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

A 3-year-old horse presented with intermittent generalized seizures of 2-month duration. During interictal periods, the horse appeared normal and a cause for the seizures could not be identified. Necropsy revealed opacity of the leptomeninges, covering most of one cerebral hemisphere along with thinning and collapse of the cortex in the ipsilateral pyriform lobe. Histopathology demonstrated leptomeningeal vascular proliferation and meningothelial hyperplasia. Prominent tortuous vessels of the gyri and sulci extended into some regions of the subjacent cortex, where there was neuronal loss, ectopia, and disorganization. Clusters of prominent arterioles were found in the sclerotic choroid plexus of the lateral and fourth ventricles. Milder vascular lesions were present in the leptomeninges of the ventral brain stem, right cerebrum, spinal cord, and in the eye. The left trigeminal nerve was distorted by swollen fasicles containing onion bulb-like structures. Most bulbs contained central axons surrounded by myelin sheaths of variable thickness. Electron microscopy demonstrated concentrically arranged cells with continuous basal laminae and rare pinocytotic vesicles. S-100 immunohistochemistry showed strong positive staining in these cells. This is an unusual combination of lesions to which analogies can be drawn with the human neuroectodermal dysplasias, specifically Sturge-Weber disease. The relationship of the neuropathy to the leptomeningeal hemangiomatosis is unclear, but a compound anomaly in embryological development resulting in dysplasia and neoplasia may be involved.
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PMID:Meningocerebral hemangiomatosis resembling Sturge-Weber disease in a horse. 368 94

Risk management, or quality assurance, in 1st trimester abortion service delivery, is unique in medicine for having developed a systematic set of actions to prevent or mitigate medical complications as well as consequences of fires, vandalism, harassment, bombings, job actions, and counseling and administrative crises. Risk management principles should be incorporated into facility design, staff selection, equipment selection and maintenance, physician hiring and monitoring, patient screening, regular review of protocols for medical emergencies, high-risk tissue examination. Types of medical crises include cardio-pulmonary collapse, hemorrhage, visceral injury, shock, seizure, and coma. Counseling crises imply suicide or homicide threat, acute psychosis, and reactions of other clients and visitors. Under administrative crises were listed fire, threats or acute bombing, arson, or assault, power or water failures, personnel shortage, harassment, and hostile media. All types of crises are handled by developing a plan of action, training staff, repeating training regularly, and conducting drills, feedback sessions, equipment checks, and designing in security. It should be expected that medical crises will occur on the average in 1/400 terminations, which amounts to one every 2-3 years for a small clinic, or 1-2 per month for a large one. All staff, including counselors, should be able to recognize destabilizing vital signs and to do cardio-pulmonary resuscitation. Appropriate alarm signals should be prearranged to transport the patient to hospital, without concern for personal ego damage, social disruptions, lack of hospital privileges, insurance, or cost. Equipment necessary to handle medical crises is listed, as are security measures to minimize administrative crises. An example of a severe drug reaction and its efficient handling, a result of pre-planning, is detailed.
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PMID:Risk management in pregnancy termination. 370 10

Propafenone is a type 1c antiarrhythmic drug that recently has become available for clinical trials within the United States. We present the case of a 2-year-old child who accidentally ingested 1,800 mg (133 mg/kg) of propafenone. The patient subsequently developed cardiac conduction abnormalities and generalized seizures. Following the administration of IV phenytoin, cardiopulmonary collapse occurred. The patient had a successful outcome with aggressive cardiopulmonary life support.
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PMID:Propafenone ingestion. 382 14

Phenytoin (DPH) was evaluated for its capacity to reduce several motor manifestations of decerebrate rigidity in the cat. In doses of the order of 40 to 50 mg/kg i.v., DPH diminished the force necessary to collapse the hyperextended limbs; at about half this dose range, the drug reduced gamma-motoneuron discharges; at still lower doses the drug profoundly depressed mechanical and electromyographic responses evoked by stretch from both forelimb and hindlimb extensor muscles. Serum levels of DPH associated with substantial reduction in electrical and mechanical manifestations of the extensor hypertonus were of the same order conventionally encountered when the drug is administered to humans for acute seizure management. The data are supportive of a centrally and peripherally mediated muscle relaxing effect of the drug in states where muscle spindle involvement is a contributing factor, and may help to explain further the utility of DPH in the treatment of spasticity.
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PMID:Description and analysis of the myotonolytic effects of phenytoin in the decerebrate cat: implications for potential utility of phenytoin in spastic disorders. 396 98

We investigated whether anesthetized dogs (n = 6) could be resuscitated from massive cardiovascular toxic intravenous bupivacaine overdoses. Five mg/kg of bupivacaine was given into the right atrium over 10 sec every minute until cardiac collapse occurred. At the same time the bupivacaine was given, the animals were made apneic for 90 sec (to mimic the clinical situation in which seizures often render patients apneic) and then ventilated with 100% oxygen. After bupivacaine administration, cardiovascular collapse occurred in the form of ventricular tachycardia, or more commonly, electromechanical dissociation. Resuscitation was performed using open-chest heart massage, bretylium for ventricular tachycardia, and epinephrine with atropine for electromechanical dissociation and bradycardia. After successful resuscitation, each animal was again given bupivacaine as above until cardiovascular collapse occurred and resuscitation was performed again. Each dog underwent three arrests and resuscitations. The total cumulative bupivacaine dose was 64.1 +/- 26.8 mg/kg. We conclude that anesthetized dogs receiving massive cardiovascular toxic doses of bupivacaine can be resuscitated easily and consistently with appropriate therapy.
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PMID:Successful cardiovascular resuscitation after massive intravenous bupivacaine overdosage in anesthetized dogs. 399 11

