1/15. Adverse effects of paclitaxel in patients with alcohol abuse histories.paclitaxel is a taxane antineoplastic agent formulated in polyoxyethylated castor oil (Cremophor El) and dehydrated alcohol. This case report describes the development of central nervous system toxicity and threatened sobriety related to the alcohol content in a paclitaxel infusion. nurses need to be aware of the alcohol contained in paclitaxel and other drugs used in oncology practice and document previous and current alcohol use prior to beginning therapy. Alternative chemotherapy regimens may need to be offered to patients with alcohol abuse histories.- - - - - - - - - - ranking = 1keywords = central nervous system, nervous system (Clic here for more details about this article) |
2/15. disulfiram-induced encephalopathy.Two patients with disulfiram-(Antabuse-)induced encephalopathy exhibited paranoid ideas, disorientation, impaired memory, ataxia, dysarthria, snout and grasp reflexes, and abnormal electroencephalograms. The first patient developed symptoms on two occasions, each time after disulfiram administration. The second patient experienced a generalized seizure followed by fulminant psychosis three weeks after starting disulfiram therapy. Spinal fluid examination in the latter patient revealed a low homovanillic acid (HVA) level. Since disulfiram inhibits dopamine oxidation, disulfiram-induced encephalopathy may be related to excess dopaminergic activity in the central nervous system.- - - - - - - - - - ranking = 1keywords = central nervous system, nervous system (Clic here for more details about this article) |
3/15. syringomyelia following Listeria meningoencephalitis: report of a case.A case of symptomatic syringomyelia which appeared six years after Listeria meningoencephalitis is described. Chronic spinal arachnoiditis, as shown by standard MRI and dynamic phase contrast (PC) cine-MRI, may occur after spinal infection and is likely the cause of syringomyelia. To our knowledge, there are no previous reports of delayed spinal complications following listeria monocytogenes infection. The possibility of developing syringomyelia should be always considered in any patient with a history of central nervous system infection.- - - - - - - - - - ranking = 1keywords = central nervous system, nervous system (Clic here for more details about this article) |
4/15. Neuroradiologic abnormalities in marchiafava-bignami disease of benign evolution.marchiafava-bignami disease has been recognized since 1903, but only recently has it become possible to achieve a probable diagnosis before death occurs. Imaging of the central nervous system with MR and CT have contributed significantly to such a diagnosis. Two cases of the disease are reported in patients, aged 33 and 59 years, with benign evolution of neurologic symptoms the diagnosis was confirmed by neurologic imaging with MR and CT and both were studied with evoked responses. Reversibility of the disease and possible prognostic indicators in these and other patients reported in the literature are discussed. The important role that diagnostic procedures, especially MR imaging, play in the management of this disease is emphasized.- - - - - - - - - - ranking = 1keywords = central nervous system, nervous system (Clic here for more details about this article) |
5/15. Alterations in EEG amplitude, personality factors, and brain electrical mapping after alpha-theta brainwave training: a controlled case study of an alcoholic in recovery.A controlled case study was conducted of effects of EEG alpha and theta brainwave training with a recovering alcoholic patient who experienced craving and fear of relapse after 18 months of abstinence. Training consisted of six sessions of thermal biofeedback to increase central nervous system (CNS) relaxation. Effects were documented with pretreatment and post-treatment personality testing, 20-channel digitized EEG evaluations both under relaxed conditions and under stress, minute-by-minute physiologic recordings of autonomic and EEG data during each training session, blood pressure, and heart rate indications taken both during relaxation and under stress, and by clinical observation. Results replicated those of a previous controlled study with chronic alcoholic patients not abstinent prior to treatment. New findings include post-treatment indications of more relaxed CNS functioning under stress, and of reduced autonomic activation both during relaxation and under stress. brain-mapping indications of anxiety associated with painful cold-pressor stimulation were seen only in the pretest readings; at post-test the brain map indicated pain-associated EEG activity in the contralateral somatosensory area, but no apparent anxiety-associated EEG activity. At 4 months post-treatment the patient's wife and colleagues report the patient appears to function in a more relaxed way under the impact of stress, and he reports no longer experiencing craving for alcohol. overall, support is provided for the possibility that alpha and theta brainwave training may be a useful intervention for the abstinent alcoholic experiencing stress-related craving and fear of relapse.- - - - - - - - - - ranking = 1keywords = central nervous system, nervous system (Clic here for more details about this article) |
