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)

Mood disorders cause significant morbidity and mortality, and existing therapies fail 20%-30% of patients. Deep brain stimulation (DBS) is an emerging treatment for refractory mood disorders, but its success depends critically on target selection. DBS focused on known targets within mood-related frontostriatal and limbic circuits has been variably efficacious. Here, we examine the effects of stimulation in orbitofrontal cortex (OFC), a key hub for mood-related circuitry that has not been well characterized as a stimulation target. We studied 25 subjects with epilepsy who were implanted with intracranial electrodes for seizure localization. Baseline depression traits ranged from mild to severe. We serially assayed mood state over several days using a validated questionnaire. Continuous electrocorticography enabled investigation of neurophysiological correlates of mood-state changes. We used implanted electrodes to stimulate OFC and other brain regions while collecting verbal mood reports and questionnaire scores. We found that unilateral stimulation of the lateral OFC produced acute, dose-dependent mood-state improvement in subjects with moderate-to-severe baseline depression. Stimulation suppressed low-frequency power in OFC, mirroring neurophysiological features that were associated with positive mood states during natural mood fluctuation. Stimulation potentiated single-pulse-evoked responses in OFC and modulated activity within distributed structures implicated in mood regulation. Behavioral responses to stimulation did not include hypomania and indicated an acute restoration to non-depressed mood state. Together, these findings indicate that lateral OFC stimulation broadly modulates mood-related circuitry to improve mood state in depressed patients, revealing lateral OFC as a promising new target for therapeutic brain stimulation in mood disorders.
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PMID:Direct Electrical Stimulation of Lateral Orbitofrontal Cortex Acutely Improves Mood in Individuals with Symptoms of Depression. 3066 50

Levetiracetam (LEV) is a newer second-generation antiepileptic drug that is found to be effective in tonic-clonic seizures, partial onset seizures, and myoclonic seizures. Among antiepileptic drugs, LEV is usually known for fewer adverse drug reactions. Psychiatric disorders after the administration of LEV have been reported in the literature. There are many case reports on LEV-induced psychosis, but there are only three case reports of mania induced by LEV use. In this report, we present a case with no history of psychiatric disorder who had a hypomania episode after receiving LEV for epilepsy treatment. The development of manic symptoms with LEV therapy is unusual. Clinicians should consider monitoring patients closely for treatment-related psychological symptoms and psychotic symptoms, including the possibility of mania.
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PMID:Levetiracetam induced hypomania: a case report. 3162 Feb 73

Lithium has been used effectively used in the management of mood disorders, such as bipolar disease, acute mania, and hypomania. As the therapeutic index is very narrow for lithium, it is important to monitor lithium levels periodically to avoid toxic effects. Common toxic effects include diarrhea, tremor, muscle weakness, ataxia, and myoclonus. Severe toxicity can present with seizures, coma, and death. Cardiotoxicity secondary to lithium is rarely reported in the medical literature and can range from dysrhythmias and cardiomyopathies to myocardial infarction. We describe an interesting case report of cardiac toxicity secondary to lithium in a bipolar patient managed conservatively in an intensive care setting.
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PMID:Lithium-induced Cardiotoxicity: A Rare Clinical Entity. 3278 90

Arachnoid cysts are benign congenital malformations of the arachnoid which account for approximately 1.4% of the intracranial lesions. Although it is usually asymptomatic, it may be accompanied by headache, hydrocephalus and seizure. Psychiatric disorders associated with arachnoid cysts are rare. In this article, we present a giant arachnoid cyst with hypomania symptoms and marked cognitive impairment. A 44-year-old female patient was admitted to our outpatient clinic with a 4-year history of headache, nervousness and attention problems. Magnetic resonance imaging revealed a giant arachnoid cyst with a size of 5.5x10.5x12.5 cm was found in the left hemisphere of the patient. Considering the patient's irritability, increase in the amount of speech, flight of ideas, sleep disturbance and attention disorders, the diagnosis of hypomania was made. The neuropsychological tests showed that the speed of information processing, mental flexibility and attention functions decreased, and executive functions were impaired. The patient was consulted to the neurosurgery department. But no surgical treatment was offered. Drug therapy for hypomanic symptoms and cognitive impairment was planned, but could not be started since the patient did not attend to the follow-up exams. Albeit the lack of followup constitutes a limitation for our report, we believe that the size of the cyst, significant impairment of cognitive functions and the presence of hypomania symptoms might contribute significantly to the literature. Other cases with arachnoid cyst displaying cognitive impairment were summarized in our article.
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PMID:A Case of Arachnoid Cyst Presenting with Cognitive Impairment and Hypomania Symptoms. 3259 1


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