scholarly journals Quantitative Electroencephalographic Analysis of Delirium Tremens Development Following Alcohol-withdrawal Seizure

2021 ◽  
Author(s):  
Hee-Jung Mo ◽  
Jee-Eun Yoon ◽  
Dong Wook Kim ◽  
Hee-Jin Im
Keyword(s):  
Alcohol Withdrawal ◽  
Neuronal Excitability ◽  
Spectral Power ◽  
Delirium Tremens ◽  
Quantitative Eeg ◽  
Healthy Controls ◽  
Retrospective Case ◽  
Band Frequency ◽  
Beta Frequency ◽  
Age And Sex

Abstract Seizures and delirium tremens (DTs) are recognized as severe alcohol-withdrawal symptoms. Prolonged admission and serious complications associated with alcohol-withdrawal are responsible for increased costs and use of medical and social resources. We compared differences in quantitative electroencephalography (EEG) in patients after alcohol-withdrawal seizures (AWS; n = 13), performed in the intensive care unit within 48 h of admission, and in age- and sex-matched healthy controls. We also investigated the prognostic value of quantitative EEG, for the development of alcohol DTs after AWS in a retrospective, case‒control study. The spectral power of each band frequency and the ratio of the theta to alpha band (TAR) in the electroencephalogram were analysed using iSyncBrain® (iMediSync, Inc., Korea). The beta frequency and the alpha frequency band power were significantly higher and lower, respectively, in patients than in age- and sex-matched healthy controls. In AWS patients with DTs, the relative beta3 power was lower, particularly in the left frontal area, and the TAR was significantly higher in the central channel than in those without DTs. Quantitative EEG showed neuronal excitability and decreased cognitive activities characteristic of AWS patients associated with alcohol withdrawal state and we demonstrated that quantitative EEG also might be a helpful tool for detecting patients at high risk of developing DTs during an alcohol-dependence period.

Kindling as a Model for Alcohol Withdrawal Syndromes

1978 ◽  
Vol 133 (1) ◽  
pp. 1-14 ◽  
Author(s):  
James C. Ballenger ◽  
Robert M. Post
Keyword(s):  
Limbic System ◽  
Alcohol Withdrawal ◽  
Neuronal Excitability ◽  
Delirium Tremens ◽  
Withdrawal Symptoms ◽  
Subcortical Structures ◽  
Personality Changes ◽  
Eeg Changes ◽  
Withdrawal Syndromes

SummaryPeriodic brain stimulation, particularly in the limbic system, at stimulus intensities initially too low to produce any behavioural or EEG effects, progressively produces EEG changes, motor automatisms, and eventually convulsions, an effect called kindling. Data are presented and reviewed that suggest that the severity of alcohol withdrawal symptoms progressively increases over years of alcohol abuse in a stepwise fashion similar to the kindling process. The model is presented that the limbic system hyperirritability which accompanies each alcohol withdrawal serves over time to kindle increasingly widespread subcortical structures. These long-term changes in neuronal excitability might relate to the progression of alcohol withdrawal symptoms from tremor to seizures and delirium tremens, as well as the alcoholic personality changes between episodes of withdrawal.

scholarly journals Severe alcohol withdrawal syndrome: review of the literature

2019 ◽  
Vol 19 (4) ◽  
pp. 306-315 ◽  
Author(s):  
George Benson ◽  
Nicola Roberts ◽  
Jacqueline McCallum ◽  
Andrew McPherson
Keyword(s):  
Risk Factors ◽  
General Hospital ◽  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Delirium Tremens ◽  
Significant Risk ◽  
Hospital Setting ◽  
Alcohol Withdrawal Syndrome ◽  
Retrospective Case ◽  
Content Type

Purpose The purpose of this paper is to identify published literature from a general hospital setting that may highlight variables implicated in the development of severe alcohol withdrawal syndrome (SAWS) in patients who have alcohol dependence syndrome (ADS). Design/methodology/approach A systematic literature review was carried out using the electronic databases: MEDLINE, Medline in Process, Cinahl, Embase and PsycINFO from 1989 to 2017. The focus of this search was on English language studies of individuals over 16 years admitted to general hospital with ADS, delirium tremens (DTs), alcohol-related seizure (ARS) or alcohol withdrawal syndrome (AWS). Findings Of the 205 studies screened, eight met the criteria for inclusion. Six studies were quantitative retrospective cohort and two were retrospective case-control. Six studies investigated risk factors associated with DTs, one examined SAWS and one alcohol kindling. Descriptive analysis was performed to summarise the empirical evidence from studies were 22 statistically significant risk factors were found; including the reason for admission to hospital, daily alcohol consumption, previous DTs and prior ARS. The last two factors mentioned appeared in two studies. Research limitations/implications Further research should consider the quality and completeness of the alcohol history data and competence of staff generating the data in retrospective studies. Originality/value The paper suggests that the factors linked to SAWS development from the literature may not fully explain why some individuals who have ADS develop SAWS, and others do not.

