Antidepressant therapeutic effect of mianserin-induced generalized tonic-clonic seizure in an elderly patient

Generalized tonic-clinic seizures may appear as a side-effect of all antidepressant drugs, including mianserin. We present here a case of an 83-year-old woman whose major depressive episode (superimposed on mild dementia) completely resolved following a generalized tonic-clonic seizure. The improvement, which was maintained for 3 months, may be attributable to the drug-induced single convulsion. It would be of interest to know whether other psychiatrists have had similar experiences concerning an immediate antidepressant effect to a single tonic-clonic seizure (drug-induced or provoked by electroconvulsive therapy). If a subgroup of patients responsive to single generalized tonic-clonic seizure were to exist (especially among elderly patients), it would allow them to receive a minimal number of electroconvulsive therapy (ECT) sessions, decreasing the probability of the appearance of ECT side-effects.     

Orofacial injuries associated with prehospital management of febrile convulsion in Nigerian children

Abstract –  The aim of this prospective study was to determine in a population of pediatric patients with febrile convulsions the prevalence and pattern of orofacial and dental injuries caused by traditional remedies used in a suburban Nigerian community. Over the study period of 28 months, 75 cases of febrile convulsion presented to the Children's Emergency unit of our hospital. Of these, 27 children (36%) sustained orofacial injuries caused by forceful insertion of a spoon into the mouth (96.3%) or a bite (3.7%) during convulsive episodes. The ages of the patients ranged from 12 to 84 months with a mean 39.8 ± 18.3 months. There were 15 males and 11 females with a male to female ratio of 1.4:1. The orofacial and dental injuries sustained from prehospital treatment at home were lacerations and bruising of soft tissues including lips, tongue, mucosa and commissures and tooth subluxation, displacement or avulsion. Other injuries sustained outside the mouth include second-degree burns to the feet, a chin laceration and facial bruises resulting from a fall. Many oral injuries were overlooked by pediatricians. Prompt recognition and appropriate management of febrile convulsion would be of great benefit to the pediatric patients.     

HLA study of 21 families with two or more members affected by febrile convulsions

21 Italian families with at least two members who had had febrile convulsions (FC) were HLA-typed for class I antigens. A total of 49 subjects and 43 close relatives (parents or sibs) were examined. No single antigen or haplotype was statistically more frequent among pooled FC subjects. The study, however, is not conclusive regarding a relationship between FC and HLA region because of the possible genetic heterogeneity of proneness to FC. In a significant proportion of cases two FC affected sibs had unaffected parents: besides the models of inheritance so far proposed for this pathology, the involvement of two complementary dominant factors was also considered. The report includes uncommon cases: a family where one FC affected parent transmitted the same HLA haplotype to all three affected sibs; two more families, with both parents and progeny affected by FC. The HLA typing of all members of these unusual families, although not furnishing relevant information at present, may be of value to other investigators.

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Sommario è stata effettuata la tipizzazione del sistema HLA, antigeni della classe 1, in 21 famiglie in cui almeno 2 membri avevano manifestato convulsioni febbrili (CF). Sono stati esaminati un totale di 49 soggetti e 43 consanguinei di I⁰ grado (genitori o fratelli). Non sono risultati statisticamente più frequenti, nell’insieme dei soggetti affetti da CF, nè un singolo antigene nè un aplotipo. La ricerca comunque non consente di trarre ipotesi conclusive circa il rapporto tra CF e regione HLA, a causa della possibile eterogeneità genetica della suscettibilità alle CF stesse. In una proporzione di casi significativa due fratelli con CF avevano genitori sani: è stata presa in considerazione, oltre i modelli di trasmissione ereditaria finora proposti per questa affezione, anche la possibile implicazione di due fattori complementari dominanti. Tra i casi studiati alcuni appaiono non comuni: per esempio una famiglia dove un genitore con CF aveva trasmesso lo stesso aplotipo HLA ai 3 figli affetti e, ancora, 2 famiglie con entrambi i genitori e i figli affetti da CF. La tipizzazione HLA di tutti i membri di queste famiglie atipiche, anche se non dà informazioni di rilievo nell’attualità, può essere utile per altri ricercatori.

     

Convulsion in the Aged

Abstract: The convulsion and electroencephalographic patterns were examined on 2,625 subjects aged 60 and over. Of these, 2,000 were consecutive autopsy cases. Convulsion was noted in 4% of the 2,625 cases and the incidence of epilepsy was 0.076%. In 26.4% of 72 cases with cerebrovascular disorders who died during the past two years, convulsion was found, and the value indicated a remarkable increase compared with the previous report. Convulsion was noted most frequently in the acute state of cerebral apoplexy and myoclonus was most common. The prognosis of such cases was poor. The incidence of convulsion in 30 consecutive patients with brain tumor was 13.3%. On 20,000 electroencephalograms, the incidence of the typical spike and wave complex was less than 0.005%. No 6 and 14 c/sec positive spike was recognized.     

