Maintenance electroconvulsive therapy and cognitive function

1997 ◽  
Vol 170 (3) ◽  
pp. 285-287 ◽  
Author(s):  
Richard C. Barnes ◽  
Ali Hussein ◽  
David N. Anderson ◽  
David Powell
Keyword(s):  
Cognitive Deficits ◽  
Acute Treatment ◽  
Prophylactic Treatment ◽  
Single Case ◽  
Bipolar Affective Disorder ◽  
Psychometric Testing ◽  
Cognitive Effects ◽  
Single Case Report ◽  
Serial Testing ◽  
Maintenance Ect

BackgroundECT is rarely used as a prophylactic treatment. A 74-year-old woman with unstable bipolar affective disorder receiving maintenance ECT presented a unique opportunity to measure the cognitive effects of continuing ECT.MethodA single case report with serial psychometric testing during over 400 ECT treatments as a single maintenance treatment.ResultsSerial testing did not demonstrate progressive cognitive deterioration, but consistent cognitive deficits typical of acute treatment were evident. The degree of cognitive difficulty may be related to the frequency of treatment.ConclusionsMaintenance ECT can be an effective prophylactic treatment for selected patients. Cognitive effects would appear to be no greater than with acute treatment and seem to be non-progressive.

scholarly journals 098 A case of delayed post-hypoxic leukoencephalopathy complicating drug overdose

2019 ◽  
Vol 90 (e7) ◽  
pp. A32.1-A32
Author(s):  
Min Fong ◽  
Nicholas Rigby ◽  
Paul Pun ◽  
Roger Mitchell ◽  
Daniel Schweitzer ◽  
...  
Keyword(s):  
White Matter ◽  
Single Case ◽  
Neuropsychiatric Symptoms ◽  
Bipolar Affective Disorder ◽  
Cerebral White Matter ◽  
High Signal ◽  
White Matter Changes ◽  
Hypoxic Event ◽  
Diffusion Weighted Images ◽  
Single Case Report

IntroductionDelayed post-hypoxic leukoencephalopathy (DPHL) is a syndrome characterised by neurological deterioration following a period of recovery after an initial hypoxic event with striking white-matter change on magnetic resonance imaging. We present a case characterised by insidious onset and a fluctuating course of cognitive and neuropsychiatric symptoms.MethodsSingle case report.ResultsA 61 year old lady, with a background history of previously well managed bipolar affective disorder, was found unresponsive following an intentional overdose of temazepam and tramadol. She was hypotensive, hypoxic and required ventilatory and inotropic support. Following extubation, the patient had residual left-sided weakness and MRI confirmed a right frontal watershed infarction. A three week period of clinical improvement was followed by marked deterioration firstly with fluctuating mood and other neuropsychiatric symptoms which progressed to severe impairment of cognition and alertness. There was generalised slowing on the EEG and the CSF was unremarkable. Repeat neuroimaging undertaken on day 41 of the admission, revealed new symmetric and confluent cerebral white matter changes with high signal on the Diffusion Weighted Images (DWI) and Fluid Attenuated Inversion Recovery (FLAIR) images. The patient was managed with supportive care and sustained a clinically significant recovery (MOCA 26/30), despite ongoing cognitive impairments including working memory and deficits in social cognition including mood instability and disinhibition. Repeat neuroimaging 3 months after initial presentation revealed partial resolution of the white matter changes.ConclusionA diagnosis of DPHL should be considered in patients with variable mood and cognition following initial improvement after a hypoxic event.

scholarly journals A SINGLE CASE REPORT ON HYPERAMMONEMIA INDUCED BY VALPROATE MONOTHERAPY WITHOUT HEPATIC DYSFUNCTION

2017 ◽  
Vol 9 (4) ◽  
pp. 218 ◽  
Author(s):  
C. Prarthana Saraswathi ◽  
J. Anu Rita ◽  
S. Nambi
Keyword(s):  
Case Report ◽  
Mental Status ◽  
Hepatic Dysfunction ◽  
Single Case ◽  
Bipolar Affective Disorder ◽  
Mood Stabilizer ◽  
Altered Mental Status ◽  
Plasma Ammonia ◽  
Manic Symptoms ◽  
Single Case Report

Valproate is a commonly used mood stabilizer. One of the important and rare side effects of valproate is hyperammonemia leading to delirium and hepatic encephalopathy. Valproate-induced delirium is commonly mistaken for worsening of manic symptoms or psychosis. We hereby report a case of bipolar affective disorder who was on a therapeutic dose of valproate monotherapy developed altered mental status where we found elevated levels of plasma ammonia which decreased after the discontinuation of valproate and with normal levels of serum valproate, LFT’s, EEG and imagings. This case report emphasises on the need to consider plasma ammonia levels in patients with altered mental status receiving valproate in addition to other investigations.

scholarly journals Can idiosyncratic drug reactions occur in quick succession? a case of cross sensitivity between levetiracetam and phenytoin

2017 ◽  
Vol 6 (8) ◽  
pp. 2098
Author(s):  
Chitralekha Anilkumar Nayak ◽  
Kalyani Pai Kakode ◽  
Padmanabh V. Rataboli
Keyword(s):  
Case Report ◽  
Early Detection ◽  
Adverse Drug Reactions ◽  
Prophylactic Treatment ◽  
Single Case ◽  
Idiosyncratic Drug Reactions ◽  
Drug Reactions ◽  
Diagnostic Dilemma ◽  
Single Case Report ◽  
Post Traumatic

The occurrence of adverse drug reactions (ADRs) to more than one drug in quick succession can cause diagnostic dilemma to the doctor and increased burden of suffering to the patient. We present a single case report of a 23 year old female who developed rash and agranulocytosis in quick succession as ADRs to phenytoin and levetiracetam respectively. These antiepileptic drugs (AEDs) were prescribed as prophylaxis against post traumatic seizures (PTS). Hence a proper rationale for the prophylactic treatment of PTS and pharmacovigilance for early detection of adverse drug reactions is the need of the hour.