scholarly journals Comparison of Retinal Layer Thickness and Capillary Vessel Density in the Patients with Spontaneously Resolved Acute Central Serous Chorioretinopathy

2020 ◽  
Vol 10 (1) ◽  
pp. 45
Author(s):  
Kyu Jin Han ◽  
Hyeong Ju Kim ◽  
Je Moon Woo ◽  
Jung Kee Min
Keyword(s):  
Visual Acuity ◽  
Layer Thickness ◽  
Central Serous Chorioretinopathy ◽  
Subretinal Fluid ◽  
Vessel Density ◽  
Foveal Avascular Zone ◽  
Retinal Layer ◽  
Healthy Controls ◽  
Retrospective Case ◽  
Capillary Vessel

We investigate retinal layer thickness and capillary vessel density (VD) in the patients with central serous chorioretinopathy (CSC) who recovered spontaneously and evaluate the correlation between the changes in these values and visual outcomes using swept-source optical coherence tomography (SS-OCT) and OCT angiography (OCTA). This retrospective case–control study included 34 eyes of 34 patients with spontaneously resolved acute CSC. The changes in retinal layer thickness and capillary VD were examined using SS-OCT and OCTA after complete resolution of subretinal fluid (SRF). The fellow eyes and 34 healthy eyes were used as controls. In the eyes with CSC, the outer retinal layer was significantly thinner than in the eyes of fellow and healthy controls. The foveal avascular zone area and VDs in the superficial and deep capillary plexus in the eyes with CSC were not significantly different from those in the eyes of fellow and healthy controls. The VD of the choriocapillaris in the eyes with CSC was significantly lower than that in the eyes of fellow and healthy controls. Correlation analyses revealed that the outer retinal layer thickness and initial visual acuity were positively correlated with the final visual acuity. Furthermore, the initial SRF area and height were negatively correlated with the outer retinal layer thickness after SRF resolution. Attenuation of outer retinal layer thickness and decreased VD of the choriocapillaris were observed in the eyes with spontaneously resolved acute CSC. The outer retinal layer thickness could be an important visual predictor of CSC.

scholarly journals Reactive arthritis and undifferentiated peripheral spondyloarthritis share human leucocyte antigen B27 subtypes and serum and synovial fluid cytokine profiles

Rheumatology ◽  
2020 ◽  
Author(s):  
Jyoti Ranjan Parida ◽  
Sandeep Kumar ◽  
Sakir Ahmed ◽  
Smriti Chaurasia ◽  
Ratnadeep Mukherjee ◽  
...  
Keyword(s):  
Statistical Difference ◽  
Human Leucocyte Antigen ◽  
Healthy Controls ◽  
Hla B27 ◽  
Serum Cytokine ◽  
Cytokine Profiles ◽  
Cytokine Levels ◽  
Peripheral Spondyloarthritis ◽  
Multiplex Cytokine ◽  
Age And Sex

Abstract Objectives Peripheral SpA (pSpA) is comprised of ReA, PsA, enteritis-associated arthritis and undifferentiated pSpA (upSpA). ReA and upSpA share T cell oligotypes and metabolomics in serum and SF. We investigated HLA-B27 subtypes and cytokines in serum and SF that were compared between ReA and upSpA. Methods ReA and upSpA were compared in two cohorts. In cohort I (44 ReA and 56 upSpA), HLA-B27 subtyping was carried out. In cohort II (17 ReA and 21 upSpA), serum and SF cytokines were compared using a multiplex cytokine bead assay (27 cytokines). A total of 28 healthy controls with similar age and sex to cohort II were included for comparison of serum cytokine levels. Results In cohort I, HLA-B27 was positive in 81.8% (36/44) of ReA and 85.71% (48/56) of upSpA patients. HLA-B27 typing was successful in 70 patients (30 ReA and 40 uSpA). HLA-B*2705 was the most common, followed by HLA-B*2704 and HLA-B*2707. Frequencies were the same between ReA and upSpA. In cohort II, 14 cytokines were detectable in the serum of patients. The levels of eight cytokines were higher than in the controls. The cytokine levels of ReA and upSpA were similar. Sixteen cytokines were detectable in the SF of patients. There was no statistical difference in the levels between ReA and upSpA. The cytokine profiles in sera and SF were also similar among HLA-B27-positive and negative patients. Conclusion ReA and upSpA have similar HLA-B27 subtype associations and similar cytokine profiles. They should be considered as a single entity during studies as well as clinical management.

