Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0027066 (myoclonus)
 4,275 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Atypical dementias confront the adequacy of current diagnostic concepts. The two patients with atypical dementia syndromes described here shared common postmortem features of numerous neocortical neuritic (senile) plaques and microvascular amyloid, sparing of hippocampus and substantia nigra, and the virtual absence of neurofibrillary tangles. Microscopically, the two differed only by the presence of a few subcortical Lewy bodies in case 1. These similar morphologic features were associated with dramatically different clinical presentations. In the first patient, visual hallucinations, Capgras' syndrome, cognitive slowing, myoclonus, parkinsonism, and primitive reflexes evolved over 3 years. Memory and language were relatively spared. In the second, dysphagia, nonfluent aphasia, hypophonia, motor perseveration, and a severe disorder of attention developed during this 18-month illness. At autopsy, an unrecognized colon malignancy was found. Despite high neuritic plaque counts in cortex, neither the clinical nor the pathologic criteria for Alzheimer's disease adequately describe either case. The cases will be examined first as clinical, then as neuropathologic, entities. From this approach, we conclude that a specific clinical dementia syndrome may be expressed by several neuropathologic "diseases" and that a variety of clinical syndromes may represent a single neuropathologic diagnosis. This strategy identifies a conceptual dichotomy between Alzheimer's syndrome and postmortem Alzheimer's disease. Meticulous clinical and neuropathologic observation is essential in advancing an understanding of the relationship between the two.
 ...
PMID:Alzheimer's disease or plaque disease? Two cases at the frontier of a definition. 141 64

Four patients with idiopathic Parkinson's disease developed subacute confusional states, associated with delusions, hallucinations, and myoclonus, following an increase in the dose of levodopa. The EEG revealed periodic generalized triphasic waves. The clinical condition and EEG cleared following levodopa dose reduction or discontinuation. This is the first report of encephalopathy associated with periodic triphasic activity following levodopa treatment.
 ...
PMID:Periodic triphasic waves in levodopa-induced encephalopathy. 173 82

Two patients with opsoclonus-myoclonus syndrome are reported whose magnetic resonance imaging (MRI) showed brain stem lesions. Both patients developed the opsoclonus-myoclonus syndrome after an upper respiratory illness. One case had visual hallucinations during the course of illness and MRI revealed a focal lesion in the pons involving the junction of basis and tegmentum. MRI of the second case showed a focal lesion at the upper pontine tegmentum.
 ...
PMID:Pontine lesion in opsoclonus-myoclonus syndrome shown by MRI. 322 Dec 25

A 15 years-old girl with no previous history of epilepsy or neurological disease presented three types of epileptic symptoms the same day: 1) clusters of rhythmic myoclonus of the left hemiface; 2) episodes of painful paresthesias of the left arm followed by secondary generalised seizures; 3) episodes of elementary visual hallucinations of the right hemifield. She had several seizures each hour and some were recorded. There were no EEG abnormalities during the facial myoclonus but rapid rhythms were seen during the sensory and visual partial seizures on the right parietal and left occipital lobes. There was no fever and no drowsiness. The CSF tap showed pleocytosis. Serological studies indicated recent mumps. The drugs were initially inefficient. The seizures disappeared after a month. The drugs were stopped after three months and the seizures had not relapsed after a one year's follow-up. Though there were no other sign of encephalitis, we believe that episode of multifocal seizures was due to mumps encephalitis.
 ...
PMID:[Multifocal epileptic crises following mumps]. 338 23

The ability of four hallucinogenic compounds--ketamine, phencyclidine, quipazine, and SKF-10 047--to produce some specific electrical pattern in portions of the limbic system and the hemispheric lateralization of such effects were studied in cats with permanently implanted electrodes. Electronic frequency and area integrators were used to analyze the results, and the percentage change in electrographic alterations was calculated. All compounds studied produced trains of spike and wave complexes in the cingulum, rapid discharges in the amygdala complex, and slow-wave synchronous activity in the septal nucleus. Those changes predominated in the left hemisphere. At small but hallucinatory concentrations of these drugs, the cortical EEG was not affected. Exploratory movements directed toward nonexistent objects, classified as hallucinatory-like behavior, appeared simultaneous with these changes in the EEG recordings. We concluded that there could exist a relationship between the appearance of spike and wave complexes in the limbic system without epileptic signs (twitching or myoclonus) and the presence of hallucinations, and that there is a left side hemispheric lateralization of the electrographic effects, viewing cerebral dominance phenomena as a functional and fluctuating state.
 ...
PMID:Lateralization of spike and wave complexes produced by hallucinogenic compounds in the cat. 370 27

