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

Pulmonary edema complicating generalized tonic-clonic seizures has rarely been reported in children, although it has been well documented in adults. We report two patients, aged 8 and 9 years, who developed clinical and radiographic evidence of the condition. Fever, leukocytosis, and arterial hypoxemia are seen in the absence of cardiac dysfunction or infection. Rapid and complete recovery is to be expected if supportive therapy is instituted. Since these patients had no underlying cardiac pathology, control of the seizures will prevent further episodes.
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PMID:Postictal pulmonary edema in children. 391 31

Prolonged seizures produce central nervous system damage. Physiologic consequences of status epilepticus may exacerbate this damage or may mislead the physician into making inappropriate therapeutic decisions. Status results in an elevation of body temperature, an increase in the peripheral white cell count, and often a transient pleocytosis in the spinal fluid. A marked metabolic acidosis occurs routinely. Prominent elevations in plasma hormonal concentrations occur as well. Epinephrine levels are in the arrhythmogenic range and could play a role in sudden death. Transient but marked pressure responses occur in the systemic and pulmonary circulations. Pulmonary edema may result from these pressure transients.
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PMID:Physiologic consequences of status epilepticus. 392 51

We evaluated the effectiveness and safety of iv naloxone in 12 septic patients who remained hypotensive despite volume replacement, appropriate antibiotics, and vasopressor therapy. Only four patients responded positively to naloxone, by increases in mean arterial pressure of between 10 to 15 mm Hg that lasted for 15 to 60 min. These patients could not be distinguished from the others on the basis of underlying illness, laboratory or physical findings, length of preceding hypotension, or glucocorticoid therapy. Four patients had adverse reactions: one developed pulmonary edema, one patient had a grand-mal seizure, and two patients became severely hypotensive. We conclude that in patients with well-established septic shock, naloxone does not reliably improve mean arterial pressure or other physiologic variables, and may cause severe adverse reactions.
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PMID:Efficacy and safety of naloxone in septic shock. 396 46

Six cases of oral intoxication with lindane-solvent mixtures are reviewed. The ingested doses of lindane (mean dosage 120 mg/kg +/- 86 mg/kg) and benzene (mean dosage 366 mg/kg +/- 93 mg/kg) exceeded the toxic level. Symptoms (vomiting, dizziness and hyperreflexia) occurred within 30 min and all patients had epileptiform seizures. Two patients suffered from pulmonary edema and one of them had a severe rhabdomyolysis. Diazepam was sufficient to control convulsions in five cases. Gastric lavage was performed in five patients and activated charcoal, liquid paraffin with saline cathartic, and cholestyramine were used as adsorbents. Recovery was complete in all patients.
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PMID:Acute oral poisoning with lindane-solvent mixtures. 619 84

Status epilepticus is a medical emergency. Recent experimental studies have shown that permanent brain damage can occur after only 60 minutes of uncontrolled seizure activity. Cardiac arrhythmias are a common cause of death. Other complications include rhabdomyolysis, acute tubular necrosis and neurogenic pulmonary edema. Management is divided into three phases: stabilization of the patient, termination of the seizures and diagnostic evaluation.
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PMID:Status epilepticus. 661 91

Methyl bromide (MeBr) is used as an insecticide fumigant. Four deaths and three recent hospitalizations have resulted from exposures to MeBr in Dade County, FL. Six cases occurred during burglaries of tented houses over a nine-month period. In four lethal exposures, the symptoms of nausea, vomiting, and malaise preceded fulminant respiratory failure. Two of these also had seizures, delirium, and agitation. Serum or plasma bromide ion levels ranged from 40 to 583 mg/L. Pulmonary edema, hyaline membranes, and hemorrhagic alveolitis were present at autopsy along with varying degrees of cerebral edema. The nonlethal exposures resulted in symptoms of conjunctival irritation, headache, or nausea. Plasma bromide concentrations varied between 17.5 and 321 mg/L. Methyl bromide characteristics, use, morbidity, and mortality in Florida during the past 25 years are reviewed. Remedies for illegal entry are proposed.
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PMID:Death and injury caused by methyl bromide, an insecticide fumigant. 661 79

Twenty-five adolescents receiving chronic steroid therapy for inflammatory bowel disease underwent major intestinal surgery and each experienced vasodilation during induction of anesthesia. Systemic hypotension occurred in each patient and was treated by large volumes of intravenous crystalloid solution which caused intraoperative and postoperative water retention with resultant hypertension as well as occasional pulmonary edema and seizures. Ten adolescents who did not receive steroids and who underwent similar operations had higher urine outputs during and immediately after surgery, but did not experience these complications. Intravenous fluid administration in excess of maintenance requirements and calculated fluid losses should be given with caution to children receiving high-dose steroids who undergo major intestinal surgery. Perioperative fluid retention under those circumstances may be best treated with early diuretic administration.
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PMID:Complications of excessive operative fluid administration in children receiving steroids for inflammatory bowel disease. 674 88

A patient with a seizure disorder since childhood was poorly compliant with anticonvulsant medication. He died suddenly following a seizure secondary to a rapid decrease in plasma anticonvulsant drug levels. Autopsy demonstrated pulmonary edema. This noncardiac form of pulmonary edema has been related to low anticonvulsant drug levels in many epileptics who die suddenly. Patients receiving anticonvulsant medication must make no change in drug dosage without medical guidance because of the risk of this catastrophic consequence.
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PMID:Anticonvulsants and neurogenic pulmonary edema. 686 65

The pathophysiology of postictal pulmonary edema was investigated by inducing seizures with bicuculline in nine paralyzed, halothane-anesthetized sheep and measuring of pulmonary lymphatic flow, pulmonary arterial and left atrial pressures, and lymph and plasma albumin concentration. Pulmonary microvascular pressure and transcapillary albumin conductance were calculated. Seizures transiently (less than 15 min) elevated microvascular pressure in all animals; lymph flow increased greater than twofold in response to the increased hydrostatic driving force. However, the elevation in lymph flow, with a stable lymph-to-plasma protein ratio and doubled transcapillary albumin conductance, persisted for the duration of the experiment, more than 3 h after microvascular pressure returned to base line. These changes were neurally mediated because they were blocked by cervical spinal cord transection in four additional animals.
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PMID:Elevated pulmonary lymph flow and protein content during status epilepticus in sheep. 706 Dec 83

Eight cases of unexpected, unexplained death in young ambulatory epileptics were examined postmortem with special attention to the heart and lungs. Lung weights uniformly exceeded the expected value, with gross evidence of hemorrhagic pulmonary edema. Microscopic examination revealed moderate to severe pulmonary edema with protein-rich fluid as well as alveolar hemorrhage. There was no evidence of recent or old myocardial disease. Although death due to a seizure is usually thought to be almost instantaneous, the neurogenic pulmonary edema exemplified by these cases takes time to develop and may be remediable. The high frequency of absent or non-therapeutic anticonvulsant levels at the time of death in these patients may play a role in a possible centrally mediated adrenergic cause of neurogenic pulmonary edema and ventricular arrhythmia.
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PMID:Neurogenic pulmonary edema in unexpected, unexplained death of epileptic patients. 727 Dec 41


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