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

Cocaine poisoning has increased recently, and survival is rare because of its sudden onset and rapidly fatal course. A patient is described in whom cocaine poisoning developed. This condition was manifest by the findings of acute agitation, diaphoresis, and tachycardia, and was complicated by grand mal seizures, severe respiratory and metabolic acidosis, apnea, and accelerated idioventricular rhythm. After control of the seizures with diazepam and treatment of the acidosis with ventilation and bicarbonate, the ventricular dysrhythmia abated, and the patient made a quick recovery. Recently reported experiments suggest that seizures are a major determinant of lethality in cocaine poisoning. Treatment of the seizures is of prime importance, and correction of the acidosis can normalize cardiac rhythm and function in these critically ill patients.
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PMID:Acute cocaine poisoning. Importance of treating seizures and acidosis. 631 83

Thirty-five patients with malignant brain tumors (23 with primary brain tumors and 12 with brain metastases) progressing after cranial irradiation +/- chemotherapy received cisplatin, 60 to 120 mg/m2, into the internal carotid artery by a transfemoral approach. Courses of therapy were repeated every 4 weeks. Therapeutic evaluation was performed monthly using the CT scan of the brain and clinical neurologic examination. Thirty patients were evaluable for response. Of 20 evaluable patients with primary malignant brain tumors, 6 responded to therapy and 5 had stable disease. The median time to tumor progression for responding patients was 33 weeks, for stable patients 16 weeks, and 13 weeks for all patients. Five of 10 evaluable patients with brain metastases responded to intracarotid cisplatin, and 2 patients had stable disease. The estimated median time to progression for responding patients was 30+ weeks and 12+ weeks for patients with stable disease. Side effects included seizures in 5 courses, mental agitation and motor restlessness in 1, and transient hemiparesis in 7. One patient may have had a drug-related death, and one patient appeared to develop encephalopathy after treatment. Five patients had clinical deterioration in vision; in two patients it was bilateral. Intracarotid cisplatin has definite activity in patients with malignant primary brain tumors and in patients with brain metastases. The recommended starting dose for intracarotid cisplatin is 60 to 75 mg/m2. At this dose level side effects are uncommon, but includes the risk of neurologic and retinal toxicity.
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PMID:Intracarotid infusion of cis-diamminedichloroplatinum in the treatment of recurrent malignant brain tumors. 633 26

Various indications of benzodiazepines in the treatment of chronic alcoholism are discussed. They are prescribed in the treatment of Delirium Tremens and other acute withdrawal syndromes, often by intramuscular injections or intraveinous infusions. Their efficacy is particularly marked on withdrawal seizures, agitation, more inconstant on confusion, hallucinations and even on tremor symptoms. They more prevent withdrawal symptoms than they reverse severe ethanol withdrawal symptomatology, on humans like on experimental animals. Most authors recommend short prescriptions of BZD in alcoholic patients: the main difficulty is not the problem of the pharmacological interactions between alcohol and BZD, only observed during acute and important ingestions of alcohol and more linked to summation than to potentialisation , but the risk of an abuse and even a psychological and physical dependency to BZD. Such a dependence syndrome would probably develop more frequently in alcoholic patients. One must not overrate its importance; the extended prescription of BZD must not be therefore prohibited when they seem useful in the maintain of alcohol abstinence.
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PMID:[Benzodiazepines in the treatment of alcoholism]. 637 35

During the clinical development of bupropion (Wellbutrin) 1,153 depressed patients and 157 normal volunteers received bupropion (doses, 15-1200 mg/day); 177 placebo-treated and 196 tricyclic-treated patients (doses, 25-300 mg/day) also participated in these trials to provide a control comparison. Safety measures during the clinical trial program included adverse event symptomatology, vital signs, clinical laboratory examinations, and EEGs. There were no bupropion-related changes in vital signs, clinical laboratory, or EEG results severe enough to warrant treatment discontinuation. The most common cause for discontinuation in the bupropion (9.1%), placebo (6.8%), and tricyclic groups (9.2%) was agitation/excitement. The only adverse experience considered of medical significance in bupropion patients was major motor seizure. The incidence of a seizure was less than 1 per 1,000 at usual outpatient doses and less than 1 per 100 at usual inpatient doses. These incidences appear to be comparable to those seen with equally therapeutic doses of tricyclic antidepressants.
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PMID:Overview of clinically significant adverse reactions to bupropion. 640 56

