scholarly journals Seizure following the Use of the COX-2 Inhibitor Etoricoxib

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Valentina Arnao ◽  
Marianna Riolo ◽  
Brigida Fierro ◽  
Paolo Aridon
Keyword(s):  
Clinical Presentation ◽  
Clinical Symptoms ◽  
Epileptic Seizures ◽  
Clonic Seizure ◽  
Tonic Clonic Seizure ◽  
Generalized Seizures ◽  
Appropriate Treatment ◽  
History Of ◽  
Cox 2 ◽  
Cox 2 Inhibitors

We describe a case of epileptic seizures occurring after the use of a COX-2 inhibitor. A 61-year-old man was admitted to our department because of a generalized tonic-clonic seizure. EEG showed generalized slowdown of the activity. Neuroimaging and blood samples studies did not evidence alterations, but a careful pharmacological history revealed that the patient had taken the COX-2 inhibitor etoricoxib to treat lumbago few days before the onset of clinical symptoms. No seizures were reported after etoricoxib discontinuation and an EEG resulted to be normal two months after this. Conclusion. Knowing the pharmacological history of a patient is important for understanding the clinical presentation and selecting appropriate treatment. This is, to the best of our knowledge, the first reported case of generalized seizures associated with the use of COX-2 inhibitors.

scholarly journals Modulatory effects of neuropeptides on pentylenetetrazol-induced epileptic seizures and neuroinflammation in rats

2019 ◽  
Vol 65 (9) ◽  
pp. 1188-1192
Author(s):  
Erkan Kilinc ◽  
Handan Gunes
Keyword(s):  
Interleukin 1 ◽  
Plasma Concentrations ◽  
Onset Time ◽  
Epileptic Seizures ◽  
Clonic Seizure ◽  
Tonic Clonic Seizure ◽  
Interleukin 1 Beta ◽  
Calcitonin Gene ◽  
Epilepsy Treatment ◽  
Dual Action

SUMMARY OBJECTIVE We aimed to explore the effects of neuropeptides ghrelin, obestatin, and vasoactive intestinal peptide (VIP) on seizures and plasma concentrations of neuroinflammation biomarkers including calcitonin gene-related peptide (CGRP), substance-P (SP), and interleukin-1 beta (IL-1β) in pentylenetetrazol-induced seizures in rats. METHODS Ghrelin (80 µg/kg), obestatin (1 µg/kg), VIP (25 ng/kg) or saline were administered to rats intraperitoneally 30 min before pentylenetetrazole (PTZ, 50 mg/kg) injections. Stages of epileptic seizures were evaluated by Racine’s scale, and plasma CGRP, SP, and IL-1β concentrations were measured using ELISA. RESULTS Both obestatin and VIP shortened onset-time of generalized tonic-clonic seizure, respectively, moreover VIP also shortened the onset-time of first myoclonic-jerk induced by PTZ. While PTZ increased plasma CGRP, SP and IL-1β concentrations, ghrelin reduced the increases evoked by PTZ. While VIP further increased PTZ-evoked CGRP levels, it diminished IL-1β concentrations. However, obestatin did not change CGRP, SP, and IL-1β concentrations. CONCLUSION Our results suggest that ghrelin acts as an anticonvulsant, obestatin acts as a proconvulsant, and VIP has dual action on epilepsy. Receptors of those neuropeptides may be promising targets for epilepsy treatment.

A clinico-aetiological and ultrasonographic study of Peyronie's disease

Sexual Health ◽  
2006 ◽  
Vol 3 (2) ◽  
pp. 113 ◽  
Author(s):  
Bhushan Kumar ◽  
Tarun Narang ◽  
Somesh Gupta ◽  
Madhu Gulati
Keyword(s):  
Clinical Presentation ◽  
Clinical Symptoms ◽  
Tunica Albuginea ◽  
Connective Tissue Disorder ◽  
Peyronie’S Disease ◽  
Penile Curvature ◽  
Age Group ◽  
History Of ◽  
Peyronie's Disease ◽  
Symptoms And Signs

Background: Peyronie’s disease is a localised connective tissue disorder that involves the tunica albuginea of the penis. Although long recognised as an important clinical entity of the male genitalia, the aetiology of this disease has remained poorly understood. Methods: The epidemiology and clinical presentation of Peyronie’s disease during a 10-year period was evaluated. Results: Forty-two men with Peyronie’s disease from Chandigarh, India were reviewed retrospectively. The prevalence of Peyronie’s patients was 1.97/1000 patients. Their ages ranged from 23 to 70 years. Most of them presented during the early phase of the disease. The most common presenting complaint was penile curvature in 34 (80.95%) followed by pain on erection in 28 (66.66%). History of penile trauma was revealed by four (9.52%) patients. Among the risk factors, hypercholesterolemia (60%), hypertension (33.3%) and asymptomatic hyperuricemia (28.34%) were the most common. Twenty-two patients with Peyronie’s disease were studied by ultrasonography. Ultrasonogram was more accurate than clinical assessment in delineating the extent of lesions. In one-third of the patients, sonography demonstrated the plaques to be more extensive than had been detected by clinical examination. Conclusions: The clinical symptoms and signs in our study were, in general, similar to those found in the previous studies. Higher incidence of hypertension and diabetes in patients with Peyronie’s disease may also be to an extent due to patients being in an older age group.

