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)

A 65 year old male with the entity, scleromyxedema, experienced exacerbation of the disease in which the main clinical features involved the central nervous system. He presented with clouded sensorium, disorganized thinking, combative behavior, headache, unsteady gait and grand mal seizures. A few days after hospital admission the symptoms abated. After a 6 day hiatus, the symptoms suddenly recurred, continuing for another week. The symptomatology again suddenly ceased with complete clearance of mental status. During the full-blown delirium, the electroencephalogram had demonstrated diffuse slowing while lumbar puncture, brain scan, E.M.I. scan and cerebral arteriogram failed to contribute to the understanding of the clinical presentation. Scleromyxedema rarely involves the central nervous system. This case illustrates a very unusual manifestation of scleromyxedema, prominent central nervous system involvement presenting as an acute organic brain syndrome. It is the only case which includes formal mental status examination, cerebrospinal fluid findings and electroencephalogram results.
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PMID:Acute cerebral symptomatology, a rare presentation of scleromyxedema. 41 72

Systemic toxic were encountered in eight of 10,469 patients during or immediately following the intramuscular injection of 4,800,000 units of procaine penicillin G for the treatment of gonorrhea. Fear of imminent death, visual and auditory disturbances, violent combativeness, confusion, disorientation, and restlessness, disturbance in taste, cardiovascular changes, and grand mal seizures are the principal manifestations; these usually subside in two to 10 minutes spontaneously or after treatment. Symptoms and signs closely parallel systemic toxic reactions to local anesthetics. Pharmacokinetic analysis in dogs using 14C-procaine and 14C-procaine penicillin G showed rapid distribution of labeled drugs from plasma to cerebrospinal fluid for the intravenous as compared to the intramuscular route of administration. The animal studies were consistent with the hypothesis that the inadvertent intravenous administration of procaine penicillin G is responsible for the systemic toxic reactions. Plasma procainesterase (pseudocholinesterase) activity was assayed with an ultraviolet spectroscopic method. Substrates were procaine and procaine penicillin G. The plasma procainesterase activity of patients who had experienced systemic toxic reactions was significantly decreased as compared to that of controls, an observation not previously reported.
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PMID:Systemic toxic reactions to procaine penicillin G. 41 9

An analysis of seven sporadic cases of Legionnaires' disease confirmed clinical features recorded during epidemics and identified aspects of the illness either unreported or not emphasized. Four patients had central nervous system abnormalities. Mental status changes included somnolence, obtundation, delirium, disorientation, and confusion. Three patients experienced visual hallucinations, and one patient without pneumonia had a grand mal seizure with residual memory deficit. Two patients had disseminated intravascular coagulation with thrombocytopenia, elevated split fibrin products, and prolonged partial thromboplastin and prothrombin times. Four patients had severe hypoxia; one patient had an exudative pleuritis. One patient whose treatment included erythromycin had radiologic improvement of his pneumonia despite deteriorating ventilatory function that led to death. The concept of Legionnaires' disease as a severe, diagnostically perplexing pneumonic illness is valid but too narrow. The emerging spectrum is that of a multisystem disease that, besides the lungs, often involves the central nervous system and can be accompanied by disseminated intravascular coagulation.
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PMID:Sporadic cases of Legionnaires' disease: the expanding clinical spectrum. 43 28

The action of intravenously injected taurine, glycine and GABA has been tested on convulsions induced by strychnine using electroencephalographic and electromyographic recordings. The dose of strychnine necessary to produce a generalized tonic-clonic seizure was 0.55 +/- 0.15 mg/kg intravenously for rabbits pretreated with taurine, which was significantly higher than for control animals (0.38 +/- 0.13 mg/kg). After pretreatment with glycine, the strychnine dose required to evoke convulsions (0.51 +/- 0.22 mg/kg) was also higher than the control values, but the difference was statistically not significant. The convulsive dose of strychnine in animals pretreated with GABA was slightly but not significantly lower than in control animals (0.31 +/- 0.13 mg/kg). These results suggest that taurine is the most effective amino acid to protect rabbits from seizures induced by strychnine.
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PMID:Effects of taurine, glycine and GABA on convulsions produced by strychnine in the rabbit. 43 61

A 62-year-old man presented with a grand mal seizure, progressive abdominal distention, and refractory hypotension 18 years after colonic bypass of a benign stricture of the low middle third of the esophagus. He died 3 hours after admission to the hospital. The patient had a history of liniment ingestion in childhood plus a long history of dysphagia and substernal pain. Autopsy disclosed a large ulcer of the anterior wall of the distal esophagus, which had eroded through the posterior wall of the left atrium. Histologic examination revealed chronic esophagitis with fibrous obliteration of the esophageal wall, pericardium, and left atrial myocardium near the site of perforation. Foreign material was present within small arteries of multiple viscera, and in several of these fragments transverse striations were demonstrated. Esophageal-atrial perforation is a rare but fatal complication of chronic esophageal ulceration. The clinical and pathological features of this and previously reported cases of nontraumatic esophageal-atrial perforation are reviewed.
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PMID:Esophageal-atrial perforation due to recurrent esophagitis 18 years after esophageal bypass surgery. 45 25

