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

Convulsive activity was induced in functionally decapitate cat preparations by topical and by systemic administration of toxic amounts of penicillin. The paroxysmal movement patterns and the electrographic signs of spinal seizure activity recorded from spinal ventral and dorsal roots and from the dorsal surface of the spinal cord are described. Paroxysms of interictal myoclonic twitching as well as tonic and clonic ictal seizures reminiscent of epileptiform convulsions of intact animals were seen in the absence of descending influences from the brain. Tonic seizures consisted of flexion--extension sequences; co-contraction of antagonistic muscles was the rule. Clonic activity consisted of rhythmic discharges at 4--6/sec, In dorsal roots, electrotonically conducted paroxysmal negative potential shifts as well as antidromically conducted trains of impulses were recorded. Ictal paroxysmal waves of the cord dorsum potential consisted of either biphasic positive--negative sequences or of purely negative waves. Diphenylhydantoin effectively controlled spinal seizures in the absence of a functioning cerebellum. Diphenylthiohydantoin changed the pattern of seizures, suppressing all ictal activity and greatly enhancing the amplitude and frequency of interictal bursts. Three different barbiturates suppressed seizure activity, but diazepam was ineffective, indicating that the site of its clinical anticonvulsant action may be supraspinal. Seizure activity, once induced, continued for up to 18 h. Intravenous administration of penicillinase abolished seizures indicating that their usual persistence is caused by the presence of the drug in the tissue, not by an irreversible biochemical lesion.
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PMID:Motor and electrical signs of epileptiform activity induced by penicillin in the spinal cords of decapitate cats. 6 Feb 12

Subdural empyema is an intracranial infection that has remained difficult to diagnose and to treat. Seventeen patients with this infection, treated between 1967 and 1974, are analyzed and compared to published series with particular regard to diagnosis using newer procedures and treatment, considering the primary focus of infection. The infection is usually located in the supratentorial spaces, is often bilateral, and results most often from para-nasal sinusitis (single most common cause), otitis, neurosurgical operative infections, and meningitis in infants. Patients suffering from subdural empyema generally present with rapid onset of depressed sensorium, seizures, focal neurological deficits, and signs of increased intracranial pressure, following a period of days to weeks characterized by headache and fever. All 17 of our patients demonstrated localizing neurological signs and 16 manifested either fever or leukocytosis. Diagnostic studies, except for cerebral arteriography, do not reliably corroborate or exclude the diagnosis. Cerebral arteriography established the diagnosis and defined the location and extent of the empyema in all of our cases. The EEG and brain scan produced frequent false-negative and/or non-localizing results in 10 and 8 patients, respectively. The cerebrospinal fluid was abnormal from all 15 patients examined by lumbar puncture, but the findings were similar to those in other infectious and non-infectious central nervous system diseases. Signs of transtentorial herniation developed within eight hours following lumbar puncture in three of seven patients who had exhibited signs of increased intracranial pressure before the procedure was performed. Bacterial cultures were positive in 13 of our cases. A review of our data and that of other studies indicates that the organisms associated with subdural empyema are consistent with those expected from infections of the primary site; e.g. sinusitis, otitis, meningitis, site of prior neurosurgery. A therapeutic approach is suggested which emphasizes specific antibiotic regimens appropriate to the primary site of infection and prompt neurosurgical intervention with evacuation of the subdural spaces bilaterally. In general, combination antimicrobial therapy employing high parenteral doses of penicillin G, a semi-synthetic penicillinase-resistant penicillin and chloramphenicol is recommended.
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PMID:Subdural empyema: analysis of 17 recent cases and review of the literature. 118 92

The pattern of intracortical potential distribution during focal interictal epileptiform discharges (FIED) was analysed with respect to the occurrence of descending neuronal activity to the spinal cord recorded as spinal field potentials (SFPs). The experiments were performed in rats. Epileptiform activity was elicited by application of penicillin to the motor cortex. The spread of active penicillin was limited by penicillinase in part of the experiments. (1) When penicillinase was applied 10--20 sec before penicillin to the cortical surface typical FIED appeared in the epicortical lead. During well-established focal activity they were accompanied by negative field potentials at a depth of 300 micrometers and 600 micrometers and by positive field potentials in deeper records. This pattern of intracortical potential distribution was not associated with characteristic SFPs. (2) When penicillinase was applied simultaneously with penicillin, the fully developed epicortical FIED were accompanied by negative intracortical field potentials which in this case reached a depth of 900 micrometers. In the layers below predominantly positive potential fluctuations occurred. This pattern of intracortical potential distribution was associated with characteristic SFPs. (3) Intracortical application of penicillin at a depth of 800--900 micrometers led to negative field potentials of large amplitude in all intracortical records, with the concomitant epicortical potentials being positive in polarity. In this case SFPs occurred throughout the interictal activity. Since seizure activity can be restricted to only a few cortical laminae, descending neuronal activity to the spinal cord need not be correlated with definite epicortical potentials. A prerequisite for cortical output is intracortical activity reflected negative potentials at a depth of approx. 900 micrometers.
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PMID:Pattern of intracortical potential distribution during focal interictal epileptiform discharges (FIED) and its relation to spinal field potentials in the rat. 616 38

