Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0009676 (confusion)
 21,692 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Transnasal administration of systemic medication offers a convenient alternative to intravenous and intramuscular routes. Butorphanol, a noncontrolled, synthetic opioid agonist-antagonist analgesic is available in a nasal spray formulation. Transnasal butorphanol appears to be a safe and effective alternative for the treatment of moderate to severe postoperative and migraine headache pain. Side effects include sedation, nausea and confusion; transnasal butorphanol also has the potential to induce abstinence syndromes in opioid-dependent patients.
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PMID:Transnasal butorphanol. 794 13

Five patients: three children, one adolescent, and one young adult, examined in an emergency room setting were diagnosed with post-traumatic transient cortical blindness. This syndrome is characterized by transient visual loss, normal pupillary response and normal funduscopic examination following minor head trauma. In each case, vision returned to normal within minutes to hours following injury, leaving no neurological sequelae. Headache, confusion, irritability, anxiety, nausea and vomiting were the most common related symptoms. While the mechanism responsible for the transient blindness is unknown, most authors propose an abnormal vascular response to trauma with resultant transient hypoxia and cerebral dysfunction. The similarity between the symptoms accompanying this syndrome and those seen during a classic migraine attack has led many investigators to suggest a common underlying pathophysiology. The purpose of this report is to highlight the salient clinical features and diagnostic approaches to this syndrome, thereby providing ophthalmologists and emergency room physicians a heightened awareness of this entity and the means to detect it.
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PMID:Post-traumatic transient cortical blindness. 813 7

A case of an 8-year-old boy with recurrent migraine auras without headache, precipitated by minor head trauma, is reported. Aura was characterized, besides other brain-stem signs, by confusional state. An uncommon electroencephalographic pattern recorded during the episodes, characterized by diffuse continuous beta activity, is described. Recognition of this finding may prevent an inappropriate diagnosis of drugs ingestion.
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PMID:Uncommon EEG pattern in an 8-year-old boy with recurrent migraine aura without headache. 826 99

Three children with pronounced livedo reticularis present since birth (cutis marmorata-telangiectasia congenita) have been followed to the ages of eight, 17 and 21 years. During childhood they developed frequent recurrent transient stroke-like hemipareses, affecting either side of the body, associated with ipsilateral pain, headache, visual symptoms, dysphasia, fits and confusion. Intellectual failure and, in one, progressive spasticity have followed. Attacks were more frequent in winter. Other problems have included abnormal peripheral vascular responses to temperature change, gastro-intestinal bleeding, glaucoma, local tissue hypertrophy and, in the two older patients, renal involvement with hypertension. Their condition represents a form of congenital vasculopathy. Anticonvulsants, anti-migraine agents, anti-platelet drugs and flunarizine have been ineffective. Nifedipine prevented further attacks in one patient and reduced attacks in another, but has not helped the third child. Adequate clothing and warmth may also be important.
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PMID:Congenital livedo reticularis and recurrent stroke-like episodes. 840 21

Migraine in children can present as a state of confusion or agitation with or without a history of migraine. These events can arise spontaneously or can be triggered by mild head trauma. Transient blindness and hemiplegia may accompany the confusional state. We present two cases of children with histories of confusion and agitation, one with multiple episodes after mild head trauma. The symptomatology, differential diagnosis, theories on pathogenesis, and natural history of confusional migraine are discussed.
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PMID:Acute confusional migraine and trauma-triggered migraine. 863 2

A case of an 11-year-old boy with recurrent migraine auras without headache is reported. Aura was preceded by an anisocoria and was characterized, besides other brain-stem signs, by confusional state. Ictal EEG recordings showed fast activity. Recognition of this finding may prevent an inappropriate diagnosis of drug ingestion. However, whether non-reactive beta activity is typical for basilar migraine remains to be determined.
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PMID:Migraine aura without headache and ictal fast EEG activity in an 11-year-old boy. 877 28

