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 33-year-old female presented for elective excision of a posterior fossa tumour following two generalized seizures six months earlier. The patient had been asymptomatic on phenytoin 300 mg/day. Two h pre-operatively, a 300-mg dose of phenytoin was administered, general anesthesia induced and pancuronium bromide given to achieve neuro-muscular paralysis. Respiration was supported and anesthesia maintained with isoflurane and nitrous oxide in oxygen. Thirty min into the operation a further 2-mg dose of pancuronium bromide was administered. One h later, the patient coughed. A peripheral nerve stimulator was applied to the right common peroneal nerve with surface electrodes. Over the next 75 min a total of 15 mg of pancuronium bromide was required. With each dose there was a complete loss of response to peripheral nerve stimulation, followed by a rapid return of full train-of-four response, accompanied by coughing and cerebral engorgement. At this point, metocurine iodide was administered with full sustained paralysis for 45 min. Blood samples collected during a second operation indicated the patient had an extremely short pancuronium elimination half-life and a small volume of distribution. Several explanations are offered including phenytoin induction of hepatic microsomal enzymes responsible for the biotransformation of pancuronium, alterations in tissue or protein binding and/or alterations in myoneuronal junctional response.
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PMID:Pancuronium-phenytoin interaction: a case of decreased duration of neuromuscular blockade. 322 Jun 9

A mixture containing 3 g of boric acid and 300 mg of cinchocaine chloride prescribed due to painful dental protrusion was accidentally ingested by a 12-month-old girl. She developed violent vomiting and coughing. Irritability, tremor, seizures and a delirious reaction. She was treated with diazepam, intubated, sedated and ventilated. Her diuresis was stimulated with furosemide and fluid. Within the first 24 h she was treated with haemodialysis twice on femoral catheters. Her renal function was unaffected. In two days she fully recovered. The maximum measured levels of boric acid and cinchocaine chloride approximately 6 h after ingestion were 26 micrograms/ml and 71 ng/ml respectively. The plasma half-life of boric acid was 7.0 h and decreased to 3.6 and 4.4 h during the two haemodialyses. The total body clearance of boric acid increased correspondingly from 21 ml/min to 41 and 34 ml/min. The in vitro clearance of boric acid of the dialyser was later determined to be 18 ml/min. It is concluded that haemodialysis is valuable in the treatment of boric acid intoxication because it increases the elimination of the drug even in patients without any sign of renal toxicity.
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PMID:Combined boric acid and cinchocaine chloride poisoning in a 12-month-old infant: evaluation of haemodialysis. 337 4

Twenty-three of 23 neonates were contaminated in the course of an outbreak of respiratory syncytial virus (RSV) in a neonatal care unit. Symptoms among 22 infected symptomatic infants included rhinitis (n = 21), dyspnea (n = 19), cough (n = 17), apnea (n = 5), seizures (n = 3), fever (n = 3). Five patients presented with severe respiratory distress. The occurrence of non-obstructive apnea was significantly correlated with a history of respiratory disease, RSV infection during the first 15 days of life and the severity of lower respiratory tract RSV infection.
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PMID:[Respiratory syncytial virus infections in newborn infants]. 371 65

The non-opioid antitussives dextromethorphan and carbetapentane, the active ingredients of several over-the-counter cough suppressants, provide a dose-related protection against maximal electroshock seizures in rats. Both drugs, which bind with high affinity to the same site in the brain, potentiated the effects of the prototypic antiepileptic drug diphenylhydantoin. We propose that these novel anticonvulsant drugs may represent potentially useful therapeutic agents for the treatment of some forms of epilepsy, either alone or in combination with existing antiepileptic drugs.
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PMID:Dextromethorphan and carbetapentane: centrally acting non-opioid antitussive agents with novel anticonvulsant properties. 376 95

Foreign body in the tracheobronchial tree is a relatively infrequent, but, potentially fatal event, requiring rapid and expert intervention. The symptoms and signs may be mistaken for asthma and pneumonia, - or, as in the case described, with grand mal epileptiform seizures. This emphasises the need to take a thorough case history, and to have a high index of suspicion in a case presenting with convulsion associated with cough, wheezing or respiratory distress.
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PMID:Pulmonary aspiration presenting with generalised convulsions. 641 86

Impulse activity of the medulla respiratory neurons and electrical activity of the diaphragm and intercostal muscles were studied prior to, during and after coughing fit in anesthetized cats under conditions of normoxia and hypoxia. Simultaneously the intrapleural pressure was recorded and O2, paCO2, SaO2 were determined in arterial blood. Massive excitation of inspiratory and expiratory neurons as well as considerable augmentation of respiratory muscles electrical activity occurred during coughing fit. Soon after the fit the activity of neurons and muscles restored to initial level. During acute hypoxia the coughing fit shortened, the coughing seizures weakened as compared with the normoxic conditions. After the coughing fit, in result of hyperventilation during the fit, the paCO2 sharply dropped in arterial blood, the neuronal volley activity and the muscles rhythmic activity became disorganized, and apnea occurred. Within 20-40 sec rhythmic volley activity of the medulla inspiratory neurons disrupted the apnea.
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PMID:[Respiratory center function in the course of the cough reflex in normoxia and hypoxia]. 687 61

Cerebellar and thalamic stimulation has been known for many years to improve control of epileptic seizures. In the past few years electrical vagus nerve stimulation (VNS) has been introduced and has been effective in controlling seizures in animal models. These encouraging results led to the development of a transcutaneous programmable pulse generator and electrode lead for human use. 2 pilot studies and a multicenter, prospectively-randomized, parallel, double-blind study of patients with refractory partial seizures were performed. In a 3-22 month follow-up, in about 50% of patients seizures were reduced by 30-50%. There were no significant complications of the implant. Side-effects associated with VNS included intermittent hoarseness, coughing and throat pain. Additional controlled clinical trials with many patients and long follow-up are needed. We report 2 patients, the first in Israel, who underwent VNS.
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PMID:[Vagus nerve stimulation for partial seizures]. 755 11

