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)

Overnight metabolic studies in 39 poorly controlled insulin-treated diabetic patients aged 9 to 66 years showed hypoglycaemia (blood-glucose less than 2 mmol/1) in 22 patients; it lasted 3 h or more in 17. Hypoglycaemic symptoms were very mild or absent, but 19 patients had other features of overtreatment with insulin. These included lethargy, depression, night sweats, morning headaches, fits (3 patients), glycogen-laden hepatomegaly (3), and acquired tolerance to high doses of insulin (mean 1 u/kg/24 h). The best clinical clue to recurrent nocturnal hypoglycaemia was the intermittent occurrence of symptoms, however "mild" and infrequent these appeared to be. Reduction of insulin by a mean of 25% in these patients (without change of species) did not result in loss of overall control; 1 patient with recurrent ketoacidosis was stablished on 40% of his initial dose. It is difficult, sometimes impossible, to achieve good overnight control with conventional once or twice daily insulin therapy. Since patients readily become tolerant of low blood-glucose levels, reliance on urine tests and symptoms of hypoglycaemia as a guide to dosage easily produces a spiral of overtreatment.
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PMID:Unrecognised nocturnal hypoglycaemia in insulin-treated diabetics. 8 75

Seven patients with cancer complicated by nonmetastatic sagittal sinus thrombosis were encountered in a 7-year period. Five had hematologic malignancies and two had solid tumors. There were two different presentations. In the first, neurologic signs and symptoms (e.g., headaches, seizures, hemiparesis, lethargy) occurred suddenly in five patients shortly after initiation of cancer therapy. Four of these five patients recovered with minimal residua; the fifth died as a direct result of the sinus thrombosis. The second presentation occurred in the two patients with terminal cancer who declined gradually without focal signs; both patients died. Only arteriography can reliably establish the diagnosis of sagittal sinus occlusion. In patients with cancer, sagittal sinus occlusion probably results from a "hypercoagulable state" associated with the systemic neoplasm.
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PMID:Nonmetastatic superior sagittal sinus thrombosis complicating systemic cancer. 28 38

Prophylactic irradiation of the skull and intrathecal application of methotrexate has proven to be highly effective in preventing central nervous system disease in acute lymphoblastic leukemia or non-Hodgkin-lymphoma. Prophylactic treatment may be complicated by a somnolence syndrome occuring 4--8 weaks after the end of irradiation. The main features of this clinical entity are somnolence, lethargy, dullness, anorexia, headache, and vomiting. EEG frequently displays a distinct slowing of activity. All symptoms are reversible after 3--49 days. The syndrome clearly is consequence of skull irradiation. Its metabolic basis probably is transient disturbance of myelinization.
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PMID:[Non-leukemic disease of the central nervous system in children with acute lymphoblastic leukemia. I. Somnolence syndrome (author's transl)]. 36 88

A 40-year-old hypertensive black female, who suddenly developed aphasia, lethargy, and a right hemiparesis, and a 42-year-old non-hypertensive black male, who suddenly developed intractable headache, drowsiness, and vomiting, were found by angiography to have moyamoya disease. This condition is characterized by a decreased caliber of the internal carotid arteries and bilateral occlusion of the anterior and middle cerebral arteries with visualization of an extensive collateral network of tortuous blood vessels of the rete mirabile type at the base of the brain.
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PMID:Moyamoya disease in black adults. 44 57

This report describes light and ultrastructural features of a functional parathyroid gland adenoma, principally composed of transitional oxyphil cells, in a 64-yr-old hypertensive black woman. She was hospitalized for repeated episodes of headaches, lethargy, and dizzy spells. Her serum calcium level was 2.92 mmol/l and immunoassay for parathormone was 390 pg/ml. On neck exploration, the left lower parathyroid gland was found enlarged and therefore removed in toto. The serum calcium and phosphate levels returned to normal following parathyroidectomy. Microscopically, the diagnosis of functional oxyphil adenoma was made. On ultrastructural examination, the tumour was composed principally of transitional cells, occasional typical, and degenerating oxyphil cells. The predominant transitional cells were rich in mitochondria and contained multiple active Golgi complexes, stacked profiles of rough endoplasmic reticulum, and a few secretory granules. On the other hand, typical oxyphil cells were tightly packed with mitochondria at the expense of other organelles. It appeared that neoplastic oxyphil cells were chief cells transformed in response to some unknown oncogenic stimulus.
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PMID:A functional parathyroid gland adenoma of transitional oxyphil cells. A light and ultrastructural study. 53 Jul 57

Thirteen cases of posterior fossa arachnoid cyst are described. Presenting features were usually headache, vomiting, lethargy, and delayed development in infants. Association with congenital defects is sometimes noted. The cysts are considered to result from abnormalities occurring in foetal life.
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PMID:Developmental arachnoid cysts of the posterior fossa-an analysis of 13 cases. 60 49

