Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0494475 (tonic-clonic seizure)
 1,319 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three days after arriving in Switzerland from Bolivia a 35-year-old man presented at a casualty department. He was anxious, agitated and hallucinating, and he expressed delusional ideas of being poisoned. As a general physical examination was without abnormal findings he was thought to suffer from a psychiatric disorder. It was only when he had evacuated in stool a long oval foreign body, packed in plastic sheeting and filled with a dark paste, that cocaine poisoning due to cocaine transport in the gastrointestinal tract (body packer syndrome) was suspected. Plain X-ray of the abdomen revealed numerous regular structures of poor X-ray contrast and the urine contained cocaine metabolites, confirming the tentative diagnosis. As the patient's state of consciousness deteriorated and he had a grand mal seizure, an emergency laparotomy was performed. 78 packages (two of them had opened) were removed by gastro- and caecotomy. Total cocaine weight was 650 g. He was discharged from hospital after 11 days, free of symptoms.
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PMID:[Cocaine poisoning from transport of the drug in the gastrointestinal tract (the body-packer syndrome)]. 147 70

Psychiatric disorders in epilepsy are frequently encountered. Contradictory reports are given in literature about the phenomenology of such disturbances and their relationship to seizure frequency. Depression has been described as mostly like "endogenous" with a family history of psychiatric illness or mostly "reactive". 32 patients with idiopathic Grand mal-seizures were studied using the Inpatient Multidimensional Psychiatric Scale (IMPS). They showed significant higher levels in scales of anxious depression and impaired functioning, no signs of hostility or delusion. Severity of depression was moderate compared with groups of inpatients suffering from endogenous and neurotic-depressive disorders. It was correlated with frequency of epileptic seizures and history of behaviour disturbances in infancy (Spearman-rang correlation).
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PMID:[Depressive disorder of the epilepsy patient--symptoms and factors of influence]. 169 87

This is a case of Ramsay Hunt syndrome with mental disorder. The patient had action myoclonus, grand mal seizure and severe cerebellar ataxia. Schizophrenia-like symptoms including delusion of persecution and self-reference, auditory hallucination and incoherence were characteristically observed before the neurological disturbance became manifest. Subsequently, euphoria, disinhibition, moria and mild dementia appeared with neurological symptoms. The possibility of Ramsay Hunt syndrome to accompany organic mental syndromes and the relationship between cerebellar dysfunction and psychiatric symptoms are discussed.
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PMID:Ramsay Hunt syndrome with mental disorder. 181 81

We conducted a randomized multicenter clinical trial on 397 patients ranging in age from 2 to 70 years to assess the effectiveness of treatment of the first unprovoked epileptic seizure. Subjects seen within 7 days after a first witnessed tonic-clonic seizure with or without partial onset were randomized to immediate treatment (carbamazepine, phenytoin, phenobarbital, or sodium valproate) or to treatment with the same drugs only after seizure recurrence. We excluded individuals with acute symptomatic seizures, progressive neurologic disorders, or gross psychiatric illness. Thirty-six of 204 subjects randomized to treatment and 75 of 193 randomized to delayed treatment experienced seizure recurrence during follow-up. The cumulative time-dependent risk of relapse among treated subjects was 25% by 24 months. The corresponding figure for untreated subjects was 51%. The risk of relapse was 2.8 times higher (95% CI, 1.9 to 4.2) for untreated subjects. There were no interactions between age and EEG findings (the only predictors of risk of relapse) and treatment effects. We conclude that treatment of the first seizure with antiepileptic drugs leads to a significant reduction of the risk of relapse.
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PMID:Randomized clinical trial on the efficacy of antiepileptic drugs in reducing the risk of relapse after a first unprovoked tonic-clonic seizure. First Seizure Trial Group (FIR.S.T. Group) 816 53

Nonconvulsive status epilepticus can be confused with psychiatric disorders. Inappropriate drug treatment can represent a precipitating factor. We describe two patients with idiopathic generalized epilepsy in whom nonconvulsive status epilepticus, aggravated by carbamazepine, was misdiagnosed as psychiatric disorder. A 14-year-old girl experienced a tonic-clonic seizure at age 12 years preceded by monthly episodes of confusion with awkward behavior since age 9 years. She was treated with carbamazepine, and the episodes of confusion became more frequent, leading to a diagnosis of dissociative disorder. An electroencephalogram during one of these episodes revealed nonconvulsive status epilepticus. Substitution of carbamazepine with valproic acid controlled the episodes of status epilepticus. A 23-year-old woman presented at age 16 years with a tonic-clonic seizure. Since early adolescence, she had had episodes of depressive mood, worsening of school performances, and facial tics. Carbamazepine treatment caused worsening of the depressive episodes and facial tics. An electroencephalogram during a typical episode revealed nonconvulsive status epilepticus. Carbamazepine substitution with valproate led to seizure freedom and behavioral improvement. Nonconvulsive status epilepticus should be suspected and searched for in patients with epileptic seizures and ictal or fluctuating behavioral disorders.
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PMID:Nonconvulsive status epilepticus precipitated by carbamazepine presenting as dissociative and affective disorders in adolescents. 1622 18