Over-the-counter stimulants (phenylpropanolamine hydrochloride, ephedrine, pseudoephedrine, caffeine) are used widely as decongestants, anorectic agents, amphetamine substitutes, and "legal stimulants." Toxic effects may result from overdose, drug interactions, or diseases that increase sensitivity to sympathomimetic agents. The most important toxic effect of the alpha-adrenergic agonist phenylpropanolamine is hypertension, which may result in hypertensive encephalopathy or intracerebral hemorrhage. The therapeutic index of phenylpropanolamine is low, and severe hypertension may occur after ingestion of less than three times the therapeutic dose. Ephedrine and pseudoephedrine may also cause hypertension, as well as tachyarrhythmias due to beta-adrenergic stimulation. Toxic reactions from caffeine are characterized by agitation, seizures, tachyarrhythmias, and hypotension. Management of toxic reactions to over-the-counter stimulants includes control of hypertension with a rapidly acting vasodilator, beta-blockers for tachyarrhythmias, and control of seizures.
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PMID:Toxicity of over-the-counter stimulants. 647 21

Methyl bromide (MeBr) is used as an insecticide fumigant. Four deaths and three recent hospitalizations have resulted from exposures to MeBr in Dade County, FL. Six cases occurred during burglaries of tented houses over a nine-month period. In four lethal exposures, the symptoms of nausea, vomiting, and malaise preceded fulminant respiratory failure. Two of these also had seizures, delirium, and agitation. Serum or plasma bromide ion levels ranged from 40 to 583 mg/L. Pulmonary edema, hyaline membranes, and hemorrhagic alveolitis were present at autopsy along with varying degrees of cerebral edema. The nonlethal exposures resulted in symptoms of conjunctival irritation, headache, or nausea. Plasma bromide concentrations varied between 17.5 and 321 mg/L. Methyl bromide characteristics, use, morbidity, and mortality in Florida during the past 25 years are reviewed. Remedies for illegal entry are proposed.
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PMID:Death and injury caused by methyl bromide, an insecticide fumigant. 661 79

Three cases of choreoathetosis which developed during phenytoin therapy in children less than 2 years of age are described. The most striking clinical manifestations included the sudden onset of restlessness and agitation with superimposed choreoathetosis. None of these children had toxic levels of phenytoin in the blood. Discontinuation of phenytoin resulted in prompt cessation of the symptoms. Phenytoin-induced choreoathetosis should be a diagnostic consideration in children with a preexisting CNS insult who manifest violent choreoathetosis during therapy for seizure control. This consideration is especially pertinent in the pediatric intensive care unit, where other more common causes of agitation could be misdiagnosed.
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PMID:Phenytoin-induced choreoathetosis in infancy: case reports and a review. 664 26

Baclofen is widely used in the treatment of spasticity of spinal origin. It is relatively free of side effects or toxic actions on the nervous system or other organs. Agitation, personality change, and auditory and visual hallucinations have been described following its abrupt withdrawal. One patient with generalized seizures and one with complex partial seizures after baclofen withdrawal have been reported. This paper presents a patient who developed status epilepticus after baclofen withdrawal, and who sustained hypoxic cerebral injury. This observation further emphasizes the possibility of infrequent complications of baclofen therapy, and the advisability of gradual changes in baclofen dosage.
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PMID:Status epilepticus after baclofen withdrawal. 673 10

Massive cocaine intoxication is manifested by central nervous system stimulation (restlessness, tremors, convulsions) and then depression (respiratory and cardiovascular failure). A young man presented with new seizures and eventual development of status epilepticus, respiratory failure, and cardiovascular depression. Investigation revealed ingestion of cocaine-filled condoms which had ruptured in the gastrointestinal tract. Smuggling of illicit drugs via the oral-fecal route may lead to severe physiologic derangements if the container ruptures.
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PMID:Cocaine intoxication: massive oral overdose. 677 47

The results of the initial North American trial of the nonionic, water-soluble contrast medium iopamidol for lumbosacral myelography are reported. The iopamidol was easily visualized by fluoroscopy during introduction, and the radiographic quality of all 12 conventional myelographic examinations was excellent. The diagnoses were herniated nucleus pulposus (seven), traumatic dislocation (one), metastasis (one), and normal (three). One patient had a repeat myelogram with a different hydrosoluble contrast medium 2 months after his iopamidol examination and surgery and showed no radiographic evidence of arachnoiditis. The adverse reactions were all mild and transient: headache (four cases), nausea (two), and leg pain (one). There were no diaphoresis, fever, seizures, hallucinations, agitation, or vital sign changes. Electrocardiography, hematology, and blood chemistries were all normal. In two patients, electroencephalogram changes, three to four bursts of diffuse intermittent rhythmic delta activity with no spiking, were present at 6 hr with return to normal at 24 hr.
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PMID:Clinical trial of iopamidol for lumbosacral myelography. 680 Feb 40


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