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

An elderly woman who had spinal epidural anesthesia thereafter had headache, anorexia, nausea and vomiting, dehydration, seizures, and cardiovascular collapse. CAT scan revealed air in the posterior fossa, probably caused by intradural injection of air during epidural anesthesia. We propose that this may be an occasional cause of headache or more substantial complications after epidural anesthesia, and suggest that CAT scanning may be helpful in identifying this complication.
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PMID:Pneumocephaly from epidural anesthesia. 682 9

We review our experience in the management of patients with plasma theophylline concentrations of 30 micrograms/ml or greater. Over a two-and-a-half-year period, 22 patients (Group 1) had plasma theophylline concentrations of 37 +/- 1 micrograms/ml (mean +/- SE) and experienced no severe toxicity (i.e., ventricular extrasystoles or tachycardia, seizures, cardiovascular collapse, or death). Six patients (Group 2) took overdoses of theophylline (92 +/- 12 micrograms/ml) and one died. Eight patients (Group 3) were iatrogenically intoxicated (48 +/- 6 micrograms/ml) and three died. Six patients from Groups 2 and 3 underwent hemoperfusion and did well, except for one patient, in whom seizures developed before hemoperfusion was initiated. We conclude from this experience that charcoal hemoperfusion is a useful procedure for the treatment of theophylline intoxication because of: (1) the serious morbidity and mortality of theophylline intoxication, (2) the prevention of complications with hemoperfusion, and (3) the relative safety of the procedure. We provide tentative guidelines for the initiation of hemoperfusion for the treatment of theophylline intoxication.
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PMID:Use of hemoperfusion for treatment of theophylline intoxication. 685 64

In urethane-anaesthetized guinea-pigs, the effect of theophylline (theo) on heart rate, arterial blood pressure, respiration rate and limb movements were recorded. Continuous intravenous infusion of theo initially increased the respiratory and heart rates and lowered the arterial blood pressure. After infusion of about 50 mg/kg of theo, the cardiovascular effects reached a maximum and were then only slightly changed until the terminal stage. A tonic stretching of the limbs (at 155 +/- 15 mg/kg) preceded generalized seizures of clonic tonic convulsions which were recorded after infusion of 367 +/- 25 mg/kg of theo. At this stage, respiration was highly irregular. PaO2 started to fall and PaCO2 to rise, while a plasma acidosis developed rapidly. The convulsions progressed in frequency and intensity and were terminally associated with respiratory and cardiovascular collapse. The convulsive effects of theophylline were similar to those observed in conscious guinea-pigs after 250 mg/kg of theo orally. The present findings agree with the view that the convulsive effect is a primary life-threatening action of theophylline. The method described may be of use in the search for new, less toxic xanthine drugs.
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PMID:Convulsive effect of theophylline in conscious and anaesthetized guinea-pigs. 722 38

Ten fatalities and one survivor of attempts to smuggle cocaine within the body were investigated. Most cases have occurred since 1979. All but one of the victims were male. Victims found dead at home or in hotel rooms had little or no drug paraphernalia at the scene, although abundant laxatives and enema apparatus were often evident. Some died aboard aircraft, and witnesses described agitated behavior followed by grand-mal type seizures, respiratory collapse, and death. Seven victims presented to hospital emergency rooms. The symptoms include mydriasis, seizures, acute toxic psychosis, and coma in various combinations. One individual, realizing his plight, sought emergency room help by claiming he attempted suicide by using cocaine. All victims had recently returned to the United States on flights from South America. Balloons, condoms, or plastic bags filled with 3 to 6 g of cocaine each were swallowed and found in the gastrointestinal tract of eight victims. One of these had ingested more than 147 packets totaling 460 g. Two victims inserted packets of cocaine into their rectums, and one woman was found with nearly 170 g of cocaine in her vagina. The packets, being semipermeable membranes, do not have to break open to cause death from acute cocaine toxicity. Characteristic autopsy and radiologic findings, circumstances of death, and toxicologic data are presented. The "body packer syndrome" should be considered in any international traveler who dies suddenly, has seizures, or presents with any signs consistent with cocaine toxicity.
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PMID:The "body packer syndrome"-toxicity following ingestion of illicit drugs packaged for transportation. 725 65

Chlorambucil neurotoxicity was observed in two children treated for frequently relapsing minimal change nephrotic syndrome. In the first child the drug was overdosed. Myoclonic jerks were observed, followed by a generalized tonic-clonic seizure. Concomitant EEG abnormalities disappeared after discontinuation of therapy, but reappeared 6 months later without further seizures. In the second child chlorambucil treatment was started twice, but had to be interrupted each time; the first time because of sudden collapse, bradycardia and respiratory arrest, and the second time because of myoclonic jerks. EEG changes were limited to generalized slowing and improved after discontinuation of therapy. According to the literature chlorambucil neurotoxicity is found almost exclusively in children, after overdosage or in the nephrotic syndrome. Strict neurologic supervision of patients treated with this drug is recommended.
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PMID:Chlorambucil neurotoxicity: report of two cases. 741 Jan 14