The electrical induction of seizures with a therapeutic aim began in 1938, but the history of electric currents to relieve mental illness began 2 centuries earlier with the pioneering work of the Italian Giovanni Aldini and the American Benjamin Franklin.These early experiments are described demonstrating that the electrical force encouraged hopeful applications. This history emphasizes the unique contribution in the induction of grand mal seizures as the therapeutic basis rather than the role of electricity alone.
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PMID:Electrotherapy for melancholia: the pioneering contributions of Benjamin Franklin and Giovanni Aldini. 1920 70

Atypical antipsychotics are known to be associated with electroencephalogram abnormalities. Olanzapine can lower seizure threshold and induce epileptiform discharges. However in patients on olanzapine for the treatment of a primary psychiatric disorder, clinical seizure is a rare occurrence. We report the case of a 25-year-old man with a diagnosis of paranoid schizophrenia with obsessive-compulsive disorder of 8 years' duration who developed new-onset generalized tonic-clonic seizure with exposure to olanzapine. Electroencephalogram showed epileptiform discharges; results of computed tomographic scan and metabolic investigations were normal. His antipsychotic was changed to haloperidol, and the patient showed a significant improvement in psychotic symptoms with no recurrence of seizures and did not require anticonvulsant therapy. Olanzapine has a profile similar to that of clozapine and shares its seizure-inducing potential. Typical antipsychotics such as haloperidol might be a safer option for such patients.
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PMID:Olanzapine-induced clinical seizure: a case report. 1982 Apr 34

Nonconvulsive status epilepticus (NCSE) is common but often under-diagnosed. Due to the absence of specific symptoms, it is frequently misdiagnosed as a psychiatric disorder, which delays treatment. The cases of two patients who exhibited psychiatric symptoms and subtle cognitive disturbances (without confusion) as the sole manifestation of frontal lobe NCSE are reported. Both patients were initially treated as psychiatric disorders (depression and anorexia nervosa). The correct diagnosis was established by the electroencephalographic study, in one case after the patient experienced a generalized tonic-clonic seizure and in the other, after failure to improve with supposedly adequate treatment. There are reports of patients with NCSE whose symptoms suggest a psychiatric disorder (inappropriate behavior, emotional disinhibition, perseveration, reduced speech and motivation). This can occur without altered consciousness and symptoms may fluctuate, making the correct diagnosis extremely difficult. This entity can occur at any age and without a previous history of seizures. A high level of suspicion is necessary for prompt electroencephalographic study to confirm the diagnosis. Early treatment will correct the symptoms and significantly improve quality of life for patients and their families.
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PMID:Psychiatric disorders secondary to nonconvulsive status epilepticus of frontal origin. Two clinical case reports. 2272 34

A novel antiepileptic drug, levetiracetam, has been reported to cause several psychiatric adverse effects in spite of its effectiveness on epilepsy. However, a possible relationship between levetiracetam and obsessive-compulsive behavior has only been reported in a few studies with adult epilepsy patients. We treated a pediatric patient with epilepsy without past or family history of psychiatric disorder. Levetiracetam was started to control generalized tonic-clonic seizure. Two months after initiation of levetiracetam with favorable seizure control, she started to show an obsessive-compulsive behavior such as repetitive checking of her back, pants, and chair. Based on the course of its appearance, levetiracetam administration was identified as a possible cause. After termination of levetiracetam, her obsessive-compulsive behavior completely disappeared with reappearance of seizures. This case provides clear evidence that levetiracetam may cause obsessive-compulsive behavior even in a pediatric epilepsy patient without psychiatric background, possibly mediated by modulation of the glutamate system by levetiracetam.
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PMID:Obsessive-compulsive behavior induced by levetiracetam. 2500 11

Atypical antipsychotics are known to be associated with electroencephalogram abnormalities. Olanzapine can lower seizure threshold and induce epileptiform discharges. However in patients on Olanzapine for the treatment of a primary psychiatric disorder, clinical seizure is a rare occurrence. We report the case of a 23-year-old female with mild mental retardation with schizophrenia with obsessive compulsive disorder who developed new-onset generalized tonic-clonic seizure probably due to Olanzapine. Electroencephalogram showed epileptiform discharges. The seizure risk associated with Olanzapine was reviewed.
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PMID:Seizure associated with olanzapine. 3059 64


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