Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patients with epilepsy on long term antiepileptic drug (AED) therapy deserve special consideration not only concerning seizure control but also the effect on anaesthetic metabolism and hepatorenal functions. In the present study, we examined the effects of sevoflurane anaesthesia on plasma inorganic fluoride (F-) level and hepatorenal function in patients with and without AED therapy. Twenty-two patients (12 with AEDs = AED group, and ten without AEDs = control group = C group), ASA I, who were free of hepatorenal disease, received approximately 2-3 h sevoflurane anaesthesia. Plasma F- analysis was performed at the stages of: 1) induction of anaesthesia, 2) conclusion of anaesthesia, 3) 15 h after the conclusion of anaesthesia, using an ion-selective electrode calibrated with a standard solution of sodium fluoride. Pre- and postoperative hepatic (aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, total bilirubin) and renal (blood urea nitrogen, creatinine) function was tested. There were no significant differences between the two groups in the average age (AED group = 9.4 and control group = 10.1 y.o.), body weight, duration of anesthesia, and MAC hours (2.6 and 2.4). The mean peak F- levels were 15.5 and 13.6 microM, in AED and C groups (not significant), respectively. No patient exhibited F- values greater than 50 microM, the hypothetical nephrotoxic threshold. The patients showed no abnormal values either in hepatic or renal function tests postoperatively. These results suggest approximately 2-3 h sevoflurane anaesthesia to be safe in patients taking AEDs.
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PMID:Clinical characteristics and biotransformation of sevoflurane in paediatric patients during antiepileptic drug therapy. 888 Aug 18

During sevoflurane anaesthesia cerebral blood flow is preserved or slightly decreased. Cerebral oxygen consumption is reduced to 50% under 1 MAC sevoflurane. Autoregulation of cerebral blood flow and responsiveness of cerebral blood flow to changes in Pa CO2 are widely preserved. Sevoflurane produces a dose dependent increase in intracranial pressure and a decrease in cerebrovascular resistance that can not be observed under hypocapnic conditions. Central stimulus processing, the electroencephalogram and sensory evoked potentials are suppressed under sevoflurane in a dose dependent fashion. The electrophysiological data indicate that intraoperative awareness phenomena should be suppressed with sevoflurane 1.5-2.0 vol.%. Recovery of cognitive and psychomotor functions seems to be faster and more complete after sevoflurane than after isoflurane anaesthesia. In inducing seizure like EEG or muscle activity, sevoflurane seems to be comparable with isoflurane. There is no limitation of sevoflurane use in patients with concomitant psychiatric or neurological diseases, and sevoflurane may be valuable addition in neurosurgery or carotid surgery.
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PMID:[Sevoflurane and the nervous system]. 989 79

The effects on cerebral circulation and metabolism of sevoflurane and desflurane are largely comparable to isoflurane. Both induce a direct vasodilation of the cerebral vessels, resulting in a less pronounced decrease in cerebral blood flow compared to the decrease in cerebral metabolism. This direct vasodilation seems to be dose-dependent and more pronounced for desflurane > isoflurane > sevoflurane. Many reports suggest luxury perfusion at high concentrations of desflurane. Sevoflurane maintains intact cerebral autoregulation up to 1.5 MAC. Desflurane induces a significant impairment in autoregulation, with a completely abolished autoregulation at 1.5 MAC. Both sevoflurane and desflurane (up to 1.5 MAC) maintain normal CO(2) regulation. As to their effect on final intracranial pressure (ICP), both sevoflurane and desflurane revealed no increases in ICP. However, compared to intravenous hypnotics, subdural ICP is higher with volatiles because of their tendency to increase cerebral swelling after dura opening (isoflurane > sevoflurane). Several case reports have noted seizure-like movements, as well as EEG recorded seizures during induction of sevoflurane anesthesia. Especially, in children during inhalational induction with hyperventilation at a high sevoflurane concentration, severe epileptiform EEG with a hyperdynamic response were observed, which urges for caution using inhalational sevoflurane induction in children for neurosurgical procedures. Neuroprotective properties (reduced neuronal death either by necrosis or apoptosis) have been attributed to all volatile agents. However, these neuroprotective effects have been described in experimental or animal models, so their possible effect on humans remains to be proven.
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PMID:[Newer inhalation anaesthetics and neuro-anaesthesia: what is the place for sevoflurane or desflurane?]. 1512 Jul 83

Nontuberculous mycobacteria (NTM) infections still represent a large group of insidious diseases hard to deal with. Traditionally, immunocompromised patients suffer from NTM infections, especially with respiratory involvement or disseminated diseases due to MAC (Mycobacterium avium complex). Here we report a rare case of Mycobacterium intracellulare infection involving skin and soft tissue, manifested as a chronic cutaneous ulcer in an immunocompetent patient with several comorbidities, including seizures. Accurate diagnosis of species was obtained with in vitro culture and RT-PCR (Real Time-Polymerase Chain Reaction) following a high clinical suspicion. Despite the high complexity of NTM infections, it is possible to achieve diagnostic goals through the appropriate employment of recent DNA-molecular technologies and an adequate management.
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PMID:Skin and soft tissue infection by Mycobacterium intracellulare in an immunocompetent patient. 3209 14


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