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

Secondary complications from extreme and prolonged convulsive seizures occurred in a young dog. Physical exertion resulted in necrosis of a substantial amount of skeletal muscle. The release of large quantities of myoglobin into the circulation caused severe impairment of renal function. Anoxia, apparently associated with the inability to breathe during seizures, resulted in brain damage. It was concluded that, although primary therapy must be directed toward alleviation of intense seizure activity, subsequent screening for renal disease and corollary supportive therapy would be appropriate.
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PMID:Seizure-induced rhabdomyolysis accompanied by acute renal failure in a dog. 65

There have been recent reports of rhabdomyolysis associated with cocaine abuse. The pathologic findings from these cases have not been described. Pathologic abnormalities in two fatalities with cocaine-associated rhabdomyolysis, including one with hyperpyrexia, acute renal failure, and disseminated intravascular coagulation, are discussed in detail. Skeletal muscle in both cases showed necrosis without evidence of vasculitis, polarizable foreign crystals, or other specific lesions. The individual with renal failure showed acute tubular necrosis with granular myoglobin casts in tubules. The mechanism of cocaine-associated rhabdomyolysis is unclear, but potentially includes ischemia due to vasoconstriction, direct toxicity, hyperpyrexia, and increased muscle activity from agitation or seizure. Adulterants may also play a role. In unexplained cases of rhabdomyolysis, toxicologic evidence of cocaine should be sought. In those cases of rhabdomyolysis associated with acute renal failure, the presence of cocaine in blood may be prolonged because of impaired renal clearance.
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PMID:Rhabdomyolysis associated with cocaine abuse. 174 98

A 47-year-old man developed progressive renal impairment after a series of seven generalised tonic-clonic seizures. The patient did not become oliguric and because recovery of renal function was rapid, dialysis was not required. The diagnosis of myoglobin-induced renal failure was made on the basis of markedly elevated muscle enzyme values, and myoglobin in the urine.
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PMID:Myoglobinuric renal failure after generalised tonic-clonic seizures. A case report. 341 14

Thirty four consecutive neonates with birth asphyxia or respiratory problems were examined in the first week of life to clarify the relation between neonatal myoglobinuria and acute renal failure. Investigations included determination of creatinine clearance, fractional sodium excretion, and N-acetyl-beta-D glucosaminidase index as an indicator of tubular injury. The infants' gestational ages ranged from 29 to 41 weeks (mean 36 weeks). Fifteen infants did not have myoglobinuria on the first day of life (group A); myoglobinuria was mild in eight infants (group B) and severe in eleven (group C). Two infants in group B and seven in group C developed acute renal failure (47%). Ten infants in group C (91%) had severe asphyxia, five of whom (45%) also suffered neonatal seizures and intracranial haemorrhage. We suggest that myoglobin derived from muscle breakdown in asphyxiated infants may lead to acute renal failure secondary to a reduction in renal blood flow, or to tubular damage.
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PMID:Effects of perinatal asphyxia and myoglobinuria on development of acute, neonatal renal failure. 406 43

In 11 patients with epilepsy serum myoglobin level determinations were performed by the RIA method 10 minutes, 1 hour, 4, 12, and 24 hours after tonic-clonic seizure and were compared with myoglobin concentrations in a group of 30 healthy persons. A statistically significant increase of myoglobin concentration was shown already in the first hour after the seizure with maximal level, almost five times exceeding the baseline level in the fourth hour, and slightly lower--four times exceeding the baseline--12 hours after the seizure. The correlative studies, comparing the profile of myoglobinaemia with the clinical picture (duration of the disease, age and sex, presence or lack of EEG changes, type of therapy used) showed no statistical significance.
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PMID:[Level of myoglobin in serum of patients with epilepsy after generalized tonic-clonic seizure]. 794 77

Rhabdomyolysis is a condition affecting body homeostasis that results from impaired supply of muscles with energy, nutritional factors and blood. Complex pathophysiological mechanism causes that extended myolysis may complicate different clinical conditions, such as: crush syndrome, excessive physical effort (work, seizures), toxic effect of drugs and toxins, water-electrolyte disturbances, congenital enzymatic deficiencies etc. It seems that on the cellular level, essential role is played by excessively high intracytoplasmatic calcium level, which affects metabolic processes. So high calcium level is a consequence of muscular cell injury irrespective to its reason. It manifests clinically as muscular weakness, pal and oedema and laboratory tests reveal elevated CK, GOT, GPT, aldolase and LDH levels as well as dark brown urine colour. Demonstration of elevated serum myoglobin level or its presence in urine directly confirms development of rhabdomyolysis. In unfavorable conditions, rhabdomyolysis may result in acute renal failure. Appropriately early and adequate water supply and alkalization plays an essential role in prevention of impairment in renal function. In advanced phase of renal failure, hemodialysis is a standard treatment.
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PMID:[Rhabdomyolysis: clinical features, causes, complications and treatment]. 974 Nov 96

Rhabdomyolysis results from muscular fibre lysis with release of cellular contents (myoglobin, enzymes, electrolytes) into the plasma. Traumatic (crush syndrome) and non-traumatic rhabdomyolysis have been mostly reported in adults. Traumatic rhabdomyolysis are mostly due to ischemic and reperfusion injuries. Non-traumatic rhabdomyolysis include several factors: muscular compression (comas), cytotoxic injury (infections and poisonings), ischemia (shock, cardiorespiratory arrest) or excessive muscular activity (seizures, strenuous exercise). The main etiologies reported in children are: anoxic-ischemic encephalopathy (including sudden infant death and life threatening events); electrolyte disorders; severe hyperthermia; poisonings; hereditary myopathies. Non-traumatic rhabdomyolysis must be suspected in these circumstances, requiring blood creatinine phosphokinase measurements. Indeed, clinical signs are inconstant and non-specific, and functional signs are difficult to appreciate in children. During the initial phase, the main risk is arrhythmias secondary to hyperkalemia. The two main complications are the compartmental syndrome leading to irreversible vasculo-nervous injuries and acute renal failure. Treatment of traumatic and non-traumatic rhabdomyolysis includes correction of hyperkalemia, active fluid loading in order to prevent acute renal failure and alkalinisation. Prognosis of rhabdomyolysis relates to the aetiology and the presence of acute renal failure.
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PMID:[Acute rhabdomyolysis in the child]. 975 96

