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

Psychogenic polydipsia (PPD), a clinical disorder characterized by polyuria and polydipsia, is a common occurrence in inpatients with psychiatric disorders. The underlying pathophysiology of this syndrome is unclear, and multiple factors have been implicated, including a hypothalamic defect and adverse medication effects. Hyponatremia in PPD can progress to water intoxication and is characterized by symptoms of confusion, lethargy, and psychosis, and seizures or death. Evaluation of psychiatric patients with polydipsia warrants a comprehensive evaluation for other medical causes of polydipsia, polyuria, hyponatremia, and the syndrome of inappropriate secretion of antidiuretic hormone. The management strategy in psychiatric patients should include fluid restriction and behavioral and pharmacologic modalities.
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PMID:Psychogenic polydipsia review: etiology, differential, and treatment. 1752 21

Renovascular disease accounts for 8-10% of all cases of paediatric hypertension, whereas, in adults, its incidence is approximately 1%. The Turkish Paediatric Hypertension Group aimed to create the first registry database for childhood renovascular hypertension in Turkey. Twenty of the 28 paediatric nephrology centres in Turkey responded to the survey and reported 45 patients (27 girls, 18 boys) with renovascular hypertension between 1990 and 2005. The age at presentation ranged from 20 days to 17 years. The mean blood pressure at the diagnosis was 169/110 mmHg. Chief complaints of symptomatic patients were headache (38%), seizure (18%), epistaxis (4%), growth retardation (4%), cognitive dysfunction (4%), polyuria (2%), palpitation (2%), and hemiplegia (2%). Renovascular hypertension was found incidentally in 11 children. The diagnosis of renovascular hypertension was established with conventional angiography in 39 patients, MR angiography in three, CT angiography in two, and captopril diethylene triamine penta-acetic acid (DTPA) scintigraphy in one patient. Twenty-one children had bilateral renal artery stenosis and 24 had unilateral renal artery stenosis. Of these, 14 (31%) had fibromuscular dysplasia; 12 (27%) Takayasu's arteritis; six (13%) neurofibromatosis; two (5%) Williams syndrome; one (2%) Kawasaki disease; one (2%) mid-aortic syndrome; one (2%) extrinsic compression to the renal artery, and eight (18%) unspecified bilateral renal artery stenosis. Hypertension was controlled with antihypertensive drugs in 17 patients. Percutaneous transluminal angioplasty (PTRA) or surgery had to be performed in 28 patients: PTRA in 16 patients, PTRA + surgery in one patient and surgery in 11 patients (four nephrectomies). The importance of vasculitic disease, especially Takayasu's arteritis, should not be underestimated in children with renovascular hypertension.
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PMID:Reno-vascular hypertension in childhood: a nationwide survey. 1753 66

Central pontine myelinolysis (CPM) has been reported in women with severe hyperemesis gravidarum-induced hyponatremia followed by rapid correction. Gestational diabetes with adipsia complicated by acute hypernatremia resulting in CPM has never been reported. Here is a case of a disabled female who presented with polydipsia, polyuria, seizures, fetal death in utero, hyperglycemia, and hyper-osmolar hypernatremia on her 31st gestational week. The dead fetus was delivered and the patient's plasma glucose and sodium were later stabilized. When the patient developed quadriplegia and respiratory failure 5 days later, brain magnetic resonance imaging showed central pontine and extra-pontine myelinolysis. Gestational diabetes complicated by hyper-osmolar crisis may cause fetal death and severe neurologic sequela. Early recognition and delivery of the fetus and placenta may improve the electrolyte and fluid imbalance.
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PMID:Gestational diabetes and central pontine myelinolysis with quadriplegia: a case report. 1965 45

A 13-month-old, male bichon frise was examined for the investigation of intermittent seizures, ataxia, abnormal behavior, polyuria, and polydipsia. At presentation, clinical and neurological examinations were unremarkable with the exception of mild truncal ataxia and a domed skull. Severe hyponatremia and hypoosmolality were identified, and following diagnostic testing a diagnosis of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) was made. Magnetic resonance imaging revealed changes consistent with severe hydrocephalus. Water restriction resulted in increased serum osmolality and a reduction in severity of clinical signs. The current case report documents SIADH associated with hydrocephalus in a dog. Structural brain disease should be excluded before a diagnosis of idiopathic SIADH is made.
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PMID:Syndrome of inappropriate antidiuretic hormone secretion associated with congenital hydrocephalus in a dog. 1972 49

Focal motor seizures are common in nonketotic hyperglycemia but occipital seizures as the initial symptom of hyperglycemia are exceptional. Sporadic electroencephalographic description has rarely been reported. A 56-year-old man presented to the emergency department with a 4-day history of intermittent, 30-minute episodes of flashing lights (blue-yellow color), 3-4 times per day in his left lower temporal visual field. His past medical history was significant for hypercholesterolemia and hypertension. The results of the ophthalmology examination were normal. When asked, the patient reported polyuria, polydipsia and weight gain for the previous 4 months. His general state was good and no other neurological symptoms were present. Among the laboratory tests, non-ketonic hyperglycemia of 339 mg/dl and mild plasma hyperosmolarity of 302 mOsm/kg were found. The results of visual campimetry were normal. Brain magnetic resonance imaging showed minimal alterations unrelated to the visual symptoms. An electrographic seizure in the right occipital region associated with visual symptoms was recorded. The patient was treated with hydration and insulin and was completely asymptomatic after 48 hours.
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PMID:[Occipital seizures with electroencephalographic alterations as the initial manifestation of diabetes mellitus]. 2011 16

