scholarly journals Fluoxetine overdose in a teenager resulting in serotonin syndrome, seizure and delayed onset rhabdomyolysis

2018 ◽  
pp. bcr-2018-225529 ◽  
Author(s):  
Richard Lee-Kelland ◽  
Sabeeka Zehra ◽  
Pradeesh Mappa
Keyword(s):  
Creatine Kinase ◽  
Young Adult ◽  
Muscle Pain ◽  
Serotonin Reuptake ◽  
Serotonin Syndrome ◽  
Clonic Seizure ◽  
Tonic Clonic Seizure ◽  
Intravenous Fluids ◽  
Delayed Onset ◽  
Fluoxetine Overdose

A 14-year-old young adult took an overdose of 1.2 g of fluoxetine, a selective serotonin reuptake inhibitor (SSRI) that he had been prescribed for depression. He had a generalised tonic/clonic seizure at 6 hours postingestion.After the seizure, he developed signs consistent with serotonin syndrome: fine tremor, agitation, sweating and hyperreflexia. This was followed by severe muscle pain and rhabdomyolysis with peak creatine kinase (CK) of 33 941 at 74 hours. He was managed with intravenous fluids and analgesia and discharged after 4 days, having avoided renal injury. The use of SSRI’s such as fluoxetine in teenagers has increased in recent years. While it is generally considered benign in overdose, this report illustrates the severe consequences of overdose at high quantities and discusses appropriate management in these cases. We note that in this case, there was a delayed onset of rhabdomyolysis with peak CK at 74 hours postingestion.

scholarly journals Delayed-Onset Seizure in a Mild Quetiapine Overdose: Report of a Case and Review of the Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Jason A. Chen ◽  
Katherine M. Unverferth ◽  
Erick H. Cheung
Keyword(s):  
Atypical Antipsychotics ◽  
Low Dose ◽  
Clonic Seizure ◽  
Tonic Clonic Seizure ◽  
Review Of The Literature ◽  
Potential Complication ◽  
Onset Seizure ◽  
Pharmacokinetics And Pharmacodynamics ◽  
Delayed Onset ◽  
Unusual Phenomenon

Among atypical antipsychotics, quetiapine is commonly prescribed and considered to have a favorable side effect and safety profile. Here, we report the case of a patient who developed a generalized tonic-clonic seizure 28 hours following ingestion of 1,400 mg of quetiapine. Review of the literature identifies delayed-onset seizure as a potential complication of quetiapine overdose. Unique to this case, delayed-onset seizures occurred in a patient with a relatively low dose of quetiapine and no obvious toxidrome, suggesting that this reaction may be an important consideration in the management of quetiapine overdose. The pharmacokinetics and pharmacodynamics of quetiapine may explain this unusual phenomenon.

Neurobehavioral Consequences Associated with Long Term Tramadol Utilization and Pathological Mechanisms

2020 ◽  
Vol 18 (10) ◽  
pp. 758-768 ◽  
Author(s):  
Khadga Raj ◽  
Pooja Chawla ◽  
Shamsher Singh
Keyword(s):  
Alzheimer’S Disease ◽  
Parkinson’S Disease ◽  
Alzheimer's Disease ◽  
Parkinson's Disease ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Serotonin Syndrome ◽  
Dopamine Synthesis ◽  
Synthetic Analog

: Tramadol is a synthetic analog of codeine used to treat pain of moderate to severe intensity and is reported to have neurotoxic potential. At therapeutic dose, tramadol does not cause major side effects in comparison to other opioid analgesics, and is useful for the management of neurological problems like anxiety and depression. Long term utilization of tramadol is associated with various neurological disorders like seizures, serotonin syndrome, Alzheimer’s disease and Parkinson’s disease. Tramadol produces seizures through inhibition of nitric oxide, serotonin reuptake and inhibitory effects on GABA receptors. Extensive tramadol intake alters redox balance through elevating lipid peroxidation and free radical leading to neurotoxicity and produces neurobehavioral deficits. During Alzheimer’s disease progression, low level of intracellular signalling molecules like cGMP, cAMP, PKC and PKA affect both learning and memory. Pharmacologically tramadol produces actions similar to Selective Serotonin Reuptake Inhibitors (SSRIs), increasing the concentration of serotonin, which causes serotonin syndrome. In addition, tramadol also inhibits GABAA receptors in the CNS has been evidenced to interfere with dopamine synthesis and release, responsible for motor symptoms. The reduced level of dopamine may produce bradykinesia and tremors which are chief motor abnormalities in Parkinson’s Disease (PD).

