Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023380 (lethargy)
 5,697 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Recurrent encephalopathy affecting cerebellar and extrapyramidal structures was observed in five members of two families. The syndrome is characterized by sudden onset of truncal ataxia, occasionally accompanied by lethargy and impairment of speech. Choreic and athetoid movements were present, and there was loss of deep tendon reflexes with presence of pathological reflexes. Onset of the disease was early in childhood. Attacks lasted for days to weeks; residual symptoms comprising speech impairment and incoordination were seen in some patients. Both sexes were affected. The pedigrees suggest autosomal dominant inheritance. Pathogenesis remains unexplained by the laboratory studies done; metabolic or immunological processes predisposed by genetic factors are suggested. Similar reports from the literature are discussed; no identical family could be found.
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PMID:Autosomal dominant recurrent encephalopathy of childhood. 685 11

Disulfiram is known to produce toxic encephalopathy and peripheral neuropathy. The case of a 37-year-old alcoholic who attempted to commit suicide by taking 22.5 g disulfiram is described. During the first 6 days after the intoxication he was stuporous and had cerebellar ataxia and dysarthric speech. Then he became comatose, and as he recovered from coma, he showed peripheral neuropathy including diplegia faciei and severe tetraparesis. Denervation potentials were detected in both facial muscles and distal muscles of the upper and lower limbs, while conduction velocity was normal. Axonal degeneration was verified by sural nerve biopsy. In addition neurofilamentous axonopathy was documented. The recovery from his paresis lasted 2 years.
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PMID:[Polyneuropathy caused by disulfiram poisoning]. 686 Jan 22

Primary amebic meningoencephalitis and granulomatous amebic encephalitis are well recognized clinicopathological entities caused by free-living amebas. Associated arteritis and "mycotic aneurysms" with infiltration of intracranial arteries by lymphocytes, amebic trophozoites and cysts have not been previously reported. A 26-month-old girl had a 3-week history of encephalitis, characterized, initially, by vomiting and low-grade fever. Subsequently, she developed ataxia, generalized weakness, lethargy, and esotropia. The first CSF showed 490 RBC/microliters, 705 WBC/microliters with 90% mononuclears. Her pupils reacted briskly to light. Moderate nuchal rigidity, nystagmus, fixed downward gaze, anisocoria, bilateral 6th nerve palsy, left arm monoparesis and left Babinski were present. CAT scan revealed slight symmetrical dilatation of anterior horns of lateral ventricles and an area of abnormal enhancement above the 3rd ventricle. She died 14 days after admission, 5 weeks after onset of symptoms. The brain showed focal necrotizing encephalopathy, involving thalami, cerebellum, brain stem, and cervical and upper thoracic spinal cord. Numerous free-living amebic trophozoites and cysts were present within a chronic granulomatous encephalitis. There were trombosis of basilar, posterior cerebral, and vertebral arteries with profuse chronic panarteritis, fibrinoid necrosis, and mycotic aneurysms.
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PMID:Granulomatous encephalitis, intracranial arteritis, and mycotic aneurysm due to a free-living ameba. 689 86

Two brothers had intermittent episodes of muscle weakness, lethargy, hyperammonemia, rhabdomyolysis, and elevated activities of creatine phosphokinase (CPK), lactic dehydrogenase, and SGOT in serum associated with low muscle carnitine but normal serum carnitine concentrations. These siblings represent a "mixed" form of carnitine deficiency with the elements of both systemic and myopathic carnitine deficiency. The older sibling died suddenly after a 24-hour fast. The younger boy has received carnitine for three years. During this period, serum CPK activity has remained elevated and increased further during illnesses, but no clinical symptoms of encephalopathy or myopathy have appeared.
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PMID:Encephalopathy and fatal myopathy in two siblings. Their association with partial deficiency of muscle carnitine. 709 Oct 87

50% of hospitalized medical emergency cases are cardiological and respiratory emergencies. Myocardial infarction, cardiogenic shock, ventricular arrhythmias and left ventricular failure often cause sudden death occurring within 1 or 2 hours. Therefore immediate management is necessary already in the prehospital phase of cardiovascular events. This does also apply for acute respiratory failure due to obstructive ventilatory disorders. Acute exacerbations of chronic obstructive pulmonary disease frequently are masked and may be misinterpreted as encephalopathy or alcohol withdrawal syndrome. Sedation may be dangerous. Also neuroglucopenic syndrome and hyperosmolar coma are occasionally interpreted wrongly. Thyrotoxic crisis, adrenal crisis and hypercalcemia are characterized by lethargy, mental disturbance and weakness, by dehydration, myopathy, nausea, constipation, diarrhea or tenesms or arrhythmias. In this situation of varied symptoms the most important action is to think of endocrine emergency, which may have multiple etiologies.
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PMID:[Cardiovascular emergencies--endocrine and metabolic crises. Practical hints for the physician in emergency service]. 711 36

The intracerebral inoculation of hamster neurotropic measles virus produces a fatal acute encephalopathy in the majority of weanling BALB/c mice. The few survivors remain healthy indefinitely. In contrast, weanling SJL/J mice are relatively resistant to acute encephalopathy, and about one-third of the survivors predictably develop a chronic encephalitis many weeks after inoculation. This later illness is characterized clinically by wasting, lethargy, seizures, or focal paralysis, usually culminating in death. Pathologically, a considerable brain inflammatory response occurs in association with abundant measles viral antigen. Viral antigen and inflammation were demonstrable predominantly in the limbic system but was also present in the cerebellum and brain stem. Antibody to measles virus was readily demonstrated in all animals with chronic encephalitis. This report constitutes the first description of chronic measles encephalitis in an inbred host.
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PMID:Chronic measles encephalitis in mice. 744 Oct 20

