Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An 18-year-old university student with Osler-Weber-Rendu disease collapsed in the bathroom. Attempted resuscitation was unsuccessful. Her past history included recurrent epistaxes, mucosal telangiectasias, intracranial arteriovenous malformations with previous hemorrhage, a single pulmonary arteriovenous malformation, recent onset of grand mal seizures, and depression. There was a positive paternal family history. At autopsy the pulmonary arteriovenous malformation was confirmed. In addition, within the brain there were widespread areas of gliosis with hemosiderin deposition and small vascular malformations. No other significant abnormalities were detected and toxicological screening revealed only moderately elevated levels of carbemazepine. Death was attributed to epilepsy associated with glial scarring from previous microhemorrhages. The detection of vascular malformations in the lung or brain at autopsy should prompt careful examination of all tissues for similar lesions. Given the possibility of Osler-Weber-Rendu disease in such cases, fibroblast cultures should be undertaken to enable molecular studies to proceed. The heritable nature of this disorder necessitates accuracy of diagnosis at autopsy; once the diagnosis is confirmed family screening should be recommended.
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PMID:Osler-Weber-Rendu syndrome--pathological manifestations and autopsy considerations. 1137 11

Magnetic seizure therapy (MST) is a novel means of performing convulsive therapy using rapidly alternating strong magnetic fields. MST offers greater control of intracerebral current intensity than is possible with electroconvulsive therapy (ECT). These features may result in a superior cognitive side effect profile for MST, while possibly retaining the efficacy of ECT. The objective of this study was to determine whether MST and ECT differ in seizure characteristics, and acute objective and subjective cognitive side effects. A total of 10 inpatients in a major depressive episode referred for ECT were enrolled in this randomized, within-subject, double-masked trial. Seizure threshold was determined with MST and ECT in the first two sessions of a course of convulsive therapy, with order randomized. The remaining two sessions consisted of suprathreshold stimulation with MST and ECT. A neuropsychological battery and side effect rating scale were administered by a masked rater before and after each session. Tonic-clonic seizures were elicited with MST in all patients. Compared to ECT, MST seizures had shorter duration, lower ictal EEG amplitude, and less postictal suppression. Patients had fewer subjective side effects and recovered orientation more quickly with MST than ECT. MST was also superior to ECT on measures of attention, retrograde amnesia, and category fluency. Magnetic seizure induction in patients with depression is feasible, and appears to have a superior acute side effect profile than ECT. Future research will be needed to establish whether MST has antidepressant efficacy.
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PMID:Safety and feasibility of magnetic seizure therapy (MST) in major depression: randomized within-subject comparison with electroconvulsive therapy. 1286 3

Bupropion hydrochloride is currently available in three formulations: immediate-release, sustained-release, and extended-release (ER). Several published reports exist concerning bupropion's history of inducing seizures in both the immediate- and sustained-release formulations. Although the potential of the ER formulation for causing seizures is noted in the drug's prescribing information, there is no previously published report of bupropion ER inducing seizures. In the case reported, a 27-year-old woman who was prescribed bupropion ER as well as clonazepam and lamotrigine (anticonvulsants), hydrocodone bitartrate (for irritable bowel syndrome), and zolipidem tartrate (for depression and associated anxiety and insomnia) experienced a grand mal seizure 6 months after beginning bupropion ER therapy. The patient was taken to the emergency department, where she had a second grand mal seizure 8 hours after the first one. Extended-release bupropion was discontinued, and the patient had not had additional seizures at 8 months follow-up.
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PMID:Extended-release bupropion induced grand mal seizures. 1844 24

We present a rare case of 26-year-old male patient without a history of epilepsy, who underwent a voice monitoring surgery under local anesthesia plus sedation using modified neuroleptanalgesia. As he developed generalized tonic-clonic seizure probably due to pentazocine, the operation was cancelled. Later, the same surgery was rescheduled. After a premedication with intramuscular phenobarbital, the patient was sedated with dexmedetomidine and locally anesthetized, showing sedation of high quality with no respiratory depression and no seizure. Dexmedetomidine was used succesfully for voice monitoring surgery.
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PMID:[Dexmedetomidine for sedation during voice monitoring surgery in a patient with an episode of seizure]. 1871 13

A 55-year-old man with congenital hemiparesis of the right side, three episodes of generalised tonic-clonic seizure at 16 years of age, and two episodes of severe depression and two episodes of hypomania in the past, presented with severe depression with psychotic symptoms. Computed tomography of the brain showed a grey matter-lined cerebrospinal fluid-filled cleft in the left cerebral hemisphere, involving the temporoparietal region. He was diagnosed to have bipolar II disorder, and was currently severely depressed with psychotic symptoms and schizencephaly. He improved with sodium valproate 1,000 mg/day, quetiapine 450 mg/day and escitalopram 20 mg/day after three weeks without any emergent side effects, and was maintaining well at three months follow-up. Although uncommon, schizencephaly may be considered as one of the differentials in cases of bipolar disorder along with congenital hemiparesis, mental retardation and/or seizures; and neuroimaging should be done to confirm the diagnosis.
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PMID:Schizencephaly associated with bipolar II disorder. 1929 19

