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)

A 6-year-old male golden retriever, with an 8-month history of seizures and a clinical diagnosis of lymphoma in the central nervous system, was (at the owner's request) euthanized after signs of respiratory distress and shock developed. Upon postmortem examination, the diagnoses of meningoencephalitis and pneumonia were made. A histological examination of selected tissues from both the lung and central nervous system revealed a severe, acute, multifocal, amoebic, embolic pneumonia and a severe, chronic, multifocal, nonsuppurative, amoebic meningoencephalitis. Indirect immunofluorescence analysis confirmed the presence of trophozoite and cyst stages of Balamuthia mandrillaris. This is the first report of B. mandrillaris (which is a free-living amoeba) causing fatal, multifocal granulomatous amoebiasis in a dog in Australia.
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PMID:Multifocal Balamuthia mandrillaris infection in a dog in Australia. 1703 42

Patients with epilepsy may suffer from renal or hepatic diseases that interfere with their antiepileptic drug (AED) treatment. Furthermore, such diseases may themselves cause seizures. Reduced renal function and hypoalbuminemia lead to accumulation of renally excreted AEDs, such as gabapentin, vigabatrin, topiramate, levetiracetam, and phenytoin. Valproate, lamotrigine, and benzodiazepines are less affected. Low protein-bound AEDs are extensively removed by hemodialysis and supplemental doses are required for dialysis patients. Uremia and related conditions, including intracranial hemorrhage, glucose and electrolyte imbalances, and concomitant drug use, can cause seizures, as can dialysis encephalopathy, primary cerebral lymphoma, fungal infections, and immunosuppressant toxicity in renal transplant recipients. Hepatic dysfunction reduces enzymatic metabolism of AEDs and causes hypoalbuminemia. Gabapentin, topiramate, and levetiracetam are preferred in these conditions, whereas conversely valproate and felbamate are potentially hepatotoxic and should be avoided. Seizures related to hepatic encephalopathy are controlled by oral lactulose or neomycin. Porphyria sufferers may benefit from gabapentin, oxcarbazepine, or levetiracetam. Seizures in Wilson's disease may derive from d-penicillamine-induced pyridoxine deficiency. Effective treatment of seizures in renal and hepatic diseases requires attention to changes in AED pharmacokinetics and adequate care of the underlying illnesses. Monitoring of free drug concentrations is a valuable aid to therapy.
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PMID:Optimizing therapy of seizures in patients with renal or hepatic dysfunction. 1719 Sep 18

Tumor lysis syndrome (TLS) is an important metabolic disorder frequently encountered in the management of a variety of cancers including lymphoma, leukemia, and neuroblastoma. Delayed recognition can result in a variety of biochemical abnormalities resulting in life-threatening complications such as renal failure, arrhythmias, and seizures. Identification of high-risk patients and early recognition of the syndrome is crucial in the early institution of appropriate prophylaxis and treatment. Recent advances in the understanding of urate metabolism, development of new urate-lowering drugs, and the application of biomarkers, calculation methods, and prognostic models to identify high-risk patients will pave the way in improving the management of TLS. We included in this review the new information regarding the urate transporters URAT-1, organic anion transporter 1/3, and MRP4; the urate elimination pathway; a comparison of the old- (allopurinol, native uricase) and new- (febuxostat, Y-700, PEG-uricase, rasburicase) generation urate-lowering agents; and application of new biomarkers (cystatin-C, neutrophil gelatinase-associated lipocalin, kidney injury molecule 1), estimated glomerular filtration rate and calculation methods (modification of diet in renal disease and prognostic model (Penn Predictive Score of Tumor Lysis Syndrome) in the identification of high-risk patients, and alternative unexplored mechanisms (asymmetric dimethylarginine and adenosine) to explain renal injury related to TLS.
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PMID:Tumor lysis syndrome. 1752 97

