Surgical management of complex partial seizures

Article Abstract:

A case study of a 23-year-old white female with a history of uncontrollable complex partial epileptic seizures is discussed. The girl's medical history was completely normal until age 18 months when she received a smallpox vaccine. She experienced two febrile seizures (associated with fever), the second one resulting in temporary paralysis on her right side. She was treated with an anticonvulsant drug (phenobarbital) and had no more symptoms until 6 years of age when she developed complex partial seizures, which did not respond to medication. Complex partial seizures (also known as temporal lobe or psychomotor epilepsy) are accompanied by a loss of consciousness during the seizure, and they originate in one focus of the brain. This patient was having six to eight of seizures per month at the time of her evaluation. The results of various imaging procedures localized the seizure focus to her left hemisphere. Surgeons applied a subdural (under the dura covering the brain) grid, which enabled them to precisely locate the epileptic focus, as well as the areas controlling speech and movement. The epileptic focus was found to be in the left anterior temporal lobe, and was clearly separate from the speech and motor areas. Because of these findings, the patient was an excellent surgical candidate, and she underwent a left partial temporal lobectomy with no complications. She was discharged and has had only occasional partial simple seizures (auras) since that time (15 months), while being maintained on minimal doses of anticonvulsant drugs. If possible, this medication will be discontinued in two years. A discussion on the importance of various diagnostic questions pertaining to this case, and epilepsy in general, is included. According to the literature, anterior temporal lobectomies have a 50 percent complete success rate, and a 25 percent improvement rate. With the new technology available today, it is estimated that the response rate will improve to approximately 90 percent. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Complications and side effects, Surgery, Brain, Temporal lobe epilepsy, Brain surgery

---

A pregnant surgical resident? Oh my!

Article Abstract:

Although close to 40 percent of medical school applicants and graduates are women, until recently few women chose to enter the field of surgery. In 1982, there were 875 women surgical residents; in 1990 this number quadrupled to 3,709. Since the average age of medical school graduates is 28 years, and residency programs last from between 4 and 9 years, a significant portion of a woman surgical resident's childbearing years pass while she is in training. Residents commonly spend over 100 hours per week in the hospital, and must endure long periods with no sleep; increased risk of disease transmission from blood contact and needlesticks is prevalent. In the face of this adversity, recently reported data indicating that pregnancy in female surgical residents is as likely to result in successful childbirth as pregnancy in a similar group of nonresidents (spouses or companions of male residents). On the other hand, the rate of induced abortions was significantly higher among residents (many of whom were unmarried) than nonresidents, perhaps reflecting the bleak future foreseen by many of the pregnant residents. Indeed, scarcity of affordable day care, lack of overnight services to care for their children, feelings of guilt and exclusion from the child's development may all contribute to the environment that led 24 percent of the respondents to a recent questionnaire to rate pregnancy during residency as ''miserable'', while another 52 percent rated it only ''tolerable''. Encouraging trends appear to be making significant inroads in this undesirable state of affairs; residency program directors and co-residents are making good-faith efforts to minimize stress on pregnant residents, and to allow them to rearrange their rotation schedules and sick leave or vacation so as to best manage pregnancy, childbirth, childrearing, and their medical careers. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Employment, Pregnant women, Career development, Residents (Medicine), editorial

---

Similar abstracts:

• Abstracts: The diagnosis and management of aortic dissection. Ethical values at stake in health care reform
• Abstracts: Antichlamydial activity of vaginal secretion. Violence and gynecologic health in women <50 years old. The G-spot: a modern gynecologic myth
• Abstracts: Development of type 1 diabetes despite severe hereditary B-cell deficiency. Hereditary periodic fever
• Abstracts: Farm center plants seeds for safety. Microwave safety
• Abstracts: Cost-effectiveness of detecting and treating diabetic retinopathy. Diabetic retinopathy

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.