Acute renal failure is the most common complication of rhabdomyolysis, with an 8-20% reported incidence. In particular, rhabdomyolysis associated with acute renal failure is frequently observed in critically ill patients, with a 6-16% reported incidence in Intensive Care Units. Dialytic treatment is necessary to correct hydroelectrolytic imbalance and renal function alterations and it may be a pathogenetic therapy by myoglobin removal. In the present study we evaluated our experience on patients suffering from rhabdomyolysis and acute renal failure subjected to dialytic treatment. We retrospectively studied 28 patients, 17 admitted in our Intensive Care Unit (ICU-patients) and treated by continuous renal replacement therapy (particularly by continuous venovenous hemofiltration, continuous venovenous hemodialysis and continuous venovenous hemodiafiltration) and 11 admitted in our Nephrology Department (NICU-patients) and treated by high-efficiency daily hemodialysis. We excluded one ICU-patient from the study because she was affected with lung end-stage neoplasia and it would have been difficult to evaluate the effects of the dialytic treatment on RML biochemical index and on her final outcome. ICU-patients were older, with a mean age of 64 +/- 10 yrs, and were suffering from MODS and typical elderly diseases, such as cardiac and respiratory chronic failure, except from 3 patients with acute liver failure resulting from poisoning, who were relatively younger. In NICU-patients, instead, the mean age was 36 +/- 16 yrs and the causes of RML were narcotic drugs abuse, repetitive seizures and vigorous exercise, more frequently observed in young people. In three relatively older NICU-patients RML was due to lipid lowering drugs assumption. Before starting the dialytic treatment, in ICU-patients CPK plasma level was 2615 +/- 3586, while K+ was 5.10 +/- 1.08 and sCr was 5.69 +/- 4.06 In NICU-patients, on the other hand, CPK was 14273 +/- 9266, while K+ was 5.75 +/- 0.92 and sCr was 5.9 +/- 0.4. ICU-patients mortality rate was 50% (8/16 patients) in spite of the good recovery of renal function and the biochemical RML indexes improvement. In NICU-patients, instead, only one patient died for septic complications (he was a heroin-addict and suffered from overdose syndrome). Early dialytic treatment of RML allows not only to avoid life-threatening complications (first of all the acute renal failure) but moreover it's a pathogenetic treatment because it removes great amount of myoglobin from the plasma. Beside this, continuous renal replacement therapy allows a successful management of critically ill patients with severe hemodynamic conditions. Nevertheless, the final outcome may be very different between ICU- and NICU-patients, with a higher mortality rate in ICU-patients, suffering from MODS.
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PMID:Dialytic treatment of rhabdomyolysis-induced acute renal failure: our experience. 1141 50

The clinical syndrome of rhabdomyolysis is caused by injury of skeletal muscles, leading to the release of various intracellular muscle constituents. Rhabdomyolysis occurs frequently but is usually asymptomatic (i.e., lab abnormalities only). However, in more serious cases, severe electrolyte disorders and acute renal failure may occur, leading to life-threatening situations. Rhabdomyolysis can develop in any circumstances where energy demands in muscles exceed the available energy supplies; it accounts for between 2 and 5% of all cases of acute renal failure in the ICU. Frequent causes of severe rhabdomyolysis include crush injuries, prolonged immobilization, seizures, severe infections and drug toxicity. Factors contributing to the development of more severe clinical symptoms include hypovolemia, hyperthermia, electrolyte disorders and the presence of pre-existing (congenital) muscle disorders. The diagnosis is established by elevation of serum muscle enzymes and muscle constituents such as creatinine phosphokinase and myoglobin. Preventive measures include maintenance of normal or high intravascular volume and administration of diuretics (loop diuretics rather than mannitol) once hypervolemia/euvolemia have been achieved. Some evidence suggests that early initiation of renal replacement therapy can help improve outcome. Administration of bicarbonate to induce urinary alkalosis can be considered, but it has not been proven to be effective.
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PMID:Acute renal failure and rhabdomyolysis. 1564 12

An immature Baird's tapir (Tapirus bairdii) with a history of seizure-like episodes developed signs of respiratory disease. The initial clinical diagnosis was pneumonia, and antibiotic therapy was started. The animal failed to improve after 14 days of therapy and developed unilateral, bloody nasal discharge. Endoscopic examination and radiography revealed a soft tissue mass in the nasopharynx depressing the soft palate. The tapir died 32 days after initial presentation. Histologic examination of the mass demonstrated a mesenchymal tumor composed of spindle cells with elongate nuclei forming densely packed fascicles. The neoplastic spindle cells showed prominent cross-striations. Immunohistochemistry revealed the cells to be positive for desmin and myoglobin, but negative for smooth muscle actin, confirming diagnosis of rhabdomyosarcoma. Embryonal rhabdomyosarcoma is the most common nasopharyngeal soft tissue tumor of humans, and it has been reported infrequently in dogs, horses, and pigs. Neoplasia should be a differential diagnosis in cases of unilateral nasal discharge and inspiratory stridor, even in young animals.
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PMID:Embryonal rhabdomyosarcoma in an immature Baird's tapir (Tapirus bairdii). 1746 86


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