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Query: UMLS:C0009676 (confusion)
 21,692 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A hypercalcemic condition can be observed in association with hyperthyroidism. The case of a patient suffering from hypercalcemia and hyperthyroidism is reported. A confusional state and EEG alterations, among which diffuse monomorphic delta rhythms were remarkable, are shown. As soon as normalization of calcemia was achieved, a rapid clinical and EEG improvement took place. A hypothetical interpretation is proposed, according to which a prolonged, though inconstant, and mild hypercalcemia in the course of hyperthyroidism could determine an encephalopathy, concealing in some way thyrotoxic symptoms.
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PMID:Hypercalcemic encephalopathy in the course of hyperthyroidism. 397 17

Six patients who had gastric reduction for morbid obesity suffered severe complex neurologic disturbances that included confusion and inappropriate behavior. All were profoundly weak or paraplegic, and recovery was delayed and incomplete. Encephalopathy was documented by EEG and neurologic examination. The cause is uncertain. Acute catabolism of lipid may predispose to damage of the nervous system, but relative vitamin deficiency is a more obvious and treatable explanation.
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PMID:Neurologic complications of gastric partitioning. 401 64

An 8-year-old boy with a short gut had six episodes of metabolic acidosis and neurological dysfunction over a 1 month period. The neurological features consisted of a depressed conscious state, confusion, aggressive behaviour, slurred speech and ataxia. The organic acid profile of urine demonstrated increased amounts of lactic, 3-hydroxypropionic, 3-hydroxyisobutyric, 2-hydroxyisocaproic, phenyllactic, 4-hydroxyphenylacetic and 4-hydroxyphenyllactic acids. Of the lactic acid 99% was D-lactic acid. The anaerobic gut flora consisted almost entirely of Lactobacilli in unusually large numbers. A course of vancomycin prevented further episodes. A urinary organic acid profile may be diagnostic when a person with a short gut develops metabolic acidosis or an unusual encephalopathy and bacterial metabolites should be considered in other patients with unusual combinations of organic acids in the urine.
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PMID:Severe illness caused by the products of bacterial metabolism in a child with a short gut. 401 4

Two patients had clinical findings of encephalopathy that progressed in 4 to 5 months. One patient had headache, fatigue, lethargy, hemiparesis, and a seizure. The second patient had only forgetfulness, confusion, and lethargy without focal signs. Herpes simplex virus was grown from brain biopsy in the first patient and from CSF in the second patient. These cases suggest that herpes simplex virus caused the encephalitis and that it should be considered in the differential diagnosis of chronic encephalopathy.
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PMID:Chronic encephalitis possibly due to herpes simplex virus: two cases. 403 28

To determine whether the presence or absence of left ventricular (LV) intracavitary microbubbles during cardiac surgery predicts neurologic sequelae, 82 patients undergoing cardiac surgery were studied using transesophageal 2-dimensional (2-D) echocardiography. Cross-sectional images were recorded just before and immediately after cardiopulmonary bypass and stop frames were reviewed for the presence of microbubbles, rated as: 0 = absent, 1 = fewer than 5/frame, 2 = 10 to 25/frame, 3 = too numerous to count. Microbubbles were detected after cardiopulmonary bypass in 34 patients (41%) and found more often in valvular or other intracardiac manipulations than in coronary revascularization, 30 of 40 vs 4 of 42, respectively (p less than 0.001). When grade 2 or 3 microbubbles were identified (22 of 34 patients), mechanical attempts to eradicate them were not successful. Postoperative follow-up in all patients revealed no new focal neurologic deficits. Prolonged encephalopathy (confusional state more than 72 hours) occurred in 4 of 48 patients with no detectable microbubbles and in 3 of 34 patients with microbubbles (difference not significant). Thus, intracavitary left ventricular microbubbles are often detected during cardiac operations, particularly during valve replacement, but are not predictive of postoperative neurologic complications. This is true even if microbubbles are densely concentrated; attempts to eradicate microbubbles are unsuccessful and may be unnecessary.
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PMID:Value of intraoperative left ventricular microbubbles detected by transesophageal two-dimensional echocardiography in predicting neurologic outcome after cardiac operations. 406

