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)

Glutamic acid decarboxylase (GAD) activity in cerebrospinal fluid (CSF) was determined in 53 patients with neurological diseases as follows: Epilepsy (n:17), febrile convulsions (n:3), meningoencephalitis (n:17), encephalopathies (n:10), CNS leukemia (n:3), congenital hydrocephalus (n:2) and pseudoileus neonatorum (n:1). Compared with the mean normal value (5.2 +/- 2.5 pmol CO2 formed/hr/ml) reported in Part I, a significant increase of GAD activity in CSF was demonstrated in patients with uncontrolled epileptic seizures (11.4 +/- 3.9 pmol CO2 formed/hr/ml), febrile convulsions (13.5 +/- 8.7), viral meningitis with or without encephalitis (20.3 +/- 13.6), encephalopathies (30.0 +/- 25.9), CNS leukemia (11.1 +/- 5.0), congenital hydrocephalus (20.5 +/- 7.3) and pseudoileus neonatorum (28.6). Markedly high GAD activity was found in patients with CNS leukemia several days after intrathecal injection of methotrexate (39.8 +/- 18.0). On the other hand, significantly low GAD activity was shown in patients with bacterial meningitis or brain abscess (1.3 +/- 1.2). This suggests that some bacterial factors may be inhibitory toward GAD activity in CSF. High GAD activity in CSF may be useful as an indicator of aseptic brain dysfunction, although it was not always correlated with the severity of symptoms.
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PMID:Glutamic acid decarboxylase in cerebrospinal fluid in infancy and childhood Part II. Glutamic acid decarboxylase activity in cerebrospinal fluid of children with neurological diseases. 666 Apr 21

Haemophilus influenzae type b (HIb) is the most common cause of bacterial meningitis in children with a mortality rate ranging from 1.6% to 14%. Most patients have a 2-3 day history of symptoms prior to admission. A few have fulminating disease with rapid neurological deterioration. Review of 191 cases of HIb meningitis revealed a mortality rate of 2.1% but all who died had fulminating meningitis (FM). Four of six patients with FM died. FM patients had symptoms for less than 24 hours before rapid neurological deterioration with increased ICP, seizures, coma and/or respiratory arrest. Review of 10 FM cases revealed that on admission, 5 had hypotension, 3 had thrombocytopenia, and 8 had coma. Typical CSF changes were seen in only 7. All fatal cases died within 24 hours. Brain swelling and tonsillar herniation were found at autopsy. SDS-PAGE outer membrane protein subtyping did not show one "killer strain". Animal and autopsy data suggest that diminished CSF outflow and cerebral edema contribute to increased ICP. To improve survival of FM patients, initial treatment must (1) decrease ICP below levels impairing cerebral perfusion, (2) maintain adequate ventilation and blood pressure, and include (3) LP when stable, (4) antibiotics, and (5) close monitoring. Utilizing these principles, two FM patients survived without major sequelae.
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PMID:Fulminating haemophilus influenzae b meningitis. 670 99

Among 302 infants and children with acute bacterial meningitis, the syndrome of cerebral herniation occurred in 3 of 10 fatal cases and in 15 patients who survived. The interval from time of admission to herniation was 8 hours or less, and no predictive factors could be determined. Seizures occurring immediately prior to cerebral herniation made diagnosis more difficult. Early recognition of cerebral herniation and prompt treatment with osmotic diuretics can reduce the mortality of bacterial meningitis.
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PMID:Cerebral herniation in bacterial meningitis in childhood. 677 73

The usefulness of the CSF lactate concentration in the diagnosis of bacterial meningitis was studied in 109 adults and children with a variety of infectious and neurologic diseases. A positive correlation was found between elevated lactate levels and the presence of leukocytes in the CSF. Elevations of the CSF lactate concentration with concomitantly negative Gram's stains and cultures were found in patients with infections at anatomic sites other than the CNS, accidental or neurosurgical head trauma, subarachnoid hemorrhage, and seizures due to alcoholism. When performed routinely on CSF, the positive predictive value was 31%, indicating that a diagnosis other than bacterial meningitis is more likely. We conclude that the CSF lactate concentration does not contribute to the diagnosis in children or adults with suspected meningitis.
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PMID:CSF lactate in diseases of the CNS. 684 11

Lactic acid concentration has been determined in the cerebrospinal fluid (CSF) of 715 patients suffering from various neurological diseases. It was found to be most often elevated in cases of ischemic cerebral infarction, cerebral contusion, arteriosclerotic dementia, metastatic encephalitis, bacterial meningitis, menigiosis carcinomatosa and after epileptic seizures. In fewer cases lactate levels were increased with brain tumors, encephalitis, viral meningitis and radiculitis. Diagnostic relevance of CSF lactic acid determination is discussed with regard to ischemic cerebral disorders, differential diagnosis of viral and bacterial meningitis and for the confirmation of epileptic seizures.
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PMID:[Importance of cerebrospinal fluid lactate determination in neurological diseases]. 686 67