Dexmedetomidine Infusion as Adjunctive Therapy to Benzodiazepines for Acute Alcohol Withdrawal

2008 ◽  
Vol 42 (11) ◽  
pp. 1703-1705 ◽  
Author(s):  
Jamil Darrouj ◽  
Nitin Puri ◽  
Erin Prince ◽  
Anthony Lomonaco ◽  
Antoinette Spevetz ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Alcohol Withdrawal ◽  
Delirium Tremens ◽  
Poor Response ◽  
Altered Mental Status ◽  
Primary Treatment ◽  
Respiratory Drive ◽  
Medical Unit ◽  
Pubmed Database

Objective: To report a case of alcohol withdrawal and delirium tremens successfully treated with adjunctive dexmedetomidine. Case Summary: A 30–year-old man with a history of alcohol abuse was admitted to the general medical unit because of altered mental status and agitation. He was initially treated for alcohol withdrawal with benzodiazepines; his condition then deteriorated and he was transferred to the intensive care unit. Because of the patient's poor response to benzodiazepines (oxazepam and lorazepam, with midazolam the last one used), intravenous dexmedetomidine was started at an initial dose of 0.2 µg/kg/h and titrated to 0.7 µg/kg/h to the patient's comfort. Midazolam was subsequently tapered to discontinuation due to excessive sedation. In the intensive care unit, the patient's symptoms remained controlled with use of dexmedetomidine alone. He remained in the intensive care unit for 40 hours; dexmedetomidine was then tapered to discontinuation and the patient was transferred back to the general medical unit on oral oxazepam and thiamine, which had been started in the emergency department. He was discharged after 5 days. Discussion: A review of the PubMed database (1989-2007} failed to identify any other instances of dexmedetomidine having been used as the principal agent to treat alcohol withdrawal. The use of sedative to treat delirium tremens Is well documented, with benzodiazepines being the agents of choice. The clinical utility of benzodiazepines is limited by their stimulation of the γ-aminobutyric acid receptors, an effect not shared by dexmedetomidine, a central α2-receptor agonist that induces a state of cooperative sedation and does not suppress respiratory drive. Conclusions: In patients with delirium tremens, dexmedetomidine should be considered as an option for primary treatment. This case illustrates the need for further studies to investigate other potential uses for dexmedetomidine.

Foot Function in Patients With Surgically Treated Preaxial Polydactyly of the Foot Compared With Age- and Sex-Matched Healthy Controls

2018 ◽  
Vol 40 (4) ◽  
pp. 414-421
Author(s):  
Elise B. Burger ◽  
Shaktie A. Lalé ◽  
Steven E. R. Hovius ◽  
Christianne A. van Nieuwenhoven ◽  
Sicco A. Bus
Keyword(s):  
Pressure Distribution ◽  
Plantar Pressure ◽  
Healthy Controls ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Aesthetic Appearance ◽  
Patient Reported ◽  
Foot Function ◽  
Peak Pressures ◽  
Age And Sex

Background: Treatment of preaxial foot polydactyly, a duplication of the first ray, consists of excision of an extra ray, aiming to improve shoe fitting and aesthetic appearance, while maintaining foot function. Currently, the effect of excision on foot function and foot-related patient experiences is unclear. Methods: A cross-sectional comparison between 37 children treated for preaxial foot polydactyly and 37 age- and sex-matched healthy controls was performed. Dynamic foot function was assessed using plantar pressure measurements and static foot characteristics by physical examination. Patient-reported outcomes for foot function and footwear were evaluated, using the Oxford Ankle Foot Questionnaire for Children (score, 0-100). Results: Compared with controls, patients had significantly lower median peak pressures at the hallux (148 kPa [IQR, 98-245] vs 272 kPa [IQR, 205-381], P < .001) and significantly higher peak pressures at the second metatarsal (217 kPa [IQR, 147-338] vs 166 kPa [IQR, 141-235], P = .002) and third to fifth metatarsals (214 kPa [IQR, 147-290] vs 161 kPa [IQR, 135-235], P < .001). Additionally, patients had a more medially deviated hallux, both while seated (15 degrees (IQR, 11-20) vs 12 degrees [IQR, 10-15], P = .001) and standing (20 degrees [IQR, 15-26] vs 18 degrees [IQR, 15-20], P = .001). No significant correlation between peak pressure distribution and hallux deviation was found. Patients reported minimal problems with foot function (87.5 [IQR, 64.6-100]), but distinct problems with footwear use (50.0 [IQR, 25.0-100]). Conclusion: Patients with surgically treated preaxial foot polydactyly had a substantially altered plantar pressure distribution with more lateral foot progression than healthy controls. Although an increased hallux deviation was not related to altered foot function, it seemed to be the reason for the patient-perceived problems with footwear. Level of Evidence: Level III, comparative series.

