We experienced a rare clinical manifestation of a digoxin induced catatonic stupor without other features of digoxin toxicity. This case suggests that the neurological manifestation of digoxin toxicity can occur without the usual side effects. Also, a serum digoxin level should be checked in any elderly patient presenting with abnormal cerebral func-tions, irrespective of whether or not the dose of digoxin has been changed. (J Korean Neurol Assoc 19(4):438~439, 2001)
Aged ; Digoxin ; Humans ; Neurologic Manifestations ; Stupor*

Acute encephalopathy with thalamotegmental involvement is characterized by the rapid evolution of stupor and coma, associated with generalized seizures and decorticate or decerebrate rigidity without focal neurologic or meningeal irritation signs. The magnetic resonance findings in a 6-year-old patient with neurologic abnormalities demonstrate bilateral symmetrical high signal intensity lesions involving both the thalami and the tectum in axial T2-weighted image. We report a case of acute encephalopathy with thalamotegmental involvement.
Child ; Coma ; Decerebrate State ; Humans ; Seizures ; Stupor

Cefepime is a widely used beta-lactam antibiotic. We first report two cases of cefepime-induced reversible encephalpathy in Korea. Two patients with renal impairment presented stupor while being treated with cefepime for pneumonia, one of whom also developed myoclonus and asterixis. Their electroencephalogram showed triphasic waves despite of normal liver function. After discontinuation of cefepime, they completely recovered with normalization of electroencephalogram. Early recognition of cefepime-induced encephalopathy and immediate withdrawal of cefepime would be important for the prognosis of the patients.
Cephalosporins ; Dyskinesias ; Electroencephalography ; Humans ; Korea ; Liver ; Myoclonus ; Pneumonia ; Prognosis ; Stupor

We studied the contents of referral sheets of the patients transferred to DMC Emergency Center from Jan 1, 1999 to Jan 31, 1999. The study far the completion and chief complaints in the referral sheets shows the followings. 1. Examining the referral sheets status of disease, name and age record of 5 major items grade 0.92, the highest point, examining item and laboratorial record grade 0.72, dignosis record grades 0.38, and patients condition and diagnosis opinion record grade 0.10. 2, Name and age item had high completion score in referral sheets from local clinic and hospital for secondary referral level. For address item, however, local clinic scored 0.63 and hospital for secondary referral level scored 0.28, which showed statistically significant difference(P<0.001). 3. In the aspect of severity, name and age record leveled 0.94 to the non emergency patient, 0.92 to the emergency patient, 0.91 urgent patient, showed and no statistic significant difference. 4. The major 10 symptoms of the complaints were these the pain of abdomen and pelvis(25.2%), somnolence and stupor, coma(13.6%), headache(10.9%), and open wound of head(4.0%), ranked 10th common symptom level.
Abdomen ; Diagnosis ; Emergencies ; Humans ; Referral and Consultation* ; Stupor ; Wounds and Injuries

Targeted therapy has been proven to be one of the most effective cancer treatments. However, some endocrine disorders can occur during treatment with targeted agents. We report the case of a patient who exhibited a wax and wane pattern of hypoglycemia that was attributed to sorafenib therapy. A 32-year-old woman with metastatic hemangiopericytoma visited the emergency department in a stuporous state. Nonhyperinsulinemic hypoglycemia was diagnosed, was exacerbated shortly after sorafenib therapy, and was improved by the cessation of sorafenib with additional glucocorticoid therapy. Patients with metastatic hemangiopericytoma should be carefully monitored with particular attention to hypoglycemia when sorafenib therapy is initiated.
Adult ; Emergency Service, Hospital ; Female ; Hemangiopericytoma* ; Humans ; Hypoglycemia* ; Stupor

Lethal catatonia is a life-threatening febrile neuropsychiatric syndrome, mainly consist of bizzare behavior, mounting fever, extreme hyperactivity, stuporous exhaustion and evenlual death. Although the entity has been reported in the literaure for over 160 years, the rarity of the illness makes prompt recognition being very difficult tasks, particularly in young children. We experienced a typical case of lethal catatonia in 7-year-old boy who previously had no organic illness. Electroconvulsive therapy (ECT) was the most successful mode of treatment among many therapies attempted. We feel that this could be the youngest case in the literature of lethal catatonia.
Catatonia* ; Child* ; Electroconvulsive Therapy ; Fever ; Humans ; Male ; Stupor

