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

In the case described, electroencephalography (EEG) proved valuable for determining the nature of spells of loss of consciousness with brief clonic jerks associated with ear and throat pain. A 70-year-old woman had a history of episodic brief attacks of pain below the right ear and deep in the neck that had started three years previously. The spells became more severe and progressed to loss of awareness associated with clonic jerks of the extremities. Because of a concern that the spells represented seizures, an EEG was performed, with electrocardiographic monitoring. Multiple spells were recorded; they began with profound bradycardia followed by generalized slow-wave activity and then by suppression of all EEG activity correlating with loss of consciousness and clonic jerking. The spells were thought to represent syncopal attacks associated with glossopharyngeal neuralgia.
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PMID:An electroencephalographic study of glossopharyngeal neuralgia with syncope. 335 4

The safety and efficacy of administering individualized phenytoin sodium loading doses by intravenous infusion were studied on 40 occasions in 37 adult patients having seizures. Doses were calculated based on an average volume of distribution (0.75 L/kg) and desired plasma phenytoin concentration. Total and free phenytoin concentrations were determined before and after the infusion. Phenytoin sodium doses of 225-1300 mg were administered by intravenous infusion at a rate of 40 mg/min after dilution in 0.9% sodium chloride injection to concentrations ranging from 4.5 to 13.5 mg/mL. Infusion rates were reduced if adverse effects occurred. The dosing method accurately achieved desired phenytoin concentrations (predicted mean +/- S.D. concentration, 18.3 +/- 1.6 micrograms/mL; observed mean concentration, 17.4 +/- 2.5 micrograms/mL). Postinfusion concentrations of free phenytoin ranged from 0.8 to 3.6 micrograms/mL (mean +/- S.D., 1.7 +/- 0.6 micrograms/mL). Of 21 patients evaluated for efficacy, 16 responded. A total of 45% of patients experienced pain at the infusion site, which diminished when the infusion rate was reduced. No serious cardiovascular or neurological toxicities occurred. The intravenous infusion method of administration is safe and effective and is useful for rapid achievement of therapeutic phenytoin concentrations in the emergency room setting.
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PMID:Efficacy of individualized phenytoin sodium loading doses administered by intravenous infusion. 335 18

A 57-year-old male was repeatedly admitted to hospital because of complex neurological symptoms, including radicular pain, disturbance of micturition, seizures, and severely impaired mental state. The diagnosis was encephalomyeloradiculitis possibly of viral origin, and treatment with immunosuppressants was initiated. An alternating course with a tendency towards improvement ensued. Two and a half years after the occurrence of the initial symptoms, identification of specific antibodies in the blood and CSF led to the diagnosis of borreliosis with CNS involvement. High-dose therapy with penicillin rapidly reduced the symptoms, beginning with those of radicular pain and followed by an improvement of the mental state. Attention is directed to the wide spectrum of clinical symptoms of chronic borreliosis with CNS involvement. Previous reports that immunosuppression may result in some improvement but with a tendency towards relapse are confirmed. Our encouraging treatment results support those of other reports that penicillin therapy may lead to improvement even at late chronic stages in patients with severe CNS deficits.
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PMID:Chronic borrelia encephalomyeloradiculitis with severe mental disturbance: immunosuppressive versus antibiotic therapy. 336 60

Electrical stimulation of dorsal and dorsolateral periaqueductal gray (PAG) and internal capsule (IC) sites in the rat elicited tail flick and formalin test stimulation-produced analgesia (SPA). SPA from PAG sites was associated with aversion. SPA from IC sites was associated with aversion, generalized seizures and catalepsy. Ventrobasal nucleus of thalamus (VB) stimulation did not elicit analgesia or aversion but did induce behavior characteristic of limbic seizures. A sub-anesthetic dose of sodium pentobarbital (20 mg/kg) suppressed IC stimulation-produced generalized seizures and catalepsy, and attenuated, but did not eliminate, tail flick test analgesia. These data suggest that SPA from IC sites in the rat is partially confounded with reduced responsivity. The hypothesis that SPA associated with aversion may represent a form of stress-induced analgesia is discussed.
Pain 1988 Apr
PMID:Stimulation-produced analgesia (SPA) from brain-stem and diencephalic sites in the rat: relationships between analgesia, aversion, seizures and catalepsy. 338 May 47

We present the cases of two children with lidocaine-induced seizures resulting from the use of oral viscous lidocaine. In the first case, the drug was prescribed for herpetic gingivostomatitis. In the second, a child was treated for teething pain by the mother, who used a relative's medication.
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PMID:Seizures secondary to oral viscous lidocaine. 338 75

Painful seizures do exist, but are usually caused by uncontrolled muscle contractions that produce pain. Heretofore, no cases of seizures of the pain system have been reported. We will present a case of chest wall pain with episodic, severe exacerbation of the localized pain associated with focal muscle contractions. The episodes of severe pain could be provoked by stimulation of the internal capsule, producing repeated episodes of pain/muscle activity. The symptoms could be stopped by intravenous diazepam and reduced by periventricular grey stimulation.
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PMID:Does epileptic pain really exist? 345 Feb 42

