Masked Epilepsy Research Articles

Interdisciplinary issue: Multiple aura continua coexisting with the antiphospholipid activity of homeostasis and the possibility of therapy with Levetiracetam and Sulodexide

The antiphospholipid activity of hemostasis (APLAH) favours pathological blood clot organisation, endothelial dysfunction and bioenergetic hypoxia. The prevalence of epilepsies in patients with antiphospholipid syndrome (APS) is 8,6 % for adults. Hypoxia coexisting with antiphospholipid syndrome leads to the development of status epilepticus (SE) in 10–12 % of cases. The temporal form of focal epilepsy is the most common form, and it is characterised by significant polymorphism of clinical manifestations. Also, the variants of masked epilepsy (ME) occur in the form of aura continua (AC) — the status or auras without alteration of consciousness. 6 women aged between 40 and 68 years with prolonged somatosensorial aura had functional hyposplenism and lactic acidosis of blood. 2 of them also had hyperproduction of antiphospholipid antibodies. Based on the research results, it was found that Levetiracetam (Keppra) is the preferable medication among antiepileptic drugs (AED) in cases of temporal epilepsy (TE) resistant to therapy. At the same time, Sulodexide (Vessel Due F) proved to be an effective drug due to dominant microvasculature damage in patients with antiphospholipid syndrome. It has an antiplatelet effect, normalises the state of the endothelial tissue, has a profibrinolytic and antiatherogenic effect.

On Morel's 'épilepsie larvée: the first Danish epileptologist Frederik Hallager's opposition in 1884 against Morel's psychical epileptic equivalents.

In 1860 B. A. Morel published some cases of masked epilepsy, i.e., paroxysmal behaviour disturbances or "epileptic equivalents". The majority behaved criminally. Hughlings Jackson opposed and Hallager showed that all the cases related later as épilepsie larvée could be explained as postepileptic attacks, general paralysis, paradoxical normalization, schizophrenia, mania and otherwise. True criminal behaviour was exceptional. The present author agreed. There is no need for épilepsie larvée. It is discussed whether Blumer's recent "Paroxystic neurobehaviour disorder" will revive "Morel's disorder".

Epilepsy and insanity during the early 19th century. A conceptual history.

During the first half of the 19th century, epilepsy and the insanities were considered as closely related "neurotic" disorders. Under the influence of factors such as the decline of the 18th-century Cullean concept of neurosis, the development of the new descriptive psychopathology, the introduction of statistics, and the availability of longitudinal observations of hospitalized cohorts, epilepsy was redefined as a "neurological" disease by the 1850s. The reaction of psychiatry to the exclusion of the mental disorder as a defining feature of epilepsy manifested itself in the creation of the "masked epilepsy" concept. This notion is behind the later development of categories such as "borderland" and "equivalent," which are still of some relevance to 20th-century views of epilepsy.

Masked epilepsy

masked epilepsy

Clinico-electroencephalographical study of maladjusted children in wide sense, especially about the significance of abnormal EEG in behavior-problem children.

Summary An electrcencephalographic study was made on 614 maladjusted children in a wider sense including 44 B.P.C. in narrower sense in comparism with 271 normal children of at random selection as the control group. As the activation methods, hyperventilation for 3 minutes was applied in all cases, but other methods like sleep activation, photic stimulation and Cardiazol Metrazol) activation were also used for convenience'ls sake in majority of the cases. The results obtained may be summarized as follows: 1 Of EEG on B.P.C. in a narrow sense, 21% fell within the normal limit, 29% showed borderline EEG and 50% abnormal EEG. Our statistics made in 1955 and in 1956 gave the same result respectively, comparison with the previous two series delivering almost the same result. 2 These statistical values stand between the value found in the normal group and in the epileptic and organic brain-damage groups, as a whole much nearing to values of oligophrenics. However, in analysing the quality of the abnormal waves, the B.P.C. group in a narrower sense returned epileptic discharges more frequently than the oligophrenics (20%), coming up to nearly the same level of our previous summary (21%). The author also took note of paroxysmal and non-paroxysmal slow waves (with appearance rate of 24%) which were little accounted for in this line of investigations hitherto. The meaning of generalized permanent dysrhythmia with a rate at 40% was also emphasized in this study. 3 The findings described above were obtained often by suitable activation, and the necessity for activation was keenly felt in such a study because it was difficult to find abnormal waves in sheerly resting EEG record. 4 Of the epileptic discharges presented in the present statistics, 9% were supposed as due to latent or masked epilepsy, and most of the present cases should duly be regarded as predisposed to epilepsy, answering to our previous assertion. The author may think that these children having such abnormal discharges should preferably be treated with antiepileptic therapy. 5 It was thought that most of the B.P.C. having paroxysmal slow wave and dysrhythmia seem to suffer from a maturation defect or a retarded development of the brain, though there is a suspicion not to be excluded that a part of them may have origin in an organic or a functional disturbance of the brain. These children should duly be put under social care and be educated as ‘maladjusted’ under sway of distorted dispositions. 6 In the B. P. C. group in a narrower sense, the children who returned normal EEG were slightly more (21%) than in the other groups. Special education and guidance from the side of clinical psychology and sociology will be very desirable for such children, lesser suitable the medical treatment. 7 Generally speaking, it is easier to treat medically the children with epilepsy and oligophrenics than B.P.C. in a narrower sense, not denying at the same time that there are many delinquency and behavior problems still untouched among epileptics and oligophrenics. B.P.C., however, does exhibit a far more complicated constructive factors and a peculiar pattern in EEG. Behavior problems in the maladjusted children in a wide sense including B.P.C. in narrower sense were chiefly considered and discussed in this paper. This problem, however, must be solved not only from the medical point of view but in a close connection with a wider field of measures, such as special education, social correction and social welfare. In connection, the author wants to emphasize that clinical electroencephalography offers useful ways and means to elucidate the directories for the guidance under such synthetically working system.