Untreated hyperthyroidism during pregnancy is associated with increased maternal and perinatal morbidity. Some features of this disease simulate preeclampsia, which may encourage delivery of the fetus. We report a case of poorly controlled hyperthyroidism associated with generalized seizures, where patient management was directed at a diagnosis of preeclampsia-eclampsia. Although the presence of eclampsia and marked hyperthyroidism is very rare, this case illustrates the importance of aggressive medical management of hyperthyroidism. A 17-year-old gravida was diagnosed with hyperthyroidism at 15 weeks' gestation. At 26 weeks' gestation, she was admitted to the hospital after noting edema of the upper and lower extremities, nausea, vomiting, shortness of breath, and a cough. At admission, she was hypertensive, tachycardic, and dyspneic. The patient was believed to have preeclampsia with pulmonary edema complicated by hyperthyroidism. We initiated magnesium sulfate therapy and administered several bolus doses of hydralazine, with little effect on blood pressure. Oliguria was noted, and a pulmonary artery catheter was inserted. Hours later, generalized seizure activity occurred, and a decision was made for abdominal delivery. Postoperatively, cardiovascular function stabilized. On postoperative day 3, we received the results of the thyroid function tests obtained at admission, which suggested a markedly hyperthyroid condition. Untreated or poorly treated hyperthyroidism may present a clinical picture similar to preeclampsia. In our case, both disease processes coexisted in their severest forms. It is possible, although completely unproven, that a relationship exists between poorly controlled hyperthyroidism and preeclampsia-eclampsia. More importantly, accurate diagnosis of hyperthyroidism should lead to prompt medical or surgical management, thereby decreasing maternal and perinatal morbidity.
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PMID:Hyperthyroidism and seizures during pregnancy. 761 94

Vagus nerve stimulation (VNS) significantly reduces the frequency of partial seizures in refractory epilepsy patients. We examined the serious adverse events, side effects, and tolerability as they relate to the surgical implant procedure and the stimulating device. We also reviewed potential drug interactions, device output complications, and impact of the therapy on overall health status. We analyzed the first 67 patients to exist the acute phase of the EO3 VNS trial comparing high (therapeutic) VNS to low (less or noneffective) VNS. Data were collected from case report forms used at each of the four visits during the 12-week baseline and at each of the four visits during the 14-week randomized phase of the trial. No significant complications were reported as a result of the implant procedure. Serious adverse events included 1 patient who experienced direct current to the vagus nerve owing to generator malfunction resulting in left vocal cord paralysis and withdrawal of the patient from the study. No clinically significant effects on vital signs, cardiac function, or gastric function were detected. Side effects associated with VNS in the high group were hoarseness (35.5%), coughing (13.9%), and throat pain (12.9%). In the low group, only hoarseness (13.9%) and throat pain (13.9%) were associated with VNS. These effects generally wrre not considered clinically significant and occurred primarily during the stimulation pulses. No patients discontinued VNS therapy during the acute phase because of side effects associated with normal stimulation. Except for the one instance of a short circuit in the system resulting in a direct current, stimulating system complications were minor, limited to programming, unscheduled stimulation, and high lead impedance. Patients, investigators, and patient companions rated patients receiving high stimulation as more "improved" than those receiving low stimulation in regards to overall health status. Antiepileptic drug (AED) plasma concentrations were not affected by VNS. The implant procedure, stimulating system, and therapy proved safe and tolerable during the study. The high percentage (67 of 68) of patients completing the study reflects patient acceptance and tolerability of this mode of therapy.
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PMID:Vagus nerve stimulation for treatment of partial seizures: 2. Safety, side effects, and tolerability. First International Vagus Nerve Stimulation Study Group. 802 9

Vagus nerve stimulation (VNS) has demonstrated a significant anticonvulsant effect in preclinical studies, in pilot studies in humans, and in the acute phase of a multicenter, double-blinded, randomized study. After completion of a 14-week, blinded, randomized study, with 31 receiving high (therapeutic) VNS and 36 receiving low (less or noneffective) VNS, 67 patients elected to continue in an open extension phase. During the extension phase, all 67 patients received high VNS. Seizure frequency during the 3-month treatment blocks was compared with a 12-week baseline. For both groups, all periods of high VNS demonstrated a significant decrease in seizure frequency (p < 0.01 level) as compared with baseline. For the 16-18-month period of VNS, data were available for 26 of the 31 patients randomized to high VNS. This group achieved a 52.0% mean seizure frequency percentage reduction as compared with baseline. For those converted from low to high VNS, data were available for 24 of the 36 patients at the 16-18-month time period. This group reported a mean seizure frequency percentage reduction of 38.1% as compared with baseline. No significant change in the safety/side effect profile was reported during long-term follow-up. The previously reported side effects of hoarseness/voice change, coughing, and paresthesia (sensation in neck and jaw) continued to occur during VNS. These side effects were well tolerated. During the follow-up period, 1 patient died of thrombotic thrombocytopenic purpura (TTP) and 5 patients discontinued treatment because of unsatisfactory efficacy.
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PMID:Vagus nerve stimulation for treatment of partial seizures: 3. Long-term follow-up on first 67 patients exiting a controlled study. First International Vagus Nerve Stimulation Study Group. 802 10


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