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

Creutzfeldt-Jakob disease (CJD) is a rare human transmissible spongiform subacute encephalopathy. The most common clinical manifestations of CJD include rapidly progressive dementia, behavioural changes, cerebellar dysfunction and myoclonus. Other seizure types are rare and nonconvulsive status epilepticus (SE) is exceptional. We report a case of a 44-year-old man who presented a psychotic episode followed by akinetic mutism and refractory nonconvulsive SE. The final diagnosis was CJD. Continuous video-EEG monitoring revealed the ictal pattern of nonconvulsive SE to be periodic sharp wave complexes characteristic of CJD. [Published with video sequences].
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PMID:Refractory nonconvulsive status epilepticus in Creutzfeldt-Jakob disease. 2064 12

Postictal symptoms, because of activation of inhibitory systems, have to be distinguished from ongoing ictal activity. The categorical concept of pure ictal and pure postictal symptoms cannot be supported by clinical observation alone. Differentiation between postictal and ictal behavioral phenomena can be difficult even with the use of electroencephalography, as clear-cut definitions of ictal and postictal changes are not available. Five different aspects can be considered: (1) hallucinatory symptoms recorded during and after a seizure, (2) prolonged postictal confusional states, (3) prolonged postictal psychotic states, (4) epileptic and other encephalopathies, and (5) coma with or without clinical signs of nonconvulsive status epilepticus. Presenting symptoms and conceptual considerations are presented in this review.
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PMID:Nonconvulsive status epilepticus and the postictal state. 2069 8

Delirium Tremens is quite rare in children and it is usually caused by withdrawal or abstinence from alcohol, barbiturates and other major tranquilizers. The usual symptoms of Delirium Tremens include severe altered mental status with confusion, delusions, hallucinations, and severe agitation. Although psychosis is a recognized manifestation of Phenytoin toxicity, visual hallucinations are not. This study reports the case of a 4-year-old male with febrile seizures plus syndrome who developed acute complex visual hallucinations and psychomotor agitation early after therapy with intravenous Phenytoin was administered. These visual hallucinations mimicked those linked to Delirium Tremens and were not associated with an encephalopathy or other known neuropsychiatric side effects of this drug. Moreover, the hallucinations occurred while serum Phenytoin concentrations were below therapeutic range. We made an extensive investigation in order to exclude a non-convulsive Status Epilepticus, a Central Nervous System infection, a metabolic disorder, an underlying psychiatric disease and a possible drug toxicity. The temporal relationship between initiation of Phenytoin and onset of visual hallucinations and resolution of symptoms with withdrawal of Phenytoin suggests that the visual disturbances were probably due to that antiepileptic drug.
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PMID:Phenytoin-induced visual disturbances mimicking Delirium Tremens in a child. 2072 59

This case report describes nonconvulsive status epilepticus of complex partial type in a 12-year-old, otherwise healthy girl. The case illustrates the characteristic epileptic twilight state with prolonged bizarre behaviour, psychosis, confusion and normal mental state. It may be difficult to identify the condition in childhood, as changes in behaviour and cognition are often recognized later than in adults. Treatment recommendations and other possible diagnoses are discussed.
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PMID:[Non-convulsive status epilepticus in 12-year-old]. 2082 37

In 2008 a workgroup of health care professionals from the American Epilepsy Society (AES) was convened to address the lack of consensus regarding patient care in epilepsy monitoring units (EMUs). The group developed a questionnaire designed to identify the extent to which selected adverse events occurred in EMUs, and it was sent via email to all members of the AES. We asked that only one representative from each center report. Seventy responses were received. The number of centers reporting the following adverse events included: falls by 69%, status epilepticus by 63%, and postictal psychosis by 54%. Infrequent events with serious consequences were also reported including pneumonia by 10%, cardiac arrest by 7%, fractures by 6%, and death by 3% (N=2). Of the 58 respondents who reported using intracranial electrodes, 37.9% (N=22) reported that patients pulled out or dislodged electrodes. This study highlights the need for EMUs to identify and address potential safety risks in their environment, patient population, and system of care.
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PMID:Risk of adverse events on epilepsy monitoring units: a survey of epilepsy professionals. 2130 57