Four patients who had undergone abdominoperineal resection for carcinoma of the colon and who had been taking oral bismuth subgallate developed a stereotyped recurrent and reversible neurological syndrome. This was characterized by confusion, tremulousness, clumsiness, myoclonic jerks, and an inability to walk. All patients were extensively investigated and no cause could be found, but symptoms regressed when the intake of bismuth was stopped. Postmortem examination in one patient failed to show any appreciable abnormality apart from a loss of Purkinje cells in the cerebellum. In the other three patients amino-acid chromatography performed on urine showed the presence of an abnormal unidentified constituent. It is thought that these four patients developed an encephalopathy associated with their bismuth subgallate ingestion.
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PMID:Reversible encephalopathy possibly associated with bismuth subgallate ingestion. 481 63

The neurologic manifestations of Legionnaires' disease were reviewed in this paper. Nine (42.9%) of 21 patients seen at this institution had neurologic abnormalities during acute infection, comparable to 52% of patients found in the literature. Abnormal mentation was most common, occurring in all our patients and in 29.6% of patients in the literature. Encephalopathy disproportionate to metabolic disturbances varied from mild confusion to coma, was not associated with increased mortality, and tended to resolve with acute illness although some patients reported persistent memory defects. Rarely did these changes in mentation precede the development of pulmonary infiltrates. Headache occurred in two (22.2%) of our patients and in 28.7% of those in the literature. Headache, noted in many febrile illnesses, is common but nonspecific in Legionnaires' disease. Other neurologic abnormalities including cerebellar dysfunction and focal deficits were relatively infrequent and tended to persist beyond resolution of clinical infection. In some cases these neurologic derangements may have occurred coincidentally with Legionnaires' disease. Diagnostic evaluations and autopsies were frequently normal, nonspecific, or revealing of pathology unrelated to infection. Only two patients had evidence of direct invasion of the central nervous system by Legionella, and the cause of encephalopathy and neurologic abnormalities in most cases remains unclear. Patients with neurologic abnormalities and Legionnaires' disease deserve full evaluation to exclude other entities. Only encephalopathy appears to be a characteristic manifestation of Legionnaires' disease.
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PMID:Neurologic manifestations of Legionnaires' disease. 608 42

Twelve cases of confusional state after normal or excessive doses of clioquinol are discussed. They resemble transient global amnesia (TGA) of the classic type, but the episodes last longer (1-3 days), they are often accompanied by a variety of mental disturbances, and the onset and end are less well defined than in the classic type. A combination of SMON and acute encephalopathy due to clioquinol was observed in only one case. Apart from amnesia for the acute episode a permanent retrograde amnesia for a few days up to two months was left behind. The pathophysiology of these episodes is not clear, but they resemble the toxic reactions to clioquinol observed in dogs and experimental animals.
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PMID:Transient global amnesia due to clioquinol. 623 45

Onset of confusion with myoclonus occurred in a 55-year-old patient hospitalized for infectious endocarditis and under intravenous dopamine. The speculative responsibility of dopamine in the occurrence of this myoclonic encephalopathy is discussed. Indeed, although dopamine does not cross the blood-brain barrier, inflammation of the wall of the cerebral vessels (immunologic vasculitis) may have enabled dopamine to reach the central nervous system.
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PMID:[Myoclonal encephalopathy due to dopamine]. 629 75

In a comparative randomized double-blind study, 73 patients underwent myelography using iopamidol (36 patients) or metrizamide (37 patients) as contrast medium. The overall diagnostic adequacy of iopamidol myelography was found to be comparable to that of metrizamide myelography. The incidence of examinations graded as superior (64%) or adequate (36%) with iopamidol was equivalent to that with metrizamide (57% superior, 43% adequate). Adverse reactions after iopamidol myelography were fewer, less severe, and generally of shorter duration than those associated with metrizamide. In the iopamidol group, adverse reactions occurred in nine (25%) patients, all of whom experienced mild or moderate headache, one with nausea, vomiting, and fatigue. In the metrizamide group, adverse reactions occurred in 17 (46%) patients, all of whom experienced mild or moderate headache, six with nausea and vomiting and four with back and leg pain. Of nine individuals who underwent myelography using 300 mg 1/ml metrizamide injected via lateral C1-C2 puncture, three experienced a toxic encephalopathy with confusion, dysphasia, headache, nausea, and vomiting, and a fourth individual suffered severe nausea, vomiting, fever, and irregular pulse. Encephalopathy was not observed in any of the 11 patients in whom myelography was performed via lateral C1-C2 puncture with a similar concentration of iopamidol. No seizures were encountered, and no clinically significant changes in laboratory studies were observed with either contrast medium.
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PMID:Iopamidol and metrizamide for myelography: prospective double-blind clinical trial. 638 81


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