Ornithine transcarbamylase deficiency is an X-linked recessive disorder of urea biosynthesis characterized by recurrent, often fatal, hyperammonemic encephalopathy in affected males; carrier females are usually asymptomatic. We report here the clinical and laboratory findings in five symptomatic heterozygous females with ornithine transcarbamylase deficiency. In each case, the onset of symptoms occurred in the 1st year of life, but diagnosis was delayed by up to 15 years. Symptoms included recurrent vomiting with lethargy (five patients), dietary protein intolerance (five), irritability (four), severe acute encephalopathy (three), ataxia (three), and acute hemiparesis (two). All eventually showed evidence of developmental delay or learning difficulties. Two of the three who experienced severe, acute, hyperammonemic encephalopathy suffered serious, permanent neurologic sequelae. Three of the patients showed decreased ornithine transcarbamylase activity in liver obtained by needle biopsy, and the other two had marked orotic aciduria associated with hyperammonemia. Neuroimaging studies demonstrated persistent abnormal lobar attenuation and abnormal signal on computed tomographic scan and magnetic resonance imaging. All patients showed marked symptomatic improvement on treatment with dietary protein restriction supplemented by pharmacologic measures to increase nonprotein nitrogen excretion. Ornithine transcarbamylase deficiency should be considered in the differential diagnosis of acute or chronic encephalopathy in females at any age.
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PMID:Ornithine transcarbamylase deficiency in females: an often overlooked cause of treatable encephalopathy. 749 56

We report a case of subacute encephalopathy with seizures in chronic alcoholism (age 34 years). This syndrome clearly differs from the known neurological complications of chronic alcoholism. One of the authors has observed (and reported) such cases in the Baltimore area. Subacute encephalopathy is characterized by lethargy, confusion and neurological deficits such as hemiparesis, homonymous hemianopsia and aphasia. Epileptic seizures (generalized tonic-clonic, focal) are obligatory. The EEG shows very prominent slowing and periodic lateralized paroxysmal discharges (PLEDs). The condition is complicated by a variety of internal-medical complications. Structural neuroradiological tests are either normal or irrelevant. The cause and pathogenesis remain obscure. The subacute course ends with gradual resolution.
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PMID:[Subacute encephalopathy with seizures in chronic alcoholism]. 768 29

An example of subacute necrotizing encephalopathy, the fifth case in Thailand, was recorded. A 7-month-old boy presented clinically with vomiting, lethargy, respiratory difficulty, deteriorated consciousness, and hypotonia. The CT brain scan disclosed bilateral symmetrical radiolucencies in the basal ganglia, especially the lentiform nuclei, and thalami. Postmortem examination of these areas as well as the periaqueductal region revealed subacute necrotizing encephalopathy. It was characterized by necrosis, gliosis, and status spongiosus of the neuropil with relatively preserved neurons, and hyperplasia of small blood vessels as well as endothelium. As far as we are aware, the vast majority of abnormalities in the basal ganglia visualized by CT brain imaging often show calcific foci or high attenuation with asymmetrical distribution. Bilateral symmetrical lesions of low density are rare. We reported such an abnormality in a postmortem proven case of Leigh's disease. To recognize this finding should lead to correct antemortem diagnosis of the latter.
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PMID:Subacute necrotizing encephalopathy (Leigh's disease) in a child with particular reference to CT finding. 775 78

To determine whether the aetiological agent of bovine spongiform encephalopathy (BSE) is pathogenic for mink, standard dark mink were inoculated with coded homogenates of bovine brain from the U.K. Two homogenates were from cows affected with BSE. The third was from a cow that came from a farm with no history of having had BSE or having been fed ruminant-derived, rendered by-products, the proposed vehicle for introduction of the BSE agent. Each homogenate was inoculated intracerebrally into separate groups of mink and a pool of the three was fed to a fourth group. Signs of neurological disease appeared in mink an average of 12 months after intracerebral inoculation and 15 months after feeding. Decreased appetite, lethargy and mild to moderate pelvic limb ataxia were the predominant clinical signs, quite unlike the classic clinical picture of transmissible mink encephalopathy (TME). Microscopic changes in brain sections of most affected mink were those of a scrapie-like spongiform encephalopathy. Vacuolar change in grey matter neuropil was accompanied by prominent astrocytosis. Varying greatly in severity from one mink to another, the degenerative changes occurred in the cerebral cortex, dorsolateral gyri of the frontal lobe, corpus striatum, diencephalon and brainstem. Although resembling TME, the encephalopathy was distinguishable from it by less extensive changes in the cerebral cortex, by more severe changes in the caudal brainstem and by sparing of the hippocampus. The results of this study extend the experimental host range of the BSE agent and demonstrate for the first time the experimental oral infection of mink with a transmissible spongiform encephalopathy agent from a naturally infected ruminant species.
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PMID:Experimental infection of mink with bovine spongiform encephalopathy. 807 14


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