Convulsive equivalent states.

Introduction The number of terms applied to this disorder is exceeded only by the numerous and widespread symptoms and signs that the illness may manifest. In the medical literature, the condition has been described under the following titles: abdominal epilepsy, 2 paroxysmal abdominal pain, 3,4 hypothalamic and thalamic epilepsy, 5 masked epilepsy, 6 the periodic syndrome, 7 visceral epilepsy, 11 diencephalic autonomic epilepsy, 8 and diencephalic autonomic discharge. 9 The term convulsive equivalent state 1 signifies a paroxysmal cerebral dysrhythmia manifested clinically by symptoms in various organ systems. Convulsive movements and loss of consciousness need not be present. 1 Of interest to internists are such symptoms as paroxysmal abdominal pain, hypertension, nausea, vomiting, fever, borborygmi and belching, flushing, blanching, cyanosis, urinary incontinence, syncope, and migraine headaches. 1,3-5,7,10-19 The paroxysmal nature of the symptoms is the clue to this diagnosis and should lead to a request for an electroencephalogram. Among several patterns that may be noted, the occurrence of 14- and

Masked Epilepsy

Back to table of contents Previous article Next article ArticleNo AccessMasked EpilepsyELIZABETH G. FRENCHELIZABETH G. FRENCHSearch for more papers by this authorPublished Online:1 Apr 2006https://doi.org/10.1176/ajp.114.8.765AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail "Masked Epilepsy." American Journal of Psychiatry, 114(8), p. 765 Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - American Journal of Psychiatry $35.00 Add to cart PPV Articles - American Journal of Psychiatry Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited byNone Volume 114Issue 8 February 1958Pages 765-765 Metrics PDF download History Published online 1 April 2006 Published in print 1 February 1958

Denial mechanisms in masked epilepsy.

Denial mechanisms in masked epilepsy.

Book Review: Masked Epilepsy

Book Review: Masked Epilepsy

Electroencephalography in Children with Recurrent Abdominal pain

There has been a recent revival of interest in the possibility that some attacks of sudden abdominal pain in children may be examples of "masked epilepsy" (see Pediatrics, 15:705, 1955). The diagnosis of abdominal epilepsy has been based on such criteria as attacks of abdominal pain followed by exhaustion and sleep; a favorable clinical response to treatment with anticonvulsants; and electroencephalographic records considered characteristic of epilepsy. The present report comments upon the small number of reported cases and the lack of normal controls. As part of an investigation into the cause of recurrent abdominal pains in children, the authors studied the findings in electroencephalograms. The proportion of electroencephalograms considered typical of epilepsy in a group of 133 children with recurrent abdominal pains, but without demonstrable organic diseases, and in 133 children of corresponding ages without abdominal pains, was almost identical. The authors' findings do not support the view that there is a relationship between epilepsy and recurrent abdominal pains in childhood. They suggest that the supposed causal relationship between abdominal pains and cerebral dysrhythmia may have been based on a failure to compare electroencephalograms of children having those manifestations with electroencephalograms of apparently normal children. The authors realize that a small number of children with epilepsy also have recurrent abdominal pains, but feel that abdominal pain as a sole manifestation of epilepsy must be rare. These considerations may also apply to the point of view expressed by some, that cyclic vomiting is a form of "masked epilepsy."

MASKED EPILEPSY

MASKED EPILEPSY

Masked Epilepsy [L'Epilepsie larvée]. (Prog. Méd., No. 50, No. 52, 1900, and No. 1, 1901.) Delteil, A

Dr. Ardin Delteil defines masked epilepsy as a form of epilepsy which in its various manifestations exhibits certain characteristics foreign to ordinary epilepsy, and assumes the appearance of various other clinical conditions. Those forms are called epileptic equivalents, and may be of two kinds, physical and psychical. The physical equivalents include—(1) Motor equivalents, different from convulsions; (2) Sensory equivalents, vaso-motor and visceral; (3) Sensorial equivalents (sight, hearing, smell, taste, etc.)