We sought to determine the contemporary frequency of seizures, and the associated cardiovascular changes, resulting from local anesthetic-induced seizures in all patients undergoing brachial plexus, epidural, and caudal regional anesthetics. We investigated the following variables: development and treatment of seizure or cardiac arrest during the regional anesthetic, type of anesthetic (including local anesthetic used), gender, age, ASA physical status class and type of operation (elective or emergent). In addition, each patient who experienced a seizure underwent retrospective review of the acute event to determine the arterial blood pressure and heart rate changes accompanying the seizure, as well as details of the regional block technique. There was a significant difference between the rate of seizure development between epidural, brachia, and caudal anesthetics, with caudal > brachial > epidural. A significant difference was also noted in the rate of seizure development within types of brachial block, with supraclavicular and interscalene > axillary. No adverse cardiovascular, pulmonary or nervous system events were associated with any of the seizures, including the 16 patients who received bupivacaine blocks. The frequency of local anesthetic-induced seizures stratified by block type has a wide range, and cardiovascular collapse after bupivacaine-associated seizure has a low incidence.
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PMID:Regional anesthesia and local anesthetic-induced systemic toxicity: seizure frequency and accompanying cardiovascular changes. 862 82

Beta-adrenergic agonists and theophylline are both capable of producing tremor, agitation, tachycardia, metabolic acidosis, hypokalemia, hyperglycemia, cardiac arrhythmias, and seizures. However, theophylline preparations, especially in the sustained-release formulations, are associated with a much higher incidence of morbidity and mortality secondary to status epilepticus and cardiovascular collapse. Overdoses of sustained-release preparations place patients at exceedingly high risk. This article describes the differentiation of the patient with acute and chronic theophylline overdoses and the implications for management of both clinical states.
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PMID:Concepts and controversies of bronchodilator overdose. 791 May 56

Artemisinin (qinghaosu) and several derivatives have been developed and are in use as antimalarial drugs but scant information is available regarding animal or human toxicity. Following a eight-day, multiple-dose, pharmacokinetic study of arteether (AE) (10 mg/kg/day [n = 6] and 20 mg/kg/day [n = 6]) in dogs, all high-dose animals displayed a progressive syndrome of clinical neurologic defects with progressive cardiorespiratory collapse and death in five of six animals. Neurologic findings included gait disturbances, loss of spinal and pain response reflexes, and prominent loss of brain stem and eye reflexes. Animals had prolongation of QT interval corrected for rate (QTc) on electrocardiograms (ECGs) with bizarre ST-T segment changes. Prominent neuropathic lesions were noted to be primarily limited to the pons and medulla. Similar lesions with dose-related severity were noted in eight other dogs studied in a second study with intramuscular (IM) administration of AE in sesame oil during a 28-day, dose-ranging study using 5, 10, 15, and 20 mg/kg/day. Injury, graded by a pathologist blinded to the dose group, showed a dose-related, region-specific injury in all animals that was most pronounced in the pons. Further studies in Sprague-Dawley rats using IM administration of AE and artemether (AM) at a dose of 12.5-50 mg/kg/day for 28 days confirmed the onset of a clinical neurologic syndrome with dose-related changes in body weight, activity, and seizure-like activity, stereotypic movement disorders, and ECG changes.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Fatal neurotoxicity of arteether and artemether. 794 42

Seizures followed by cardiac arrest after obstetrical epidural anaesthesia are induced by either low cerebral perfusion due to cardiovascular collapse after too excessive sympathetic blockade or after accidental total spinal anaesthesia, or by toxic accident due to accidental intravascular administration of local anaesthetic drugs. In case of toxic accident, convulsions usually occur before haemodynamic changes. Whatever the mechanism of the accident, excessive sympathetic blockade or toxic accident, when epidural anaesthesia is performed with lidocaine, bradycardia with normal QRS complexes occurs. Respiratory depression has to be treated and ephedrine has to be administered. In contrast, when bupivacaine is used, in case of toxic accident, there are dysrhythmias or bradycardia but QRS complexes are widened. The treatment is firstly to oxygenate, to stop convulsions and then to intubate the trachea and to ventilate the lungs.
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PMID:[Convulsions and cardiac arrest after epidural anesthesia. Prevention and treatment]. 808 41

Death from cocaine intoxication results from one or more of the multiple mechanisms including seizures, cardiovascular collapse, or apnea. In the free-moving rat model, continuous seizures are a major cause of death. To study other mechanisms of death unrelated to seizures in this model, we suppressed lethal seizures with diazepam (DZP) and investigated the effect of several pharmacological agents. Rats were pretreated with vehicle alone, diazepam 5 mg/kg alone, or a combination of DZP plus either nifedipine (NIFD) 2 mg/kg, propranolol (PROP) 10 mg/kg, or prazosin (PRAZ) 5 mg/kg. Five minutes after pretreatment, all animals received cocaine 100 mg/kg. Each test group consisted of 15 animals and all agents were given IP. Two animals in each group had cortical electrodes implanted. Animals that received vehicle followed by cocaine had 100% incidence of seizures and death. Those rats that received DZP alone followed by cocaine had no seizures and 53% death. Rats that received DZP plus NIFD or DZP plus PROP had suppression of seizures but no significant change in the incidence of death. The group that received DZP and PRAZ followed by cocaine had no seizures and 13% incidence of death (p < 0.001). Electroencephalogram recordings showed cortical electrical spike activity or spike-and-wave afterdischarges in all animals clinically observed to have seizures. In the absence of clinical seizure activity, no significant cortical spike activity was noted. It is concluded that animals protected from seizures with diazepam can still have nonseizure deaths after high-dose cocaine. The incidence of death in these animals is not reduced with nifedipine or propranolol pretreatment but is reduced with prazosin pretreatment.
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PMID:Acute cocaine toxicity: the effect of agents in non-seizure-induced death. 825 23


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