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)

A 57-year-old woman with a 7-year history of Parkinson's disease was admitted to our hospital because of a high fever, disturbance of consciousness, increased muscular rigidity, tachycardia and hyperhidosis after she stopped taking her prescribed levodopa + carbidopa (Menesit) 400 mg/day. In the laboratory examinations, the erythrocyte sedimentation rate was 109 mm/h, thrombocytes 7.8 x 10(4)/mm3, fibrinogen 457 mg/dl, FDP 74.8 micrograms/dl, thus suggesting disseminated intravascular coagulation (DIC). According to her biochemical examination, the serum AST (253 IU/l), ALT (178 IU/l), CK (7115 IU/l) and BUN (25 mg/dl) levels were all increased. These laboratory data and the clinical course indicated the patient to be suffering from neuroleptic malignant syndrome (NMS) with DIC. She was diagnosed to have NMS associated with DIC. She was treated with dantrolene sodium, bromocriptine, and gabexate mesilate, and her symptoms thereafter gradually improved. On day 7, she developed status epilepticus in spite of the clinical improvement in her symptoms of NMS and DIC including a clouding of consciousness. The status epilepticus was also attenuated by the use of thiamylal sodium. Patients with Parkinson's disease associated with NMS are considered to have a low incidence of DIC, status epilepticus, and in Japan this may be the first case report of the successful treatment of NMS with DIC and status epilepticus in a patient with Parkinson's disease.
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PMID:[A successfully treated parkinsonian patient with neuroleptic malignant syndrome complicated by status epilepticus and disseminated intravascular coagulation]. 1050 92

Mitochondrial functions are intimately associated with neurological symptoms. Various clinical and biological features are suggestive of energy depletion diseases, such as Leigh syndrome, Alpers syndrome, epilepsy (including myoclonic seizures and status epilepticus), stroke-like episodes, and acute cerebellar ataxia with high lactate peaks on magnetic resonance spectroscopy. Magnetic resonance imaging (MRI) discloses abnormalities in over 90% of the cases presenting with neurological symptoms. Basal ganglionic involvement, the most frequent imaging sign, can be isolated or combined with subtentorial atrophy of both the cerebellum and brainstem. MRS monovoxel proton spectroscopy is useful to reveal high lactate spikes if placed in the putamen and the cerebellar dentate nucleus. Lactate and pyruvate levels are required to exclude pyruvate dehydrogenase deficiency. However, lactate may be normal in the CSF. Clinical and biochemical investigations guide molecular studies, with two major heredities: mtDNA point mutations and autosomal recessive defects that program the majority of respiratory chain subunits. Muscle biopsy is the first test demonstrating the histochemical and ultrastructural alterations in mitochondria, even in diseases in which myopathy is not clinically prominent, and is also a good tissue for biochemical analysis, as the biopsy is not dangerous for the patient. Negative results in skeletal muscle do not exclude respiratory chain deficiency, and a liver biopsy may be necessary whatever the blood AST and ALT levels, to perform biochemical and molecular investigations. Only the identification of nuclear or mitochondrial mutation confirms the diagnosis.
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PMID:Respiratory chain deficiencies. 2362 86