Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two infants of homocystinuria with a defective activity of the N5,10-methylenetetrahydrofolate reductase in the liver, kidney, brain and/or leukocytes were reported. Contrary to four cases with similar biochemical defects reported up to date, the two cases of ours demonstrated peculiar clinical features characterized by an early onset in infancy, fits of apnea and seizures, downhill course with coma, and death within one year of life. Thus "an infantile type" of this disorder was advanced as a new clinical entity. Assay for the N5,10-methylenetetrahydrofolate reductase activity using peripheral leukocytes was established and might be useful for a diagnosis of this disorder and also for detection of heterozygotes.
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PMID:Infantile type of homocystinuria with N5,10-methylenetetrahydrofolate reductase defect. 84 45

The hospital course and therapy of 369 patients with Reye's syndrome were evaluated. Eighty-three percent of patients had deepening coma during hospitalization. Stage of coma on admission, evidence of increased intracranial pressure, and blood ammonia levels greater than 300 microgram/100 ml were all significantly associated with increasing mortality. Among survivors of Reye's syndrome, 30% of those who developed either decerebrate posturing or seizures during hospitalization had serious neurologic sequelae upon discharge. When analyzed by (1) stage of coma during admission (2) progression of coma during hospitalization, (3) degree of blood ammonia level elevation, and (4) presence of increased intracranial pressuring, no significant differences were noted between patients receiving intensive supportive care and those receiving exchange transfusions and/or peritoneal dialysis.
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PMID:Reye's syndrome: clinical progression and evaluation of therapy. 91 33

Clinical experience seems to indicate two separate types of entry to coma. Some patients follow a pathway characterized by confusion, hallucinations, mumbling delirium, myoclonic jerks, and seizures. The author has called this sequence of symptoms the high road to coma and hypothesized that its basic underlying pathophysiology involves increased neuronal firing rates. Other patients develop somnolence, lethargy, obtundation, and unresponsiveness without seizures or muscle twitches. This low road to coma involves either anatomical compression of the midbrain reticular formation or a metabolic or toxic disorder characterized by membrane stabilization and decreased neuronal excitability.
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PMID:Two roads to coma: the Scottish hypothesis. 94 May 9

An encephalopathy may occur following treatment of chronic pulmonary failure and is manifested by multifocal seizures, mild focal motor signs, and coma. The encephalopathy seems to be a multifactorial illness resulting from cerebral ischemica and hypoxia. The more important factors appear to be cerebral alkalosis, administration of aminophyline, and associated hypotension.
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PMID:Encephalopathy following treatment of chronic pulmonary failure. 94 91

Acute subdural hematoma in infants is characterized by convulsive seizure, disturbance of consciousness, vomiting and irritability soon after mild head injury. The majority of cases have tence or bulged anterior fontanel and preretinal hemorrhage. Eleven cases, all traumatic in etiology and male under the age of one year were reported. Nine of them were treated by percutaneous subdural tapping alone, i.e., "Tapping Only Method". For the first several days, tappings were carried out daily. The subdural content was liquefied old dark blood or liquefied fresh-appearing blood in most cases. After that taps were performed only in the presence of intracranial hypertension. Vomiting and irritability were fairly reliable indicaters of intracranial hypertension but the most consistent signs were the fontanel tension to palpation and the measurement of head circumference. As soon as it could be determined that increased pressure did not recur within ten days after the last tap or that dry tap was confirmed the infant was discharged and follow as an outpatient. Follow-up studies on this series by cerebral angiography, EEG, skull measurement and Denver developmental screening test revealed normal physical and mental development in nine cases, although three out of nine cases showed mild but persistent avascular area. The remaining two cases showed more or less physically and mentally retarded developments: the initial treatment for both of them was delayed more than ten days. Acute infantile subdural hematoma due to mild head injury should be divided into the following two types: "Fulminant type", which rapidly falls in coma and may be fatal. The another, "Mild type" manifests only signs and symptoms of mild intracranial hypertension. This mild type should be treated by tapping only method without delay. There is a possibility that some mild type cases are overlooked and later progress to chronic infantile subdural hematoma. For comparison, thirteen cases of acute infantile subdural hematoma treated by trephination and/or craniotomy were reviewed. Pathological study revealed that early formation of capsular membrane is one of the characteristic findings.
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PMID:[Treatment of acute subdural hematoma in infancy-tapping only method and a follow-up study (author's transl)]. 94 81

