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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors present the case report of a 19-year-old woman that contains several important points in the diagnosis and management of organic personality disturbance associated with temporal lobe epilepsy. The behavioral changes may antedate the onset of the clinical seizure. The diagnosis of complex partial seizures is a clinical diagnosis in which surface EEGs may repeatedly not demonstrate focal activity. Carbamazepine can have important psychotropic effects, in addition to its well-established anticonvulsant effects, and it may be particularly indicated if a lithium-resistant bipolar affective disorder is a differential diagnostic possibility.
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PMID:Organic personality disturbance: a case of apparent atypical cyclic affective disorder. 44 72

Lithium has become a widely accepted treatment for manic-depressive psychosis. It is dramatically effective for many cases of mania and is useful in the prevention of manic and depressive episodes. Hyperaggressiveness and hypersexuality are frequent components of manic-depressive illness and abate under the influence of lithium. A brief review is presented of the behavioral and biochemical pharmacology of lithium. This documents the inhibitory role which lithium can play in several examples of animal aggressive behavior including pain-elicited aggression, mouse killing in rats, isolation-induced aggression in mice, p-chlorophenylalanine-induced aggression in rats, and hypothalamically induced aggression in cats. The use of lithium to control human aggressive behavior has resulted in controversial findings. In epileptic conditions, improvement has been reported in interseizure aggressivity, but other reports indicate the possibility of increased seizures. Improvement in aggressive behavior in childhood has occasionally been reported as well as in emotionally unstable character disorders in young female patients. Te was a single blind study and the other a large but uncontrolled study. Both studies reported an improvement in aggressiveness as indicated by fewer recorded reports (tickets) for fighting. The final study reported is a study of 12 male delinquents age 16 to 23. They received lithium or placebo for 4 months inside an institution and then a trial of lithium for 1 to 12 months on an outpatient basis. Analysis of results in terms of the number of aggressive antisocial acts showed fewer serious aggressive episodes when the lithium level was between 0.6 and 1 meq/liter than when it was between 0.0 and 0.6 meq/liter. These results must be viewed with caution and are only suggestive since the study was not double blind.
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PMID:Lithium in the treatment of aggression. 109 Jul 6

The mechanism of action of lithium, the primary treatment for bipolar affective disorder, is unknown but may involve inhibition of second messenger production in the brain. Therefore, the concentrations of three second messengers, inositol 1,4,5 trisphosphate (Ins 1,4,5P3), cyclic adenosine monophosphate (AMP), and cyclic guanosine monophosphate (GMP), were measured in rat cerebral cortex and hippocampus after acute or chronic lithium administration, as well as after treatment with the cholinergic agonist pilocarpine alone or in combination with lithium at a dose that induces seizures only in lithium pretreated rats. Neither acute nor chronic lithium treatment altered the hippocampal or cortical concentration of Ins 1,4,5P3, cyclic AMP, or cyclic GMP. Pilocarpine administered alone increased Ins 1,4,5P3 in both regions, did not alter cyclic AMP, and slightly increased cyclic GMP in the cortex. Coadministration of lithium plus pilocarpine caused large increases in the concentrations of all three second messengers and the production of each of them was uniquely attenuated: lithium reduced pilocarpine-induced increases of Ins 1,4,5P3 in the cortex at 60 min; chronic lithium administration reduced stimulated cyclic AMP production in the hippocampus; and chronic lithium treatment impaired stimulated cyclic GMP production in both regions. In summary, chronic lithium treatment appeared only to reduce Ins 1,4,5P3 and cyclic AMP concentrations after a long period of stimulation whereas cyclic GMP production was reduced by chronic lithium administration after both short and long periods of stimulation. Thus cyclic GMP was most sensitive to lithium and lithium attenuation of second messenger formation may be most important in excessively activated pathways.
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PMID:Inositol trisphosphate, cyclic AMP, and cyclic GMP in rat brain regions after lithium and seizures. 131 77

Two cases of electroconvulsive therapy (ECT) in adolescence are presented and the literature on the use of ECT in childhood and adolescence is reviewed. ECT was effective in children and adolescents with bipolar disorder and depression. Inadequate information exists to make a judgment regarding schizophrenia, delirium, and anorexia nervosa. ECT is not effective in autism and chronic organic brain syndromes. Complications cited include organicity and seizures in the period immediately after ECT, anxiety reactions, and disinhibition. Long-term memory deficit or cognitive impairment has not been found, although further research to rule out residual impairment is needed.
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PMID:A review of ECT for children and adolescents. 222 48