ABSTRACT Two children with major depression experienced the emergence of motor and vocal tics after 2-3 weeks on imipramine at doses of 75-100 mg daily. The tics did not show any sign of subsiding for 9-10 days following the discontinuation of imipramine, but subsequently responded to treatment with haloperidol. Case 1 involved an 8-year-old child with depression, attention-deficit hyperactivity disorder (ADHD), other behavioral problems, and a history of a single febrile seizure. His family history was positive for tics, depression, anxiety, and seizures. He was found to have a toxic plasma level of the tricyclic antidepressant. Case 2 involved a 13-year-old child with depression, ADHD, behavioral problems, obsessive compulsive symptoms, intellectual deficit, developmental delays, grand mal seizures, and concomitant use of phenytoin. The child had previously developed tics while receiving methylphenidate. The family history was positive for tics, depression, obsessive compulsive symptoms, suicide, and alcohol abuse. The child had a subtherapeutic plasma level of the antidepressant. It is suggested that tricyclic antidepressants may precipitate tics consistent with the symptoms of Tourette's syndrome in genetically vulnerable children. Although this possibility has been suggested in the literature, these are the first two documented cases of this phenomenon. Speculating from these two cases, ADHD may be a risk factor for the appearance of imipramine-induced tic symptoms in depressed children.
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PMID:Emergence of motor and vocal tics during imipramine administration in two children. 1963 Jun 34

Sudden unexpected death in epilepsy (SUDEP) refers to the sudden death of a seemingly healthy individual with epilepsy, usually occurring during, or immediately after, a tonic-clonic seizure. The frequency of SUDEP varies depending on the severity of the epilepsy, but overall the risk of sudden death is more than 20 times higher than that in the general population. Several different mechanisms probably exist, and most research has focused on seizure-related respiratory depression, cardiac arrhythmia, cerebral depression, and autonomic dysfunction. Data from a pooled analysis of risk factors indicate that the higher the frequency of tonic-clonic seizures, the higher the risk of SUDEP; furthermore, risk of SUDEP is also elevated in male patients, patients with long-duration epilepsy, and those on antiepileptic polytherapy. SUDEP usually occurs when the seizures are not witnessed and often at night. In this Seminar, we provide advice to clinicians on ways to minimise the risk of SUDEP, information to pass on to patients, and medicolegal aspects of these deaths.
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PMID:Sudden unexpected death in epilepsy. 2173 36

A tonic-clonic seizure transitions from high frequency asynchronous activity to low frequency coherent oscillations, yet the mechanism of transition remains unknown. We propose a shift in network synchrony due to changes in cellular response. Here we use phase-response curves (PRC) from Morris-Lecar (M-L) model neurons with synaptic depression and gradually decrease input current to cells within a network simulation. This method effectively decreases firing rates resulting in a shift to greater network synchrony illustrating a possible mechanism of the transition phenomenon. PRCs are measured from the M-L conductance based model cell with a range of input currents within the limit cycle. A large network of 3000 excitatory neurons is simulated with a network topology generated from second-order statistics which allows a range of population synchrony. The population synchrony of the oscillating cells is measured with the Kuramoto order parameter, which reveals a transition from tonic to clonic phase exhibited by our model network. The cellular response shift mechanism for the tonic-clonic seizure transition reproduces the population behavior closely when compared to EEG data.
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PMID:Dynamical changes in neurons during seizures determine tonic to clonic shift. 2212 61

A 41-year-old white male with a history of alcoholism and depression was brought from prison into the emergency department (ED) after having had a witnessed tonic-clonic seizure lasting approximately 5 min. During the 24 h prior to admission, the patient's cell mate reported that he was restless and had consumed 11 litres of water. The patient had also been taking regular escitalopram for his depression. On arrival to the ED, the patient was found to have a sodium level of 112 mmol/l. After correction of his hyponatraemia the patient developed rhabdomyolisis with a creatine kinase level of 65 064 IU/l. To prevent an acute kidney injury a high volume alkaline diuresis protocol was started. Once corrected, his sodium level remained normal and he was discharged home after making a full neurological recovery. Rhabdomyolysis has rarely been associated with the correction of hyponatraemia.
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PMID:Rhabdomyolysis associated with polydipsia induced hyponatraemia. 2267 67

Nonconvulsive status epilepticus (NCSE) is common but often under-diagnosed. Due to the absence of specific symptoms, it is frequently misdiagnosed as a psychiatric disorder, which delays treatment. The cases of two patients who exhibited psychiatric symptoms and subtle cognitive disturbances (without confusion) as the sole manifestation of frontal lobe NCSE are reported. Both patients were initially treated as psychiatric disorders (depression and anorexia nervosa). The correct diagnosis was established by the electroencephalographic study, in one case after the patient experienced a generalized tonic-clonic seizure and in the other, after failure to improve with supposedly adequate treatment. There are reports of patients with NCSE whose symptoms suggest a psychiatric disorder (inappropriate behavior, emotional disinhibition, perseveration, reduced speech and motivation). This can occur without altered consciousness and symptoms may fluctuate, making the correct diagnosis extremely difficult. This entity can occur at any age and without a previous history of seizures. A high level of suspicion is necessary for prompt electroencephalographic study to confirm the diagnosis. Early treatment will correct the symptoms and significantly improve quality of life for patients and their families.
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PMID:Psychiatric disorders secondary to nonconvulsive status epilepticus of frontal origin. Two clinical case reports. 2272 34


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