Database : MEDLINE
Search on : Alcohol and Withdrawal and Seizures [Words]
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[PMID]: 29427828
[Au] Autor:Metten P; Schlumbohm JP; Huang LC; Greenberg GD; Hack WR; Spence SE; Crabbe JC
[Ad] Address:VA Portland Health Care System and Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, Oregon, USA. Electronic address: mettenp@ohsu.edu.
[Ti] Title:An alcohol withdrawal test battery measuring multiple behavioral symptoms in mice.
[So] Source:Alcohol;68:19-35, 2017 Sep 06.
[Is] ISSN:1873-6823
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Despite acceptance that risk for alcohol-use disorder (AUD) has a large genetic component, the identification of genes underlying various components of risk for AUD has been hampered in humans, in part by the heterogeneity of expression of the phenotype. One aspect of AUD is physical dependence. Alcohol withdrawal is a serious consequence of alcohol dependence with multiple symptoms, many of which are seen in multiple species, and can be experienced over a wide-ranging time course. In the present three studies, we developed a battery of withdrawal tests in mice, examining behavioral symptoms from multiple domains that could be measured over time. To permit eventual use of the battery in different strains of mice, we used male and female mice of a genetically heterogeneous stock developed from intercrossing eight inbred strains. Withdrawal symptoms were assessed using commonly used tests after administration of ethanol in vapor for 72 continuous hours. We found significant effects of ethanol withdrawal versus air-breathing controls on nearly all symptoms, spanning 4 days following ethanol vapor inhalation. Withdrawal produced hypothermia, greater neurohyperexcitability (seizures and tremor), anxiety-like behaviors using an apparatus (such as reduced transitions between light and dark compartments), anhedonia (reduced sucrose preference), Straub tail, backward walking, and reductions in activity; however, there were no changes in thermal pain sensitivity, hyper-reactivity to handling, or anxiety-like emergence behaviors in other apparatus. Using these data, we constructed a refined battery of withdrawal tests. Individual differences in severity of withdrawal among different tests were weakly correlated at best. This battery should be useful for identifying genetic influences on particular withdrawal behaviors, which should reflect the influences of different constellations of genes.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:Publisher

  2 / 1169 MEDLINE  
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[PMID]: 29500720
[Au] Autor:N'Gouemo P
[Ad] Address:Department of Pediatrics, Georgetown University Medical Center, Washington, DC, USA. pn@georgetown.edu.
[Ti] Title:Voltage-Sensitive Calcium Channels in the Brain: Relevance to Alcohol Intoxication and Withdrawal.
[So] Source:Handb Exp Pharmacol;, 2018 Mar 03.
[Is] ISSN:0171-2004
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:Voltage-sensitive Ca (Ca ) channels are the primary route of depolarization-induced Ca entry in neurons and other excitable cells, leading to an increase in intracellular Ca concentration ([Ca ] ). The resulting increase in [Ca ] activates a wide range of Ca -dependent processes in neurons, including neurotransmitter release, gene transcription, activation of Ca -dependent enzymes, and activation of certain K channels and chloride channels. In addition to their key roles under physiological conditions, Ca channels are also an important target of alcohol, and alcohol-induced changes in Ca signaling can disturb neuronal homeostasis, Ca -mediated gene transcription, and the function of neuronal circuits, leading to various neurological and/or neuropsychiatric symptoms and disorders, including alcohol withdrawal induced-seizures and alcoholism.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180303
[Lr] Last revision date:180303
[St] Status:Publisher
[do] DOI:10.1007/164_2018_93

