2.Myoclonic seizures in a preterm baby: is this a presentation of venlafaxine withdrawal?
Althaf ANSARY ; Samuel IBHANESEBHOR ; Chikkanayakanahalli MANJUNATHA
Singapore medical journal 2014;55(4):e57-9
Venlafaxine, a serotonin and norepinephrine reuptake inhibitor, is increasingly used in pregnant women with pre-existing depression who require continued treatment. However, its in uteroeffects on the developing fetus are not clear. Herein, we report the unusual presentation of venlafaxine withdrawal in a female preterm baby of 29 weeks gestation, who presented with myoclonic seizures on her second day of life. The seizures were confirmed using amplitude-integrated electroencephalography, and other possible causes of neonatal seizures were excluded. The baby responded to treatment with phenobarbitone and phenytoin. Magnetic resonance imaging of her brain was unremarkable at corrected gestational age of 39 weeks and 2 days. On follow-up at the corrected age of five months, she was well and developing normally with no further seizures. To the best of our knowledge, this is the first report of seizures in a preterm baby resulting from maternal venlafaxine use.
Antidepressive Agents
;
adverse effects
;
Cyclohexanols
;
adverse effects
;
Electroencephalography
;
Female
;
Humans
;
Infant, Newborn
;
Infant, Premature
;
Magnetic Resonance Imaging
;
Maternal Exposure
;
adverse effects
;
Phenobarbital
;
administration & dosage
;
Phenytoin
;
administration & dosage
;
Pregnancy
;
Seizures
;
chemically induced
;
Serotonin Uptake Inhibitors
;
adverse effects
;
Venlafaxine Hydrochloride
3.Effect of low intensity and very high frequency electromagnetic radiation on occupationally exposed personnel.
Zheng-Quan YUAN ; Feng LI ; Deng-Gao WANG ; Yong WANG ; Ping ZHANG
Chinese Journal of Industrial Hygiene and Occupational Diseases 2004;22(4):267-269
OBJECTIVETo investigate the effect of low intensity and very high frequency (VHF) electromagnetic radiation (170 MHz) on nervous system function and serum enzymes and immune function in human subjects with occupational exposure to VHF.
METHODSTo measure the intensity of VHF and other environmental factors on the spot, to hold the questionnaire about chief complaints, to examine the rheoencephalography and the neurobehavior function, to analyze ALT, AST, ALP and LDH, and IgA, IgM and IgG in experimental group and control group.
RESULTSThe intensity of VHF (direction of antenna: 0 degrees, 10 m and 135 degrees, 20 m) was higher than that of national standard on-the-spot. The incidences of symptoms such as headache, insomnia and amnesia etc. was significantly higher in experimental group (P < 0.01). Rheoencephalography indicated that the raising time of both left [(0.155 3 +/- 0.057 9) s] and right [(0.154 1 +/- 0.059 2) s] in the experimental group after exposure were significantly longer than before exposure [(0.104 4 +/- 0.030 2) s, (0.103 2 +/- 0.030 4) s respectively] or in the control [(0.118 5 +/- 0.056 8) s, (0.117 7 +/- 0.057 5) s respectively, (P < 0.01)]. Neurobehavior function test showed that digital symbol, digital span and pursuit aiming test were decreased after exposure in the experimental group (P < 0.01). Serum enzyme analysis showed that AST, ALP and LDH were significantly increased after exposure in the experimental group (P < 0.01). No marked change was found in IgA level, while the levels of IgM and IgG after exposure in the experimental group especially the latter were significantly increased (P < 0.01).
CONCLUSIONSLow-intensity VHF radiation can decrease the nervous system function in occupationally exposed personnel and induce increase in some kinds of enzymes and immunoglobulins.
Adolescent ; Adult ; Electroencephalography ; radiation effects ; Electromagnetic Fields ; adverse effects ; Higher Nervous Activity ; drug effects ; Humans ; Immunoglobulin G ; blood ; radiation effects ; Immunoglobulin M ; blood ; radiation effects ; Male ; Occupational Exposure ; Radiation Dosage ; Radio Waves ; adverse effects ; T-Lymphocyte Subsets ; immunology ; radiation effects
4.Valproic acid versus lamotrigine as a monotherapy for absence epilepsy in children.