A 15-year-old female harbor seal (Phoca vitulina) was referred to the Nantes Veterinary School, Nantes, France, with a clinical history of anorexia, seizures, and left hemiplegia. Cerebrospinal fluid analysis revealed large numbers of neoplastic lymphoid cells. After injection of a contrast agent into the cerebrospinal space, radiographs demonstrated an asymmetry of the right lateral ventricle. Necropsy examination revealed a marked edema of the right frontal lobe, extending to the basal nuclei and thalamus in the brain. Histological examination of the brain revealed leptomeningeal lymphoma. Immunohistochemical labeling demonstrated that the neoplasm was of T-cell origin. No significant macroscopic or microscopic lesions were observed in the other organs examined, including lymphoid organs. This is the first report of primary leptomeningeal lymphoma in a harbor seal.
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PMID:Primary meningeal T-cell lymphoma in a harbor seal (Phoca vitulina). 1767 18

A 31-year-old male, who had received a cadaveric renal allograft in April 2003, consulted a clinic for a transient hemiplegia in August 2004. At that time, a course observation without medication was chosen. In October 2004, he was admitted to our hospital by ambulance with a clonic seizure and a recurrence of hemiplegia on the right side of his body. Head magnetic resonance imaging (MRI) showed enhanced multifocal nodular lesions with remarkable cerebral edema mainly in the left frontal lobe. A stereotactic brain biopsy was performed, and the pathological diagnosis was nasal type extranodal T/NK cell lymphoma manifested as the post transplant lymphoproliferative disease (PTLD). Systemic staging workups showed no extra-CNS involvement. Because of his renal dysfunction and no sign of any extra-CNS involvement, a reduction of the immunosuppressants and whole brain radiation therapy (WBRT) (40 Gy) without chemotherapy were applied to his therapeutic regimen. After WBRT, MRI showed a remarkable reduction in the number and size of the tumors, and no neurological abnormalities were physically observed. As of December 2006, no sign of recurrence has subsequently been found in both the intra- and extra-CNS.
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PMID:Epstein-Barr virus-associated T/NK cell-type central nervous system lymphoma which manifested as a post-transplantation lymphoproliferative disorder in a renal transplant recipient. 1805 68

Hodgkin's disease is a neoplasm of clonal Reed-Sternberg cells. Intracranial Hodgkin's lymphoma is rare. We present a unique case of a 57-year-old woman with secondary intracranial lymphoma infiltrating the dura. Her past medical history included Hodgkin's lymphoma from which she was deemed to be in remission at the time of presentation. Following an acute onset of seizures, she underwent radiological investigations that demonstrated an enhancing right-sided temporal dural-based space occupying lesion. Histopathological findings revealed nodular sclerosing Hodgkin's lymphoma with pathognomonic Reed-Sternberg cells. In cases of intracranial lesions with dural infiltration, Hodgkin's lymphoma should be considered in the diagnosis.
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PMID:Dural infiltration of metastatic Hodgkin's lymphoma. 1856 36

Although PET imaging has been available for more than two decades, its use has greatly increased lately due to the advent of PET/CT, readily available sources of commercially supplied FDG, and mobile scanners. These features have enabled PET scanning to expand beyond select major university medical centers, with on-site cyclotron facilities to smaller institutions including free- standing children's hospitals. In these settings, imaging is generally limited to FDG, which suffices for most applications, with the majority of studies performed for tumor imaging. FDGI is being used for evaluation of many tumors in children, with its use in lymphoma being the most established. In lymphoma, it has proven quite useful in determining whether active tumor is present in residual masses following treatment, which may otherwise contain only residual fibrous tissue. For brain tumors, FDGI has some relation to tumor grade, although its more important role is distinguishing recurrent or residual tumor from the effects of treatment, particularly radiation necrosis. For neurological evaluation, interictal FDGI is helpful in localizing potential seizure foci for subsequent subdural EEG monitoring. Because of the relatively long uptake time of FDG, true ictal studies cannot be performed with FDG, and these remain within the domain of SPECT imaging of tracers such as Tc-99m HMPAO. Examinations utilizing radiopharmaceuticals other than FDG are significantly more limited in their availability and are limited to PET centers with on-site cyclotrons. However, these additional agents open the door to many additional studies, including more specific tumor-imaging agents of certain tumors such as neuroblastoma. Another neurotransmitter, F-18-fluoro-L-dopa, is of benefit outside of the central nervous system for evaluating infantile hyperinsulism. The use of PET/CT in children is increasing quickly, particularly FDGI imaging of tumors. It is expected that over the next few years, its role will become increasingly better defined.
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PMID:Positron emission tomography/computed tomography (PET/CT) in children. 1861 94