We have studied the effects of interictal epileptiform discharges originating from the striate cortex on the development of the receptive field characteristics of neurons in the lateral geniculate nucleus (LGNd) and superior colliculus (SC) in neonatal rabbits. The paroxysmal discharges were generated by twice-daily injections of penicillin into an implanted cannula. Control injections of penicillin + penicillinase were given to the other striate cortex of the same animal. Similar experimental procedures were used to study the effect of such projected discharges on the LGNd neurons in adult rabbit. The results of the first experiment show that cortical epileptiform discharges, initiated in neonatal rabbits 7--9 days of age and continuing to 20--25 days of age, retard the normal development of LGNd cells. There was an abnormal increase of indefinite cells, cells failing to respond to any light stimulation, and a concurrent decrease of cells with concentric cells was still present in adult rabbits which had interictal discharges in the striate cortex limited to the period of 7--9 days to 21--25 days of age. The fourth experiment shows that the interictal discharges in neonatal rabbits do not affect the normal receptive field development of neurons in the SC. The present results demonstrate that asymptomatic interictal epileptiform discharges, produced without focal structural damages in immature brain, can affect the development of neuronal connectivity. These results may have some clinical implications in relation to our understanding about the learning and developmental disabilities exhibited in children who had episodic seizure discharges.
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PMID:Visuocortical epileptiform discharges in rabbits: differential effects on neuronal development in the lateral geniculate nucleus and superior colliculus. 721 64

Branhamella (Neisseria) catarrhalis is a saprophytic inhabitant of the human oropharynx with the capacity to cause infection, particularly in immunodeficient hosts. There have been 2 cases of Branhamella catarrhalis pneumonia reported in the literature. Two additional cases are described and the subject reviewed. An 80-yr-old woman with chronic lymphocytic leukemia presented with left lower lobe pneumonia. Gram stain of transtracheal aspirate revealed intraleukocytic and extraleukocytic gram-negative diplococci, and a beta-lactamase producing strain of Branhamella catarrhalis was cultured. Therapy with erythromycin resulted in resolution of symptoms and eradication of the organism. A 64-ye-old alcoholic man presented with fever and multiple seizures. Chest roentgenogram revealed left lower lobe pneumonia. Cultures of endotracheal aspirate and blood grew a strain of Branhamella catarrhalis sensitive to penicillin. Penicillin treatment resulted in resolution of pulmonary infiltrate and eradication of the organism. The potential for Branhamella catarrhalis to produce pneumonia and the choice of antimicrobial therapy is discussed. It is emphasized that this organism should not be assumed to be a "normal" isolate and that penicillin may be ineffective in the treatment of Branhamella catarrhalis infections.
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PMID:Branhamella catarrhalis pneumonia: report of two cases and review of the literature. 723 78

The prototype carbapenem antibacterial agent imipenem has a very broad spectrum of antibacterial activity, encompassing most Gram-negative and Gram-positive aerobes and anaerobes, including most beta-lactamase-producing species. It is coadministered with a renal dehydropeptidase inhibitor, cilastatin, in order to prevent its renal metabolism in clinical use. Extensive clinical experience gained with imipenem/cilastatin has shown it to provide effective monotherapy for septicaemia, neutropenic fever, and intra-abdominal, lower respiratory tract, genitourinary, gynaecological, skin and soft tissues, and bone and joint infections. In these indications, imipenem/cilastatin generally exhibits similar efficacy to broad-spectrum cephalosporins and other carbapenems and is at least equivalent to standard aminoglycoside-based and other combination regimens. Imipenem/cilastatin is generally well tolerated by adults and children, with local injection site events, gastrointestinal disturbances and dermatological reactions being the most common adverse events. Seizures have also been reported, occurring mostly in patients with impaired renal function or CNS pathology, or with excessive dosage. Although it is no longer a unique compound, as newer carbapenems such as meropenem are becoming available, imipenem/cilastatin nevertheless remains an important agent with established efficacy as monotherapy for moderate to severe bacterial infections. Its particular niche is in treating infections known or suspected to be caused by multiresistant pathogens.
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PMID:Imipenem/cilastatin: an update of its antibacterial activity, pharmacokinetics and therapeutic efficacy in the treatment of serious infections. 874 Dec 35

The tolerability of the 2 most frequently used carbapenems, imipenem/cilastatin and meropenem, is reviewed. Both of these drugs, but especially imipenem, are potentially neurotoxic and may cause seizures if overdosed relative to renal function and/or bodyweight. The therapeutic margin is considerably narrower with imipenem/cilastatin which cannot be given at doses required for treatment of bacterial meningitis. Meropenem on the other hand, is considerably less prone to cause seizures and its tolerability and efficacy are well documented in 3 relatively large, controlled studies in adults and children with meningitis. They showed that meropenem was as effective and well tolerated as cefotaxime or ceftriaxone. Another potential advantage of meropenem over imipenem/cilastatin is that it can be given intravenously at a high rate without increased risk of nausea or vomiting. An obvious reason for using a carbapenem instead of a cephalosporin for empirical treatment of life-threatening infections is that both imipenem/cilastatin and meropenem have a broader spectrum of activity. They are also more resistant to hydrolysis by the most common beta-lactamases, including the class I cephalosporinase frequently produced by Enterobacter spp. and Pseudomonas spp. and the extended spectrum enzymes, now commonly found in Escherichia coli and Klebsiella spp.
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PMID:Carbapenems in serious infections: a risk-benefit assessment. 1073 43