Tie-Shuan HUANG ; Jin-Lan ZHU ; Bing LI ; Yan HU ; Li CHEN ; Jian-Xiang LIAO
Chinese Journal of Contemporary Pediatrics 2009;11(8):653-655
OBJECTIVETo compare the efficacy of valproic acid (VPA) and lamotrigine as a monotherapy for absence epilepsy in children.
METHODSA randomized, open-label design was used. Childhood absence epilepsy was diagnosed based on the presence of typical seizures and video-EEG findings. Eligible patients were randomly treated with VPA or lamotrigine. All patients were followed up for 12 months.
RESULTSForty-five out of 48 eligible children completed the study. There were 23 children in the VPA group and 22 children in the lamotrigine group. Seventeen children were seizure-free in the VPA group 12 months after treatment. Fifteen out of the 17 children showed normal EEG (no epileptic-formed discharge). Twelve children were seizure-free in the lamotrigine group 12 months after treatment. The proportion showing normal EEG in the lamotrigine group (6/22, 27.3%) was significantly lower than that in the VPA group (15/23, 65.2%) (P<0.05). Severe adverse effects were not found in both groups.
CONCLUSIONSBoth VPA and lamotrigine are safe and efficacious for treatment of absence seizures in children. VPA appears to be better than lamotrigine in tapering epileptic-formed discharge.
Anticonvulsants ; therapeutic use ; Child ; Child, Preschool ; Electroencephalography ; Epilepsy, Absence ; drug therapy ; physiopathology ; Female ; Humans ; Male ; Triazines ; adverse effects ; therapeutic use ; Valproic Acid ; adverse effects ; therapeutic use
5.Therapeutic effect of ketogenic diet for refractory epilepsy in children: a prospective observational study.
Deng-Na ZHU ; Meng-Meng XIE ; Jun-Hui WANG ; Jun WANG ; De-You MA ; Li SUN ; Lin-Chen LI ; Ming-Mei WANG
Chinese Journal of Contemporary Pediatrics 2014;16(5):513-517
OBJECTIVETo study the clinical efficiency, electroencephalogram (EEG) changes and cognitive improvements of ketogenic diet (KD) in children with refractory epilepsy.
METHODSTwenty pediatric patients (7-61 months in age) with refractory epilepsy were recruited between August 2012 and August 2013. KD therapy was performed on all participants for at least 3 months based on a fasting initiation protocol with the lipid-to-nonlipid ratio being gradually increased to 4 : 1. Seizure frequency, type and degree were recorded before and during KD therapy. A 24 hours video-electroencephalogram (V-EEG) examination and Gesell Developmental Scale assessment were performed prior to KD therapy, and 3, 6, 9 months after KD therapy.
RESULTSSix patients became seizure free after KD therapy, with a complete control rate of 30%. Seizure frequency reduction occurred in 13 (65%) patients, EEG improvement in 8 (40%) patients, and improvement in Gesell Developmental Scales (gross motor and adaptability in particular) in 6 (30%) patients. The KD therapy-related side effects were mild.
CONCLUSIONSKD therapy is safety and effective in reducing seizure frequency and improving EEG and cognitive function in children with refractory epilepsy.
Child, Preschool ; Diet, Ketogenic ; adverse effects ; Electroencephalography ; Epilepsy ; diet therapy ; physiopathology ; Female ; Humans ; Infant ; Male ; Prospective Studies ; Recurrence
6.Factors influencing the efficacy of initial adrenocorticotropic hormone therapy for infantile epileptic spasms syndrome.
Xi HUANG ; Jing PENG ; Zou PAN ; Pan PENG ; Fang HE ; Ci-Liu ZHANG ; Chen CHEN ; Fang-Yun LIU ; Fei YIN ; Lei-Lei MAO
Chinese Journal of Contemporary Pediatrics 2023;25(1):60-66
OBJECTIVES:
To study the factors influencing the short-term (28 days) efficacy of initial adrenocorticotropic hormone (ACTH) therapy for infantile epileptic spasms syndrome (IESS), as well as the factors influencing recurrence and prognosis.