scholarly journals The Effect of ARHGEF15 Knockout and Forebrain-Specific Human ARHGEF15 Knock-In on Seizure Susceptibility in Mice

2021 ◽  
Author(s):  
Yi-Dan Liu ◽  
Meng-Yu Ma ◽  
Yan-Ling Wang ◽  
Mei-Juan Ding ◽  
Yu Yang ◽  
...  
Keyword(s):  
Brain Tissue ◽  
Total Duration ◽  
Epileptic Seizures ◽  
Clonic Seizure ◽  
Tonic Clonic Seizure ◽  
Nucleotide Exchange ◽  
Adult Mice ◽  
Guanine Nucleotide Exchange ◽  
Nucleotide Exchange Factor ◽  
Significant Difference

Abstract Background The ARHGEF15 gene encodes the Rho guanine nucleotide exchange factor 15. Although multiple evidence indicates that ARHGEF15 may be related to epilepsy, it is not clear what role it plays. Methods Subjects were homozygous ARHGEF15 knockout (E5−/−) mice, wild-type (WT) mice, Cre-positive homozygous human ARHGEF15 conditional knock-in (E5CKI/CKI•Cre+) mice which can overexpress human Ephexin5 in the forebrain, and Cre-positive (E5WT/WT•Cre+) mice. Models with epileptic seizures were established by intraperitoneal injection of pentylenetetrazol (PTZ) in 60 mg/kg, and seizures were recorded by video. Then 7 indexes were counted, including “maximum seizure level”, “seizure level classification”, “tonic-clonic seizure or not”, “latency of tonic-clonic seizure”, “number of times of tonic-clonic seizure”, “total duration of tonic-clonic seizure”, and “dead or not”. Western blot was used to detect Ephexin5, RhoA, p-RhoA, ROCK2, and p-ROCK2 in WT mice and E5−/− mice. Results Compared with WT mice, E5−/− mice had a shorter “total duration of tonic-clonic seizure”. For levels of RhoA, p-RhoA, ROCK2 and p-ROCK2 in the adult hippocampus, there was no significant difference between WT and E5−/−. The level of Ephexin5 was high in the whole brain tissue of 2-day-old WT mice, and an extremely low expression of Ephexin5 was detected in the brain tissue of E5−/− mice of the same age. There was no significant difference between E5CKI/CKI•Cre + mice and E5WT/WT•Cre + mice in seizures. Conclusions ARHGEF15 knockout can decrease the “duration of tonic-clonic seizure” in adult mice with epileptic seizures induced by PTZ. ARHGEF15 knockout did not affect the expression of the RhoA-ROCK2 pathway in the hippocampus of adult mice, which probably attributed to no expression of Ephexin5 in the hippocampus of adult mice. The overexpression of human Ephexin5 in the forebrain has no significant effect on the behavior of epileptic seizures induced by PTZ in adult mice.

scholarly journals Gray matter heterotopia: clinical and neuroimaging report on 22 children

2021 ◽  
Author(s):  
A. Di Nora ◽  
G. Costanza ◽  
F. Pizzo ◽  
C. F. Oliva ◽  
A. Di Mari ◽  
...  
Keyword(s):  
Gray Matter ◽  
Clinical Characteristics ◽  
Epileptic Seizures ◽  
Clonic Seizure ◽  
Clinical Findings ◽  
Magnetic Resonance Images ◽  
Tonic Clonic Seizure ◽  
Subcortical Band Heterotopia ◽  
Periventricular Heterotopia ◽  
Intellectual Deficit

