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

Neurobehavioral evaluation of the high-risk neonate represents an important advance in early detection of behavioral anomalies which may give rise to later neuropsychological sequelae. In the present study neonates comprising three diagnostic categories (i.e., respiratory distressed, seizure-disordered, normals) were evaluated with the Brazelton Neonatal Behavior Assessment Scale (BNBAS) to determine the extent to which differences in neurobehavioral organization could be detected with the scale, and how they were related to diagnostic classification. Average conceptional age at testing for the three groups was within the range usually considered full term: e.g., 38.81 weeks (respiratory distressed), 40.18 weeks (normal healthy) and 42.54 weeks (seizure disorder). Infants who had been diagnosed with neonatal seizures exhibited consistently less optimal behavior than did either of the other two groups. Infants with respiratory distress and normal controls did not differ significantly on most summary measures of neurobehavioral organization scored with the BNBAS. The study offers support for the discriminative validity of the BNBAS and its potential usefulness in the assessment of clinically ill newborns.
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PMID:Neurobehavioral anomalies in neonates with seizures. 292 33

The effects of pregnancy on acute metabolic complications of diabetes may have important consequences for both mother and fetus. The consequences of pregnancy for chronic complications of diabetes, including retinopathy, nephropathy, neuropathy, and hypertension, are not clear. Recent data are reviewed so that health care providers will be able to provide reasonable advice to insulin-dependent diabetic women contemplating pregnancy both for problems that may potentially arise during gestation and those that may affect long-term health and survival. Diabetic ketoacidosis is an uncommon problem that arises during gestation. Acute alterations in pH and electrolyte concentrations as well as hyperglycemia, however, may have important consequences for mother and fetus, including perinatal asphyxia and reduced fetal oxygen delivery. Hypoglycemia, on the other hand, may result in maternal coma or seizures and, when frequent, has been associated with infant respiratory distress syndrome. Background retinopathy often worsens during gestation, with regression common postpartum. Data suggest that progression of background disease is related to both glycemic control and the acute institution of intensive insulin therapy with those patients with poor control requiring more aggressive therapeutic intervention most adversely affected. The course of proliferative retinopathy is more variable, with both progression and regression reported. Preconception photocoagulation may prevent progression. Preconceptional ophthalmologic evaluation with frequent assessments during pregnancy is advised. Increases in 24-hour protein excretion are common during gestation in patients with preexisting renal disease and resolve in many patients postpartum. Serum creatinine and creatinine clearance increase during the first trimester and generally do not change during the remainder of pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Impact of pregnancy on complications of insulin-dependent diabetes mellitus. 313 6

Two patients, aged 44 and 68 years, presented with generalized seizures either witnessed or highly suspected. Both patients had laboratory-proven subtherapeutic anticonvulsant serum levels. The patients differed with regard to risk; one patient had existing cardiopulmonary disease, and the other was free of such risk factors except liver disease. An apparently appropriate dose of intravenous phenytoin was initiated in each case, and the patients were monitored appropriately and given supplemental oxygen. Bradycardia, hypotension, respiratory distress, and, ultimately, cardiopulmonary arrest occurred in both. The criteria proposed by Earnest et al. should be implemented for each seizure case that requires a decision on the urgent need for therapeutic anticonvulsant levels, whether by mechanical infusion, manual intravenous push, or oral loading. The mechanical infusion is the easiest method to standardize and monitor. The manual intravenous push has a greater possibility of inadvertent overdosage during some small time frame, as well as more local symptoms by some reports. Record et al. have recommended oral loading in selected patients. Careful consideration must be made of the choice of environment in which intravenous loading is done (e.g., emergency department, intensive care unit), as dictated by patient parameters, nursing staff levels, and planned disposition. The crucial factors contributing to the deterioration of both patients in the two cases presented were the concentration of phenytoin manually infused and the possibility that their high-risk status made them poor candidates for manual intravenous phenytoin. Dose and a hypersensitivity reaction were doubtful factors in these cases.
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PMID:Cardiopulmonary arrest following intravenous phenytoin loading. 337 Jan 3

I retrospectively describe 20 episodes of water intoxication in 19 infants, with hypothermia, seizures, and hyponatremia. Overdilution of formula or aggressive supplementation with water or clear juices were documented in 16 of the 20 episodes. Seizures and respiratory distress were severe enough in six cases to require intubation and ventilatory support. Marked diaphoresis was noted as a premonitory symptom to seizures in eight children. The children were an average of 5.1 +/- 4.3 months of age; serum sodium values averaged 118 +/- 4.3 mmol/L. No evidence of excess production of antidiuretic hormone was found. Water intoxication in infants is common, and I discuss its possible relationship to demyelinating disease of the central nervous system.
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PMID:Seizures and hypothermia due to dietary water intoxication in infants. 356 73