METHODS:
The clinical data were collected from the children with IESS who received ACTH therapy for the first time in the Department of Pediatric Neurology, Xiangya Hospital of Central South University, from April 2008 to January 2018 and were followed up for ≥2 years. The multivariate logistic regression analysis was used to evaluate the factors influencing the short-term efficacy of ACTH therapy, recurrence, and long-term prognosis.
RESULTS:
ACTH therapy achieved a control rate of seizures of 55.5% (111/200) on day 28 of treatment. Of the 111 children, 75 (67.6%) had no recurrence of seizures within 12 months of follow-up. The possibility of seizure control on day 28 of ACTH therapy in the children without focal seizures was 2.463 times that in those with focal seizures (P<0.05). The possibility of seizure control on day 28 of ACTH therapy in the children without hypsarrhythmia on electroencephalography on day 14 of ACTH therapy was 2.415 times that in those with hypsarrhythmia (P<0.05). The possibility of recurrence within 12 months after treatment was increased by 11.8% for every 1-month increase in the course of the disease (P<0.05). The possibility of moderate or severe developmental retardation or death in the children without seizure control after 28 days of ACTH therapy was 8.314 times that in those with seizure control (P<0.05). The possibility of moderate or severe developmental retardation or death in the children with structural etiology was 14.448 times that in those with unknown etiology (P<0.05).
CONCLUSIONS
Presence or absence of focal seizures and whether hypsarrhythmia disappears after 14 days of treatment can be used as predictors for the short-term efficacy of ACTH therapy, while the course of disease before treatment can be used as the predictor for recurrence after seizure control by ACTH therapy. The prognosis of IESS children is associated with etiology, and early control of seizures after ACTH therapy can improve long-term prognosis.
Child
;
Humans
;
Infant
;
Adrenocorticotropic Hormone/therapeutic use*
;
Spasms, Infantile/drug therapy*
;
Treatment Outcome
;
Seizures
;
Electroencephalography/adverse effects*
;
Spasm/drug therapy*
7.Cefepime-induced encephalopathy with triphasic waves in three Asian patients.
Deidre Anne De SILVA ; Andrew B S PAN ; Shih-Hui LIM
Annals of the Academy of Medicine, Singapore 2007;36(6):450-451
Aged
;
Anti-Bacterial Agents
;
adverse effects
;
therapeutic use
;
Asian Continental Ancestry Group
;
Cephalosporins
;
adverse effects
;
therapeutic use
;
Electroencephalography
;
Female
;
Humans
;
Kidney Failure, Chronic
;
Liver Cirrhosis
;
Male
;
Middle Aged
;
Neurotoxicity Syndromes
;
diagnosis
;
etiology
;
Singapore
8.A Case of Life-Threatening Acute Kidney Injury with Toxic Encephalopathy Caused by Dioscorea quinqueloba.
Kyung Sik KANG ; Sang Taek HEO
Yonsei Medical Journal 2015;56(1):304-306
Some herbal medications induce acute kidney injury. The acute kidney injuries caused by herbal medications are mild and commonly treated by palliative care. A 51-years-old man who drank the juice squeezed from the raw tubers of Dioscorea quinqueloba (D. quinqueloba) was admitted with nausea, vomiting and chilling. He developed a seizure with decreased level of consciousness. He was diagnosed with acute kidney injury, which was cured by continuous venovenous hemodialfiltration. Non-detoxified D. quinqueloba can cause severe acute kidney injury with toxic encephalopathy. It is critical to inform possible adverse effects of the medicinal herbs and to implement more strict regulation of these products.
Acute Kidney Injury/*chemically induced/*complications
;
Dioscorea/*adverse effects
;
Disease Progression
;
Electroencephalography
;
Humans
;
Length of Stay
;
Male
;
Middle Aged
;
Neurotoxicity Syndromes/*complications
9.Sleep disturbance induced by cocaine abstinence involving in A2A receptor over-expression in rat hypothalamus.
