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)

Severe myoclonic epilepsy in infants (SME) is one of the most malignant epileptic syndromes recognized in the latest classification of epileptic syndromes. The clinical details and electroencephalographic (EEG) characteristics have been elucidated by Dravet et al. The diagnosis of SME depends largely on the combination of clinical and EEG manifestations at different ages, of which the presence of myoclonic seizures appears to be the most important. However, because of the inclusion of different types of myoclonic attack and the lack of strict criteria for diagnosing SME, there has been some confusion as to whether patients without myoclonic seizures or myoclonus should be classified as SME, despite other identical clinical symptoms (SME borderlands (SMEB) group). Among the various clinical manifestations characterizing SME, special attention has been paid to seizures easily precipitated by fever and hot baths in Japan. We have demonstrated that the onset of myoclonic attack in these patients is very sensitive to the elevation of body temperature itself rather than its etiology. Using simultaneous EEG and rectal temperature monitoring during hot water immersion, we showed that epileptic discharges increased in frequency, and eventually developed into seizures at temperatures over 38 degrees C. We believe that the unique fever sensitivity observed in SME is similar to, but more intense than that of febrile convulsions. We have also identified a group of cases who have had innumerous myoclonic and atypical absence seizures daily which were sensitive to the constant bright light illumination. In these cases, spike discharges increased or decreased depending on the intensity of constant light illumination. Although these cases form the most resistant SME group, they lost the constant light sensitivity with increasing age, leaving only relatively common types of fever-sensitive grand mal seizures (FSGM) at the age of around 5 years. In the long run, only convulsive seizures continue, while myoclonic or absence seizures and photosensitivity disappear with advancing age, thus it is conceivable that SMEB constitutes a basic epileptic condition underlying SME. There is a clinical continuum that extends from the mildest end of SMEB to the severest end of SME with constant light sensitivity, with intermediates of frequent or infrequent myoclonic and absence seizures in-between. This spectrum concept appropriately explains the clinical variabilities between SME and SMEB during early childhood.
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PMID:Severe myoclonic epilepsy in infants--a review based on the Tokyo Women's Medical University series of 84 cases. 1170 Dec 88

A 20-year-old woman attended a 'rave party' where she took the drug 3,4-methylenedioxymethamphetamine (MDMA, 'ecstasy'). She had used this drug previously without serious adverse effects. On this occasion, while both she and her friends drank a large quantity of water, only she became seriously ill. The initial manifestation was an altered sensorium; several hours later she had a grand mal seizure. In the Emergency Department, the most striking features were the severe degree of hyponatraemia (112 mmol/l) and cerebral oedema. To explain the basis for this life-threatening clinical presentation, an imaginary consultation was sought with Professor McCance. Using both a deductive and a quantitative analysis that involved several medical subspecialties, he illustrated that a simple story of water ingestion and vasopressin release was not sufficient to explain her hyponatraemia. It was only after events in her gastrointestinal tract were analysed that a plausible hypothesis could be constructed.
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PMID:Acute hyponatraemia and 'ecstasy': insights from a quantitative and integrative analysis. 1209 53

Cyclophosphamide (CY) is an alkylating agent used to treat a variety of autoimmune disorders. Water intoxication is a well-known complication of high-dose intravenous (i.v.) CY, but is rare in patients treated with low dose i.v. CY. We describe two patients with lupus nephritis and water intoxication following low dose i.v. CY. The first patient was treated with oral prednisolone and azathioprine for eight weeks with inadequate response and persistent renal inflammatory activity. Eight hours after the first i.v. CY pulse she had a grand mal seizure. The second patient had WHO class III lupus nephritis, and after a single i.v. CY pulse developed vomiting, diarrhoea and grand mal seizures. They were both fluid-restricted and their serum sodium levels returned to normal. In conclusion, even at low doses i.v. CY may induce hyponatremia related to inappropriate antidiuretic hormone secretion. This potentially life-threatening complication of i.v. CY could be minimized by avoidance of overhydration following pulse i.v. CY.
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PMID:Water intoxication induced by low-dose cyclophosphamide in two patients with systemic lupus erythematosus. 1294 25

Hot water epilepsy (HWE) was induced in freely moving Wistar rats by applying hot water jets over the head region. The status of the blood-brain barrier (BBB) during the seizures and during hot water-induced hyperthermia without seizures was examined using Evans blue dye. In order to investigate the contribution of concomitant factors to this process, synchronized body temperature and blood pressure recordings were also made. Tonic-clonic seizure activity was observed within an average of 3.9 min (SE= 0.6 min) in the rats exposed to the hot water jets; this treatment induced BBB opening in the cortical and deep brain areas. Body temperature and blood pressure increased from 36.5 degrees +/- 0.3 degrees C to 40.0 degrees+/- 0.2 degrees C, and from 91+/- 3 mmHg to 153+/- 4 mmHg, respectively. In the group of animals exposed to hot water application without inducing seizures, there were significant increases both in blood pressure and body temperature; however, the extravasation of Evans blue was not pronounced in the brains. Hot water-induced seizures, increased cerebrovascular permeability. Although high blood pressure and hyperthermia contribute to this permeability, the seizure activity is the major factor in this change.
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PMID:Changes in blood-brain barrier permeability during hot water-induced seizures in rats. 1465 37

