Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0085632 (apathy)
 4,089 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An 18-year-old woman in her first pregnancy with hyperemesis gravidarum, presented dehydration, without hyponatremia. She was confused with profound disorientation, apathy, and drowsiness. She presented upbeating nistagmus on upward gaze and gate ataxia recognised as Wernicke's encephalopathy. Laboratory tests demonstrated hypokalemia, hypernatremia and aminotransferase elevation. The serum osmolality was 319 mOsm/kg and the water deficiency 2.73 l. The patient developed weakness in the four limbs, with hypotonicity, absence of tendon reflexes and showed bilateral Babinski signs. A T2 weighted sagittal cranial-magnetic resonance imaging revealed a high signal within mid-pons suggesting central pontine myelinolysis. In this case we highlight the absence of hyponatremia. Furthermore, the central pontine myelinolysis was probably secondary to hypokalemia, hypernatremia and hyperosmolality.
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PMID:[Central pontine myelinolysis induced by hyperemesis gravidarum]. 1041 97

Hepatitis C virus (HCV) infection is often associated with abnormal immunological responses. We describe four patients with vasculitic neurological signs and symptoms following HCV infection. A 56-year-old woman with HCV infection developed peripheral neuropathy characterized by asymmetric distal painful hypesthesia, dysesthesia and moderate motor weakness of the lower limbs. Serological examinations revealed cryoglobulinemia and low levels of complement C4. A biopsy of the sural nerve revealed vasculitic neuropathy. HCV infection associated immunomediated vasculitis was diagnosed. While steroid therapy was ineffective, treatment with interferon-alpha improved the neuropathy considerably without, however, eliminating HCV infection. A 62-year-old man with HCV infection developed peripheral sensory neuropathy. Complement C3 was slightly diminished. Nerve biopsy revealed vasculitic neuropathy. A 71-year-old woman developed chronic symmetric sensomotor polyneuropathy. HCV hepatitis followed blood transfusions. Cryoglobulins tested positive, consistent with type II cryoglobulinemia. Complements C3 and C4 were diminished. Inflammatory infiltrates in the sural nerve biopsy specimen led to the diagnosis of chronic vasculitic disorder. A 55-year-old woman with HCV infection developed vasculitis of the skin, connective tissue, visceral organs, and kidney, leading to hemodialysis. Neurologically she developed severe apathy and drowsiness, myoclonic jerks, exaggerated deep tendon reflexes, and positive pyramidal signs. Magnetic resonance imaging of the brain showed diffuse increased signal abnormalities involving supra- and infratentorial white matter suggesting cerebral vasculitis. Cryoglobulins were positive, complements C3 and C4 slightly diminished (54 mg/dl, 4.3 mg/dl). Supportive therapy resulted in neurological improvement. Treatment with interferon-alpha was discontinued because of agranulocytosis. In patients with peripheral neuropathy or signs of leucencephalopathy, a hepatitis C associated vasculitis should be considered in the differential diagnosis.
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PMID:Neurological manifestations of chronic hepatitis C. 1043 76

The authors describe a case of a 53 years old man with myotonic dystrophy. Based on characteristic clinical symptoms and EMG results the diagnosis was established and proved on DNA examination. Myotonic dystrophy gene analysis showed on 3' untranslated region one hundred and fifty CTG triplet repeats. The accessory examinations revealed: cataract arrhythmias, gallbladder stones, impotence, cerebral atrophy on neuroimaging (CT and MRI). Apathy, somnolence, concentration troubles were present. Pedigree of the presented patient and possibility of spontaneous mutation are discussed.
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PMID:[A case of myotonic dystrophy proved by DNA analysis]. 1046 39

A 68-year-old right handed man with treated hypertension presented with acute-onset somnolence without hemiparesis, dysarthria or sensory disturbance. Although he became laconic and his verbal responses were only in short terms, his replies were accurate and judgmental. A cranial MRI in axial, coronal, and sagittal section revealed small hemorrhagic infarcts essentially limited to the bilateral capsular genua without involvement of the inferior thalamic peduncles. A 123I-IMP single photon emission CT disclosed remarkable hypoperfusion in the bilateral frontal cortex. After a week of somnolence, he gradually became wakeful, but was still abulic. Neuropsychological examinations revealed no memory disturbance. We consider that disconnection of the thalamo-frontal projection at the genua of the internal capsules caused somnolence, apathy, and abulia in our case. The hitherto reported cases of the genu infarcts that showed memory disturbance had the lesion involving both the inferior thalamic peduncle and its nearby mamillothalamic tract. In contrast, our case without memory disturbance had infarcts confined to the genua apparently sparing the two tracts, implicating that memory function may be preserved when such structures are intact.
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PMID:[A case of abulia without memory disturbance due to infarction of the bilateral genua of the internal capsules]. 1054 18

Spontaneous intracranial hematoma is not rare, but with bad prognosis, complication in patients on maintenance hemodialysis (HD). Diagnostic difficulties result from a fact that symptoms of acute hematoma such as headaches,, nausea, vomitis, apathy, sleepiness, parestesia and seizures may also suggest dysequilibrium syndrome, dialytic dementia as well as hypertensive encephalopathy. We describe a case of female patient with 20-year interview data of hypertension on HD since 1981 because of end-stage renal failure in a course of chronic glomerulonephritis, who developed spontaneous epi- and subdural hematoma four year ago in 47 age of life. Performed CT examination confirmed diagnosis and on the same day the patient underwent right frontoparietotemporal craniotomy and the hematoma was removed. During postoperative period, HD sessions were performed without heparin. After surgery the patient developed transcient hypertonia, epileptic sizures and left-sided paresis. Currently, 48 months after craniotomy the patient is fully rehabilitated, with normal blood pressure, without epileptic sizures or palsy. Gradually we discontinued anticonvulsans and antihypertensives.
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PMID:[Long-term good results of surgical treatment for spontaneous epi- and subdural hematoma in a female patient on maintenance hemodialysis]. 1139 5