A light- and electron-microscopic study was made of the lungs of magnesium (Mg)-sufficient and Mg-deficient pathogen-free weanling rats raised in a gnotobiotic environment. Mg-sufficient rats were studied unstressed, after mild auditory stress, or after strychnine seizures and showed essentially no pulmonary pathology. Mg-deficient rats were studied with no known seizures or immediately after audiogenic seizure-shock. Light microscopy of lung from Mg-deficient rats with audiogenic seizure-shock revealed atelectasis, generalized edema and hemorrhage, and pleural petechiae. Ultrastructural changes in lung alveoli of Mg-deficient rats with seizure-shock included gaps in capillary endothelium, swelling and separation of endothelial cells from the underlying basement membranes; Type I cell necrosis and separation from basement membranes; and intraalveolar red blood cells, fibrin, and precipitated plasma. The seizure-shock episode of acute Mg deficiency produces structural changes in the lung similar to changes produced by several forms of shock, early acute oxygen toxicity, and the respiratory distress syndrome (RDS) in human neonates.
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PMID:Pulmonary lesion induced by stress in magnesium-deficient rats. A light- and electron-microscopic study. 359 2

A study of pregnancy outcome was performed using a 1982-1985 regional network database of 60,456 infants. The perinatal mortality rate was 15.6 deaths per 1,000 births (total, 942), while the antepartum, intrapartum and neonatal mortality rates were 5.3, 1.6 and 8.7, respectively. Seven hundred forty-three multiple gestation pregnancies (1.2%) and 1,632 major congenital anomalies (2.7%) were identified. The corrected perinatal mortality rate was 13.8 deaths per 1,000 births. This study revealed that prematurity, postdatism, congenital anomalies, low Apgar scores and neonatal complications, including respiratory distress syndrome, pneumothorax, persistent fetal circulation, intracerebral hemorrhage and seizure activity, were major factors contributing to mortality. This analysis suggests that a further reduction in mortality should follow a reduction in preterm deliveries and their sequelae and the early identification and management of maternal and fetal antenatal complications.
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PMID:Perinatal morbidity and mortality in a regional perinatal network. 365 98

Twenty-three of 23 neonates were contaminated in the course of an outbreak of respiratory syncytial virus (RSV) in a neonatal care unit. Symptoms among 22 infected symptomatic infants included rhinitis (n = 21), dyspnea (n = 19), cough (n = 17), apnea (n = 5), seizures (n = 3), fever (n = 3). Five patients presented with severe respiratory distress. The occurrence of non-obstructive apnea was significantly correlated with a history of respiratory disease, RSV infection during the first 15 days of life and the severity of lower respiratory tract RSV infection.
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PMID:[Respiratory syncytial virus infections in newborn infants]. 371 65

Fat embolism causes a distinctive clinical syndrome usually seen in trauma victims with long bone fractures. Clinical findings include hyperthermia, respiratory distress, petechiae and retinal fat emboli. Neurologic changes include decreased sensorium, decerebrate posturing and seizure activity. Chest radiographs commonly demonstrate bilateral fluffy infiltrates. Laboratory abnormalities include hypoxemia, respiratory alkalosis, anemia and hypocalcemia. Treatment consists of general supportive care with vigorous pulmonary therapy. Most patients have a good recovery.
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PMID:Fat embolism: a clinical diagnosis. 379 15

Neonates are susceptible to infection since several elements of the immune system are deficient. At present, the most common pathogens are Group B streptococci and Escherichia coli. Prolonged rupture of membranes with amnionitis is a high-risk setting. Clinical signs suggesting neonatal sepsis include respiratory distress, poor feeding, hypothermia, seizures and hypotonia. After the sepsis work-up is completed, the initial choice of antibiotics is based on the prevailing organisms and antibiotic sensitivities within the community.
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PMID:Neonatal sepsis. 389 74

The acute effects of diisopropylfluorophosphate (DFP) were assessed in DBA/2Ibg, C57BL/6Ibg and C3H/2Ibg mice. The DFP was administered by intraperitoneal injection in saline. Brain acetylcholinesterase (AChE) activity was maximally inhibited within 5 min after injection. All mice showed signs of organophosphate intoxication including salivation, lacrimation, diarrhea, respiratory distress, tremor and, at high doses, seizures. The C57BL mice were most susceptible to these effects of DFP. The LD50 values for DFP were 8.0, 7.6, and 6.8 mg/kg for male DBA, C3H, and C57BL mice, respectively. The LD50 values for females were nearly the same. Body temperature and brain AChE activity decreased in a dose-dependent manner following injections of DFP of 3.17, 4.22, 5.28, and 6.33 mg/kg. Maximum temperature depression occurred 2 hours after DFP administration; by 24 hours temperatures had returned to normal except for C57BL mice treated with the highest dose of DFP. The C57BL strain was most susceptible to the DFP-induced hypothermia, the C3H strain was the most resistant, and the DBA strain was intermediate. Maximum temperature depression and residual AChE activity, as measured 24 hours after injection, were linearly related. These strain differences do not seem to be explained easily by a differential inhibition of AChE activity.
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PMID:Genetically determined differences in acute responses to diisopropylfluorophosphate. 399 71


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