Anaesthesia for neurosurgery and electroconvulsive therapy

2017 ◽  
Author(s):  
Markus Klimek ◽  
Francisco A. Lobo ◽  
Luzius A. Steiner ◽  
Cor J. Kalkman
Keyword(s):  
Electroconvulsive Therapy ◽  
Patient Positioning ◽  
Neurophysiological Monitoring ◽  
Optimal Conditions ◽  
Increased Intracranial Pressure ◽  
Neuronal Tissue ◽  
Local Bleeding ◽  
Anaesthetic Depth ◽  
Blood Pressures ◽  
The Brain

Neuroanaesthesia is the subspecialty of anaesthesiology that deals with patients undergoing surgical procedures in or close to the brain and the spinal cord. Neuroanaesthesia can be challenging, because sometimes apparently contradictory demands must be managed, for example, achieving optimal conditions for neurophysiological monitoring while maintaining sufficient anaesthetic depth, or maintaining oxygen delivery to neuronal tissue and simultaneously preventing high blood pressures that might induce local bleeding. Atypical patient positioning, management of increased intracranial pressure, and the need for early postoperative neurological evaluation are other typical challenges. This chapter addresses the general principles of neuroanaesthesia and special aspects of the most relevant procedures. A section on anaesthesia for electroconvulsive therapy is also included.

ELECTROCONVULSIVE THERAPY AND THE BRAIN: EVIDENCE FOR INCREASED DOPAMINE-MEDIATED RESPONSES

The Lancet ◽  
1982 ◽  
Vol 320 (8295) ◽  
pp. 400-404 ◽  
Author(s):  
D.W. Costain ◽  
M.G. Gelder ◽  
P.J. Cowen ◽  
D.G. Grahame-Smith
Keyword(s):  
Electroconvulsive Therapy ◽  
The Brain

scholarly journals SURVIVAL OF POLIOMYELITIC VIRUS IN THE BRAIN OF THE RABBIT

1918 ◽  
Vol 27 (3) ◽  
pp. 443-447 ◽  
Author(s):  
Harold L. Amoss
Keyword(s):  
Intracranial Pressure ◽  
Pressure Effects ◽  
Rabbit Brain ◽  
High Dilution ◽  
Increased Intracranial Pressure ◽  
Intracerebral Inoculation ◽  
Pathological Lesions ◽  
Active Virus ◽  
The Brain

Suspensions of the central nervous tissues of monkeys, containing the active filterable virus of poliomyelitis, may be injected into the brain of rabbits without setting up symptoms, provided the volume of injection does not cause dangerous increased intracranial pressure. Aside from the pressure effects which develop quickly, no other symptoms or pathological lesions are produced by the suspensions. The active virus of poliomyelitis survives in the brain of rabbits for 4 days, as determined by tests in the monkey, into which the excised site of injection in the rabbit brain is reinoculated. It cannot be detected by this test after the expiration of 7 days. The virus of poliomyelitis is unadapted to the rabbit, and neither induces lesions nor survives long in the central nervous organs of that animal. In this respect it differs from certain streptococci cultivated from poliomyelitic tissues. A monkey immunized to streptococcus cultivated from human poliomyelitic nervous tissues yielded a serum which agglutinated the streptococcus in high dilution, but was without neutralizing action on the filtered virus; and the streptococcus-immune monkey was not protected against the effects of an intracerebral inoculation of the filtered virus. The experiments recorded provide additional reasons for concluding that the streptococcus cultivated from cases of poliomyelitis differs essentially from the filterable virus and is not the microbic cause of epidemic poliomyelitis.

scholarly journals Catatonia Associated With Late Paraphrenia Successfully Treated With Lithium: A Case Report

2020 ◽  
Author(s):  
Hiroko Sugawara ◽  
Junpei Takamatsu ◽  
Mamoru Hashimoto ◽  
Manabu Ikeda
Keyword(s):  
Case Report ◽  
Mood Disorders ◽  
Electroconvulsive Therapy ◽  
Late Onset ◽  
Treatment Strategies ◽  
Psychotic Symptoms ◽  
Case Presentation ◽  
Limited Efficacy ◽  
Cumulative Evidence ◽  
The Brain

