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)

With the introduction of several new anticonvulsant drugs into clinical practice in recent years, renewed attention has been paid to treatment-emergent effects, especially behavioural syndromes. In this review, the more severe psychiatric syndromes that may be associated with anticonvulsants are discussed, especially personality disorders, affective syndromes and psychoses. The important concept of forced normalisation is discussed, and its clinical counterpart, alternative psychosis. Affective disorders and psychoses have been described as associated with most of the new anticonvulsant agents, and they are often seen in a setting in which previously intractable patients suddenly become seizure free. Other cases may relate to intoxication, the precipitation of a status epilepticus, or ensue as part of the background frequency of those syndromes that are seen in epilepsy irrespective of medication.
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PMID:Anticonvulsant-induced psychiatric disorders. The role of forced normalisation. 887 70

This article describes the diary of a man from 19th-century England (1829-1834) that documents the onset and course of his wife's epilepsy after a stroke. Her stroke produced aphasia and right hemiparesis, but her epilepsy was the diary's focus and caused the greatest concern. The diary documents the history of her epilepsy in detail. In addition to tonic-clonic seizures, she experienced frequent bouts of status epilepticus and complex partial seizures. The diary contains some of the earliest recorded descriptions of status epilepticus and its aftermath of delirium, mood disorder, and hysteria. It also offers some of the earliest and most detailed accounts of complex partial seizures. Bleeding by cupping was the only symptomatic or prophylactic treatment recorded. These aspects of the diary are presented, as are the historical perspectives on epilepsy, including early beliefs and stigmas, therapeutic remedies, and early European views of epilepsy.
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PMID:A diary of epilepsy in the early 1800s. 1726 88

Repetitive transcranial magnetic stimulation (rTMS) is emerging as a new therapeutic tool in epilepsy, where it can be used to suppress seizures or treat comorbid conditions such as mood disorder. However, as rTMS carries a risk of inducing seizures among other adverse events, its safety and tolerability in the population with epilepsy warrant distinct consideration, as this group is especially seizure-prone. Accordingly, we performed a review of the literature to estimate the risk of seizures and other adverse events associated with rTMS in patients with epilepsy. We performed an English-language literature search, and reviewed all studies published from January 1990 to February 2007 in which patients with epilepsy were treated with rTMS, and complemented the literature search with personal correspondence with authors when necessary. We identified 30 publications that described patients with epilepsy who underwent rTMS, and noted total number of relevant subjects, medication usage, incidence of adverse events, and rTMS parameters including stimulus frequency, number of stimuli, train duration, intertrain interval, coil type, and stimulation sites. The data were analyzed for adverse events related to rTMS. Crude per-subject risk, as well as per-subject mean risk weighted by sample size and risk per 1000 stimuli weighted by number of stimuli in each study, were computed for seizures and for other adverse events. Adverse events or lack thereof was reported in 26 studies (n=280 subjects). Adverse events attributed to rTMS were generally mild and occurred in 17.1% of subjects. Headache was most common, occurring in 9.6%. The most serious adverse event was seizure during treatment, which occurred in four patients (1.4% crude per-subject risk). All but one case were the patients' typical seizures with respect to duration and semiology, and were associated with low-frequency rTMS. A single case of an atypical seizure appearing to arise from the region of stimulation during high-frequency rTMS is reported. No rTMS-related episodes of status epilepticus were reported. We cautiously conclude that the risk of seizure in patients with epilepsy undergoing rTMS is small, and the risk of other mild adverse events is comparable to that seen when rTMS is used to treat other diseases. Status epilepticus or life-threatening seizures have not been reported in patients undergoing rTMS treatment. rTMS thus appears to be nearly as safe in patients with epilepsy as in nonepileptic individuals, and warrants further investigation as a therapy in this population.
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PMID:Safety and tolerability of repetitive transcranial magnetic stimulation in patients with epilepsy: a review of the literature. 1749 77

Mood disorders and major depression are frequently comorbid with epilepsy. While the nature of this comorbidity is not fully understood, multiple lines of evidence suggest that changes in serotonin (5-HT) neurotransmission may be an underlying mechanism. In this study, we tested the hypothesis that chronic epilepsy in rats can be associated with loss of 5-HT neurons in the dorsal raphe (DR) nuclear complex, the main source of 5-HT projections to the cerebral cortex, which would help to explain respective behavioral deficits. Epilepsy was induced using the kainate model of status epilepticus in adult Wistar rats. After a 3-month recovery period, all kainate-treated rats that had experienced status epilepticus showed spontaneous seizures and reduced sucrose preference (anhedonia), a core symptom of depression. No changes in the forced swim test were detected. The total numbers of 5-HT immunoreactive cells were estimated in all DR subdivisions of control and epileptic rats. Interestingly, epilepsy-related loss of 5-HT neurons (approximately 35%) was observed only in the interfascicular part of the DR complex, which is known to innervate brain regions involved in depression. These findings support the notion that mental health impairments observed in epilepsy may be related to loss of a specific population of the DR 5-HT neurons projecting to limbic brain areas.
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PMID:Altered taste preference and loss of limbic-projecting serotonergic neurons in the dorsal raphe nucleus of chronically epileptic rats. 2645 22