ABSTRACT
Diffuse alveolar hemorrhage is persistent or recurrent pulmonary hemorrhage that occurs due to a variety of causes. Here, we present the case of a 15-year-old male child who presented with chief complaints of involuntary jerking movements of the entire body in the morning followed by coughing out a massive amount of blood. At presentation, the patient’s blood glucose level was high. Bronchoscopy revealed bleeding in the middle and lower lobes of both lungs. Computed tomography (CT) brain was suggestive of cerebral edema and the CT chest was suggestive of diffuse opacities in bilateral lung fields. The patient was started on corticosteroids, antiplatelet drugs, antiepileptics, insulin, and oxygen inhalation which helped the patient to recover and was discharged in a week’s time.
ABSTRACT
Background: Headache is the most common symptom encountered in neurology outpatient department (OPD). One-fifth of patients in neurology clinics present with headache. Headache was long been found to be associated with epilepsy, especially migraine both chronic neurologic disorders share possible clinical interrelationships. Studying their association is necessary as identification of clinical subgroups vulnerable to develop to both disorders can be made possible in the future. Aims and Objectives: The objective of the study was to analyze the characteristic features of various types of headaches in epilepsy patients and their causal association. Materials and Methods: A total of 100 epilepsy patients with headache were recruited from the OPD of the neurology department in a tertiary care center and interviewed regarding the characteristic features of headache through a questionnaire. Results: Out of our study population, female outweighs the male (53, 47). Out of all, interictal was more prevalent (57%), followed by post-ictal (48%), pre-ictal (22%), and intra-ictal (0%) among epilepsy patients. Migraine was found to be the most common type of headache in all subgroups of headaches in epilepsy patients (pre-ictal – 77% of migraine, postictal – 81% of migraine, and interictal – 61% of migraine). Associated characters of headaches such as photophobia (42%) and their prevalence are also studied. Conclusions: Stronger association between migraine and headache is validated, and the strongest associated with migraine in postictal headache is highlighted (81%). This can strengthen the theories proposed so far such as the frequent triggering of headache by a seizure. Further research on common etiologic or pathophysiological processes to these associations can lead to a common therapeutic strategy and prevention of morbidity in patients.
ABSTRACT
O objetivo do presente trabalho foi testar se a indução de potenciação de longa duração (LTP) no córtex frontal seria capaz de bloquear os efeitos depressores sobre a plasticidade pré-sináptica da via hipocampo (CA1)-córtex pré-frontal medial (mPFC) induzidos por pós-descarga no hipocampo (AD; atividade epiléptica) ou pela injeção sistêmica de cetamina (KET; modelo farmacológico de psicose). Ratos anestesiados com uretana receberam implantes de eletrodos de estimulação e registro, em CA1 e mPFC, respectivamente. Estímulos elétricos monofásicos pareados foram aplicados em CA1 a cada 20s para eliciar potenciais pós-sinápticos de campo (P1 e P2) no mPFC. Avaliamos a plasticidade de curta duração através da facilitação por pulso pareado (PPF), definida pela razão entre as amplitudes de P2 e P1. Após 90min de registros de linha de base, grupos independentes de animais receberam aplicação de AD, injeção de KET-S(+) (12,5 mg/kg i.p.) ou injeção de veículo (NaCl 0,15M), e foram registrados por mais 120min. Em outro experimento registramos 30min de linha de base e aplicamos estímulos de alta frequência (HFS) para indução de LTP aos 30 e 60min. Trinta minutos depois, os animais receberam KET, AD ou veículo e tiveram seus potenciais corticais registrados por mais 120 min. Nossos resultados mostram que AD gera significativa redução (-50%) da eficiência de transmissão basal na via CA1-mPFC, enquanto KET promove leve aumento (+10%). Ambos os tratamentos também promovem prejuízo significativo da PPF na mesma via (-15%). Além disso, observamos que a indução prévia de LTP atenua as alterações da eficiência basal e bloqueia os prejuízos da PPF na via CA1-mPFC induzidos por KET e AD. Nossos achados reforçam evidências recentes de que moduladores alostéricos positivos de NMDA e AMPA atenuam os prejuízos cognitivos em modelos animais de psicose. Acreditamos, portanto, que a aplicação prévia de HFS na região CA1 do hipocampo pode ser uma ferramenta útil para melhor entendermos como prevenir os prejuízos de plasticidade sináptica no mPFC em modelos de psicose e psicose pós-ictal.
The present work aimed to test whether the induction of cortical long-term potentiation (LTP) was able to prevent the presynaptic plasticity impairment in the hippocampus (CA1)-medial prefrontal cortex (mPFC) pathway induced by hippocampal after-discharge (AD; epileptic activity) or systemic injection of ketamine (KET; pharmacological model of psychosis). Electrodes were stereotaxically positioned into CA1 and mPFC in urethane-anesthetized rats. Monophasic paired-pulses of electrical stimuli were applied to CA1 in order to evoke field post-synaptic potentials (P1 and P2) in the mPFC every 20s. Short-term plasticity was evaluated by measuring paired-pulse facilitation (PPF), defined as the amplitude ratio P2/P1. After 90min of baseline recordings, three independent groups of animals received hippocampal-AD, KET-S(+) (12.5mg/kg, i.p.) or vehicle (NaCl 0.15M) followed by 120min of evoked response monitoring. In an additional experiment, two applications of high-frequency stimuli (HFS) were given at 30 and 60min after baseline. Thirty minutes after the second HFS, the rats received KET, AD or vehicle and their cortical evoked potentials were monitored for further 120min. Our results showed that AD significantly decreased (-50%) whereas KET enhanced (+10%) CA1-mPFC basal synaptic transmission. In addition, AD and KET similarly impaired short-term plasticity in the mPFC (-15%). Interestingly, pre-induction of LTP in the mPFC prevented the PPF disruption induced by KET and AD. Altogether, our findings support recent evidences that positive allosteric modulators of NMDA and AMPA receptors attenuate cognitive impairments in animal models of psychosis. We believe that controlled HFS in CA1 can be a useful tool to better understand how to prevent synaptic plasticity disruptions observed in experimental models of psychosis and pos-ictal psychosis.
Subject(s)
Humans , Psychotic Disorders , Long-Term Potentiation , Frontal Lobe , Ketamine , Rats, WistarABSTRACT
Objective To determine the clinical characteristics of post ictal headache (PIH) and clinical risk factors associated with the occurrence of PIH in patients with localization related epilepsy.Methods The subjects were 47 patients with temporal lobe epilepsy (TLE),21 patients with occipital lobe epilepsy (OLE),and 29 patients with frontal lobe epilepsy (FLE).The subjects were directly asked whether headaches occurred just after seizures and its characteristics.Results The characteristics of PIH were:throbbing quality,which was exacerbated by coughing,vomiting,bending,and sudden head movement,accompanied by photophobia,phonophobia,and relieved by sleep.The incidence of PIH was 21 3% for TLE,61 9% for OLE,and 41 4% for FLE.The risk of PIH was significantly higher for OLE than for TLE or FLE,and for patients with generalized tonic clonic seizures.Younger onset age of epilepsy was also a risk factor for PIH.Conclusions PIH possess some characteristics similar to migraine.The occurrence of PIH may be related to the region of epileptic focus and the region of the spread of epileptic discharges.