Abstract Background: Catatonia is a psychomotor syndrome that presents various symptoms ranging from stupor to agitation, with prominent disturbances of volition. Its pathogenesis is poorly understood. Benzodiazepines and electroconvulsive therapy (ECT) are safe and effective standard treatments for catatonia; however, alternative treatment strategies have not been established in cases where these treatments are either ineffective or unavailable. Here, we report a case of catatonia associated with late paraphrenia classified as very-late-onset schizophrenia-like psychosis, which was successfully treated with lithium. Case presentation: A 66-year-old single man with hearing impairment developed hallucination and delusions and presented with catatonic stupor after a fall. He initially responded to benzodiazepine therapy; however, his psychotic symptoms became clinically evident and benzodiazepine provided limited efficacy. Blonanserin was ineffective, and ECT was unavailable. His catatonic and psychotic symptoms were finally relieved by lithium monotherapy.Conclusions: Catatonic symptoms are common in patients with mood disorders, suggesting that lithium may be effective in these cases. Moreover, lithium may be effective for both catatonic and psychotic symptoms, as it normalizes imbalances of excitatory and inhibitory systems in the brain, which underlies major psychosis. Cumulative evidence from further cases is needed to validate our findings.

What Is Electroconvulsive Therapy?

2010 ◽  
Author(s):  
Max Fink MD
Keyword(s):  
Emotional Disorders ◽  
Electroconvulsive Therapy ◽  
The Elderly ◽  
The Body ◽  
Electroconvulsive Treatment ◽  
Single Episode ◽  
Psychotropic Medicines ◽  
Long Duration ◽  
Motor Activities ◽  
The Brain

Electroconvulsive therapy (ECT) is an effective medical treatment for severe and persistent psychiatric disorders. It relieves de pressed mood and thoughts of suicide, as well as mania, acute psychosis, delirium, and stupor. It is usually applied when medications have given limited relief or their side effects are intolerable. Electroconvulsive therapy is similar to a surgical treatment. It requires the specialized skills of a psychiatrist, an anesthesiologist, and nurses. The patient receives a short-acting anesthetic. While the patient is asleep, the physician, following a prescribed procedure, induces an epileptic seizure in the brain. By making sure that the patient’s lungs are filled with oxygen, the physician precludes the gasping and difficult breathing that accompany a spontaneous epileptic fit. By relaxing the patient’s muscles with chemicals and by inserting a mouth guard (not unlike those used in sports), the physician prevents the tongue biting, fractures, and injuries that occasionally occur in epilepsy. The patient is asleep, and so experiences neither the painful effects of the stimulus nor the discomforts of the seizure. The physiological functions of the body, such as breathing, heart rate, blood pressure, blood oxygen concentration, and degree of motor relaxation, are monitored, and anything out of the ordinary is immediately treated. Electroconvulsive therapy relieves symptoms more quickly than do psychotropic drugs. A common course of ECT consists of two or three treatments a week for two to seven weeks. To sustain the recovery, weekly or biweekly continuation treatments, either ECT or medications, are often administered for four to six months. If the illness recurs, ECT is prescribed for longer periods. The duration and course of ECT are similar to those of the psychotropic medicines frequently used for the same conditions. Electroconvulsive therapy has been used safely to treat emotional disorders in patients of all ages, from children to the elderly, in people with debilitating physical illnesses, and in pregnant women. Emotional disorders may be of short or long duration; they may be manifest as a single episode or as a recurring event. Electroconvulsive treatment is an option when the emotional disorder is acute in onset; when changes in mood, thought, and motor activities are pronounced; when the cause is believed to be biochemical or physiological; when the condition is so severe that it interferes with the patient’s daily life; or when other treatments have failed.

Do Benzodiazepines Interfere with the Action of Electroconvulsive Therapy?

1992 ◽  
Vol 160 (4) ◽  
pp. 545-546 ◽  
Author(s):  
Samuel I. Cohen ◽  
Claire Lawton
Keyword(s):  
British Journal ◽  
Electroconvulsive Therapy ◽  
Chronic Administration ◽  
Depressed Woman ◽  
Induced Changes ◽  
The Brain

A 67-year-old anxious and depressed woman was withdrawn from a long-term course of a benzodiazepine and soon after was given ECT. This proved ineffective, but ECT given some months later was successful. It is suggested that the chronic administration of the benzodiazepine may have induced changes in the brain that interfered with ECT.British Journal of Psychiatry (1992), 160, 545–546