A 25-year-old woman who had experienced brief periods of loss of consciousness and grand mal seizures was found to have a midline mass in the sellar region as evidenced by computer tomography and angiography. Preoperatively, it was thought to be a meningioma but histologically and ultrastructurally it turned out to be a Schwannoma. Since cranial nerves were not involved, clinically or morphologically, this nerve sheath tumour could have originated from Schwann cells of sensory, possibly trigeminal, nerves, vasomotor nerves, or ectopic Schwann cells.
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PMID:Schwannoma of the sellar region. 48 74

Water hemlock is a ubiquitous plant that can be mistaken for a turnip as in the case reported. Oral ingestion causes an explosive illness consisting of nausea, vomiting, abdominal cramps, and grand mal seizures that can progress to cyanosis and death. In the reported case a 30-year old man was found semi-comatose some 75 minutes after ingesting a "turnip". The history revealed profuse emesis shortly after eating lunch that changed from bile to frank blood. There was a mean orthostatic blood pressure change of 30 torr, with an increase in the heart rate of 10%. Neurologic examination revealed a lethargic patient. Following administration of 4 liters of Ringer's lactate the patient's blood pressure stabilized and with continued isotonic fluid maintenance he improved rapidly. This case indicates that appropriate management should be directed toward protecting the patient's airway from gastric aspiration, restoring the intravascular and extracellular volume deficit, and controlling cerebral edema.
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PMID:A case of water hemlock poisoning. 49 28

Seven cases of retinal cavernous haemangioma are presented. Three cases have been followed for more than 6 years, and three cases between 1 and 2 years. Six cases had no eye symptoms related to the vascular tumour, while in one case vitreous haemorrhage occurred on two occasions. On both these occasions full vision was regained. None of the vascular tumours were treated. Two patients had grand mal seizures. They also had convulsive disease in the family history. In three cases family members of two generations were found to have normal eyes on examination.
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PMID:Cavernous haemangioma of the retina. 52 95

High pressure oxygen (HBO) and 1,1-dimethylhydrazine (UDMH) both cause grand mal seizures, brain glycogen degradation, and inhibition of glutamic acid decarboxylase (GAD). Brain glycogen degradation is a sudden process that is perhaps initiated by convulsions in the case of UDMH-poisoning, but a gradual decrease in glycogen is detectable before the onset of hyperbaric oxygen toxicity symptoms. UDMH injection causes consecutive convulsions that follow a predictable sequence. (Time to convulsions is referred to as the induction period, and time between convulsions as the interictal period.) After a single injection of UDMH, there is a gradual decrease in resistance to HBO during the induction period, measured as time to convulsions breathing 100% oxygen at 6 ATA; in the first interictal period, this time is only 4 1/2 min in comparison with a control value of 26 min for untreated rats. Administration of pyridoxine, a B6-vitamin, 2 h after UDMH injection in the first interictal period, resulted in an immediate tenfold increase in resistance to oxygen toxicity, from 4 1/2 to 48 min. Pyridoxine may reverse the inhibitary effect of UDMH on GAD, and there is perhaps an accumulation of substrate, which is made available when GAD inhibition is diminishing. Simultaneous injection of pyridoxine and UDMH causes no convulsions, no change in brain glycogen levels, and an unchanged or increased resistance to HBO, measured two and three hours after injection.
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PMID:Alterations in seizure mechanisms caused by oxygen high pressure, 1,1-dimethylhydrazine, and pyridoxine. 53 96

411 patients with epileptic seizures manifest only after the age of 25 were investigated as to aetiology, seizure type and frequency and age and sex distribution. Neurological, neuro-radiological and EEG findings are reported: There was a clear prevalence of male patients (67%). Manifestation occurred mainly between 30 and 40 years of age (65%). Most seizures were primarily of the generalized grand mal type (68%). Grand mal with focal onset occurred in 13%, partial seizures in 11%, complex partial seizures (psychomotor seizures) in 5%, the latter plus grand mal seizures in 2% and other types in 1% of the cases. Aetiological factors were: chronic alcoholism (31%), vascular diseases (17%), tumours (12%), traumatic brain lesions (8,5%), toxic metabolic lesions (6%) and other factors (6%). Idiopathic epilepsy of late onset was a rare cause (4%). The aetiology remained unknown in 15% of cases. We found that the differences in age distribution, seizure type and the EEG findings are significant factors in the differential diagnosis and we compared them with those found in similar investigations.
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PMID:[So-called late epilepsy (author's transl)]. 56 52


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