Fenfang HONG ; Xiaojun LIU ; Changsheng HE ; Shulong YANG
Journal of Biomedical Engineering 2012;29(6):1068-1072
Adult rats were implanted with sleep-wake recording electrodes in our experiments. Polygraphic signs of undisturbed sleep-wake activities were recorded for 24 h before cocaine administration, cocaine withdrawal day 1 (acute), day 8 (subacute), and day 14 (subchronic). Western blot method was performed to examine the expression levels of adenosine receptor subtypes in hypothalamus and cerebellum. Non rapid eye movement (NREM) sleep was significantly increased during nighttime (P < 0.01) and daytime (P < 0.05) on withdrawal day 8. The increase of NREM sleep was significant during nighttime (P < 0.01) and slight during daytime on withdrawal day 14, whereas both daytime and nighttime rapid eye movement (REM) sleeps were reduced markedly (P < 0.01) on withdrawal day 8 and 14. In addition, A2A receptor level was significantly enhanced on cocaine withdrawal day 8 and day 14 (P < 0.05), whereas A1 receptor level reduced markedly on withdrawal day 14 (P < 0.05). However, compared with that in the control group, no significant changes existed among adenosine A1, A2A and A2B receptors in rat cerebellum on cocaine withdrawal day 1, day 8 and day 14. Our findings suggest that sleep disorder caused by subacute and subchronic cocaine abstinence may be associated with over-expression of adenosine A2A receptor in rat hypothalamus to some extent.
Animals
;
Cocaine
;
adverse effects
;
Dyssomnias
;
chemically induced
;
Electroencephalography
;
Hypothalamus
;
metabolism
;
Male
;
Rats
;
Rats, Sprague-Dawley
;
Receptor, Adenosine A2A
;
metabolism
;
Substance Withdrawal Syndrome
10.Treatment of depression using sleep electroencephalogram modulated repetitive transcranial magnetic stimulation.
Ming-Li HE ; Zheng-Tian GU ; Xin-Yi WANG ; Heng-Ping SHI
Chinese Medical Journal 2011;124(12):1779-1783
BACKGROUNDAs a treatment of depression, the efficacy of conventional repetitive transcranial magnetic stimulation (rTMS) is limited, and symptoms recurrence is easy to occur after the treatment. This study aimed to examine the efficacy and safety of sleep electroencephalogram modulated repetitive rTMS (SEM-rTMS) in the treatment of depression.
METHODSAfter 7 days without psychoactive medication, 164 patients with clinically defined depression were randomly divided into 3 groups: SEM-rTMS group (n = 57), conventional rTMS (C-rTMS, n = 55) group and sham-rTMS group (n = 52). Every patient was treated with the corresponding method for 30 minutes everyday for 10 days. Before and after scores on the 24-item Hamilton rating scale for depression (HAMD-24) and the clinical outcome on the 10th day of therapy for all subjects were analyzed.
RESULTSTwenty-two cases in the SEM-rTMS group obtained improved mood as compared to 6 in the C-rTMS group and 2 in the sham-rTMS group (χ(2) = 15.89, P = 0.0004). After completion of the rTMS phase of the protocol, a (51 ± 5)% reduction of HAMD-24 scores from the baseline in the SEM-rTMS group was found compared with a (34 ± 4)% in the C-rTMS group (q = 26.09, P = 0.001) and a (14 ± 3)% in sham-rTMS group (q = 57.53, P = 0.000). The 88% total effective rate in the SEM-rTMS group was significantly higher than 68% in the C-rTMS group and 20% in the sham-rTMS group (χ(2) = 12.01, P = 0.0025). No significant side effects were noted.
CONCLUSIONSEM-rTMS is an effective and safe way for treating depression with repetitive transcranial magnetic stimulation (ChiCTR-TRC-00000438).
Adolescent ; Adult ; Aged ; Child ; Depressive Disorder ; psychology ; therapy ; Electroencephalography ; Emotions ; Female ; Humans ; Male ; Middle Aged ; Sleep ; physiology ; Transcranial Magnetic Stimulation ; adverse effects