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)

The steady rise in the promiscuous use of phencyclidine (PCP) as a "recreational" drug has recently gained nationwide attention because of the numerous violent and/or bizarre incidents caused by the use of this drug. Because the media often exaggerate reports of bizarre and violent behavior to make a "good" story, the potential PCP user may be tempted to ignore the media warnings. In the case of PCP, however exaggerated the story, a real danger does exist. So, despite numerous newspaper, radio and television warnings about the possible consequences of PCP use and abuse, the incidence of toxic reactions continues to climb. In many cases PCP is sold as other drugs, particularly THC, and in various colored capsules, tablets, liquids and crystals which may explain the increased usage despite the numerous warnings against its use. The advances in laboratory techniques and chemical processess have enabled the clandestine chemist to prepare relatively pure PCP and thus eliminate many of the toxic side effects due to impurities in the drug. In addition, 30 or more psychoactive PCP analogues have been developed and are starting to make an appearance on the street. PCP is perhaps the most potent psychotomimetic compound known at the present time and is capable of inducing a psychosis which is clinically indistinguishable from schizophrenia. The psychosis-producing effects of PCP are the most common toxic effects seen in hospital emergency rooms; but as the amount of PCP taken and/or the simultaneous involvement of other drugs, particularly barbiturates, occurs, severe medical problems (e.g., coma, seizures, respiratory arrest) begin to appear. Death from high doses of PCP or PCP plus other drugs does occur, but the principal cause of death from PCP abuse is due to trauma, homicide or suicide (usually of the bizarre or violent form). Young adult males, persons predisposed to mental illness and naive drug users appear to be the most susceptible to the adverse effects of PCP. The fact that chronic PCP users are starting to increase in number is mute testimony that not all users experience "bad trips" with PCP. Unfortunately for the user, however, this does not guarantee that the next trip will not be a bad one. The effects of chronic use seem to be twofold: severe depression with suicidal thoughts and numerous violent, agitated behavioral patterns. Neither seems to be a suitable alternative. At the present time there is not specific antidote for toxic PCP reactions and the prolonged psychosis induced in some cases does not appear to respond to the standard antipsychotic medications as quickly as do the functional psychoses. The major improvement from a medical standpoint is the development of more sensitive laboratory techniques to confirm the presence of PCP in body fluids. This advance has undoubtedly led to the apparent increase in the number of PCP cases reported by hospitals and to the accuracy of clinical diagnosis by medical, drug or law enforcement communities...
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PMID:PCP (phencyclidine): an update. 4 8

During the period of survey, the number of narcotic drug seizures by the law, especially cannabis resin, has increased considerably. The details on this development are presented. The following main analytical results were obtained: the median concentration of THC in cannabis resin has increased up to 8.6%, in cannabis plants the THC content has fluctuated between 1% and 3%. In the heroin samples since 1982, diamorphin has predominated in the base form; the diamorphin content had dropped to 32%, which is connected with a rise simultaneous in the concentration of noscapine (up to 9%). The concentration of cocaine hydrochloride had diminished at the end of the period to 62%; on the other hand, the amphetamine sulfate content increased to 69%. LSD trips used from 10 to 120 micrograms per trip. Methadone occurred mostly in the form of tablets containing 5 mg methadone hydrochloride.
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PMID:[Analysis of regional trends in narcotic studies between 1980 and 1986]. 280 Jul 29

It seems clear that the abundance of potential treatment options reflects the dearth of proved, effective options. Thus, although we appear to be on the brink of many potentially major breakthroughs in treatment, there currently remains a multitude of unanswered questions and the need for further study. At this point clinical recommendations must be limited to supportive care with moderation: oxygenation without hyperoxia; ventilation without hypocarbia; avoiding extremes of blood pressure, hematocrit, blood glucose, and body temperature. Unfortunately, data from human trials are extremely limited and often poorly controlled. Furthermore, even those few existing human studies have rarely--if ever--dealt with newborns infants (Table 2). In addition, many of the existing studies do not relate to generalized asphyxia but rather to single-organ reperfusion insults. Finally, there is the critical issue of timing. Unfortunately, much of the existing experimental data relate to prophylaxis rather than treatment, severely limiting their potential for clinical applicability. Interventions may have quite different effects when administered at different phases of this most intricate process. Hyperglycemia, for example, may be neuroprotective before an insult but detrimental if induced after an asphyxial episode. Conversely, the NMDA blocker MK-801 can adversely affect outcome when given before a global asphyxial insult but can reduce seizure-related damage when given during the hyperexcitability phase. Insulin-like growth factor is also neuroprotective only when given after an insult, but it is not helpful if given before. An intimate understanding of the pathophysiologic processes involved is essential before any attempts at applying the diverse data derived from numerous animal studies to the human situation in an intelligent manner. Future studies may focus on cocktails of different mixtures of the compounds discussed or on single multipotential drugs, which would make possible a multipronged approach. However, it is essential to investigate fully the potential for toxic drug interactions, as some combinations may be produce serious consequences. For example, Gluckman and Williams evaluated the potential of combining calcium channel blockers with NMDA receptor antagonists in hypoxic-ischemic rats and found that this combination led to rapid cardiovascular collapse. Other enticing approaches for future investigations will probably include some genetic-engineering-related studies in attempt to enhance endogenous antioxidant defenses with regulon stimulation or the administration of neurotrophic growth factors. Unavoidably, the trip from the laboratory to the bedside must of necessity be an arduous and rigorous one.
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PMID:Ischemia and reperfusion injury. The ultimate pathophysiologic paradox. 977 46

