Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Blepharoclonus refers to myoclonic rhythmic eyelid closure. This is an extremely rare abnormal movement of the eyelids. The symptom has an ill-defned anatomical localization and hypothesized etiologies are diverse. We describe a 42 year-old woman with known poorly controlled hypertension (HTN) who presented with a three-week history ofataxia, dysmetria, and uncontrolled eyelid twitching. The bilateral abnormal eyelid movement occurred during either eyelid closure or opening, and was compatible with blepharoclonus. MRI revealed multiple cerebral infarctions at red nucleus, dentate nucleus, and inferior olives. These foci are within Guillain-Mollaret's triangle. The ataxia and dysmetria gradually improved within three weeks. While the blepharoclonus improved, it persisted after one year offollow-up. Our conclusion was one of HTN leading to a lacunar infarct that manifested partially as blepharoclonus. Due to the neuroimaging findings and clinical course, we propose that blepharoclonus may be a variant ofpalatal myoclonus and may be considered as another lacunar syndrome.
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PMID:Blepharoclonus: anatomical localization and etiological consideration.. 2553 16

Rivastigmine is a non-competitive reversible inhibitor of acetylcholinesterase which is approved as one of the fi rst-line treatment options for Alzheimer's disease. We present the case of a 33-year-old woman with acute cholinergic syndrome secondary to deliberate rivastigmine poisoning. The patient presented at the emergency department (ED) with drowsy consciousness, dizziness, vomiting, diarrhea, sweating, and hypertension (171/103 mmHg). At the scene, an empty bottle of Rivast 120 mL/Bot, containing rivastigmine 2 mg/mL, was found beside the patient. Two hours later, we noted bronchorrhea and persistent salivation along with drowsiness, agitation, fatigue, incontinence, and limbs paralysis. A notably low serum cholinesterase level (651 U/l) was identified. Acute cholinergic syndrome secondary to rivastigmine intoxication was diagnosed. Endotracheal intubation with ventilator support was required due to respiratory failure. Atropine (0.5 mg intravenous injection) was administered. She was subsequently admitted to the intensive care unit for further care. Extubation was performed on the third day. The patient insisted on being discharged on the second day after extubation, and after administration of a total of 11 mg of atropine, no signs of either intermediate syndrome or delayed polyneuropathywere noted. rivastigmine, an acetylcholinesterase inhibitor, can precipitate an acute cholinergic crisis in cases of intoxication. Typical clinical features of cholinergic excess include increased secretions in the airway and oral cavity, miosis, diarrhea, anxiety, twitching, bronchoconstriction, convulsions, confusion, and gastrointestinal and muscular cramps. The treatment for acute cholinergic crisis is administration of atropine alone or in combination with an antidote to the cholinesterase inhibitor (such as pralidoxime). Patients often recover well with atropine supplements and optimal supportive care.
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PMID:Successful Resuscitation of a Young Girl Who Drank Rivastigmine With Respiratory Failure. 3299 49


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