important factors in a successful job search.