  3 / 1169 MEDLINE  
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[PMID]: 29478862
[Au] Autor:Malhotra S; Basu D; Ghosh A; Khullar M; Chugh N; Kakkar N
[Ad] Address:Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
[Ti] Title:An exploratory study of candidate gene(s) for Delirium Tremens: Adding the new cholinergic dimension to the conundrum.
[So] Source:Asian J Psychiatr;, 2018 Feb 12.
[Is] ISSN:1876-2026
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:BACKGROUND AND AIMS: Delirium Tremens (DT) is the most severe form of alcohol withdrawal syndrome, with a potential risk of mortality. Search for the predictors of DT led to study of candidate genes, with inconsistent and inconclusive results. This study aimed to explore the association of various candidate gene polymorphisms and DT in a case-control design. METHODS: This was a genetic association study with a case control design. Two hundred ten Alcohol dependent (AD) male subjects and 200 age matched controls were recruited. DT was diagnosed with the help of Semi-structured Assessment for Genetics of Alcoholism. SNP genotyping was done using TaqMan assay by real time PCR (q-PCR). RESULTS: T allele carrying status (GT and TT) [rs1824024] of muscarinic cholinergic receptor 2 (CHRM2) was found to be significantly associated with DT. When compared to the general population, this genetic polymorphism was not found to be more common in alcohol dependence per se, which excludes the possibility of spurious association between CHRM2 and DT. Withdrawal seizure was more common in the DT group and came out to be one of the important predictors of DT. However, the genetic association was found to be specific for DT, not related to withdrawal seizures. CONCLUSION: The present research added a new cholinergic dimension in the genetic association and biological mechanism of DT.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180226
[Lr] Last revision date:180226
[St] Status:Publisher

  4 / 1169 MEDLINE  
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[PMID]: 29433107
[Au] Autor:Stephane M; Arnaout B; Yoon G
[Ad] Address:Department of Psychiatry, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA. Electronic address: stephmas@iupui.edu.
[Ti] Title:Alcohol withdrawal hallucinations in the general population, an epidemiological study.
[So] Source:Psychiatry Res;262:129-134, 2018 Feb 05.
[Is] ISSN:1872-7123
[Cp] Country of publication:Ireland
[La] Language:eng
[Ab] Abstract:Hallucinations are sometimes encountered in the course of alcohol withdrawal; however, both the factors predisposing to alcohol withdrawal hallucinations (AWH) and the implications of AWH with respect to the mechanisms of hallucinations remain unclear. To clarify these issues, we used data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) to investigate the demographic correlates, alcohol-use clinical patterns, and psychiatric comorbidities in two groups: drinkers with and without a history of AWH. We estimated the odds ratios for studied factors and used logistic regression analyses to compare the two groups. We found that over 2% of drinkers reported AWH (758 of a sample of 34,533 subjects). Alcohol tolerance and withdrawal seizures were highly associated with AWH, and exposure to alcohol during brain development was associated with a 10-fold increase in AWH compared to exposure during adulthood. African Americans, Native Americans, and unmarried subjects, as well as subjects with lower levels of education and lower levels of income were more likely to experience AWH. Furthermore, those with a history of AWH had higher odds ratios for most psychiatric illnesses than those without such history-yet of anxiety disorders, only panic was associated with AWH. These associations suggest that higher levels of education and of standard of living could protect against AWH; while social isolation, hypervigilance, exposure to alcohol during brain development, and long and severe exposure to alcohol could predispose to AWH.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180212
[Lr] Last revision date:180212
[St] Status:Publisher

  5 / 1169 MEDLINE  
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[PMID]: 29277284
[Au] Autor:Newton J; Suman S; Akinfiresoye LR; Datta K; Lovinger DM; N'Gouemo P
[Ad] Address:Georgetown University Medical Center, Department of Pediatrics, Washington D.C., USA.
[Ti] Title:Alcohol withdrawal upregulates mRNA encoding for Ca 2.1-α1 subunit in the rat inferior colliculus.
[So] Source:Alcohol;66:21-26, 2018 Feb.
[Is] ISSN:1873-6823
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:We previously reported increased current density through P-type voltage-gated Ca channels in inferior colliculus (IC) neurons during alcohol withdrawal. However, the molecular correlate of this increased P-type channel current is currently unknown. Here, we probe changes in mRNA and protein expression of the pore-forming Ca 2.1-α1 (P/Q-type) subunits in IC neurons during the course of alcohol withdrawal-induced seizures (AWSs). Rats received three daily doses of ethanol or the vehicle every 8 h for 4 consecutive days. The IC was dissected at various time intervals following alcohol withdrawal, and the mRNA and protein levels of the Ca 2.1-α1 subunits were measured. In separate experiments, rats were tested for acoustically evoked seizure susceptibility 3, 24, and 48 h after alcohol withdrawal. AWSs were observed 24 h after withdrawal; no seizures were observed at 3 or 48 h or in the control-treated rats. Compared to control-treated rats, the mRNA levels of the Ca 2.1-α1 subunit were increased 1.9-fold and 2.1-fold at 3 and 24 h, respectively; change in mRNA expression was nonsignificant at 48 h following alcohol withdrawal. Western blot analyses revealed that protein levels of the Ca 2.1-α1 subunits were not altered in IC neurons following alcohol withdrawal. We conclude that expression of the Cacna1a mRNA increased before the onset of AWS susceptibility, suggesting that altered Ca 2.1 channel expression may play a role in AWS pathogenesis.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 171226
[Lr] Last revision date:171226
[St] Status:In-Data-Review