The student population at Edinburgh University was surveyed in 1974 to collect data on women's menstrual cycles and to examine sources of individual differences in reporting symptoms associated with the cycle. 2542 non-oral contraceptive (OC) users and 756 OC users provided data. Both sets of respondents were questioned about the occurrence, both premenstrually and during menstruation, of 9 symptoms. The "physical" symptoms (stomachache, backache, nausea, fainting) were more often reported during menstruation, whereas the so-called "emotional" symptoms (lethargy, irritability, depression, tension, headache) had a greater prevalence premenstrually. When the 9 menstrual symptoms were broken down by students' fields of concentration, arts students were found to report more "emotional" symptoms than those in the sciences and professions (medicine and law). Further analysis showed that only and 1st born children were slightly less likely to report symptoms than those whose nearest sibling is 7 or more years older or younger or later born children. A similar trend was found for the reporting of illness in an earlier analysis of data from this sample. When cycle length and reqularity were analyzed together, women with long and regular cycles were found to have the lowest proportion reporting symptoms during menstruating with the exception of tension, nausea, and fainting, and women with short and irregular cycles had a correspondingly high incidence of all symptoms. In addition, women with more regular cycles were more likely to report infrequent recall of dreams than those with irregular cycles. Overall, the women who are most likely to report menstrual symptoms, especially those of an "emotional" character, are more likely to report other illnesses with emotional connotations, recall their dreams more frequently, show a preference for the arts, and tend to have been brought up with older siblings. This cluster of personality attributes defines an "expressive" personaltiy in contrast to the more "controlled" style of women at the other extreme.
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PMID:Variations in menstrual cycle symptom reporting. 98 37

As a causative factor in spontaneous subarachnoid hemorrhage, vascular anomalies, especially aneurysm or arteriovenous malformation, have been generally recognized. On the other hand, subarachnoid hemorrhage from brain tumor and cryptic vascular malformation are rare. We experienced two cases showing subarachnoid hemorrhage from angioblastic meningioma and vascular hamartoma as an initial symptom. Case 1: A 48-year-old woman, who complained of severe headache and vomiting on Feb. 10th, 1972, gradually became lethargic. Lumbar puncture revealed moderately hemorrhagic C.S.F.. On the fifth day after the onset, she was admitted to our hospital. On admission she showed disorientation and disturbance of resent memory. Aphasia and agnosia were slightly observed. On ophthalmologic examination right homonymous lower quadrant hemianopsia was observed. The carotid angiogram showed slight square shift of the anterior cerebral artery to the right side, elevation of the middle serebral artery and a homogeneous tumor stain in the occipital region in capillary phase. A walnut sized tumor invading the middle portion of the left lateral sinus and showing firm adhesion to the tentrium was found. There was an intracerebral hematoma behined the tumor. The tumor, the tentrium and the lateral sinus were extirpated en bloc and the intracerebral hematoma was aspirated. Histologically, the tumor was angioblastic meningioma. Case 2: A 7-year-old boy, who complained of severe abrupt headache, nuchal pain and vomiting on Sept. 17th, 1972, became gradually lethargic. Lumbar puncture revealed hemorrhagic C.S.F., On the tenth day after the onset, he was admitted to our hospital. He showed confusion and agitation. The carotid angiogram showed an unrolling of the pericallosal artery, but no findings of space taking lesions. An air study indicated a globular filling defect protruding into the anterior horn of the right lateral ventricle. The tumor located in the laterobasal wall of the anterior horn was removed picemiel by transventricular approach. Histologically, the tumor was vascular hamartoma. Furthermore, we discussed various brain tumors showing subarachnoid hemorrhage as an initial symptom, its frequency and bleeding mechanism on the literature.
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PMID:[Two cases showing subarachnoid hemorrhage from angioblastic meningioma and vascular hamartoma (author's transl)]. 98 94

A patient was presented with both an aneurysm of the frontobasal branch of the right anterior cerebral artery and an arterio-venous malformation fed by the same artery. A 36-year-old man with sudden headache, nausea and vomiting was admitted to the emergency clinic on July, 4, 1974. On admission, he was slightly lethargic and complained of severe headache. The blood pressure was 112 systolic and 64 diastolic. He showed no abnormal findings except for nuchal stiffness and bloody liquor (pressure 260 mmH2o). A right carotid angiogram revealed an aneurysm, 1.0 cm in diameter, on the frontabasal branch of the right anterior cerebral artery and distal to the aneurysm the artery continued to an arteriovenous malformation. No other vascular lesion was observed by other angiographies. On July, 24, 1974, the parent artery (frontobasal branch) of the aneurysm was clipped and the part of right frontal lobe containing the nidus excisted. The patient's post operative course was uneventful.
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PMID:[Co-existing aneurysm and arteriovenous malformation--case report (author's transl)]. 103 90

Three years after radiation therapy for an intrasellar tumor, a 42-year-old housewife presented with headache, lethargy, and remarkable plain skull roentgenograms, in which dilated lateral and third ventricles were filled with air. Air apparently had entered the cranium through the sphenoid sinus and eroded sellar floor, extending directly through intrasellar remnants of the chromophobe adenoma and into the floor of the third ventricle. Frontal exploration showed an empty sella turcica and no residual tumor. She made an excellent recovery and has done well for 5 years after operative closure of the defect.
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PMID:Spontaneous pneumoventriculogram following radiation of a pituitary adenoma. 117 14


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