This review presents the potential impact of high altitude exposure on preexisting neurological conditions in patients usually living at low altitude. The neurological conditions include permanent and transient ischemia of the brain, occlusive cerebral artery disease, cerebral venous thrombosis, intracranial hemorrhage and vascular malformations, multiple sclerosis, intracranial space-occupying lesions, dementia, extrapyramidal disorders, migraine and other headaches, and epileptic seizures. New developments in diagnostic work-up and treatment of preexisting neurological conditions are also mentioned where applicable. For each neurological disorder, the authors developed absolute and relative contraindications for a trip to high altitude. These recommendations are not based on the results of controlled randomized trials, but mainly on case reports, pathophysiological considerations, and extrapolations from the low altitude situation.
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PMID:Going high with preexisting neurological conditions. 1758 4

Simultaneous occurrence of brain tumor and myeloradiculopathy in cases of Manson's schistosomiasis have only rarely been described. We report the case of a 38-year-old man who developed seizures during a trip to Puerto Rico and in whom a brain tumor was diagnosed by magnetic resonance imaging: brain biopsy revealed the diagnosis of schistosomiasis. He was transferred to a hospital in the United States and, during hospitalization, he developed sudden paraplegia. The diagnosis of myeloradiculopathy was confirmed at that time. He was administered praziquantel and steroids. The brain tumor disappeared, but the patient was left with paraplegia and fecal and urinary dysfunction. He has now been followed up in Brazil for one year, and his clinical state, imaging examinations and laboratory tests are presented here.
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PMID:Simultaneous occurrence of brain tumor and myeloradiculopathy in schistosomiasis mansoni: case report. 1968 86

We present 3 cases of severe hyponatremia occurring on a commercially guided river rafting trip on the Colorado River in Grand Canyon National Park. All 3 women appeared to have been overhydrating because of concern about dehydration and required evacuation within 24 hours of each other after the staggered onset of symptoms, which included fatigue and emesis progressing to disorientation or seizure. Each was initially transferred to the nearest hospital and ultimately required intensive care. Imaging and laboratory data indicated all 3 patients had hypervolemic hyponatremia. Unlike the well-documented exercise-associated hyponatremia cases commonly occurring in prolonged endurance athletic events, these 3 unique cases of acute hyponatremia were not associated with significant exercise. The cases illustrate the diagnostic and treatment challenges related to acute hyponatremia in an austere setting, and underscore the importance of preventive measures focused on avoidance of overhydration out of concern for dehydration.
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PMID:Three cases of severe hyponatremia during a river run in Grand Canyon National Park. 2573

Anxiety related behaviors have been reported in humans diagnosed with idiopathic epilepsy (IE) and such traits may be altered depending on seizure phase. The purpose of this study was to determine the presence and severity of anxiety related behaviors in dogs with IE compared to other medical populations, and to determine if behavioral changes were associated with seizure control. In this retrospective cross-sectional study, the owners of 102 dogs presenting for wellness examination (37), epilepsy (38), and intervertebral disc disease (27) were surveyed utilizing a questionnaire developed based on the shortened Canine Behavioral Assessment and Research Questionnaire (mini-CBARQ), previously validated for its ability to analyze canine behavior. Veterinarians of participating dogs completed a questionnaire to verify diagnoses. Dogs with IE and IVDD had a higher likelihood of being fearful/anxious when approached by an unfamiliar dog compared to the wellness group. Dogs with IE receiving polytherapy had decreased excitement before a walk (P = 0.0007) or car trip (P = 0.027), increased fear/anxiety when groomed (P = 0.0197), and increased shaking, shivering, or trembling when left alone (P = 0.0004) compared to dogs receiving monotherapy. Polytherapy dogs had increased agitation when their owner/others showed affection toward other people/dogs during preictal (Pperson = 0.005, Panimal = 0.0083), postictal (Pperson = 0.001, Panimal = 0.0068), and interictal (Pperson = 0.0083, Panimal = 0.02) period compared to monotherapy dogs. Seizure frequency and severity was not correlated with anxiety related behavior in dogs with IE. While seizure phase was associated with behavior changes in 38% (14/37) of our epileptic population, one specific seizure phase was not more likely to produce behavior changes than another. Behavioral changes noted in dogs with IE raises further questions about how this disease affects QoL. Research was presented in abstract form at the ACVIM Forum, Denver, CO, USA, June 2016.
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PMID:Behavioral Changes in Dogs With Idiopathic Epilepsy Compared to Other Medical Populations. 3178 83

We report two cases of malaria diagnosed in Rhode Island. First, a 21-year-old female who presented with 5 days of fevers, chills, headache, and myalgias after returning from a trip to Liberia, found to have uncomplicated malaria due to P. ovale which was treated successfully with atovaquone/proguanil and primaquine. Second, a chronically ill 55-year-old male presented with 3 days of headache followed by altered mental status, fever, and new-onset seizures after a recent visit to Sierra Leone, found to have P. falciparum malaria requiring ICU admission and IV artesunate treatment. The diagnosis and management of malaria in the United States (US), as well as its rare association with subdural hemorrhage are subsequently reviewed.
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PMID:Cerebral and Plasmodium ovale Malaria in Rhode Island. 3275 71