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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Deep brain stimulation is a minimally invasive targeted neurosurgical intervention that enables structures deep in the brain to be stimulated electrically by an implanted pacemaker. It has become the treatment of choice for Parkinson's disease, refractory to, or complicated by, drug therapy. Its efficacy has been demonstrated robustly by randomized, controlled clinical trials, with multiple novel brain targets having been discovered in the last 20 years. Multifarious clinical indications for deep brain stimulation now exist, including dystonia and tremor in movement disorders; depression, obsessive-compulsive disorder and Tourette's syndrome in psychiatry; epilepsy, cluster headache and chronic pain, including pain from stroke, amputation, trigeminal neuralgia and multiple sclerosis. Current research argues for novel indications, including hypertension and orthostatic hypotension. The development, principles, indications and effectiveness of the technique are reviewed here. While deep brain stimulation is a standard and widely accepted treatment for Parkinson's disease after 20 years of experience, in chronic pain it remains restricted to a handful of experienced, specialist centers willing to publish outcomes despite its use for over 50 years. Reasons are reviewed and novel approaches to appraising clinical evidence in functional neurosurgery are suggested.
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PMID:Deep brain stimulation: indications and evidence. 1785 Jan 94

Patients with vitamin B12 deficiency have protean neurological manifestations that are often insidious. Acute onset of cerebellar dysfunction and extrapyramidal manifestations like dystonia and chorea are rather uncommon in adults. We describe a patient who manifested with acute onset of language dysfunction, chorea and ataxia. There was no history of hypertension, diabetes or ischemic heart disease. He had low serum vitamin B12 and elevated serum homocystine levels. He improved dramatically following B12 replacement therapy. Our patient provides insight into the pathophysiological mechanism of this rare manifestation. Further the importance of considering vitamin B12 deficiency, in country like India, where vegetarian food practice is quite common, is being emphasized.
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PMID:Serum vitamin B12 deficiency and hyperhomocystinemia: a reversible cause of acute chorea, cerebellar ataxia in an adult with cerebral ischemia. 1867 79

Resonance chronophytotherapy (RCT) was carried out to patients with epilepsy, bronchial asthma, rheumatism, scleroderma, hypertension, chronic glomerulonephritis, vegetovascular dystonia, female sterility, round-type alopecia, vitiligo, eczema, psoriasis, onychomycosis. Special medicine technology RCT does not have any adverse effects nor contraindications and is intended first of all to eliminate non specific signs of a disease, decrease dependence and complications of applying chemical synthetic medications. RCT may be used together with any type of specific treatment. Internet variant of TRC have been developed.
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PMID:[About phenomenon of time and efficiency of chronotherapy of chronic diseases]. 1882 54

The course of time itself in alive organisms is treated from positions of the special theory of the relativity created by A. Einstein in 1905 and added by the Nobel winners H.A.Lorentsem, M. Plankom, M. fon Laue. These achievements of fundamental physics have been put in a basis of special medical technology "Resonant chronophytotherapy" (SMT RCPT) which is applied in practice of treatment of chronic diseases for 27 years. Grass tinctures in various dosages are used in SMT RCPT, which patients take once a day during precisely designated time. Parameters "dosage-time" daily vary. SMT RCPT have been conducted in treatment of epilepsy bronchial asthma, rheumatism, sclerodermia, hypertension, chronic glomerulonephritis, vegeto-vascular dystonia, female sterility, circular alopecia, vitiligo, eczema, psoriasis, onychomycosis. SMT RCPT does have adverse events, has no contra-indications to its use, directed, first of all, on elimination of nonspecific signs of a disease, reduces dependence and complications of the use of chemical synthetic preparations. SMT RCPT can be combined with any kind of specific treatment. Internet-variant of SMT RCPT has been developed. Chronomedicine is priority tendency in industrialized countries of the world--the USA, the Great Britain, Germany, France, Russia, China, Japan and appears on lead positions among alternative methods of treatment, both traditional, and non-traditional.
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PMID:[Chronotherapy and relativity theory]. 1914 32

Intrathecal baclofen (ITB) is increasingly being used to reduce spasticity among children with cerebral palsy, dystonia, and spinal cord injuries. However, complications such as withdrawal, which is a potentially life-threatening condition, can occur. Intrathecal baclofen withdrawal should be differentiated with autonomic dysreflexia, malignant hyperthermia, neuroleptic malignant syndrome, and serotonin syndrome. We report a case of ITB withdrawal secondary to low residual volume in the pump reservoir and resembling serotonin syndrome in an adolescent with cerebral palsy. He presented with agitation, diaphoresis, increasing spasticity, rigidity, jitteriness, hyperreflexia, clonus, tachycardia, hypertension, and rhabdomyolysis. Treatment consisted of emergent refilling of the pump, intravenous diazepam, and oral cyproheptadine. We also emphasize the importance of prompt recognition of ITB withdrawal among high-risk patients.
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PMID:Intrathecal baclofen withdrawal resembling serotonin syndrome in an adolescent boy with cerebral palsy. 1924 Jun 73