Chemically Induced Myelinopathies

1998 ◽  
Vol 17 (3) ◽  
pp. 231-275 ◽  
Author(s):  
Marciavan Gemert ◽  
James Killeen
Keyword(s):  
Nervous System ◽  
Oxidative Phosphorylation ◽  
Peripheral Nervous System ◽  
Cholesterol Synthesis ◽  
Fluid Pressure ◽  
Neuronal Tissue ◽  
Chemically Induced ◽  
The Central Nervous System ◽  
The Brain ◽  
Increased Pressure

The diverse, structurally unrelated chemicals that cause toxic myelinopathies have been investigated and can be categorized into two types of primary demyelinators. Some demyelinating chemicals seem to leave intact the myeli-nating cells (oligodendrocytes in the central nervous system and Schwann cells in the peripheral nervous system), while others damage the myelinating cells as well as the myelin. The significance between the two is that with the myelinating cells still in tact, repair of the myelin sheath can occur. However, if the myelinating cells are destroyed, repair and reversal of the neuropathy may not occur. Histologically, these chemicals produce an edema of the white matter of the brain, and in some cases the peripheral nervous system, that appears spongy by light microscopy. By electron microscopy, vacuoles can be seen in the myelin surrounding axons. These vacuoles are characterized as fluid-filled separations (splitting) of myelin lamellae at the intraperiod line. In some cases these vacuoles can degenerate further to full demyelination, affecting conduction through those axons. Regeneration of the myelin layers can occur, and in some cases occurs at the same time other axons are undergoing toxic demyelination. Several of these chemicals, however, have been shown to increase cerebrospinal fluid pressure in the brain, optic nerve, and spinal cord, and/or intraneuronal pressure in the perineurium surrounding the axons in the peripheral nervous system. This increased pressure has been correlated with decreased conduction capacity through the axon, ischemia to the neuronal tissue from decreased blood flow because of pressure against the blood vessels, and, if unrelieved, permanent axonal damage. Several of these chemicals havebeen shown to inhibit oxidative phosphorylation, while others uncouple oxidative phosphorylation. One chemical appears to inhibit an enzyme critical to cholesterol synthesis, thus destabilizing myelin. Another hypothesis for a mechanism of action may be in the ability of these compounds to alter membrane permeability.

Infra-Low-Frequency Neurofeedback for Optimum Performance

Biofeedback ◽  
2016 ◽  
Vol 44 (2) ◽  
pp. 81-89 ◽  
Author(s):  
Siegfried Othmer ◽  
Sue Othmer
Keyword(s):  
Cognitive Skills ◽  
Low Frequency ◽  
Cortical Potential ◽  
Clinical Population ◽  
Optimal Conditions ◽  
Target Frequency ◽  
Optimum Performance ◽  
Slow Cortical Potential ◽  
Optimal Functioning ◽  
The Brain

A method of nonprescriptive neurofeedback is described that is based on the brain interacting with its own tonic slow cortical potential. In the absence of any explicit guidance by the clinician, the training depends entirely on the brain's response to the unfolding signal. When this training is performed under optimal conditions in terms of placement and target frequency, there is a bias toward optimal functioning. The brain uses the information for its own benefit. The outcomes of the training are either comparable to or exceed expectations based on conventional electroencelphalogram band-based neurofeedback. Results are shown for a cognitive skills test for an unselected clinical population.

Employee management of Diabetes Type II using Modern Technology

2018 ◽  
Vol 3 (06) ◽  
Author(s):  
Russell Sims ◽  
Briunca Valdwell ◽  
Felicia Jefferson
Keyword(s):  
Quality Of Life ◽  
Medical Condition ◽  
Modern Technology ◽  
Diabetes Type ◽  
Type Ii ◽  
Diabetes Type Ii ◽  
Blood Pressures ◽  
The Impact ◽  
The Brain

Diabetes type II is a controllable condition, with a combination of medication and diet. The most important part of the combination is the information given to bring this all into balance. Education of this condition will enhance one’s quality of life. The information provided will assist in the following; 1) How insulin affects the brain. 2) Sleep patterns are impacted by this condition. 3) Blood pressures have problems with being elevated by this condition. 4) The impact on current healthcare costs. 5) Tools needed to assist in the management of this condition. 6) The tools needed to manage this medical condition. Technology begins to be more involved in the management of this condition. When one understands, what they are facing, it is easier to maintain or improve the quality of life one has to live. It will help the loved ones be supportive throughout managing this condition.

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