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
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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
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Humans
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Infant
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Adrenocorticotropic Hormone/therapeutic use*
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Spasms, Infantile/drug therapy*
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Treatment Outcome
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Seizures
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Electroencephalography/adverse effects*
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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
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Anti-Bacterial Agents
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adverse effects
;
therapeutic use
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Asian Continental Ancestry Group
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Cephalosporins
;
adverse effects
;
therapeutic use
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Electroencephalography
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Female
;
Humans
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Kidney Failure, Chronic
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Liver Cirrhosis
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Male
;
Middle Aged
;
Neurotoxicity Syndromes
;
diagnosis
;
etiology
;
Singapore
8.The antiepileptic role of 3α-androstanediol on the epileptic rats induced by pentylenetetrazole.
Yu-Hao ZHANG ; Yin-Xiang CAO ; Yu MA ; Xi GUO ; Xin WANG
Acta Physiologica Sinica 2012;64(6):633-638
The influence of 3α-androstanediol (3α-diol) on twitch and electroencephalogram (EEG) of the epileptic rats induced by pentylenetetrazole (PTZ) has been observed in this experiment in order to comprehensively explore the role of 3α-diol on epileptic attack from the aspects of behavior and EEG. Thirty-two male Sprague-Dawley rats were evenly and randomly divided into 4 groups: the normal and supplied with oil epileptic (N+oil+PTZ) group, the normal and supplied with 3α-diol epileptic (N+3α-diol+PTZ) group, the gonadectomized and supplied with oil epileptic (GDX+oil+PTZ) group and the gonadectomized and supplied with 3α-diol epileptic (GDX+3α-diol+PTZ) group. The changes of the behavior and EEG of epileptic rats in every group were recorded and analyzed. The results of behavior observation showed that the latency to clonic seizure and tonic-clonic seizure was shortened and the number of tonic-clonic seizure was increased significantly in the GDX+oil+PTZ group in comparison with N+oil+PTZ group (P < 0.05); comparing GDX+3α-diol+PTZ group with GDX+oil+PTZ group, or N+3α-diol+PTZ group with N+oil+PTZ group, we found that the latency to clonic seizure and tonic-clonic seizure became prolonged significantly, and the number of clonic seizure and tonic-clonic seizure was decreased significantly (P < 0.05). The results of EEG showed that the latency to epileptic waves was cut and the number of epileptic waves was augmented significantly in the GDX+oil+PTZ group in comparison with N+oil+PTZ group (P < 0.05); comparing GDX+3α-diol+PTZ group with GDX+oil+PTZ group, or N+3α-diol+PTZ group with N+oil+PTZ group, we found that the latency to epileptic waves became lengthened significantly, the number of epileptic waves was reduced significantly and the percentage of change of TP (total power of spectrum) was lessened significantly (P < 0.05). These results indicate that 3α-diol has an antiepileptic activity in the gonadectomized and normal epileptic rats.
Androstane-3,17-diol
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analogs & derivatives
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pharmacology
;
Animals
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Anticonvulsants
;
pharmacology
;
Electroencephalography
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Epilepsy
;
chemically induced
;
drug therapy
;
Male
;
Pentylenetetrazole
;
adverse effects
;
Rats
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Rats, Sprague-Dawley
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Seizures
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chemically induced
;
drug therapy
9.Clinical effect of atomoxetine hydrochloride in 66 children with narcolepsy.
Shen ZHANG ; Changhong DING ; Email: DINGCHANGHONG@MEDMAIL.COM.CN. ; Husheng WU ; Fang FANG ; Xiaohui WANG ; Xiaotun REN
Chinese Journal of Pediatrics 2015;53(10):760-764
OBJECTIVETo observe the efficacy and safety of atomoxetine hydrochloride in children with narcolepsy.
METHODTotally 66 patients with narcolepsy who were conformed international classification of sleep disturbances (ICSD-2) diagnostic criteria treated with atomoxetine hydrochloride seen from November 2010 to December 2014 were enrolled into this study, 42 of them were male and 24 female, mean age of onset was 7.5 years (3.75-13.00 years), mean duration before diagnosis was 1.75 years (0.25-5.00 years). Complete blood count, liver and kidney function, multiple sleep latency test (MSLT), polysomnography (PGS), neuroimaging and electroencephalography (EEG) were performed for each patient. For some of the children HLA-DR2 gene and serum markers of infection were tested. The 66 cases were followed up from 2 to 49 months (average 18 months) to observe the clinical efficacy and adverse reactions.
RESULTSIn 62 cases excessive daytime sleepiness was improved, in 11 cases (16.7%) it was controlled (16.7%), in 29 cases (43.9%) the treatment was obviously effective and in 22 (33.3%) it was effective; cataplexy occurred in 54 cases, in 18 (33.3%) it was controlled, in 19 (35.2%) the treatment was obviously effective and in 10 (18.5%) effective; night sleep disorders existed in 55 cases, in 47 cases it was improved, in 14 (25.5%) it was controlled, in 20 (36.4%) the treatment was obviously effective and in 13 (23.6%) effective; hypnagogic or hypnopompic hallucination was present in 13 cases, in only 4 these symptoms were controlled. Sleep paralysis existed in 4 cases, it was controlled in only 1 case. In 18 cases attention and learning efficiency improved.Anorexia occurred in 18 cases, mood disorder in 5 cases, depression in 2 cases, nocturia, muscle tremors, involuntary tongue movement each occurred in 1 case. P-R interval prolongation and atrial premature contraction were found in 1 case.
CONCLUSIONAtomoxetine hydrochloride showed good effects in patients with narcolepsy on excessive daytime sleepiness, cataplexy and night sleep disorders, the effects on hallucinations and sleep paralysis were not significant. Adverse reactions were slight, anorexia and mood disorder were common. As a non-central nervous system stimulant, atomoxetine hydrochloride does not induce drug dependence and has no prescription limits; it has good tolerability, safety and effectiveness, it can be a good alternative in treatment of children with narcolepsy.
Adolescent ; Atomoxetine Hydrochloride ; adverse effects ; therapeutic use ; Cataplexy ; drug therapy ; Child ; Child, Preschool ; Electroencephalography ; Female ; Humans ; Male ; Narcolepsy ; drug therapy ; Neuroimaging ; Polysomnography
10.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
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Cocaine
;
adverse effects
;
Dyssomnias
;
chemically induced
;
Electroencephalography
;
Hypothalamus
;
metabolism
;
Male
;
Rats
;
Rats, Sprague-Dawley
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Receptor, Adenosine A2A
;
metabolism
;
Substance Withdrawal Syndrome