Retrospective analysis included case histories of 182 patients with hypertensive disorders and one or more crises (HC). The aim was to study the relationship between drug therapy and occurrence of HC. As known, clinical diagnosis of hypertensive disorder dictates therapeutic strategy for AH. It was shown that diagnosis of neurocirculary dystonia (asthenia) prevented timely prescription antihypertensive treatment and resulted in HC. Mathematical simulation of anti-AH therapy in the presence of HC allows patients at high risk of stroke to be identified for follow-up and adequate treatment.
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PMID:[Mathematical simulation for the assessment of clinical efficacy of the treatment of hypertensive crisis]. 2013 89

We report a case of bilateral ocular deviation due to droperidol-induced acute dystonia that was initially undiagnosed. A 22-year-old, 72 kg, parturient at 42 weeks' gestation underwent emergency cesarean section for pregnancy-induced hypertension under combined spinal-epidural analgesia. The epidural catheter was inserted through the T11-12 interspace, followed by intrathecal hyperbaric bupivacaine with adjunctive fentanyl. The patient complained of nausea shortly after delivery, which subsided with intravenous droperidol 1.25 mg and metoclopramide 10 mg. After surgery, epidural infusion with a mixture of ropivacaine, fentanyl, and droperidol was started. Around 25 hours postoperatively, both of the patient's eyes rotated upwards, although she was fully conscious. Brain CT/MRI did not show any abnormalities. An ophthalmologist and a neurosurgeon were consulted but there was no definitive diagnosis. On subsequent consultation with anesthesiologists, it was assumed that the symptom was related to external ophthalmoplegia secondary to spinal anesthesia. Thereafter, a "wait and see" approach was adopted. After 8 hours, she gradually developed torticollis and increased muscle tone of the lower extremities, which facilitated a diagnosis based on extrapyramidal signs. Epidural infusion was discontinued without further treatment. Her symptoms completely disappeared within 5 hours. The estimated cumulative dose of intravenous and epidural droperidol was 4.6 mg over 34 hours.
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PMID:[Case of acute dystonia during epidural droperidol infusion to prevent postoperative nausea and vomiting]. 2016 68

Modafinil is a non-amphetamine wakefulness-promoting agent used for the treatment of various sleep disorders characterized by excessive daytime sleepiness. There is little information in the medical literature with respect to supratherapeutic doses of this medication. We performed a retrospective review of the California Poison Control System database for all cases of single-substance ingestion of modafinil with follow-up to a known outcome for the time period 1998-2008. Data collected included age, gender, dose ingested, clinical effects, and medical outcome. There were a total of 87 patients, 53 (61%) of which were female. Patient ages ranged from 1.25 to 72 years with a mean of 30 years; 17 (20%) patients were aged 6 years or less. Thirty-three (38%) were intentional overdoses. Most commonly reported effects were tachycardia (n=23), agitation (n=14), anxiety (n=11), headache (n=8), hypertension (n=6), dystonia/tremor (n=6), and dizziness (n=5). Forty-nine patients (56%) were managed at home, and 38 (44%) were managed in a healthcare setting. Therapies administered included activated charcoal (n=8), benzodiazepines (n=7), antihistamines (n=2), intravenous fluids (n=2), haloperidol (n=2), and beta-blockers (n=1). Effects were classified as none (n=22), minor (n=54), and moderate (n=11). No major effects and no deaths occurred. Effects of modafinil overdose appear to be mild in most cases, with tachycardia and CNS symptoms predominating. Clinically significant effects requiring treatment occurred in a small number of patients.
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PMID:A retrospective review of supratherapeutic modafinil exposures. 2035 18

The term 'paroxysmal autonomic instability with dystonia' was first given for a group of symptoms comprising diaphoresis, intermittent agitation, hypertension, hyperthermia, tachycardia, tachypnea, and extensor posturing. This usually occurs as a complication of severe brain injury and is infrequently reported in cases of cerebral infection. We report a 1-year-old child with intracranial tuberculoma with symptoms of paroxysmal autonomic instability with dystonia. Pertinent literature is reviewed emphasizing pathophysiology and available treatment options.
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PMID:Paroxysmal autonomic instability with dystonia in a child: rare manifestation of an interpeduncular tuberculoma. 2237 46

Streptococcus pneumoniae is a common cause of bacterial meningitis, frequently resulting in severe neurological impairment. A seven-month-old child presenting with Streptococcus pneumoniae meningoencephalitis developed right basal ganglia and hypothalamic infarctions. Daily episodes of agitation, hypertension, tachycardia, diaphoresis, hyperthermia, and decerebrate posturing were observed. The diagnosis of paroxysmal autonomic instability with dystonia was established. The patient responded to clonidine, baclofen, and benzodiazepines. Although this entity has been reported in association with traumatic brain injury, and as a sequel to some nervous system infections, this is the first case, to our knowledge, associated with pneumococcal meningoencephalitis.
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PMID:Paroxysmal autonomic instability with dystonia after pneumococcal meningoencephalitis. 2309 76


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