Although there is evidence that the delirium, stupor, coma, and seizure-like activity seen in overdosage with tricyclic antidepressants and antiparkinson drugs are due to the central anticholinergic activity of these agents, patients with overdosage of these drugs are still frequently misdiagnosed. The authors present a case of reversal of anticholinergic-drug-induced prolonged coma, myoclonus, and choreoathetosis by physostigmine. This report supports the anticholinergic basis of the clinical manifestations of such overdosages, provides information on the role of acetylcholine and dopamine in psychiatric and movement disorders, and illustrates dramatically the need for accurate diagnosis and treatment.
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PMID:Reversal of tricyclic-overdosage-induced central anticholinergic syndrome by physostigmine. 96 21

Acute water intoxication with deepening coma and uncontrolled epileptiform seizures in a 25-year-old previously fit male schizophrenic was treated with hypertonic (2 N) saline and a 20% mannitol solution. This improved his neurological state but precipitated severe pulmonary oedema. Intravenous frusemide increased his urinary output sufficiently to clear the pulmonary oedema. In acute water intoxication the use of hypertonic solutions may thus precipitate left heart failure by expanding the intra-pulmonary blood volume beyond the capacity of even a healthy left ventricle to compensate. Simple water restriction will produce a slower but perhaps safer improvement.
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PMID:Pulmonary oedema during treatment of acute water intoxication. 98 Oct 97

Twenty-six patients with the syndrome of inappropriate secretion of antidiuretic hormone were reviewed. The underlying diseases were bronchogenic carcinoma (12 cases); myxoedema (five cases); diseases of the nervous system (five cases); bronchopneumonia, carcinoma of the oesophagus, acute intermittent porphria and chlorpropamide therapy (each one case). Serum sodium levels ranged between 104 and 125 mEq per litre. Eighteen patients presented neurological manifestations, which in 14 were considered to be due to hyponatraemia. Neurological signs included disorders of consciousness (stage I and II coma), extrapyramidal signs, asterixis and epileptic seizures. An hyponatraemic coma was the first manifestation of the syndrome in five cases. In all cases where the EEG was recorded it showed non-specific signs of metabolic coma. The fundi never showed signs of intracranial hypertension. Blood urea and creatinine levels were invariably low in the euthyroid patients; these values were normal or elevated in patients with myxoedema and hyponatraemia. Hypokalaemia was frequent, and hypocalcaemia constant. In eleven cases an excess of water intake revealed the clinical syndrome: six patients were excessive beer drinkers and five had received extensive intravenous infusions. In one case the deleterious effect of diuretics was evident, and in another, the syndrome became evident during radiotherapy of an oesophageal tumour. Treatment of the syndrome was successful in all cases. A review of the literature concerning the various pathogenic mechanisms corresponding to the different underlying diseases is presented. The concept of aberrant hormonal production by a tumour is illustrated by an electron microscopic study.
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PMID:Clinical, biological and pathogenic features of the syndrome of inappropriate secretion of antidiuretic hormone. A review of 26 cases with marked hyponatraemia. 100 53

Neuropathologic findings in 2 cases of cerebral lymphomatoid granulomatosis with sequelae are presented. A 30-year old male with macular rash and pulmonary lymphomatoid granulomatosis responded to Prednisone terapy but developed acute intracranial hypertension with coma. A necrotizing hemorrhagic lesion was evident in the left putamen surrounded by diffuse and perivascular atypical lymphoplasmacytic infiltration. An 18-year old girl developed pulmonary lymphomatoid granulomatosis, diplopia, slurred speech and right hemiparesis. Brain scan, angiography and EEG suggested a left fronto-parietal mass assumed to represent lymphomatoid granulomatosis. She responded well to cerebral irradiation, intrathecal methotrexate and cytoxan but relapsed with seizures and increasing respiratory insufficiency. At autopsy, stigmata of cerebral lymphomatoid granulomatosis were absent but a parenchymatous degeneration consistent with disseminated necrotizing leukoencephalopathy following antileukemic therapy in children, was found.
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PMID:Cerebral lymphomatoid granulomatosis. A report of two cases, with disseminated necrotizing leukoencephalopathy in one. 100 3

Most street hallucinogens contain either LSD or phenycyclidine HCl (PCP). Because the acute phase of LSD and PCP mimic several other drugs and conditions, it is important to exclude these other possibilities. When faced with LSD or PCP, "talking down" usually suffices for the mild case; management becomes more complex should hyperpyrexia, coma, seizures or a hypertensive crisis ensue. Diazepam, not a phenothiazine, is preferred for sedation.
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PMID:Management of hallucinogen abuse. 106 15


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