A 29-year-old man with schizophrenia was admitted to the emergency department in a stupor following the first generalized tonicclonic seizure. He had drunk about 1.5 L of Coke and 2 L of water each day for 1 week without eating any other food. A laboratory evaluation revealed severe hyponatremia (110 mEq/L), and we diagnosed a hyponatremia-induced seizure. As polydipsia and hyponatremia are not uncommon in schizophrenics, hyponatremia-induced seizure should be included in the causes of seizure in schizophrenics.
Adult ; Coke ; Eating ; Emergency Service, Hospital ; Humans ; Hyponatremia ; Polydipsia* ; Schizophrenia ; Seizures* ; Stupor ; Water

Dysphagia is common and serious problem in intracerebral hemorrhage patients. Nasogastric-tube intubation is an important method for dysphagic patients who have an intracerebral hemorrhage. But many discomforts develope in patients with a nasogastric-tube. Therefore, it is necessary to decide when to remove the tube and as early as possible. The purpose of this study is to decide the applying time of training program to facilitate deglution for dysphagic patients who have intracerebral hemorrhage. Among the 343 patients with intracerebral hemorrhage who had been admitted to P-university hospital from April, 1994 to December, 1998, the medical record of the 110 patients with nasogastric tube were reviewed retrospectively. Results from the study were as follows: 1. Nasogastric tube insert duration of improved patients was a mean of 23.2 days 2. When a L-tube was inserted and removed, the L.O.C. of improved patients was 2.6+/-0.8(in the midst of stupor or a semicoma), 1.9+/-0.5(close to drowsy), respectively. This was signifcantly different(P=0.000). 3. When a L-tube was inserted and removed, GCS of improved patients was 9.3+/-2.9, 12.1+/-2.2 respectively. This was significantly different (P=0.000). 4. The duration of nasogastric tube insertion was the longest when in a stupor(L.O.C), 6~8 points(GCS).
Cerebral Hemorrhage* ; Deglutition Disorders ; Education* ; Humans ; Intubation ; Medical Records ; Retrospective Studies ; Stupor

We have experienced 109 cases of hypertensive intracerebral hemorrhage admitted to the Department of Neurosurgery of Catholic Medical Center from January 1973 to August 1976. We analized the result of treatment of hypertensive intracerebral hemorrhage and assessed prognostic factors affecting the results of surgical treatment of hypertensive intracerebral hemorrhage. 1. The age of the patients did not significantly influence on the mortality of operative or non-operative cases provided the age is below sixty. 2. The amount of hematoma did not directly related to the outcome of operated cases if the hematoma is less than 50ml, while the mortality was considerably increased if the clot was more than 50ml. 3. There was no specific difference in operative mortality between total evacuation and partial evacuation of hematoma in surgery of the hypertensive intracerebral hemorrhage, but total evacuation had better result than that of partial evacuation in the functional recovery. 4. The operative mortality of the hypertensive intracerebral hemorrhage was 43.6% and 55.7% in non-operative cases. Thalamic hemorrhage carried the highest mortality either operated or conservatively treated. 5. The surgical treatment carried better result than non-operative treatment in the case showing progressive change in consciousness following intracerebral hemorrhage. Conservative treatment obtained good result in the cases showed progressive improvement of conscious level following intracerebral hemorrhage. 6. The interval from the ictus to surgical intervention did not constantly influence on the result of surgery and it might be wise to decide the time of surgical intervention according to the progressive changes in conscious level and neurological status after bleeding. 7. The operative result was favorable in the patients who has shown progressive worsening of conscious level and neurologic status following clear conscious at hemorrhage (class II). We also noted that the patients were unconscious at ictus then became progressively stupor with increasing neurologic deficit showed better result with surgical treatment than non-operative care.
Cerebral Hemorrhage ; Consciousness ; Hematoma ; Hemorrhage ; Humans ; Intracranial Hemorrhage, Hypertensive* ; Mortality ; Neurologic Manifestations ; Neurosurgery ; Stupor

Myoclonic-astatic epilepsy is an epileptic syndrome characterized bv the presence of myoclonic and astatic seizures. It is a rare generalized epilepsy of childhood and represents 1 to 2% of epilepsis in children up to the age of 9 years. In addition to myoclonic and astatic seizures, generalized tonic-clonic seizure, tonic seizure and absence status (non-convulsive status) can be combined. Non-convulsive status can produce apathetic and stuporous appearance. We represent 4-year-old boy who showed nonconvulsive status of myoclonic-astatic epilepsy with typical clinical and eleckoencephalographic characteristics.
Child ; Child, Preschool ; Epilepsy* ; Epilepsy, Generalized ; Humans ; Male ; Seizures ; Status Epilepticus ; Stupor