The level of information on biometeorologic reports and mood effects of weather conditions on the Zagreb population were assessed in a sample of 782 subjects. Only 103 (13.2%) study subjects had not been informed on biometeorologic reports. Mood effects of weather conditions were reported by more than 76% of study subjects, 18.3% of them reporting meteorosensitivity. Meteorosensitivity showed a female predominance, and increased with age and level of education. 88% of chronic patients reported discomforts caused by changes in atmospheric conditions. Apathy and sleepiness were the most common mood changes associated with weather changes, whereas humid weather was indicated as a weather type that caused most discomforts in study subjects.
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PMID:Mood effects of weather conditions of the Zagreb population, Croatia. 1641 54

Despite the efficacy of currently available antidepressant treatment, residual symptoms are common among individuals treated for major depressive disorder and are associated with an increased risk of relapse and poor psychosocial functioning. However, distinguishing treatment-emergent side effects from residual symptoms can be challenging for clinicians. Anxiety, sleep disturbance, somnolence/fatigue, apathy and cognitive dysfunction are among the more frequent residual symptoms. Approaches to the management of residual symptoms include addressing treatment-emergent side effects and co-morbid conditions, optimizing antidepressant dosing and using augmentation therapy. Clinicians are often guided in their decisions by anecdotal impressions. Studies assessing the evaluation and treatment of residual symptoms and side effects will contribute importantly to the optimal acute and long-term management of depression.
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PMID:Pharmacological approaches to the treatment of residual symptoms. 1664 69

A 70-year-old patient treated with oxcarbazepine experienced severe hyponatremia. The patient used oxcarbazepine (600 mg twice a day) concomitantly with diuretics (torasemide 10 mg and indapamide 1.25 mg once per day), perindopril, an angiotensin-converting enzyme inhibitor, and amlodipine, a Ca(2+) channel blocker. The patient complained of a nausea, malaise, diplopia, drowsiness, apathy, decreased diuresis (creatinine clearance - 41.51 ml/min), and exacerbation of epileptic seizures. Sodium concentration in the plasma was 113 mmol/l. The patient was hospitalized. It was suggested that a decrease in plasma sodium concentration was caused by oxcarbazepine used together with diuretics for six months. Oxcarbazepine-induced hyponatremia is reported in 22.2-50% of patients, although symptoms are present only in 5.9% of patients. The most common symptoms of central nervous system injury, experienced by patients, are drowsiness, dizziness, decreased cognitive function, coordination impairment, etc. Physicians not always in time pay proper attention to undesirable antiepileptic drug-induced effects, which can be dangerous.
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PMID:[A case of severe hyponatremia in a patient suffering from epilepsy and using oxcarbazepine]. 1696 31

While the effects of a short nap on performance and arousal level have been well investigated, less attention has been paid to its effects on mood status. The aim of the present study was to examine the effects of a short nap and natural bright light exposure on mood status. Participants were 16 healthy females who were on average 38.1 (SD = 2.68) yr old. From 11:00 to 12:00, the participants carried out a set of tasks twice with baseline lighting (<100 lux). From 12:40 to 13:10, they were subjected to three experimental conditions: control (<100 lux), natural bright light (>2,000 lux), and a 20-min nap. From 13:10 to 16:10, the tasks were repeated six times with the baseline lighting. To measure mood status, multiple visual analogue scales (to measure anxiety, sadness, anger, confusion, apathy, fatigue, and sleepiness) and the Mood Check List 3 (MCL-3) (to derive "pleasantness", "satisfaction" and "relaxation") were employed. The results showed that brief (30 min) natural bright light exposure improved one dimension of mood status, "pleasantness". A short nap also improved dimensions of mood status ("pleasantness", "satisfaction", and "relaxation"). These results suggest that the proper application of both natural light and a short nap shifts the mood status to the positive/favorable side.
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PMID:A short nap and natural bright light exposure improve positive mood status. 1748 75

Methylphenidate and other psychostimulants have received substantial attention for the management of depression in patients with medical co-morbidities as well as for the symptomatic palliation of various neuropsychiatric disorders. Despite having been of little use in the first-line treatment of depressive disorders, some evidence does suggest that they may be of potential benefit as an antidepressant augmentation strategy in patients who fail to respond to stand-alone antidepressant regimens. However, such claims appear to be based entirely on case reports and to date, no appropriate placebo-controlled studies have been carried out on healthy young subjects. We report a case of a woman with refractory depression who successfully responded to methylphenidate augmentation of fluvoxamine. Her clinical picture was dominated by significant biological symptoms, which included apathy, anergia, increased appetite, and somnolence, with marked secondary functional impairment. Several antidepressant treatment modalities were attempted, including electroconvulsive therapy, with little improvement in her symptomatology. Augmentation of fluvoxamine with methylphenidate ultimately brought about a rapid and sustained complete remission of her depression. We will highlight how methylphenidate and other psychostimulants, when used with caution and an appreciation of their potential risk for abuse, may prove to be remarkably effective agents for antidepressant augmentation, including that of partially-effective or ineffective selective serotonin re-uptake inhibitors. Evidence for such use of methylphenidate unfortunately remains largely empirical and adequate placebo-controlled studies are therefore required to support or refute this claim.
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PMID:[Methylphenidate augmentation of fluvoxamine for treatment-resistant depression: a case report and review literature]. 1756 84


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