Abstract Objective To investigate the clinical characteristics and neuroimaging features of childhood presenting with gray matter heterotopia observed in a single tertiary Pediatric Department in Catania and compare the data with those reported in the literature. Methods A retrospectively review of the history, clinical findings, electrophysiological features and magnetic resonance images of 22 children presenting with gray matter heterotopia observed from January 2010 to January 2020. Results Among the 22 children included in the study, 17 presented with periventricular heterotopia (PVNH), two with Subcortical Band Heterotopia (SBH), and three with other subcortical heterotopia (SUBH). In the affected children, the ages at first diagnosis ranged from 3 months to 16 years with a mean age of 8.2 years (± 5.4); twelve (54.5%) suffered by developmental delay and intellectual deficit; eleven children (50%) complained of epileptic seizures, mostly focal to bilateral tonic–clonic seizure. In addition, in the periventricular heterotopia group (PVNH), cerebral and systemic malformations were reported in twelve (70%) and in ten (58%) children, respectively, out of seventeen. In the SBH plus SUBH group, epileptic seizures were recorded in 3 (60%) out of 5 children, cerebral malformations in one child and systemic malformations in two children. Conclusions Heterotopic gray matter malformations include a group of disorders that manifest with a variety of neurological implications, such as cognitive impairment and epilepsy, and often related with epilepsy, other cerebral malformations and systemic anomalies.

scholarly journals Generalised tonic–clonic seizures on the subtherapeutic dose of olanzapine

2019 ◽  
Vol 12 (12) ◽  
pp. e230018 ◽  
Author(s):  
Marium Mansoor ◽  
Mohammad Hanif Mesiya ◽  
Aisha Sanober Chachar
Keyword(s):  
Risk Factors ◽  
Old Age ◽  
Dose Range ◽  
Bipolar Affective Disorder ◽  
Clonic Seizure ◽  
Tonic Clonic Seizure ◽  
Multiple Risk Factors ◽  
History Of ◽  
Therapeutic Dose Range ◽  
Clonic Seizures

Olanzapine is a second-generation antipsychotic. Incidence of olanzapine-induced seizures (OIS) is low with monotherapy. Combination therapy with another antipsychotic, drug metabolism and old age are risk factors for OIS. Our patient was a 71-year-old man, admitted to the psychiatry unit. He was managed on the lines of bipolar affective disorder current episode depression and dementia. He was started on olanzapine 1.25 mg two times/day. The patient developed generalised tonic–clonic seizure that lasted for around two and a half minutes within 24 hours of olanzapine treatment. His electroencephalogram showed findings that were suggestive of mild slowing. Our case discusses the incidence of OIS on the subtherapeutic dose. This presentation involves multiple risk factors for OIS: a history of stroke, poststroke seizure, old age and cognitive impairment. Due to scarcity of evidence of OIS; mostly with recommended therapeutic dose range physicians may underestimate seizure risk at subtherapeutic doses.

Cyclical haematological changes in a case of hypopituitarism

2021 ◽  
Vol 14 (8) ◽  
pp. e243421
Author(s):  
Rahul Nema ◽  
Abhinav Sengupta ◽  
Arvind Kumar ◽  
Naveet Wig
Keyword(s):  
Clinical Symptoms ◽  
Clonic Seizure ◽  
Appetite Loss ◽  
Cyclical Fluctuations ◽  
Severe Hyponatraemia ◽  
Secondary Hypothyroidism ◽  
Long Time ◽  
History Of ◽  
Multiple Blood ◽  
Haematological Changes

A 40-year-old woman presented to our emergency department in an altered state following a generalised tonic-clonic seizure. On regaining consciousness, she gave a history of bleeding tendencies and menorrhagia, fatigue, nausea, vomiting and appetite loss for a long time. She had received multiple blood transfusions in the last 10 years. Investigations revealed severe hyponatraemia, transaminitis and pancytopenia, which showed cyclical fluctuations in the hospital. Hyponatraemia was attributed to a central cause owing to secondary hypothyroidism and hypocortisolism on evaluation. A diagnosis of cyclical thrombocytopenia was made by logging the trends of blood cell lines and applying the Lomb-Scargle test. Liver biopsy showed features of transfusion hemosiderosis explaining transaminitis. All of the haematological abnormalities and clinical symptoms resolved on thyroxine and corticosteroid replacement, suggesting causal association hypopituitarism with cyclical thrombocytopenia

When seizures are non-epileptic

2017 ◽  
Vol 41 (S1) ◽  
pp. s499-s499
Author(s):  
J. Nogueira ◽  
R. Taylor
Keyword(s):  
Age Of Onset ◽  
Behavioral Therapy ◽  
Health Anxiety ◽  
Onset Time ◽  
Epileptic Seizures ◽  
Liaison Psychiatry ◽  
Generalized Seizures ◽  
Royal London Hospital ◽  
History Of ◽  
Competing Interest

