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

In 1957, Landau and Kleffner reported six cases of a "syndrome of acquired aphasia with convulsive disorder". Since this first report more than 130 cases with acquired language disabilities with EEG-abnormalities have been described. Comprehension of language is primarily affected, spike discharges are predominantly found in temporal regions. Facultative symptoms are epileptic seizures and psychiatric disorders. The paper gives a review of the literature describing the clinical manifestations, the therapeutic procedure, the prognosis and the etiological factors of this syndrome, which is even listed in the last version of the ICD-10 and the International Classification of Epilepsies and Epileptic Syndromes.
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PMID:[Landau-Kleffner syndrome]. 169 7

Because of case reports suggesting that use of transdermal scopolamine might be associated with the subsequent development of seizures, a retrospective cohort study was performed with computerized Medicaid claims data. Patients receiving transdermal scopolamine were compared with patients receiving diphenhydramine, meclizine, prochlorperazine, and promethazine. A four-fold increased risk of seizures after transdermal scopolamine use was observed in the claims data. However, this was not supported by the primary medical records. All patients who had seizures after using transdermal scopolamine either had seizures before receiving the drug as well or did not really suffer from seizures. The original finding appeared to be the result of the use of transdermal scopolamine for "dizziness, rule out seizures"; the ICD-9-CM coding system does not include "rule out" diagnoses. Thus these data do not confirm the existence of an association between seizures and the use of transdermal scopolamine. In addition, this study demonstrates the usefulness of pharmacoepidemiology studies in documenting drug safety and the importance of obtaining primary medical records when performing pharmacoepidemiologic studies with claims data.
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PMID:No causal relationship between transdermal scopolamine and seizures: methodologic lessons for pharmacoepidemiology. 185 48

This study was designed to evaluate a historic cohort of pure tricyclic antidepressant overdose patients for factors associated with severe toxicity. Hospitalized tricyclic antidepressant overdose patients were identified by computerized discharge diagnosis (ICD-9 codes). Patients with a serum drug screen positive for tricyclic antidepressants and an emergency department 12-lead electrocardiogram were included in the study. Multiple drug overdoses were excluded. Patients were divided into two groups: minor toxicity (n = 41 and major toxicity (n = 65). Criteria for inclusion in the major toxicity group were the occurrence of seizures, endotracheal intubation, coma, arrhythmias requiring treatment, hypotension, or death. The following were found to be associated with increased likelihood of major toxicity (p less than 0.05): ingestion of amitriptyline (odds ratio (OR) 2.57), age greater than or equal to 30 years (OR 2.56), heart rate greater than or equal to 120 bpm (OR 2.86), serum tricyclic antidepressant level greater than or equal to 800 ng/mL (OR 5.20), terminal 40 ms QRS axis (T40-ms axis) greater than or equal to 135 degrees (OR 2.73), QRS interval greater than or equal to 100 ms (OR 2.74), QRS axis greater than 90 degrees (OR 3.68), and QTc interval greater than 480 ms (OR 3.89). The mean T40-ms axis on the initial ECG was more rightward in the major toxicity group (174 +/- 84 vs 125 +/- 91 degrees, p = 0.006). We conclude that patients with severe tricyclic antidepressant toxicity tended to have a more rightward T40-ms axis than those with minor toxicity and that the presence of the above parameters was associated with an increased likelihood of severe toxicity.
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PMID:Demographic and electrocardiographic factors associated with severe tricyclic antidepressant toxicity. 200 64

Clinical pictures of 21 cases with I-cell disease patients, 12 males and 9 females, were analyzed. Characteristic coarse facial features and shortness of stature were observed in all cases. In general, the motor development was found to be more severely retarded than the mental development of the patients. Rather little involvement of the nervous system seemed to cause somewhat acceptable mental development in some cases, and also cause the absence of epileptic seizures in all cases. Involvement of the cardiovascular system, especially progressive hypertrophic cardiomyopathy, could be highly responsible for frequent sudden death of I-cell disease patients.
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PMID:I-cell disease: clinical studies of 21 Japanese cases. 299 52

A sample of 148 child and adolescent psychiatric patients with hysterical neurosis is described as to the variables features and extent of symptomatology, age and sex distribution, psychosocial adversity and prognostic factors. Out of the "classical" symptoms seizures, walking disturbances, twilight attacks and paralyses were seen most frequently whereas vision and hearing disturbances were rather rare. Only one fifth of the patients presented a monosymptomatological pattern of disturbance. Mean age at falling ill was 13.4 years, just three children were younger than 6 years. Our clinical results buttressed by other reports of the child and adolescent psychiatric literature indicate that the traditional concept of hysteria postulating a close link between somatical symptom development and a specific intrapsychic conflict is hardly tenable at least for childhood and adolescence. Classification should be rather grounded upon an essential phenomenological approach as designed by ICD 10.
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PMID:[Hysterical neuroses in childhood and adolescence]. 361 52

A critical review was given to the diagnostic transition of hyperactive children, i.e., from attention deficit disorder to attention deficit-hyperactivity disorder, in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. Based on the new diagnostic criteria for hyperactive children, or hyperkinetic disorders in ICD-10, 12 of 122 (9.8%) children with a birthweight less than 1,500 grams have found to show hyperkinetic disorders during ordinary follow-up examinations at 4 to 6 years of age. Discontinuation of stimulants during school holidays, or the "drug holidays" procedure, was recommended not only because a child's response to stimulants could be reconfirmed but also because the side effect of growth retardation could be avoided. Three typical drug responders with hyperactivity were presented. Case 1 was a 19-year-old male with some autistic features and tics. He had been taking pemoline from 10 to 13 years of age, but showed no side effects. Case 2 was a 15-year-old boy with epileptic EEG abnormalities, and had been also taking pemoline from 6 to 10. He was attacked by a partial seizure with secondary generalization just 2 months after the drug administration. Recurrence of epileptic seizures was prevented by additional medication of an anticonvalsant , carbamazepine. Case 3 was a 13-year-old boy with enuresis nocturna and with several febrile seizures, and had been taking clomipramine, a tricyclic antidepressant, from 4 to 6. The antidepressant proved very effective to his hyperactivity and temper tantrum, but not to his enuresis.
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PMID:[Diagnosis and drug treatment in hyperactive children]. 813 93