An open prospective study was undertaken to assess the efficacy and safety of subcutaneous sumatriptan in 50 consecutive children ages 6 to 18 years with severe migraine. There were 28 females and 22 males. The dose of sumatriptan was 0.06 mg/kg. Parameters included overall efficacy, time to relief, recurrence rate, adverse events, and objective global rating. Overall efficacy, defined by headache reduction from severe or moderate to mild or none, was 78%. Twenty-six percent responded within 30 minutes, 46% responded in 60 minutes, and 6% responded between 1 to 2 hours. Twenty-two percent had no response or a suboptimal response. Recurrence rate was only 6%. There was a difference in efficacy between male and female, as 91% of the males responded, while only 68% of the females responded. The males had more migraine alone while the females had migraine often with a coexistent tension-type headache. Eighty percent of all the patients had some adverse event which was usually mild and transient; however, one patient developed a transitory confusional state which resolved in 2 hours. Eighty-four percent reported a global rating of good to excellent, while 16% rated the treatment only fair to poor. These findings suggest that subcutaneous sumatriptan can be both effective and safe in childhood migraine, especially in dealing with migraine alone.
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PMID:Subcutaneous sumatriptan in the clinical setting: the first 50 consecutive patients with acute migraine in a pediatric neurology office practice. 878 73

The aim of this retrospective study was to analyze data obtained from cases with acute confusional migraine and compare them with those of other series. Data were abstracted from files of 76 patients with a discharge diagnosis of migraine admitted to British Columbia Children's Hospital, Vancouver, Canada, between January 1982 and September 1990. Of the 76 patients, 13 manifested confusional migraine (ratio of males to females was 11:2). The age ranged between 6 and 15 years (mean age 10.8 years). All patients reported headache and confusion. The duration of confusion was 2-24 hours. Other findings included a positive history of mild head trauma (4 patients), agitation (8 patients), past history of headache (7 patients), family history of migraine on the maternal side (10 patients), and history of migraine on both sides of the family (1 patient). CT scans were performed on 11 patients; 10 were reported to be normal, and 1 patient presented an arachnoid cyst. EEGs performed on 4 patients disclosed mild abnormality in 2. Cerebrospinal fluid, studied in 2 patients, was normal. Management of a child with confusional migraine must take into consideration underlying causes, such as seizures, encephalitis, and substance abuse.
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PMID:Confusional migraine in childhood. 885 96

Migraine is conventionally regarded as a specific type of headache with a small set of associated neurologic symptoms. Yet, the true scope and frequency of migrainous phenomena are much greater than is generally acknowledged. Six cases are presented to illustrate some of the diverse manifestations of migraine: (1) transient global amnesia, (2) persistent visual phenomena, (3) migraine and seizures, (4) vestibular dysfunction, (5) hearing loss, and (6) migraine masquerading as multiple sclerosis. These and other migraine-associated neurologic symptoms are discussed in relation to previous reports in the literature. Pitfalls in recognizing the diverse manifestations of migraine, which are often underdiagnosed or misdiagnosed, are reviewed. Whether or not the established diagnostic criteria for migraine are too strict, other factors contributing to failure to identify migraine when it causes nonclassic neurologic symptoms include: (1) the belief that these are rare, (2) lack of an objective measure for migraine, (3) inadequate attention to the positive diagnostic features of migraine in the absence of headache, (4) confusion regarding prior migraine history, and (5) dismissing the diagnosis because of reported failure of prior migraine treatment. Recognition of the diversity of migraine helps avoid unnecessary testing and opens the door to effective treatment.
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PMID:The menagerie of migraine. 887 61

We report two children with acute confusional migraine (ACM) and another with migrainous infarction (MI), aged 7-12 years. There was a family history of migraine in all patients. The patients, who were all right-handed, all manifested sudden onset of consciousness disturbance and other neurological deficits as the first aura in their life. The symptoms in all cases almost completely resolved spontaneously within 24 h, but transient occipital slowing on EEG with laterality corresponding to the side of migrainous origin lasted more than 24 h. In the cases of ACM in the critical phase, although MRI and MR angiography showed no abnormal findings, IMP-SPECT performed within 48 h of migraine attacks revealed a regional change in cerebral blood flow, which is one particular case demonstrated hypoperfusion in the left posterior cerebral artery (PCA) territory. Therefore, although ACM was diagnosed clinically by exclusion, SPECT was thought helpful for the diagnosis of ACM. We speculated that transient hypoperfusion affecting the dominant-sided PCA territory involving the medial temporal structures was responsible for the confusion with amnesia in ACM, in contrast to the lack of confusion or amnesia in the case of MI showing cystic encephalomalacia in the right thalamic and hippocampal regions.
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PMID:Acute confusional migraine and migrainous infarction in childhood. 910 64


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