Mutational analysis of SCN2B, SCN3B and SCN4B in a large Chinese Han family with generalized tonic–clonic seizure

2010 ◽  
Vol 31 (5) ◽  
pp. 675-677 ◽  
Author(s):  
Yang Lu ◽  
Weihua Yu ◽  
Zhiqin Xi ◽  
Zheng Xiao ◽  
Xiaoqin Kou ◽  
...  
Keyword(s):  
Mutational Analysis ◽  
Clonic Seizure ◽  
Tonic Clonic Seizure ◽  
Chinese Han

scholarly journals Ascending Tonic Clonic Seizure Syndrome after Percutaneous Vertebroplasty

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Guido Zarattini ◽  
Adam Farrier ◽  
Federico Sibona
Keyword(s):  
Percutaneous Vertebroplasty ◽  
Rare Complication ◽  
Cement Leakage ◽  
Clonic Seizure ◽  
Tonic Clonic Seizure ◽  
Leg Pain ◽  
Compression Fractures ◽  
First Case ◽  
Seizure Syndrome ◽  
Osteoporotic Compression Fractures

Background Context. Cement leakage is not a rare complication of vertebroplasty, but ascending tonic clonic seizure syndrome is exceptionally rare. We herein report the first case to our knowledge of this complication related to vertebroplasty.Purpose. We herein report the first case of ascending tonic clonic seizure syndrome following epidural cement leakage after percutaneous vertebroplasty in a patient with multiple osteoporotic compression fractures.Study Design. Case report.Methods. A 64-year-old woman with T8, T10, L2, and L4 osteoporotic compression fractures underwent percutaneous vertebroplasty using polymethylmethacrylate. 40 minutes after the procedure the patient started suffering back and leg pain, having repetitive myoclonic jerks lasting 15 seconds of the lower extremities, spasm of the back, dyspnea, sinus tachycardia, hypoxemia, and metabolic acidosis.Results. The patient recovered completely due to a combination of early effective resuscitation and considered definitive management.Conclusions. Percutaneous vertebroplasty with polymethylmethacrylate is relatively safe but has few dangerous complications, which should be prevented by a meticulous technique and excellent image quality.

scholarly journals Influence of dronedarone (a class III antiarrhythmic drug) on the anticonvulsant potency of four classical antiepileptic drugs in the tonic–clonic seizure model in mice

2018 ◽  
Vol 126 (2) ◽  
pp. 115-122 ◽  
Author(s):  
Katarzyna M. Sawicka ◽  
Agnieszka Wawryniuk ◽  
Jadwiga Daniluk ◽  
Sławomir Karwan ◽  
Magdalena Florek-Łuszczki ◽  
...  
Keyword(s):  
Antiepileptic Drugs ◽  
Antiarrhythmic Drug ◽  
Clonic Seizure ◽  
Tonic Clonic Seizure ◽  
Class Iii ◽  
Class Iii Antiarrhythmic Drug ◽  
Seizure Model

scholarly journals Factors influencing the duration of generalized tonic–clonic seizure

Seizure ◽  
2016 ◽  
Vol 34 ◽  
pp. 44-47 ◽  
Author(s):  
Sipei Pan ◽  
Fang Wang ◽  
Jing Wang ◽  
Xiang Li ◽  
Xingzhou Liu
Keyword(s):  
Clonic Seizure ◽  
Tonic Clonic Seizure ◽  
Factors Influencing

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.

scholarly journals Simultaneous Bilateral Femoral Neck Fracture Due to a Tonic-Clonic Seizure and High-Dose Steroid Therapy

2020 ◽  
Vol 6 (3) ◽  
pp. 513-516
Author(s):  
Fernando Diaz Dilernia ◽  
Martin M. Estefan ◽  
Gerardo Zanotti ◽  
Fernando Comba ◽  
Francisco Piccaluga ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Steroid Therapy ◽  
Clonic Seizure ◽  
Tonic Clonic Seizure ◽  
High Dose ◽  
High Dose Steroid ◽  
Neck Fracture

scholarly journals Obsessive compulsive symptoms in patients with primary generalized and partial onset epilepsy

2018 ◽  
Vol 6 (4) ◽  
pp. 1183
Author(s):  
Sagar Lavania ◽  
Mohd. Aleem Siddiqui ◽  
Shantanu Bharti ◽  
Abhishek Kumar
Keyword(s):  
Clonic Seizure ◽  
Tonic Clonic Seizure ◽  
Seizure Type ◽  
Check List ◽  
Onset Seizure ◽  
Obsessive Compulsive ◽  
Obsessive Compulsive Symptoms ◽  
Partial Onset Seizure ◽  
The Mean ◽  
Patients With Epilepsy

Background: To find out and compare the obsessive-compulsive symptoms / disorder among patients of primary generalized and partial onset epilepsy.Methods: Patients with epilepsy diagnosed clinically at psychiatric out patient’s department were selected for the study and categorized as primary generalized onset tonic clonic seizure type and partial onset seizure. Yale-Brown obsessive-compulsive symptoms check list and scale was applied to find out the obsessive-compulsive symptoms.Results: A total of 110 patients were categorized as primary generalized (GE) 49 and partial onset epilepsy (PE) 61 patients. Obsessive-Compulsive Symptoms (OCS) were found to be 19.9%, and OCD among 3.63%. Mean Y-BOCS scores for obsession were found to be 3.77±1.93 and 4.93±2.03, (t = -3.034, df= 108, p= .003). Whereas the mean Y-BOCS compulsions score was 2.93±1.96 and 4.62±1.87 was (t = -4.590, df= 108, p= .000) for GE and PE group respectively.Conclusions: OCD and OCS among the epilepsy patients were found to be 3.63%, and 19.9% respectively, and significantly higher mean obsessive and compulsive score were found for the group of partial onset epilepsy.

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