黑质注射升压素对大鼠氧惊厥的抑制作用

本实验用定位注射法将升压素注入大鼠黑质，观察对大鼠氧惊厥的影响。结果显示，大鼠一侧黑质注射１０ｍｇ升压素，可明显推迟氧惊厥的始发时间，但对惊厥的严重程度无明显作用。提示黑质升压素含量增加对氧惊厥有一定的抑制效应。     

Ontogeny of the post-decapitation convulsion in the rat: Effects of neonatal systemic 6-hydroxydopamine

Two systemic injections of 6-hydroxydopamine (6-OHDA) on the first day of life caused transient elevations of spinal dopamine and serotonin but permanent depletion of norepinephrine. In untreated rats, the spinal concentrations of these amines peaked at 10, 15 and 20 days respectively. 6-Hydroxydopamine abolished decapitation convulsions during adult-hood but the convulsion latency and duration were normal at 20 days of age. These data are consistent with others suggesting maturation of aspects of seizure manifestations at around 20 days. The tonic-clonic aspects of seizures may consist of an early maturing trigger involving spinal noradrenergic projections from the locus cocruleus and a later maturing modulator involving spinal serotonergic neurones.     

Changes of somatostatin content in some brain areas of rats during oxygen－induced convulsion

Ｃｈａｎｇｅｓｏｆｓｏｍａｔｏｓｔａｔｉｎｃｏｎｔｅｎｔｉｎｓｏｍｅｂｒａｉｎａｒｅａｓｏｆｒａｔｓｄｕｒｉｎｇｏｘｙｇｅｎ－ｉｎｄｕｃｅｄｃｏｎｖｕｌｓｉｏｎＨｕＣｈａｎｇｈｏｎｇ（胡长虹）；ＮｉＧｕｏｔａｎ（倪国坛）；ＨａｎｇＲｏｎｇｃｈｕｎ（杭...     

吸入麻醉药抗药物性惊厥的实验研究

目的 观察吸人麻醉药乙醚、安氟醚、异氟烷和七氟醚对小鼠药物性惊厥的影响。方法 给小鼠分别腹腔注射镇静剂量的乙醚、安氟醚、异氟烷或七氟醚，5min后注射4种不同的致惊药物，对照组注射生理盐水，观察并记录各组惊厥发生的潜伏期、类型、发生率等。结果 乙醚、安氟醚、异氟烷能对抗一叶秋碱和荷包牡丹碱的致惊作用，安氟醚能对抗N-甲基-D-天冬氨酸(NMDA)的致惊作用，乙醚能对抗士的宁的致惊作用。结论 乙醚、安氟醚和异氟烷抗惊厥作用与GABAA受体有关，安氟醚抗惊厥作用与NMDA受体有关，乙醚抗惊厥作用与甘氨酸受体有关。     

Influence of Gender and Gonadectomy on Bicuculline-Induced Convulsions and on GABAA Receptors

The response to IV administration of GABA_A receptor antagonist bicuculline was studied in young (30 days) and in adult gonad-intact or gonadectomized male and female rats. The properties of GABA_A receptors, obtained from cortex and cerebellum 30 days following gonadectomy, and the affinity of muscimol and bicuculline for cortical and cerebellar GABA binding sites were also studied. While young rats failed to show sex differences, the threshold doses of bicuculline producing the first myoclonic twitch and running/bouncing clonus (RB clonus) were lower in adult male than female rats. Fifteen days after gonadectomy or sham operation male rats needed less bicuculline to the onset of myoclonic twitch and RB clonus than identically treated females, while orchidectomized rats needed more bicuculline to the onset of tonic hindlimb extension than all other groups examined. All sex differences disappeared 30 days following gonadectomy. At the same time, in males gonadectomy decreased the affinity and enhanced the density of cortical ³H-muscimol binding sites. In female rats, gonadectomy only decreased the affinity of cortical GABA_A receptors. Only regional but not sex differences were observed in the affinity of muscimol and bicuculline for GABA_A receptors. Sex differences in the threshold doses of bicuculline-producing convulsions do not correlate either with the properties of cortical and cerebellar GABA_A receptors or with the affinity of bicuculline for the same binding sites.