Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0038220 (status epilepticus)
 7,272 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 18-year-old man was diagnosed as having measles on the basis of cutaneous and mucosal eruption and high grade fever on May 10, 2001. Six days after the skin eruption, the patient developed general convulsion (day1). He was admitted to our hospital because of status epilepticus. We made a diagnosis of acute measles encephalitis, based on the clinical features and pleocytosis with an increase in protein in the cerebrospinal fluid. Under artificial ventilation and sedation, he received intravenous immunoglobulin and dexamethasone. Electroencephalography (EEG) on day 4 revealed periodic synchronous discharge (PSD). Significant elevation of antibody titer for measles virus was found in the serum, but not in the cerebrospinal fluid. Polymerase chain reaction method did not show viral genes of measles virus, herpes simplex virus and herpes zoster virus. Serial EEG studies demonstrated a decrease in PSD, followed by irregular spike-wave complexes within 20 days. He recovered completely one month after the onset. It should be kept in mind that PSD can emerge on EEG in the early stage of acute measles encephalitis.
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PMID:[A case of acute measles encephalitis with periodic synchronous discharge on electroencephalography]. 1242 70

We present the case of a 52-year-old man with hypertension, diastolic congestive heart failure, end-stage renal disease on hemodialysis 3 times a week and a remote history of a hemorrhagic stroke who presented to the emergency department with a vesicular rash on his left arm. The rash was observed to be in a dermatomal distribution, and a diagnosis of herpes zoster was made. The patient was discharged home on valacyclovir 1 g 3 times a day for a duration of 7 days. The patient took 2 doses of valacyclovir before presenting to the hospital again with irritability and hallucinations. Over the next several days, the patient's neurologic status declined and he became disoriented and increasingly somnolent. Because of a concern for varicella zoster virus (VZV) or herpes simplex virus (HSV) meningoencephalitis, acyclovir was initiated intravenously at 600 mg (10 mg/kg) for every 12 hours. Computed tomography and magnetic resonance imaging of the brain failed to reveal an acute process. Electroencephalogram was interpreted as seizure activity versus metabolic encephalopathy. Lumbar puncture was not suggestive for meningitis, subarachnoid hemorrhage, or HSV/VZV infection. The patient subsequently had a witnessed seizure during dialysis and was felt to have status epilepticus due to acyclovir and valacyclovir neurotoxicity. The patient underwent daily hemodialysis for removal of the drug and eventually made a full neurologic recovery. Our case highlights that acyclovir neurotoxicity can result in status epilepticus, hallucinations, and altered consciousness. Differentiating acyclovir neurotoxicity from HSV or VZV meningoencephalitis is of crucial importance because the symptoms are similar but the management is vastly different.
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PMID:Valacyclovir and Acyclovir Neurotoxicity With Status Epilepticus. 2436 10