Few studies focused on the long-term outcome of Dravet syndrome in adulthood are available in the literature, but all are concordant. In this article, we consider the outcomes of 24 patients followed at the Centre Saint-Paul, Marseille, up to the age of 50, and compare them to the patients reported in the literature. Five patients (20.8%) died, at a mean age of 24.8 years, one by status epilepticus, three by sudden unexpected death in epilepsy (SUDEP), and one of unknown cause. Epileptic seizures tend to become less frequent and less severe after childhood. Fever sensitivity (temperature variations) persists throughout the clinical course of DS, but its impact on seizure frequency and severity is milder than in infancy. Generalized convulsive seizures, mostly reported as generalized tonic-clonic seizures (GTCS), were the only seizure type observed in almost all of the patients, often with a focal onset. They are less frequent than in childhood and mostly nocturnal. Some of these major convulsive seizures have less typical aspects, for example, bilateral or asymmetric tonic posturing, followed in some cases by a tonic vibratory state or clonic movements (Oguni et al., Brain Dev 2001;23:736-748; Akiyama et al., Epilepsia 2010;51:1043-1052). Other seizures like myoclonic seizures, atypical absences, and complex partial seizures (CPS) are less common in adulthood: Among our 24 patients, only 6 had atypical absences, and one myoclonic and one complex focal seizures. Electroencephalography (EEG) also changes with age but is still multiple and heterogenous, interictally and ictally. Photosensitivity and pattern sensitivity also showed a tendency to disappear before the age of 20. Motor abnormalities are common. Cerebellar features, including ataxia, dysarthria, intention tremor, and eye movement disorder, become more prominent. Walking is markedly impaired, often due to orthopedic signs such as kyphosis, kyphoscoliosis, flat feet, or claw feet. This symptomatology was minor during childhood and worsened during and after adolescence, despite physiotherapy. Mental retardation ranged from moderate to severe, with predominance of language impairment, and some patients had a major personality disorder, labeled autistic or psychotic. Dependency in adulthood is nearly constant: Only 3 of our 24 adult patients lived independently.
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PMID:Dravet syndrome: the long-term outcome. 2146 79

The widespread use of antibiotics in recent years has considerably modified the clinical features of neurosyphilis. Presently, atypical or masked forms of this disease often occur and obscure diagnosis, despite a thorough history and clinical work-up. Here, we report a patient with neurosyphilis presenting with psychotic symptoms who then developed status epilepticus and left limb weakness. Diffusion-weighted magnetic resonance imaging showed hyperintensity involving the right parietal, occipital and temporal lobes and the thalamus. Subsequent serological and cerebrospinal fluid tests confirmed the diagnosis of neurosyphilis. The coexistence of meningovascular syphilis, syphilitic meningitis, and general paresis resulted in the complex manifestation of this patients' condition, as described here in terms of the unusual presentation, evolution, and final diagnosis.
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PMID:Neurosyphilis presenting with psychotic symptoms and status epilepticus. 2146 81

Benzodiazepines are primarily used for the treatment of generalized anxiety disorder, insomnia and status epilepticus. These drugs can also be useful in hyperaroused states, catatonic stupor, manic episodes, and akathisia. This paper will review indications for their use in various psychotic conditions.
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PMID:Benzodiazepines in psychotic States. 2174 6

Antibodies against N-methyl-D-aspartate receptor (NMDAR) are identified in the form of immune-mediated encephalitis in which typical manifestations include neuropsychiatric symptoms, seizures, abnormal movements, dysautonomia and hypoventilation. The authors report two cases of anti-NMDAR encephalitis with different presentations and patterns of progression. The first patient presented with status epilepticus and later developed psychosis, pyramidal signs and diffuse encephalopathy. The second patient presented with acute psychosis followed a week later by seizures, dystonia, rigidity, oromandibular dyskinesias and dysautonomia. Possible mechanisms responsible for the clinical manifestations of this disease are discussed in light of recently described additional clinical and laboratory findings.
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PMID:Diversity in anti-N-methyl-D-aspartate receptor encephalitis: case-based evidence. 2235 28

Experience of acute medical, surgical conditions, and clinical procedures of undergraduate students were assessed via a questionnaire survey during the final week of the 1993/1998 programme at the School of Medical Sciences, Univestiti Sains Malaysia. Individual performances were assessed by a scoring system. One hundred and twenty four students responded, (response rate 97%). More than 90% had seen myocardial infarction, cerebrovascular accident, pneumonia, respiratory distress, gastroenteritis, coma, and snake bite. Less than 33% had witnessed acute psychosis, diabetic ketoacidosis, acute hepatic failure, status epilepticus, near drowning, hypertensive encephalopathy, acute haemolysis or child abuse.Acute surgical/obstetrics cases, seen by >90% students, included fracture of long bones, head injury, acute abdominal pain, malpresentation and foetal distress. Less than 33% had observed epistaxis, sudden loss of vision, peritonitis or burns. Among operations only herniorrhaphy, Caesarian section, internal fixation of fracture and cataract extraction were seen by >80% students. The main deficits in clinical procedures are in rectal and vaginal examinations, urine collection and microscopic examinations. The performance of individual students, assessed by a scoring system, showed 15 students had unacceptably low scores (<149/230, 50%), 37 had good scores (>181.4/230, 70%) and 5 had superior scores (197.6/230, 80%).
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PMID:Clinical experience of medical students at university sains malaysia. 2284 12


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