Controversy persists surrounding the relative safety of bupivacaine compared with lidocaine especially with regard to its cardiovascular toxicity and the ability to resuscitate following such occurrences. The margin of safety between seizure onset and cardiovascular collapse was compared in lightly anesthetized and ventilated cats given an equipotent infusion of either lidocaine or bupivacaine (N = 10 for each group). The infusion rates were 4 mg X kg-1 X min-1 bupivacaine or 16 mg X kg-1 X min-1 lidocaine. Onset of electrical seizure activity occurred at about the same time in both groups and was defined as the central nervous system (CNS) toxic end point. The infusion continued until the mean arterial pressure reached 10 mmHg (cardiotoxic end point). Despite the early occurrence of electrocardiographic changes in the bupivacaine group, mean arterial pressure was greater and sustained significantly longer (4.9 +/- 1.3 min; mean +/- SD) with this drug compared with lidocaine (3.0 +/- 0.6 min) (P less than 0.005). Using the blood pressure criterion for defining cardiovascular (CV) collapse, the CV/CNS toxicity ratio for drug dosage was 4.0 with lidocaine and 4.8 with bupivacaine. The use of a standardized resuscitation protocol made it possible to compare the ability to resuscitate animals in each group. Despite very high plasma local anesthetic concentrations, all lidocaine-infused animals were quickly resuscitated (4.4 +/- 3.0 min; mean +/- SD). The resuscitation time for the bupivacaine group (5.4 +/- 2.4 min) was similar. Two cats in the bupivacaine group could not be brought to resuscitation criterion, a difference, however, that was not statistically significant.
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PMID:Toxicity and resuscitation in lidocaine- or bupivacaine-infused cats. 403 1

The authors present the results of own investigations on the occurrence of side effects following myelography with the contrast medium Amipaque administered usually by the lumbar route. Sixty patients aged 21-65 years with various diseases of the spinal cord and cauda equina were studied. Clinical and myelographic investigations were performed before and after myelography. In 6 out of 60 cases (10%) transient neurological disturbances developed including epileptic seizures, speech disturbances of the type of aphasia and dysartria, visual disturbances and twitching of lower extremities. Other symptoms and signs included: headaches, vomiting, collapse. One patient with cardiorespiratory failure died hours after myelography with evidence of increased symptoms of cardiorespiratory failure. EEG changes appeared after myelography in 2/3 of cases and persisted for up to 12 days. The authors call attention to the high proportion of neurological complications and EEG changes which must be taken into account when indications to myelography are considered. Particular caution is necessary in cases with coexistent cardiorespiratory failure.
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PMID:[Clinical and electroencephalographic signs of side effects in patients after myelography using "amipaque"]. 404

A sixty-year-old man experienced successively over two years several episodes of circulatory collapse and meningeal hemorrhage, a myocardial infarction, an episode of ketoacidosis and a seizure before acute abdominal pain with fever related to the sudden, partial, necrosis of his tumor, led to the discovery of a pheochromocytoma. This observation exemplifies the multiple clinical aspects and diagnostic pitfalls of this secreting tumor. It underscores the misleading nature of normotensive pheochromocytomas.
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PMID:[Pheochromocytoma and its diagnostic pitfalls]. 632 Apr 24

Dextropropoxyphene is a widely prescribed synthetic opiate-like drug of uncertain analgesic efficacy which, in acute overdosage, manifests all the features of opiate toxicity. It is rapidly absorbed and, in association with other central nervous system depressants such as alcohol or benzodiazepine drugs, may be rapidly fatal. Seriously overdosed patients are comatose with respiratory depression, vomiting, seizures and circulatory collapse; small pupils are a useful diagnostic marker. The first priority is to establish the airway and treat convulsions, if present. All the features of overdosage are then rapidly and safely reversed by the specific opiate antagonist naloxone given intravenously. High tissue concentrations and slow elimination of dextropropoxyphene metabolites make continued and intensive monitoring after resuscitation essential because sudden unpredictable deterioration may occur for up to 24 hours. Other more slowly toxic co-ingestants such as paracetamol (acetaminophen) are often present and should be detected and treated as necessary. Dextropropoxyphene poisoning is now probably one of the most common causes of self-poisoning death because, although there is an effective antidote, subjects frequently succumb before treatment can be made available.
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PMID:Dextropropoxyphene overdosage. Pharmacological considerations and clinical management. 634 64

Two groups of patients were studied: group 1 with a brain tumor and epileptic syndrome and group 2 with epilepsy of traumatic or infectious origin. In both diseases transient collapse symptoms occurred in the post-seizure period. The development of these symptoms was analysed. It was established that with the recurrence of the paroxysms in cases with cerebral new growths the transient collapse change to permanent ones which in turn become deeper from seizure to seizure. In patients with epilepsy of traumatic or infectious etiology, no change of transient collapse to permanent ones of intensification of the latter was encountered. The dynamic symptoms described are of differential diagnostic importance in distinguishing these diseases.
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PMID:[Differential diagnostic significance of symptoms of collapse following epileptic seizures]. 677 82


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