RESUMEN
The aim of this study was to determine whether seizure susceptibility due to antihistamines is provoked in patients with febrile seizures. The study population comprised 14 patients with simple febrile seizures and 35 patients with complex febrile seizures. Detailed clinical manifestations were compared between patients with and without administration of antihistamine. The time from fever detection to the seizure onset was significantly shorter in the antihistamine group than that in the nonantihistamine group, and the duration of seizures was significantly longer in the antihistamine group than that in nonantihistamine group. Interleukin-1beta is thought to be associated with causing febrile seizures via its dual role as a pyrogen and convulsant substance. Moreover, interleukin-1beta may activate the turnover of hypothalamic neural histamine. These considerations, along with the present results, suggest that the depletion of hypothalamic neuronal histamine induced by antihistamines may increase neuronal excitability, thereby increasing seizure susceptibility in patients with febrile seizures.
Asunto(s)
Antagonistas de los Receptores Histamínicos/efectos adversos , Convulsiones Febriles/fisiopatología , Convulsiones/inducido químicamente , Susceptibilidad a Enfermedades , Exantema Súbito/fisiopatología , Femenino , Fiebre/tratamiento farmacológico , Antagonistas de los Receptores Histamínicos/uso terapéutico , Humanos , Lactante , Gripe Humana/fisiopatología , Masculino , Estudios Retrospectivos , Factores de TiempoRESUMEN
We describe a case of West syndrome with the balanced translocation t(X;18)(p22;p11.2). Treatment with high-dose vitamin B6, adrenocorticotropic hormone, thyrotropin-releasing hormone, and antiepileptic compounds was not effective, and the patient exhibited persistent refractory seizures and severe developmental delays. Although no mutation analysis and X chromosome inactivation were performed, we suggest that the chromosomal abnormality in the present patient is the main etiologic factor responsible for the infantile spasms and severe developmental delay.
Asunto(s)
Encéfalo/fisiopatología , Cromosomas Humanos Par 22/genética , Cromosomas Humanos X/genética , Espasmos Infantiles/genética , Espasmos Infantiles/fisiopatología , Translocación Genética , Electroencefalografía , Femenino , Humanos , Recién Nacido , Cariotipificación , Mutación Puntual/genética , Índice de Severidad de la Enfermedad , Espasmos Infantiles/diagnósticoRESUMEN
Four cases of double-orifice left atrioventricular (AV) valve are reported. Three of the four patients with double-orifice left AV valve had other associated congenital heart diseases, and the fourth had double-orifice left AV valve alone. A patient with associated ventricular septal defect, who presented with pulmonary congestion and hypertension, suffered from severe heart failure. However, these symptoms improved with the spontaneous closure of the ventricular septal defect. The patient with double-orifice left AV valve alone showed no cardiac symptoms. Two-dimensional and Doppler echocardiography did not detect the double-orifice left AV valve in two of the four patients. More recently, the echocardiographic technique has allowed a noninvasive and more frequent detection of this abnormality. But both of these patients had left-to-right atrial shunt and subsequent reduced transmitral flow and left ventricular volume, which may have made it difficult to detect the morphological and hemodynamic characteristics of double-orifice left AV valve. Careful and repeated echocardiographic observation of mitral configuration is required to determine the presence of double-orifice left AV valve when heart disease is associated with a left-to-right atrial shunt.