6/15. The abuse potential of benzodiazepines with special reference to oxazepam.Extensive use of oxazepam, particularly in the abuse-prone population of alcoholic patients, has shown that the dependence-producing potential of this drug is remarkably low, only four cases of dependence having been encountered over many years. Even abrupt withdrawal of oxazepam does not normally precipitate an abstinence syndrome. A computerized literature search retrieved 68 papers on benzodiazepine abuse and/or dependence, only 4 (6%) being concerned with oxazepam. Three reasons are proposed to account for the exceptionally low abuse-potential of oxazepam, the first being considered to be the most important: its onset of central nervous system activity is gradual, so there is no sudden 'intoxication' effect; it tends to cause dizziness at high dosages, discouraging the patient to increase the dose; and because it has a short half-life and no major active metabolites, intermittent therapy (which many patients now practise with all benzodiazepines), periodically allows the complete elimination of the drug from the body.- - - - - - - - - - ranking = 1keywords = central nervous system, nervous system (Clic here for more details about this article) |
7/15. Partial cardiopulmonary bypass for core rewarming in profound accidental hypothermia.Six cases of treatment of severe accidental hypothermia using cardiopulmonary bypass for core rewarming are reported and eleven cases from the literature are analyzed. Thirteen patients survived. overall survival was more likely in patients who had vital signs initially. Initial mean core temperatures in the new cases was 22.8 C. Surface and conventional core rewarming methods resulted in an average temperature increase of 2.4 C per hr. Electrical defibrillation was generally without success until the core temperature had been raised to above 30 C. Between one and six hours after admission, partial femoral-femoral cardiopulmonary bypass (CPB) for core rewarming was started, causing a mean temperature increase of 9.5 C per hr. Four patients required a thoracotomy. Two patients had a massively dilated heart with contusions, and could not be weaned off bypass. None of the four long-term survivors had a demonstrable central nervous system (CNS) deficit. All patients developed temporary pulmonary problems; two developed wound infections. The average hospital stay was 21 days. CPB for core rewarming allows circulatory support while avoiding myocardial damage from prolonged external cardiac massage; rapidly increases the myocardial temperature and counteracts myocardial temperature gradients so that DC electroversion is successful; avoids "rewarming shock"; and improves microcirculatory flow. A prospective randomized trial to compare rapid surface rewarming and CPB rewarming is suggested. Immediate CPB for rewarming is recommended for patients in ventricular fibrillation with core temperatures below 30 C. Prolonged external cardiac massage (ECM) should not be used. The value of surface rewarming and non-CPB core rewarming methods remains undefined.- - - - - - - - - - ranking = 1keywords = central nervous system, nervous system (Clic here for more details about this article) |
8/15. Morel's laminar sclerosis.A 49-year-old alcoholic woman was admitted for convulsions. She died after a 4-week clinical course characterized by a persistent coma with diffuse muscular hypertonia. Post-mortem examination of the brain demonstrated a spongy degeneration and gliosis of the cerebral cortex, limited to the 3rd and the 4th layers. No other pathological lesion of the central nervous system could be objectivated. This is the first reported case in which Morel's laminar sclerosis was the only manifestation of 'alcoholic encephalopathy'. Morel's syndrome should be considered as a pathological entity separate from the marchiafava-bignami disease.- - - - - - - - - - ranking = 1keywords = central nervous system, nervous system (Clic here for more details about this article) |
9/15. metaphor as a diagnostic tool.A case study is reported wherein the patient's frequent use of metaphors was used as presumptive evidence that the patient had been misdiagnosed ten years earlier as having central nervous system disease. The ability to produce metaphors depends upon the capacity to condense several meanings into a word or two, and this in turn implies a rather active associative process. Concretism, not associative richness, characterizes central nervous system disease. The presumption as regards diagnosis was supported by subsequent data including the patient's response to psychotherapy.- - - - - - - - - - ranking = 2keywords = central nervous system, nervous system (Clic here for more details about this article) |
10/15. Focal seizures and aminophylline.Intravenous aminophylline therapy for acute exacerbation of chronic obstructive pulmonary disease may trigger prolonged and difficult to control focal motor seizures with generalization. This can occur in previously neurologically asymptomatic patients and be associated with a poor outcome. Most patients exhibited periodic lateralized epileptiform discharges or had autopsy-proved focal central nervous system lesions, or both. If focal and generalized seizures develop during aminophylline therapy, drug toxicity should be suspect as announcing a focal central lesion. Careful individual monitoring of aminophylline dose and administration rate is essential.- - - - - - - - - - ranking = 1keywords = central nervous system, nervous system (Clic here for more details about this article) |
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