Meropenem (Merrem, Meronem) is a broad-spectrum antibacterial agent of the carbapenem family, indicated as empirical therapy prior to the identification of causative organisms, or for disease caused by single or multiple susceptible bacteria in both adults and children with a broad range of serious infections. Meropenem is approved for use in complicated intra-abdominal infection (cIAI), complicated skin and skin structure infection (cSSSI) and bacterial meningitis (in paediatric patients aged > or = 3 months) in the US, and in most other countries for nosocomial pneumonia, cIAI, septicaemia, febrile neutropenia, cSSSI, bacterial meningitis, complicated urinary tract infection (UTI), obstetric and gynaecological infections, in cystic fibrosis patients with pulmonary exacerbations, and for the treatment of severe community-acquired pneumonia (CAP). Meropenem has a broad spectrum of in vitro activity against Gram-positive and Gram-negative pathogens, including extended-spectrum beta-lactamase (ESBL)- and AmpC-producing Enterobacteriaceae. It has similar efficacy to comparator antibacterial agents, including: imipenem/cilastatin in cIAI, cSSSI, febrile neutropenia, complicated UTI, obstetric or gynaecological infections and severe CAP; clindamycin plus tobramycin or gentamicin in cIAI or obstetric/gynaecological infections; cefotaxime plus metronidazole in cIAI; cefepime and ceftazidime plus amikacin in septicaemia or febrile neutropenia; and ceftazidime, clarithromycin plus ceftriaxone or amikacin in severe CAP. Meropenem has also shown similar efficacy to cefotaxime in paediatric and adult patients with bacterial meningitis, and to ceftazidime when both agents were administered with or without tobramycin in patients with cystic fibrosis experiencing acute pulmonary exacerbations. Meropenem showed greater efficacy than ceftazidime or piperacillin/tazobactam in febrile neutropenia, and greater efficacy than ceftazidime plus amikacin or tobramycin in patients with nosocomial pneumonia. Meropenem is well tolerated and has the advantage of being suitable for administration as an intravenous bolus or infusion. Its low propensity for inducing seizures means that it is suitable for treating bacterial meningitis and is the only carbapenem approved in this indication. Thus, meropenem continues to be an important option for the empirical treatment of serious bacterial infections in hospitalized patients.
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PMID:Meropenem: a review of its use in the treatment of serious bacterial infections. 1841 87

Salmonellosis constitutes an important public health problem throughout the world. In severe infections like meningitis and septicemia, antibiotic treatment is essential. Extended-spectrum cephalosporins are preferentially used to treat salmonellosis in children. Treatment failures due to in-vivo acquisition of an extended-spectrum beta-lactamase (ESBL) gene in nontyphoidal salmonellae are now well established. A 45-day-old male baby presented to the pediatric intensive care unit with a history of fever, poor feeding, two episodes of seizures of 3 days duration and recurrent apnoea. At admission, cerebrospinal fluid, stool and blood cultures were done and Salmonella enterica serovar Typhimurium was isolated from all the samples. The stool isolate was confirmed to be ESBL producing. The baby expired due to acute pyogenic meningitis.
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PMID:A case of fatal acute pyogenic meningitis in a neonate caused by extended-spectrum beta-lactamase producing Salmonella group B. 1850 80

Carbapenems play a significant role in the current antibiotic armamentarium. Doripenem is the newest carbapenem to be commercially released. Its antimicrobial spectrum more closely resembles those of meropenem and imipenem than that of ertapenem. Thus, it has significant in vitro activity against streptococci, methicillin-susceptible staphylococci, Enterobacteriaceae (including extended-spectrum beta-lactamase-producing strains), Pseudomonas aeruginosa, Acinetobacter species, and Bacteroides fragilis. Doripenem does not have clinically useful activity against methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and the majority of gram-negative bacilli that are resistant to meropenem or imipenem. In vitro, resistant P. aeruginosa mutants appear to be harder to select with doripenem than with other carbapenems. Doripenem has been approved for use in treatment of complicated intra-abdominal infection and complicated urinary tract infection. Studies of hospital-acquired pneumonia have also been completed, including one that used a 4-h infusion to enhance the pharmacodynamic profile. In vitro, doripenem lacks the propensity to cause seizures, and a low risk of seizures has been demonstrated in clinical studies. Currently unanswered questions regarding doripenem include the utility and dosing in neonatal, pediatric, and cystic fibrosis populations and specific dosage recommendations for patients receiving hemodialysis, peritoneal dialysis, or continuous renal replacement therapies. The longevity of doripenem will depend on our ability to curtail the spread of carbapenem-resistant organisms, which are already a significant problem at some institutions.
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PMID:Doripenem. 1952 73


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