Autologous SCT is a potentially curative procedure for patients with relapsed lymphoma (NHL). We analyzed the outcomes of 34 patients > or =60 years old, including eight patients > or =70 years old, who received BU and CY and SCT for NHL. Patients received BU 0.8 mg/kg i.v. (n=25) or 1 mg/kg p.o. (n=9) q 6 h x 14 doses and CY 60 mg/kg i.v. q day x 2 days. The median age was 66 (range, 60-78) years. Twenty-two patients had large cell, 10 follicular and two-mantle cell lymphoma. Fifteen patients were in a second or greater CR and 19 patients were in a PR. The median days to ANC >500/microl and platelet count >50,000/microl were 10 and 13 days respectively. The 100-day transplant-related mortality was 0%. Toxicities included interstitial lung disease (n=2), seizures in a patient with CNS lymphoma (n=1), mild veno-occlusive disease (n=2), and transient atrial fibrillation (n=4). With a median follow-up of 40 months, the 2-year overall survival and PFS were 67 and 54% respectively. BU/CY is a well-tolerated conditioning regimen for older patients with NHL. Age alone should not be used as an exclusion criterion for autologous SCT.
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PMID:Autologous SCT with a dose-reduced BU and CY regimen in older patients with non-Hodgkin's lymphoma. 1879 68

Ahead of Print article withdrawn by publisher Blood brain barrier disruption (BBBD) is a novel technique for treating central nervous system lymphoma. This technique depends on the disruption of the tight junctions between endothelial cells (which represent the blood brain barrier) by intra-arterial injection of mannitol. The most common complications of blood brain barrier disruption are seizures and brain edema. Here, the authors present a rare complication of coronary artery spasm manifested by elevation of the ST segment and bradycardia due to carotid sinus stimulation in a 33 year-old-male during blood brain barrier disruption. To the authors' knowledge, this is the first report of a coronary artery spasm complicating blood brain barrier disruption.
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PMID:WITHDRAWN Coronary artery spasm associated with blood brain barrier disruption induced by carotid sinus stimulation. 1933 90

Limbic encephalitis is an inflammatory disease localized to the "grand lobe limbique" defined by Broca in 1878, sometimes restricted to the hippocampus, but sometimes including extralimbic abnormalities. The main features are subacute onset, short-term memory disorders and cognitive impairment, temporal seizures, and hippocampic changes on MRI. A list of underlying causes has recently been published Infectious causes used to be frequent (mainly herpes simplex virus). Paraneoplastic limbic encephalitis is characterized by the presence of various onconeural antibodies, such as AntiHu and ANNA3 (bronchial small cell carcinoma), AntiMa2 (testicular tumor), AntiCV2 (lymphoma, thymoma,...). No such antibodies are detected in 40% of patients. The prognosis of these forms is poor. Voltage-gated potassium channel-associated limbic encephalopathies are due to antibodies targeting potassium channels. Mutations of the genes encoding the Kv11 and Kv12 subunits are responsible for several Shaker syndromes, including neuromyotonia, Morvan's disease, type I episodic ataxia, and limbic encephalitis with hyponatremia. Plasma exchanges and immunotherapy are effective. In patients without detectable antibodies, hippocampic anti-neuropil antibodies should be sought, particularly those targeting N-methyl-D-aspartate receptors. Ovarian teratoma is the usual cause of this type of encephalitis. Surgery and immunotherapy are effective. These disorders have been categorized into those associated with antibodies targeting intracellular antigens (poor-prognosis paraneoplastic encephalitis) and those associated with antibodies targeting antigens reacting with cellular membranes (potassium channelopathies and antineuropil antibodies), which respond to immunotherapy and carry a better prognosis. Limbic encephalitis can also reveal Hodgkin's disease, as in a case observed by the authors.
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PMID:[Limbic encephalitis--evolving concepts]. 1944 70


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