We describe three patients with mitochondrial myopathy, dementia, loss of vision and hearing, seizure disorder with myoclonus, intermittent headaches of a vascular type, visual hallucinations, cerebellar dysfunction, and lactic acidosis. Muscle biopsies in all patients and liver biopsy in one revealed abnormal mitochondria. The disorder may be due to a deficiency of mitochondrial NADH-CoQ dehydrogenase.
 ...
PMID:Mitochondrial myopathy and encephalopathy: three cases--a deficiency of NADH-CoQ dehydrogenase? 641 59

A 15 year old boy was evaluated in the psychiatric emergency room for the acute onset of "confusion,"insomnia, headache, and shaking of one week's duration. Two days later hallucinations, formication and a movement disorder emerged characterized by action tremor, myoclonus, chorea and ataxia. Further history revealed inhalation of gasoline for its euphoric effects. Plasma lead levels were in the toxic range. Chelation therapy reversed the clinical symptoms. Behavioral changes and a movement disorder in the context of gasoline inhalation are highly suggestive of organic lead encephalopathy. Recognition of this syndrome is important as chelation therapy is effective.
 ...
PMID:Organic lead encephalopathy: behavioral change and movement disorder following gasoline inhalation. 705 7

A 59-y-old with a history of chronic renal failure on hemodialysis was diagnosed with herpes zoster and begun on 800 mg acyclovir 5 times daily. Two days later the patient developed visual hallucinations, ataxia, confusion and memory loss along with focal myoclonus, nausea and vomiting. No fever, elevated WBC count or significant electrolyte imbalance was found. CT scan of the brain was unremarkable. The patient was then dialyzed for presumed acyclovir toxicity. Her acyclovir level was later found to have been 3.4 micrograms/ml (normal peak range 0.4-2 micrograms/ml) prior to dialysis. After 3 h of hemodialysis, her post-dialysis acyclovir level was 1.9 micrograms/ml. After a second course of hemodialysis the next day the patient's mental status improved, and she was discharged 5 d later. Due to its low volume of distribution (0.6 L/kg), low protein binding (about 15%) and water solubility, acyclovir is an example of the ideal drug that can be removed by hemodialysis. About 45% of the total body amount can be extracted through a 3-h course of hemodialysis with resultant improvement in symptoms.
 ...
PMID:Hemodialysis removal of acyclovir. 757 52

Accumulation of active (toxic) metabolites of opioids might explain cases of opioid toxicity when high doses are used for long periods of time. Other mechanisms of late toxicity of opioids may be found at the receptor level. Whatever the cause, a change of opioids using equianalgesic doses can be expected to improve symptoms of toxicity in some patients, while maintaining pain control. We reviewed the experience with this technique in patients admitted to the Palliative Care Unit of the Edmonton General Hospital. Of 191 patients, 80 underwent opioid rotation (OR) for cognitive failure, hallucinations, myoclonus, nausea and vomiting, local toxicity, and persistent pain. These leading symptoms improved in 58/80 patients (73%, P < 0.01). Pain control, as measured on a 10-cm visual analogue scale (VAS), improved from 4.4 +/- 2.3 to 3.6 +/- 2.0 (P < 0.004) at a dose significantly lower than that predicted to be equianalgesic (577 +/- 1535 mg before OR versus 336 +/- 593 mg after OR, P < 0.04). We conclude that symptoms of opioid toxicity can be relieved by OR, and that a choice of two or three different opioids is necessary to obtain satisfactory long-term pain control.
 ...
PMID:Opioid rotation for toxicity reduction in terminal cancer patients. 767 70

A 40-year-old female with a lumbar drain was admitted to the neurosurgery service with a bacterial meningitis. During the course of her treatment with multiple central nervous system (CNS) active medications, the patient became disoriented and agitated with visual hallucinations and generalized myoclonus. A psychiatric consultation was requested. The case is presented and discussed within the context of the importance of understanding etiological mechanisms in treating and reversing delirium. The fluoroquinolone agent ciprofloxacin was considered to be the primary etiology of the patient's delirium. This class of medication as a cause of altered mental status is discussed.
 ...
PMID:The role of ciprofloxacin in a patient with delirium due to multiple etiologies. 773 96


1 2 3 4 5 6 7 8 Next >>