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

We questioned whether there was any way to predict which patients with high serum theophylline levels would develop life-threatening toxicity and thereby determine which patients might benefit from prophylactic therapeutic measures, such as hemoperfusion or hemodialysis. We reviewed the records of 54 consecutive patients seen over a five-year period in whom the serum theophylline level was 39 micrograms/ml or higher (range 39-78 micrograms/ml, mean theophylline level 49.5 +/- 9.6 micrograms/ml). Toxicity sought included cardiovascular--major arrhythmias (asystole, ventricular tachycardia, ventricular fibrillation) and minor arrhythmias, (central nervous system--major [seizures], minor [confusion, agitation]); and gastrointestinal (nausea, vomiting and diarrhea). In our sample of patients with extremely high theophylline levels, the incidence of life-threatening complications was low, and the subgroup of patients with high serum theophylline levels who developed life-threatening toxicity could not be easily identified. We conclude that major interventional procedures such as hemoperfusion or hemodialysis should not be used prophylactically in this population of patients of middle age to elderly men with high theophylline levels. We recommend a more conservative approach of using oral activated charcoal therapy in all patients with high serum theophylline levels, and reserving hemoperfusion or hemodialysis for those patients who develop seizures or major arrhythmias.
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PMID:Life-threatening theophylline toxicity is not predictable by serum levels. 379 59

From January 1974 to June 1983, the Paris Poison Control Centre collected 84 cases of overdosage with orphenadrine alone or in combination. Prior papers emphasized fatalities related to orphenadrine poisoning. This retrospective study suggests an underestimated incidence of anticholinergic drugs abuse in our country. The clinical picture of orphenadrine poisoning associates drowsiness, agitation, confusion, delirium and seizures. Anticholinergic symptoms are often noted: mydriasis, sinus tachycardia, dryness of the mouth and urinary retention. No severe cardiac disturbance was found in these patients.
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PMID:[Acute poisoning by orphenadrine]. 383 10

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

A 26-year-old woman ingested approximately 9 g of theophylline (Theodur). She exhibited agitation, generalized seizures, hyperglycemia, hypokalemia, hypomagnesemia, hypophosphatemia, and diuresis. Later in her hospital course rhabdomyolysis, myoglobinuria, and acute renal failure occurred. Hemodialysis was performed to correct electrolyte imbalance. She subsequently died of intractable shock and hyperkalemia. This case illustrates the metabolic abnormalities which may occur with severe theophylline intoxication.
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PMID:Fatal overdose from a sustained-release theophylline preparation. 397 Apr 1

An 11-year-old previously healthy boy had an abrupt onset of partial complex, focal, multifocal, and generalized seizures, with interictal expressive aphasia, extreme emotional lability, agitation, and complex visual and auditory hallucinations. EEGs showed frequent runs of rhythmic high-voltage delta over the right and subsequently over the right and left temporal and frontal regions. All other studies were negative (repeated computed tomography, spinal fluids, viral titers, and cultures). Nadir during the second month showed virtual unresponsiveness, prolonged rhythmic motor and apneic seizures, total anorexia, and sleeplessness. Remission of the electrical and clinical seizure activity and a gradual improvement through a state of agitation and emotional lability occurred during the third and fourth months. One year later he was entirely normal. Compared with the other previously documented cases of prolonged partial complex status, this case is notable for its florid and severe symptomatology, long duration, and final benign outcome.
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PMID:Protracted epileptiform encephalopathy: an unusual form of partial complex status epilepticus. 407 61

Between 27 September and 27 December 1969, 103 patients diagnosed as having yellow fever were admitted to Vom Christian Hospital, near Jos, Nigeria. Headache and vomiting were the commonest presenting complaints, and 95% of the patients showed scleral icterus or bile pigments in the urine. Haemorrhage, signs of renal failure, and CNS involvement (agitation, seizures) were associated with a grave prognosis. The overall case-fatality ratio was 45.6%. The average duration of illness for fatal cases was 6.4 days and for non-fatal cases 17.8 days. Six illustrative case histories are presented.
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PMID:Clinical features of yellow fever cases at Vom Christian Hospital during the 1969 epidemic on the Jos Plateau, Nigeria. 453 38