Iopamidol, a water-soluble contrast agent, has been rarely associated with seizures. We describe a case of generalized tonic-clonic seizure after cervical myelography with iopamidol in a previously healthy young man. In patients presenting with seizures, a history of recent myelography should be considered as an etiology. Iopamidol myelography may be associated with a risk of seizures. Clinicians need to be aware of this complication and inform their patients about such risk.
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PMID:Iopamidol myelography-induced seizures. 1636 90

Paclitaxel, a microtubule stabilizer, is an effective agent for treating cancer of the breast, ovary, head and neck, and lung. Because paclitaxel is insoluble in water, it is formulated with the micelle-forming Cremophor EL. Neurologic toxicity is well described with both the drug and this carrier, with most toxicities manifesting as peripheral neuropathy, motor neuropathy, autonomic neuropathy, and myopathy. Toxic effects on the central nervous system, such as seizures or encephalopathy, have been rarely reported; however, the seizures reported were closely related to the time of infusion. We describe a 41-year-old woman with no history of seizures who was treated with paclitaxel for breast cancer. Four days after the drug was infused, she developed a generalized tonic-clonic seizure that could not be attributed to other causes. The patient was treated with phenytoin and was able to complete her adjuvant chemotherapy with nab-paclitaxel without further events. Her condition was neurologically stable without phenytoin for the next 6 months. Use of the Naranjo adverse drug reaction probability scale indicated a possible association (score of 3) between the delayed seizure and paclitaxel or its solvent, Cremophor EL. Clinicians should be aware of the potential for seizure activity in patients who receive paclitaxel formulated with Cremophor EL.
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PMID:Delayed seizure associated with paclitaxel-Cremophor el in a patient with early-stage breast cancer. 1963 53

A 20-year-old military recruit suffered a generalized tonic-clonic seizure following 9 hours of moderate activity in a hot, humid environment. He had drunk at least 5.8 L of plain water before the seizure, and laboratory studies revealed that his serum sodium concentration was 113 mmol/L. Overconsumption of fluids during exercise may precipitate acute hyponatremia, a potentially life-threatening medical condition. Prompt correction of serum sodium in acute exertional hyponatremia is important to reduce the risk of permanent neurologic sequelae or death. Recommendations for prevention include ingesting the correct amount of fluid for the activity (the most important method) and consuming adequate salt through diet or beverage.
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PMID:Seizure after exercise in the heat: recognizing life-threatening hyponatremia. 2008 59

Patient of "psychotic depression" who digested large quantity of water and subsequently developed grand mal seizure and serum sodium levels of less than 121 meq/litre is presented. The physiology of psychogenic polydypsia and related disorders is reviewed. The relation of this disorder to the use of phenothiazines and antidepressants is considered.
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PMID:Water intoxication in depression: a case report. 2192 94

We tested the relation between a single short tonic-clonic seizure elicited by flurothyl vapors and changes of learning in Morris water maze (MWM) in Wistar rats. Oxidative stress usually accompanies seizures. Large melatonin doses were applied immediately before and after seizures to test consequences on learning impairment. One hour of hypobaric hypoxia (8000 m) three days prior to the seizure served as an activator of intrinsic antioxidant systems. Learning in MWM (7 days) started 24 h after seizures. Following seizures, latencies in MWM were longer than in controls and were shortened by hypoxia and preventive melatonin application. Melatonin was also applied before hypoxia to influence free radical (FR) production and intrinsic antioxidant activation. Some behavioral characteristics were changed and preconditioning effect of hypoxia was reduced. Melatonin after seizure (150 s and 6 h) had negligible effect. Results allow us to hypothesize about the role of FR and the beneficial effect of melatonin on the behavioral consequences of seizures.
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PMID:An isolated epileptic seizure elicits learning impairment which could be prevented by melatonin. 2234 63

A 41-year-old white male with a history of alcoholism and depression was brought from prison into the emergency department (ED) after having had a witnessed tonic-clonic seizure lasting approximately 5 min. During the 24 h prior to admission, the patient's cell mate reported that he was restless and had consumed 11 litres of water. The patient had also been taking regular escitalopram for his depression. On arrival to the ED, the patient was found to have a sodium level of 112 mmol/l. After correction of his hyponatraemia the patient developed rhabdomyolisis with a creatine kinase level of 65 064 IU/l. To prevent an acute kidney injury a high volume alkaline diuresis protocol was started. Once corrected, his sodium level remained normal and he was discharged home after making a full neurological recovery. Rhabdomyolysis has rarely been associated with the correction of hyponatraemia.
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PMID:Rhabdomyolysis associated with polydipsia induced hyponatraemia. 2267 67


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