Auditory brainstem response (ABR) was used to assess possible brainstem damage in 60 patients recovering from bacterial meningitis. Clear evidence of brainstem abnormalities was evident in 10% of the patients tested. Another 15% had ABRs classified as borderline normal. We evaluated various clinical and demographic factors to determine their predictive value with regard to neurologic abnormalities. Brainstem involvement was most likely when meningitis was complicated by seizures, hydrocephalus, nerve palsies (not including the eighth nerve), and a hemoglobin level of less than 11 g/dL, and when pretreatment symptoms persisted for longer than three days. Instances of partial and complete reversibility of brainstem damage were documented, indicating that reorganization of brainstem structures persisted after patients were discharged from the hospital.
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PMID:Auditory brainstem response in infants recovering from bacterial meningitis. Neurologic assessment. 687 Jun 11

Of 102 patients with bacterial meningitis admitted to the Children's Hospital of Buenos Aires, 25 were selected for computed tomographic (CT) scans on the basis of altered consciousness for more than 96 hours after admission, persistent or recurrent seizures after 72 hours of antibiotic therapy, development of focal neurologic signs, increased intracranial pressure or prolonged fever. Scan findings included hydrocephalus, cerebritis, vasculitis, subdural effusion, cerebral atrophy, abscess, and ependymitis. Serial CT scans demonstrated the progression or regression of some complications. The CT scan was very useful in indicating the need for neurosurgical procedures.
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PMID:Computed tomography in purulent meningitis. 697 22

A clinical diagnosis of meningitis in neonates is difficult because of paucity of physical findings. In older infants and children, nuchal rigidity, Kernig's or Brudzinski's sign, or bulging fontanelles are sought. A review of 1,064 cases of bacterial meningitis beyond the neonatal period revealed that 16 (1.5%) patients had none of those meningeal signs during the entire hospitalization, despite CSF pleocytosis. Eight patients (50%) were 2 years old or older. Lumbar punctures were done because of unexplained fever, changes in behavior or mental status,, seizures, or occurrence of skin petechiae in febrile patients. These patients frequently had moderate pleocytosis and all survived. The meningitis was caused by Neisseria meningitidis in seven patients, Haemophilus influenzae in six, Streptococcus pneumoniae in two, and Salmonella enteritidis in one patient. CSF should be examined in a patient of any age whenever meningitis is a consideration, even if patients lack meningeal signs.
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PMID:Bacterial meningitis without clinical signs of meningeal irritation. 707 40

The DuPont ACA lactic acid procedure was evaluated for use on cerebrospinal fluid (CSF). The method was linear to at least 13.9 mmol per L, day-to-day precision ranged from 3 to 9 percent (CV), and recovery of lactate added to cerebrospinal fluid averaged 104 percent. The method correlated closely with a centrifugal analyzer procedure; r = 0.996, SEy,x 0.16 mmol per L. The reference range, based on patient CSF samples, was 0.8 to 2.3 mmol per L. Elevated CSF lactate concentrations were found in patients with bacterial, but not viral, meningitis. Less marked elevations occurred with head trauma, seizures, strokes, or hemorrhage in the central nervous system. The results suggest that this method is useful in the early diagnosis of bacterial meningitis.
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PMID:Lactic acid in cerebrospinal fluid: evaluation and application of an automated enzymatic assay. 733 9

The purpose of this study was to identify possible risk factors associated with a poor prognosis in childhood bacterial meningitis. We also analysed the influence of duration of symptoms and prehospital antibiotic therapy on outcome. Ninety-two children aged 1 month to 13.8 years were included, of whom 4 died (4.3%) and 14 (15.2%) experienced permanent neurological sequelae. Hearing impairment was the most frequent sequela and was strongly associated with the length of history. Multiple logistic regression revealed duration of symptoms > 48 h, pre-hospital seizures, peripheral vasoconstriction, < 1000 x 10(6)/l leucocytes in cerebrospinal fluid and temperature < or = 38.0 degrees C on admission as risk factors independently associated with later death or sequelae. There was no association between pre-hospital oral or parenteral antibiotic therapy and outcome. These risk factors may be of value in selecting patients for more intensive therapy and in identifying possible candidates for new treatment strategies.
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PMID:Prognostic factors in childhood bacterial meningitis. 748 9


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