After a discussion of the various basic problems concerning the application of psychopharmacological drugs in children and adolescents, paradoxical reactions and interactions of some psychopharmaca are considered. Stimulantia can especially cause disturbances of growth and as a paradoxial reaction the increase of hypermotoric behaviour. Neuroleptics may lead to tardive dyskinesia, to interactions with hypotensors and occasionally to epileptic seizures. As to tricyclic antidepressive it is known that they can cause interactions with hypotensors and thyroid hormones, as well as paradoxical aggressive reactions. In connection with tranquilizers paradoxical reactions as anxiety and agitation as well as the so-called paradoxical rage reaction could be observed. Combinations of antiepileptica and psychopharmaca should only be used if there is no other possibility for adequate treatment. After all, the field of indications of psychopharmacological drugs in children and adolescents seems to be rather narrow.
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PMID:[Paradoxical reactions and interactions of psychopharmaca in children and adolescents (author's transl)]. 610 21

The effectiveness of low-dose intrauterine irradiation for benign diseases and its possible carcinogenic effect on the uterus was studied in 190 patients who were treated during the years 1952-1974. The indications for irradiation were premenopausal functional bleeding, leukemia, hemophilia, fibroids, endometriosis or other benign reason. Radiation was also performed on patients with severe neurologic diseases that contraindicated surgery and on some mentally retarded patients whose restlessness and epileptic seizures were aggravated premenstrually and during menstruation. The mean follow-up period was 15 years. Uterine bleeding recurred in 21% of the patients. No cases of uterine malignant degeneration were found.
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PMID:Uterine malignant degeneration after low- dose endometrial irradiation. 610 64

The analgesic meperidine has been reported to produce signs of central nervous system excitation in human beings. To determine the relationship between signs and symptoms of central nervous system excitation and plasma levels of meperidine and normeperidine, we studied 67 patients receiving meperidine for the relief of postoperative or chronic pain. In 48 patients, excitatory effects ranging from mild nervousness to tremors, twitches, multifocal myoclonus, and seizures were directly correlated with accumulation of normeperidine in plasma. Evidence of compromised renal function occurred in only 14 of the 48 symptomatic patients, suggesting that renal dysfunction may contribute to but is not the sole factor in the accumulation of normeperidine or its relation to adverse neurological signs. In a second study we surveyed mood alterations in 47 patients receiving meperidine and 29 receiving other narcotic analgesics for postoperative pain. The repeated administration of meperidine was associated with adverse alterations in various elements of mood (e.g., apprehension, sadness, restlessness).
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PMID:Central nervous system excitatory effects of meperidine in cancer patients. 618 75

The 6 cases reported here constitute, with 5 previously published cases, a special nosological entity tentatively called "acute benign cerebral angiopathy" by the authors. These 11 cases have in common certain radiological and clinical features. Arteriography shows segmental, multifocal and assymetrical stenoses involving the cerebral arteries between Willis' circle and the terminal arterioles and looking like "strings of sausages". The lesions disappear within one month and present the radiological characteristics of arteritis of medium caliber vessels. The clinical symptoms are suggestive of meningeal haemorrhage or acute cerebromeningeal oedema, with acute repetitive attacks of severe headache and agitation with obnubilation; epileptic seizures and transient neurological deficit may occur. True meningeal haemorrhage confirmed by lumbar puncture is seen in nearly one half of the cases; it seems to be due to alterations in the blood-brain barrier induced by the angiopathy. Intracerebral haematoma may develop, but the disease is usually benign and regresses spontaneously in a few days. None of the usual causes of cerebral arteritis (intra-cranial infection, collagen disease, allergic or toxic angitis) has been found. Pseudo-arteritis (notably spasm of ruptured arterial aneurysms) has been excluded. No aetiological factor common to the 11 cases reported has been elicited, although 6 of the patients had recently given birth and our 6 patients had benign virus infection before or during the clinical manifestations of the disease. In the authors' opinion, the most rewarding line of research would be the role of short acute attacks of arterial hypertension.
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PMID:[Acute benign cerebral angiopathy. 6 cases]. 622 47


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