During a 24-month period, 205 consecutive new referrals to Muhimbili psychiatric unit were studied. Their socio-demographic characteristics, sources of referral, types of treatment received before referral and the nature of their clinical problems were identified. Their neuropsychiatric disorders were classified according to ICD-10. The ratio of males to females was found to be 1.6:1. The average age was 29.3 years. 23.4% of adult patients were unemployed, two fifths of all patients were single and 70% of all subjects had less than eight years of formal education. Whereas 42.9% of all referrals were from other departments of Muhimbili hospital, the remaining were largely from parastatal dispensaries, district and regional hospitals within Dar es Salaam city. At least a fifth of all patients had consulted traditional healers prior to referral and antimalarials had been given inappropriately to 34 patients with mental problems. Mental disorders consisted of functional psychosis, 36.6% of which three quarters were schizophrenia, neurosis (19.5%), seizures (16.6%), substance abuse (8.8%), organic mental disorders (5.3%), headache (4.9%), sexual dysfunction (2.9%). The rest had conduct disorders and pseudocyesis. Seventeen percent of all cases had concomitant physical disorders. Most patients had delayed to seek medical help.
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PMID:Nature of referrals to the psychiatric unit at Muhimbili Medical Centre, Dar es Salaam. 868 72

Studies of psychiatric out-patients from India have found that diagnosis of some of the subcategories of the dissociative and conversion disorders of the ICD and DSM classificatory systems are rarely made in this setting. Moreover, it was found that a significant percentage of patients seen in psychiatric practice may not fit into the defined subcategories of dissociative (conversion) disorders of these systems of classification. We studied the prevalence of various ICD-10 and DSM-IV categories of dissociative (conversion) disorders and our own proposed category of 'brief dissociative stupor' (BDS), among all the in-patients of a psychiatric unit in a general teaching hospital, over a 2-year period. There were 18 patients who fulfilled our criteria for BDS and 18 patients in the second group which included all of the remaining subjects with a diagnosis of any other subcategory of dissociative disorder according to ICD-10. Our analysis revealed that there were no patients with a diagnosis of dissociative amnesia, fugue, stupor, trance and possession disorders or identity disorders. There were significantly more female patients in the BDS group, and they also had significantly more comorbid Axis-I diagnoses and panic attacks. Since 50% of our patients fulfilled the criteria for BDS, there is clearly a need for further studies to establish the prevalence of this subcategory in patients from other centres. The classification of these patients with this phenomenology is problematic. Inclusion of a subcategory of dissociative non-epileptic seizures, instead of dissociative convulsions, should improve the classification of dissociative (conversion) disorders.
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PMID:Limited utility of ICD-10 and DSM-IV classification of dissociative and conversion disorders in India. 911 49

The frequency and clinical presentation of autism in 28 probands with tuberous sclerosis complex (TSC) are reported and risk factors that may influence the development of autism in TSC are examined. Eight probands meet ICD-10 and DSM-IV criteria for autism, an additional 4 meet criteria for pervasive developmental disorder (PDD). Twelve TSC probands with autism/PDD are compared to 16 TSC probands without these conditions for factors which may underlie the association of autism and TSC. A specific seizure type, infantile spasms, as well as mental retardation, are increased in the TSC, autistic/PDD group. Furthermore, rates of social phobia and substance abuse are elevated among first-degree relatives of TSC probands with autism compared to first-degree relatives of TSC probands without autism. Implications of these findings in understanding the association of autism and TSC are discussed.
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PMID:Autism in tuberous sclerosis complex. 958 71

Mu-Opioid receptor-mediated neurotransmission is involved in the reward, tolerance, and withdrawal effects of alcohol. The present association study tested the hypothesis that the common Asn40Asp substitution polymorphism in the N-terminal domain of the human mu-opioid receptor (OPRM) confers vulnerability to subtypes of alcohol dependence. The genotypes of the Asn40Asp substitution polymorphism were assessed in 327 German alcohol-dependent subjects (according to ICD-10) and in 340 control subjects of German descent, using an assay based on allele-specific polymerase chain reaction. To select alcoholics with a presumed high genetic load, three subgroups were delineated, marked by (1) a family history of parental alcoholism (n = 114); (2) the inability to abstain from alcohol before the age of 26 years (n = 73); and (3) a history of alcohol withdrawal seizure or delirium (n = 107). The frequency of the Asp40 allele did not differ significantly between the controls [f(Asp40) = 0.078] and either the entire group of alcoholics [f(Asp40) = 0.107; p = 0.066], or the alcoholics with parental alcoholism [f(Asp40) = 0.114; p = 0.094], or the early-onset alcoholics [f(Asp40) = 0.096; p = 0.471,[ or the alcoholics with severe withdrawal symptoms [f(Asp40) = 0.098; p = 0.350]. Our results do not provide evidence that the common Asn40Asp substitution polymorphism of the OPRM gene contributes a major effect to the pathogenesis of alcohol dependence.
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PMID:Human mu-opioid receptor variation and alcohol dependence. 988 58


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