Ten years after a diagnosis of sarcoidosis, a 33-year-old woman presented with a severe headache of 5 days' duration. Neuroradiologic evaluation revealed a large cystic lesion of the left temporal lobe, causing a mass effect. An exploratory operation proved the lesion to be a loculated portion of the temporal horn of the lateral ventricle. Drainage of the loculated ventricle relieved the patient's cephalgia. Within 2 months, however, pain in the head recurred and an unsteady, broad-based gait appeared. Reevaluation disclosed hydrocephalus for which a ventriculoperitoneal shunt was inserted. After this procedure, the patient did well neurologically for 1 year, after which seizures, personality changes, incontinence, and disturbance of gait developed. Death occurred after revision of the shunt, and widespread granulomatous disease was found at autopsy. Neurosarcoidosis, with emphasis on intracranial mass lesions in sarcoidosis, is discussed; the role of surgical treatment in some of these lesions, and in hydrocephalus, is stressed.
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PMID:Neurosarcoidosis causing ventricular loculation, hydrocephalus, and death. 371 3

The medical records of all patients admitted to the solid tumor service of the Johns Hopkins Oncology Center over a three-month period were reviewed to determine the incidence and nature of major neurologic problems on the inpatient service of a university-based comprehensive cancer center. Seventy-four of 162 patients (46 percent) admitted during this time had tumor invading or compressing the nervous system, pain, seizures, or alteration in mental status. The most common problems were pain (34 patients) and altered mental status (25 patients). The evaluation or treatment of a neurologic problem constituted the second most common reason for admission to this inpatient oncology unit. Neurologic problems will soon be the most common reason for hospital admissions in patients with disseminated cancer as a result of changes in patterns of health care delivery and improvements in systemic therapy and supportive care.
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PMID:Incidence and nature of neurologic problems in patients with solid tumors. 379 54

A newly developed synaptosomal model was used to evaluate the in vivo effects of the GABA-elevating drugs aminooxyacetic acid (AOAA, 30 mg/kg i.p.) and valproic acid (VPA, 200 mg/kg i.p.) on GABA levels in nerve endings of 11 brain regions in rats as a function of time after administration. The data obtained were compared with the magnitude and time course of the effects of both drugs in rats on body temperature, pain response and against seizures induced by electroshock, pentylenetetrazol and 3-mercaptopropionic acid. Following AOAA, maximum increases in synaptosomal GABA levels of brain regions were observed 6 hr after administration. At this time, GABA was significantly elevated up to 300% over control values in synaptosomal fractions from all 11 regions. However, the hypothermic and antinociceptive effects of the drug as well as its anticonvulsant action against electroshock and pentylenetetrazol induced seizures were maximal 1 hr after injection and had vanished after 6 hr, i.e. at the time of maximum GABA increases in synaptosomes. The only pharmacological effect of AOAA which paralleled the time course of the synaptosomal GABA elevation was the attenuation of seizures induced by 3-mercaptopropionic acid. Following VPA, the effect on synaptosomal GABA levels was much more rapid in onset and significant increases were already determined 5 to 30 min after administration. Significant increases of up to 80% over control values were found in synaptosomal fractions from olfactory bulb, frontal cortex, hippocampus, hypothalamus, tectum, substantia nigra and cerebellum. In contrast to AOAA, the time course of the synaptosomal GABA increases, at least in some regions, was similar to the time course of VPA's antinociceptice effects and its anticonvulsant effects in the three seizure models studied. The data may suggest that AOAA and VPA increase different pools of GABA within nerve terminals, only one of which is involved in GABA-mediated neurotransmission.
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PMID:In vivo effects of aminooxyacetic acid and valproic acid on nerve terminal (synaptosomal) GABA levels in discrete brain areas of the rat. Correlation to pharmacological activities. 392 47

This retrospective study examines the indications and the effects of 119 doses of succinylcholine or pancuronium given in the emergency department during a 24-month period to patients considered to have immediately life-threatening emergencies. The most common indication for succinylcholine was to accomplish tracheal intubation (20 of 25 patients). Indications for pancuronium included computerized tomography of the head (60 of 94), control of agitation (40 of 94), facilitation of tracheal intubation (20 of 94), control of ventilation (12 of 94), and control of seizure unresponsive to anticonvulsants (4 of 94). Deterioration following succinylcholine occurred in three cases. These included two involving bradycardia and one involving ventricular tachycardia. Major complications following pancuronium included four incidences of ventricular arrhythmias. Intubation failure requiring surgical airway occurred in one patient given succinylcholine, two patients given pancuronium, and one patient who received both succinylcholine and pancuronium. Inadequate documentation of neurological examination prior to blockade was noted in six of 25 succinylcholine and nine of 94 pancuronium cases. Failure to sedate patients who might be aware of paralysis occurred in three of 25 succinylcholine and eight of 94 pancuronium uses. Neuromuscular blocking agents facilitate expeditious management of selected critical patients in the ED. Their prudent use requires anticipation of potential complications, preparation for surgical airway should intubation fail, documentation of physical examination before paralysis, and prior sedation when the patient responds to pain.
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PMID:Neuromuscular blockade for critical patients in the emergency department. 394 57


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