Recent research on the various biological indices of bipolar mood disorder reveals a complex framework for the understanding of this psychobiological disorder. Four major constructs emerge from the professional literature to form the basis of the current understanding of and approaches to bipolar disorder. The first construct is that of biological rhythms and mood disorders. From this perspective, time is considered as a biological dimension evidenced by biological rhythms. Disruption of certain internal circadian rhythms yields behavioral change and symptoms of psychobiological disequilibrium. Concepts inherent in this particular construct include sleep, effect of light on mood pattern, and possible biochemical indices of mood modulation such as melatonin or phenylethylamine. The second construct attempts to explore the linkage between biochemical brain function and aberrant mood behavior. This information bifurcates into two major categories: (1) effects of psychopharmacological substances on neurotransmitter synthesis and release; and (2) implications of dietary influences on neurotransmitter activity and the psychobiological ramifications of such activity on the clinical understanding of the behavioral disorder. An eclectic set of concepts form the third construct in the framework presented here. These concepts address other possible etiological or mitigating biological influences on bipolar mood states. Such influences include, but are not limited to, limbic seizure activity, neuroendocrine dysfunction, and organic substrates of bipolar states such as various malignancies. The final construct explores the role of genetics in either the predisposition to or the emergence of bipolar mood disordered states. This report will focus on a review of the aforementioned constructs, pointing to significant research and narrative professional publications. In addition, the presentation will address the application of the nursing process to psychobiological aspects of bipolar mood disorder, specifically circadian rhythmicity disturbance and dietary influences on neurotransmission.
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PMID:Psychobiological indices of bipolar mood disorder: future trends in nursing care. 231 96

Valproic acid and its enteric-coated derivative, divalproex sodium, have been used extensively in a wide variety of seizure disorders. Recent preliminary research demonstrates the effectiveness of valproate in the treatment of manic-depressive illness, including acute mania, prevention of bipolar episodes, and schizoaffective disorder. In uncontrolled and controlled studies, treatment-resistant patients with these disorders have responded well to valproate. Preliminary results of an ongoing community-based open trial of valproate treatment of those affective illnesses reveal that valproate is frequently effective and has a favorable side effect profile. Overall, approximately two out of three patients with refractory bipolar disorder respond to acute therapy with valproate. Response in schizoaffective patients has been moderate, and valproate seems to be less effective in the treatment of depression. Experience suggests the importance of monitoring plasma drug levels to maximize efficacy and minimize potential toxicity.
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PMID:U.S. experience with valproate in manic depressive illness: a multicenter trial. 249 53

Although lithium remains the treatment of choice for manic depression, it is now well recognized that 20%-40% of patients either do not tolerate the drug or their disease does not respond to it. This subgroup of patients accounts for a substantial majority of the morbidity that accompanies this illness. For this reason, alternatives to lithium therapy will have a significant clinical impact. In a great majority of cases, the rapid-cycling variant of this disorder accounts for the resistance to lithium treatment. Recently, a growing body of literature has suggested that several medications routinely used in the management of seizure disorders, particularly carbamazepine and valproate, have therapeutic mood-altering properties. These drugs have been evaluated in numerous drug trials using open, double-blinded, longitudinal, and (in the case of carbamazepine) randomized designs. The authors comment on the phenomenology of manic depression and review the literature on use of anticonvulsants in the management of lithium-resistant manic depression.
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PMID:Anticonvulsants for treatment of manic depression. 269 Nov 15

The authors present psychiatric and neurologic data on 20 patients who developed mania after closed head trauma. An association was seen between severity of head trauma (based on length of posttraumatic amnesia), posttraumatic seizure disorder, and type of bipolar disorder. The manic episodes were characterized by irritable mood rather than euphoria and by assaultiveness. Psychosis occurred in only 15% of the sample, and 70% had no depressive episodes. Bipolar disorders were absent among 85 first-degree relatives. The authors suggest that posttraumatic seizures may be a predisposing factor in posttraumatic mania.
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PMID:Mania following head trauma. 379 47

'Spike-wave stupor' was observed in a 58-year-old male patient with manic-depressive psychosis. Almost continuous atypical spike-wave activity was seen in conjunction with a stuporous episode with stereotyped automatism. Intravenous diazepam ended both the electroencephalographic epileptiform discharges and the clinical stupor. Before and during this episode the patient was treated with an average-dose amitriptyline monotherapy. There was no family history of epileptic seizures. The patient had had electroconvulsive therapy. The history suggests that the analeptic property of amitriptyline induced the 'spike-wave stupor' in this patient.
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PMID:Unusual 'spike-wave stupor' in a patient with manic-depressive psychosis treated with amitriptyline. 618 83

The current practice of German psychiatric hospitals restricts electroconvulsive therapy (ECT) to patients with profound disability and failure to respond to pharmacotherapy. We studied clinical features and seizure parameters in 63 patients who received ECT in a 3-year period at a German university hospital. Patients with unipolar and bipolar disorder (depressed) (n = 47) showed a complete or partial recovery as assessed 2 weeks after completion of the ECT course in 31.9 and 38.3%, respectively. Multiple linear regression analysis performed on several clinical and ECT seizure parameters failed to identify strong outcome predictors in our selected sample of patients. Most patients who eventually responded did so early in the course of ECT, while there was little improvement when > 10 ECT treatments were given. Our report highlights the efficacy of ECT in the management of severe psychiatric disorders even in a highly selected sample of patients previously found to be resistant to alternative modes of psychiatric treatment.
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PMID:Patient selection and remission rates with the current practice of electroconvulsive therapy in Germany. 755 48


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