Bipolar Affective Disorder Minus Left Prefrontal Cortex Equals Schizophrenia

1996 ◽  
Vol 168 (5) ◽  
pp. 647-650 ◽  
Author(s):  
Alfred Pang ◽  
Shôn W. Lewis
Keyword(s):  
Prefrontal Cortex ◽  
Affective Disorder ◽  
Past History ◽  
Single Case ◽  
Bipolar Affective Disorder ◽  
Specific Pattern ◽  
Left Temporal Lobe ◽  
Single Case Report ◽  
History Of ◽  
The Relationship

BackgroundAn investigation of the relationship between bipolar affective disorder and schizophrenia, following a severe head injury and removal of the left prefrontal cortex.MethodA single case report.ResultsAn individual with past history of bipolar affective disorder suffered traumatic damages to the left prefrontal cortex with a second lesion in the left temporal lobe. The patient developed typical schizophrenia nine months later. The relevance of his brain lesions in determining the schizophrenic symptoms is discussed.ConclusionWe propose that the specific pattern of brain injury in this patient was sufficient to change the phenotype from bipolar affective disorder to schizophrenia.

scholarly journals Sequential bilateral Behçet’s neuroretinitis associated with prepapillary vitreous exudate: case report

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Imen Ksiaa ◽  
Safa Ben Aoun ◽  
Sourour Zina ◽  
Dhouha Nefzi ◽  
Sana Khochtali ◽  
...  
Keyword(s):  
Case Report ◽  
Single Case ◽  
Signal Loss ◽  
Fiber Layer ◽  
Swept Source ◽  
Single Case Report ◽  
Shadowing Effect ◽  
Eye Involvement ◽  
The Right ◽  
Inflammatory Changes

Abstract Objective To describe a case of Behçet disease (BD) uveitis manifesting with sequential bilateral neuroretinitis associated with prepapillary inflammatory vitreous exudate (PIVE). Material and methods A single case report documented with multimodal imaging. Results A 37-year-old man developed neuroretinitis with associated PIVE in the left eye. He was diagnosed with ocular toxoplasmosis and treated accordingly based on positive serologic testing and negative work-up for other entities, including BD. The disease course was favorable, but 1 year later a similar neuroretinitis developed in the right eye. Extraocular features of BD became evident only at the time of the second eye involvement, and the patient received corticosteroid and immunosuppressive therapy. Swept source (SS) OCT showed at the acute phase in both eyes a typical “mushroom-shaped” prepapillary hyperreflectivity of the PIVE. SS OCT angiography (OCTA) demonstrated a corresponding prepapillary hypointense area due to shadowing effect, decreasing in size while scanning deeper layers. It also detected peripapillary retinal hypervascularity in both eyes and a sectoral area of flow signal loss in the first involved left eye. Visual acuity improved following the resolution of the PIVE and associated acute inflammatory changes in both eyes. The left eye showed residual optic disc pallor and retinal nerve fiber layer defects. Conclusion Sequential bilateral neuroretinitis associated with PIVE may occur before other clinical features of BD become evident. SS OCT and OCTA can provide useful information for the diagnosis and management of this rare, but typical, ocular manifestation of BD uveitis.

scholarly journals Right Visual Hemiagnosia: A Single Case Report

Cortex ◽  
1988 ◽  
Vol 24 (2) ◽  
pp. 347-355 ◽  
Author(s):  
A. Charnallet ◽  
S. Carbonnel ◽  
J. Pellat
Keyword(s):  
Case Report ◽  
Single Case ◽  
Single Case Report

Suicide of a Tenor Amidst the Stage Setting of the Werther Opera's Death Scene

Crisis ◽  
2021 ◽  
Author(s):  
Manina Mestas ◽  
Florian Arendt
Keyword(s):  
Single Case ◽  
Causal Effects ◽  
Death Scene ◽  
Individual Level ◽  
Fictional Narrative ◽  
Single Case Report ◽  
Werther Effect ◽  
High Level ◽  
Identification Processes

Abstract. Background: Reporting on suicide can elicit an increase in suicides, a phenomenon termed the “Werther effect.” The name can be traced back to an alleged spike in suicides after the publication of Goethe's novel The Sorrows of Young Werther in 1774, in which the protagonist Werther dies by suicide. Aims: Acknowledging the importance and primacy of systematic ecological and individual-level studies, we provide a historical single-case report of the suicide of a “late arrival of the Werther epidemic,” as the death was headlined in a news report in 1927. Method: Archival research on tenor Paul Vidal's suicide was conducted. Results: Vidal reconstructed the scene of the final act of the opera Werther in his apartment and died by a gunshot, as did Werther. Limitations: Causal interpretations must be made with caution. Conclusion: Striking similarities between Werther's and Vidal's deaths support the idea of strong identification with the fictional narrative and suggest causal effects. Considering the repeated high level of immersiveness and the intense emotions of opera performances, it is likely that performing the role of Werther increases identification processes, contributing to detrimental effects. The lack of knowledge regarding the role of fictional suicide stories on artists' suicides is discussed.

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