IntroductionNon-epileptic seizures (NES) are a diverse group of disorders, whose paroxysmal events can be mistaken for epilepsy, although they are caused by a mental or psychogenic process rather than a neurological cause.Objectives/methodsWe present a case of a 45-year-old female patient with history of generalized seizures prior to Meningioma resection in August 2015, referred to the Liaison Psychiatry outpatient follow up clinic at the Royal London Hospital after has gone several times to emergency department complaining about flush and hot sensation that proceeded to corners of mouth turning down, teeth chattering, shaking of left arm and torso at first and then legs. During the episodes, she was awake with no consciousness loss. Her mood was low, with clinical evidence of depression and she had very high levels of health anxiety.DiscussionA diagnosis of non-epileptic attacks was made in the sequence of those episodes. A holistic and multidisciplinary approach was made, including pharmacotherapy, cognitive-behavioral therapy and domiciliary support. The clinical response was good regarding both mood, anxiety levels and NES.ConclusionsApproximately 25% of patients who have a previous diagnosis of epilepsy and are not responding to drug therapy are found to be misdiagnosed and it is common that epileptic patients have both epileptic and non-epileptic seizures. Although distinguishing epileptic and non-epileptic seizures is not easy, there are some clinical clues that the physicians should look for, like age of onset, time of the day that episodes occur and presence or absence of postictal confusion.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals A rare case of varicella zoster virus encephalitis in a 16 years old unvaccinated girl

2021 ◽  
Vol 1 (1) ◽  
pp. 7-11
Author(s):  
Abdul Wali Khan ◽  
Abad Khan ◽  
Muhammad Ishaq ◽  
Irfan Ullah ◽  
Marhami Fahriani
Keyword(s):  
Emergency Department ◽  
Rare Case ◽  
Altered Mental Status ◽  
Clonic Seizure ◽  
Tonic Clonic Seizure ◽  
The Body ◽  
Persistent Fever ◽  
Varicella Zoster ◽  
Appropriate Treatment ◽  
Unvaccinated Girl

We reported a 16-year-old girl, with diffuse vesicular rashes all over the body, presented to the emergency department with altered mental status, irritability, persistent fever and one episode of a generalized tonic-clonic seizure. After thorough evaluation and investigations, the case was a varicella zoster-associated encephalitis in an unvaccinated patient. Appropriate treatment was initiated, the patient was then shifted to the critical care and subsequently discharged with no sequelae. Early diagnosis and treatment should be emphasized as they play an important role in the clinical outcome of chickenpox-associated encephalitis.

scholarly journals Epileptic events in the XIX century as reported by the Brazilian Royal Family

2010 ◽  
Vol 68 (3) ◽  
pp. 472-474
Author(s):  
Marleide da Mota Gomes ◽  
Heber de Souza Maia-Filho
Keyword(s):  
Medical Knowledge ◽  
Family Health ◽  
Epileptic Seizures ◽  
Febrile Convulsion ◽  
Royal Family ◽  
Generalized Seizures ◽  
History Of ◽  
Symptomatic Seizures ◽  
Generalized Epilepsy ◽  
Acute Symptomatic Seizures

Members of the Brazilian Royal Family carry a rich medical history of epileptic seizures and alike. OBJECTIVE: To present the medical knowledge about epilepsy by the time of the Brazilian Empire, as reported by the royal family. METHOD: Narrative review of historical facts about D. Pedro I's family health. RESULTS: The Royal Family, since D. João VI's generation is full of members with epilepsy or acute symptomatic seizures of different etiologies. CONCLUSION: The reported cases suggest that Dom Pedro I's family presented epilepsy with tonic-clonic generalized seizures, besides psychogenic, organic non epileptic events and acute symptomatic seizures. As a whole, this familial epilepsy could fit the diagnosis of generalized epilepsy with febrile convulsion plus.

Psychogenic Non-Epileptic Seizures: A Case Report

2018 ◽  
pp. 1-6
Keyword(s):  
Psychiatric Comorbidity ◽  
Clinical Presentation ◽  
Epileptic Seizures ◽  
Clinical History ◽  
The United States ◽  
Modern Medicine ◽  
Serum Prolactin ◽  
Pharmacological Interventions ◽  
History Of ◽  
Epileptiform Seizures

Psychogenic non-epileptiform seizures (PNES) are a common condition that affects over 400,000 individuals within the United States. PNES are a challenging entity in modern medicine, for they are located at the interface between neurology and psychiatry regarding clinical presentation and pathophysiology. The experiences and symptomatology of the patients resemble those associated with epileptic seizure activity, however many patients present with co-occurring psychiatric comorbidity. A combination of video-electroencephalography and a concise, welldocumented clinical history of the event helps in a definitive clinical diagnosis of PNES. Measuring the levels of serum prolactin may prove useful as an adjunctive laboratory test in diagnosing PNES. Management of PNES involves prompt patient education regarding the condition and treating the psychiatric comorbidity as well. A combined approach of both psychotherapeutic and pharmacological interventions helps in the optimal treatment of PNES.

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