scholarly journals Physical Feature Encoding and Word Recognition Abilities Are Altered in Children with Intractable Epilepsy: Preliminary Neuromagnetic Evidence

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Maria Pardos ◽  
Milena Korostenskaja ◽  
Jing Xiang ◽  
Hisako Fujiwara ◽  
Ki H. Lee ◽  
...  
Keyword(s):  
Word Recognition ◽  
Intractable Epilepsy ◽  
Objective Evaluation ◽  
Healthy Children ◽  
Healthy Controls ◽  
Language Function ◽  
Sensory Inputs ◽  
Feature Encoding ◽  
Preliminary Study ◽  
Age And Sex

Objective evaluation of language function is critical for children with intractable epilepsy under consideration for epilepsy surgery. The purpose of this preliminary study was to evaluate word recognition in children with intractable epilepsy by using magnetoencephalography (MEG). Ten children with intractable epilepsy (M/F 6/4, mean ± SD 13.4 ± 2.2 years) were matched on age and sex to healthy controls. Common nouns were presented simultaneously from visual and auditory sensory inputs in “match” and “mismatch” conditions. Neuromagnetic responses M1, M2, M3, M4, and M5 with latencies of ~100 ms, ~150 ms, ~250 ms, ~350 ms, and ~450 ms, respectively, elicited during the “match” condition were identified. Compared to healthy children, epilepsy patients had both significantly delayed latency of the M1 and reduced amplitudes of M3 and M5 responses. These results provide neurophysiologic evidence of altered word recognition in children with intractable epilepsy.

scholarly journals Quantitative EEG evaluation in patients with acute encephalopathy

2013 ◽  
Vol 71 (12) ◽  
pp. 937-942 ◽  
Author(s):  
Aline Souza Marques da Silva Braga ◽  
Bruno Della Ripa Rodrigues Assis ◽  
Jamil Thiago Rosa Ribeiro ◽  
Patricia Maria Sales Polla ◽  
Breno Jose Hulle Pereira ◽  
...  
Keyword(s):  
Spectral Analysis ◽  
Spectral Power ◽  
Quantitative Eeg ◽  
Acute Encephalopathy ◽  
Frequency Range ◽  
Alpha Frequency ◽  
Outcome Group ◽  
Spectral Peaks ◽  
Group A ◽  
Group B

Objective To investigate the use of quantitative EEG (qEEG) in patients with acute encephalopathies (AEs) and EEG background abnormalities. Method Patients were divided into favorable outcome (group A, 43 patients) and an unfavorable outcome (group B, 5 patients). EEGLAB software was used for the qEEG analysis. A graphic of the spectral power from all channels was generated for each participant. Statistical comparisons between the groups were performed. Results In group A, spectral analysis revealed spectral peaks (theta and alpha frequency bands) in 84% (38/45) of the patients. In group B, a spectral peak in the delta frequency range was detected in one patient. The remainder of the patients in both groups did not present spectral peaks. Statistical analysis showed lower frequencies recorded from the posterior electrodes in group B patients. Conclusion qEEG may be useful in the evaluations of patients with AEs by assisting with the prognostic determination.

scholarly journals Rapid Diagnosis of Malaria by Antigen Detection

2009 ◽  
Vol 3 (1) ◽  
pp. 14-16
Author(s):  
Mesbah Uddin Ahmed ◽  
Md Akram Hossain ◽  
AKM Shamsuzzaman ◽  
Md Murshed Alam ◽  
Abdul Hossain Khan ◽  
...  
Keyword(s):  
Thin Films ◽  
Sensitivity And Specificity ◽  
Standard Method ◽  
Gold Standard ◽  
Rapid Diagnosis ◽  
Healthy Controls ◽  
Immunochromatographic Test ◽  
Gold Standard Method ◽  
Malaria Antigen ◽  
Age And Sex

The study was conducted to evaluate the sensitivity and specificity of Immunochromatographic test (ICT) for antigen, using microscopy as the "gold standard" method for diagnosis of malaria. A total of 98 clinically suspected malaria patients and another 30 age and sex-matched healthy controls were included in this study. Thick and thin films were also prepared and examined under microscope as well as Immunochromatographic test (ICT) was performed for malaria antigen. Sensitivity and specificity of ICT for antigen were 93.22% and 94.87% respectively. Keywords: Detection of malaria antigen, Immunochromatographic test   doi: 10.3329/bjmm.v3i1.2965 Bangladesh J Med Microbiol 2009; 03 (01): 14-16

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