Zonisamide is an antiepileptic drug that acts on voltage-sensitive sodium and calcium channels, with a modulatory effect on GABA-mediated neuronal inhibition and an inhibitory effect on carbonic anhydrase. It is used mainly for the treatment of partial seizures, and is generally well tolerated at therapeutic doses. The most common reported adverse effects are somnolence, anorexia, dizziness, and headache. There are limited data on zonisamide overdose in the literature, and no case of zonisamide mono-intoxication has been published to date. We describe the first case of zonisamide mono-intoxication in a 25-year-old woman who ingested 12.6 g of this substance with suicidal intent. Despite a plasma zonisamide concentration of 182 mg/L on admission, the patient exhibited a benign clinical course with vomiting and central nervous system depression, requiring brief intubation. Somnolence persisted for 50 hours, and normal-anion-gap metabolic acidosis and polyuria for several days. Complete recovery may be expected with supportive care, even after ingestion of large zonisamide overdoses.
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PMID:Moderate toxic effects following acute zonisamide overdose. 2146 69

Diabetic ketoacidosis (DKA) is a life-threatening condition and a major cause of morbidity and mortality in children with type 1 diabetes mellitus. The deficiency of insulin leads to metabolic decompensation, causing hyperglycemia and ketosis that resolves with the administration of insulin and fluids. However, an induced state of ketosis is the basis for the success of the ketogenic diet (KD), which is an effective therapy for children with intractable epilepsy. We report the case of a 2-year-old girl who presented to the emergency department with 1-week history of decreased activity, polyuria, and decreased oral intake. Her past medical history was remarkable for epilepsy, for which she was started on the KD with a significant improvement. Her laboratory evaluation was compatible with DKA, and fluids and insulin were given until correction. Because of concerns regarding recurrence of her seizures, the KD was resumed along with the simultaneous use of insulin glargine and insulin aspart. Urine ketones were kept in the moderate range to keep the effect of ketosis on seizure control. Under this combined therapy, the patient remained seizure-free with no new episodes of DKA.
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PMID:Successful treatment of type 1 diabetes and seizures with combined ketogenic diet and insulin. 2225 30

A 5-year-old female spayed Shetland Sheepdog Mix dog was evaluated for a history of recent seizure activity, progressive hind limb ataxia, polyuria, and polydipsia and no history of gastrointestinal signs. Physical examination findings included conscious proprioceptive deficits, ataxia, and anterior uveitis along with a hypermature cataract in the right eye. Results of a CBC, serum biochemical profile, urinalysis, and computed tomography scan of the brain were unremarkable. Cerebrospinal fluid (CSF) analysis revealed marked eosinophilic pleocytosis and rare organisms consistent with Prototheca spp within neutrophils and macrophages. On postmortem histologic examination, mononuclear inflammation and numerous intralesional algal organisms, similar to those seen on the cytologic preparation of CSF, were found in the brain, eyes, kidneys, and heart. Abnormalities were not detected on gross and histologic examination of the gastrointestinal tract. Cultures of CSF and subdural/olfactory bulb, but not intestinal tract, yielded growth of Prototheca spp, and PCR analysis and DNA sequencing confirmed the organism as Prototheca zopfii genotype 2. We have reported a rare case of disseminated protothecosis that was diagnosed by evaluation of CSF in a dog presented with neurologic signs and no overt enteric disease. Protothecosis should be considered as a rare cause of seizures, even in the absence of obvious enteric signs, and should be included in the differential diagnosis of eosinophilic pleocytosis.
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PMID:Disseminated protothecosis diagnosed by evaluation of CSF in a dog. 2225 Oct 39

We report a rare case of cisplatin-induced acute hyponatremia leading to a seizure and coma. A 66-year-old woman with breast cancer received adjuvant chemotherapy with docetaxel and cisplatin. She had no nausea, vomiting, or diarrhea during or after chemotherapy administration. She had an acute onset of a generalized seizure and coma on the fourth day after chemotherapy. On arrival in the emergency department, she was unconscious with a Glasgow Coma Score of 6 (eyes 1, verbal 1, motor 4). Computed tomography of the brain did not show any lesions. She had no underlying diseases except breast cancer. The laboratory studies showed severe hyponatremia (Na 113 mmol/L) with low plasma osmolality, and elevation of both urinary sodium and urinary osmolality. In addition, polyuria (about 4 L/day) was also noted. Her consciousness level gradually improved the next day with a rise in serum sodium after 3% NaCl infusion. She recovered fully with no sequelae. Assessment using the Naranjo probability scale suggested that cisplatin was the probable cause for the adverse event. The mechanism of hyponatremia induced by cisplatin in our case was thought to be renal salt wasting syndrome (RSWS). In conclusion, cisplatin-induced acute hyponatremia leading to seizures and coma is seen rarely. When RSWS is suspected, hypertonic saline should be administered.
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PMID:Cisplatin-induced acute hyponatremia leading to a seizure and coma: a case report. 2249 Apr 59

Central Diabetes Insipidus mostly presents with polydipsia and polyuria but may also present with confusion, psychosis, seizure or coma. We present a case of Central Diabetes Insipidus presenting with manic symptoms. A 21 year old Indian male had Central Diabetes Insipidus, which was confirmed by water deprivation test. He presented to our hospital with full blown manic symptoms meeting the ICD 10 criteria. He was managed with intranasal Desmopressin, water restriction and Olanzapine. In contrary to routine psychiatric patients which may present with psychogenic polydipsia or Central Diabetes Insipidus patients presenting in delirium or psychosis, our case presents a unique example of Central Diabetes Insipidus presenting with manic symptoms. It hints about a relationship between a common pathway for Central Diabetes Insipidus and mood disorders which needs further research. Diencephalon has already been the focus of attention for several researchers but no concrete evidence is available yet.
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PMID:Central Diabetes Insipidus presenting with manic symptoms. 2305 Nov 26


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