  6 / 1169 MEDLINE  
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[PMID]: 29127761
[Au] Autor:Matovu D; Alele PE
[Ad] Address:.
[Ti] Title:Seizure vulnerability and anxiety responses following chronic co-administration and acute withdrawal of caffeine and ethanol in a rat model.
[So] Source:J Basic Clin Physiol Pharmacol;, 2017 Nov 11.
[Is] ISSN:2191-0286
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:BACKGROUND: Caffeine antagonizes the intoxicating effects of alcohol. Consequently, there has been a dramatic global increase in the consumption of caffeinated drinks together with alcohol, especially among young adults. We assessed the seizure vulnerability and anxiety responses following the chronic co-administration of, and withdrawal from, caffeine and ethanol in male rats. METHODS: The rats were randomly assigned to six groups consisting of 10 animals each: 10 mg/kg of caffeine, 20 mg/kg of caffeine, 4 g/kg of 20% ethanol, combined caffeine (20 mg/kg) and ethanol (4 g/kg of 20%), 4 mL/kg distilled water, and an untreated control group. The test substances were administered intragastrically twice daily for 29 days. On day 29, the rats were tested on the elevated plus maze to assess anxiety-related responses. On day 30, pentylenetetrazol (PTZ), a chemoconvulsant, was administered intraperitoneally at a dose of 40 mg/kg to the animals. Seizure responses and mortality up to 72 h were recorded. RESULTS: Compared with the control group, the rats that received chronic treatment with low-dose caffeine, ethanol alone, and combined caffeine and ethanol exhibited significant anxiogenic-like effects, unlike with high-dose caffeine. Both low- and high-dose caffeine significantly increased PTZ seizure latency. Ethanol alone and combined caffeine and ethanol both lowered PTZ seizure latency. No significant difference occurred between the controls and the untreated group for either anxiety or seizure expression. Combined caffeine and ethanol increased the seizure-induced mortality from withdrawal effects at 72 h. CONCLUSIONS: These findings suggest that the chronic co-administration of caffeine and ethanol and the acute withdrawal from these drugs lead to anxiogenic effects and increased seizure vulnerability.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171113
[Lr] Last revision date:171113
[St] Status:Publisher

  7 / 1169 MEDLINE  
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[PMID]: 29033486
[Au] Autor:Khivsara A; Raj JP; Hegde D; Rao M
[Ad] Address:Department of Psychiatry, St. John's Medical College, Bengaluru, Karnataka, India.
[Ti] Title:Topiramate-induced acute liver injury: A rare adverse effect.
[So] Source:Indian J Pharmacol;49(3):254-256, 2017 May-Jun.
[Is] ISSN:1998-3751
[Cp] Country of publication:India
[La] Language:eng
[Ab] Abstract:Idiosyncratic drug-induced liver injury (DILI) is damage to liver occurring at recommended dose of a drug in contrast to toxic or predictable DILI. Although it is common in first-generation antiepileptic drugs (AEDs), it is rare in newer AEDs such as topiramate. Topiramate commonly causes neurological adverse effects such as psychomotor slowing and somnolence. Hepatotoxicity by topiramate is rare and has been previously reported in combination with other drugs such as valproate and carbamazepine. Here, we report a case of topiramate-induced asymptomatic elevation of liver enzymes in an adult man diagnosed with alcohol dependence syndrome and alcohol withdrawal complicated with seizures.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1710
[Cu] Class update date: 171018
[Lr] Last revision date:171018
[St] Status:In-Process
[do] DOI:10.4103/ijp.IJP_414_16

  8 / 1169 MEDLINE  
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[PMID]: 28936822
[Au] Autor:Mengi T; Seçil Y; Çoban A; Beckmann Y
[Ti] Title:Alkol Yoksunlugu ile Tetiklenen Posterior Reversibl Ensefalopati Sendromu. [Posterior Reversible Encephalopathy Syndrome Triggerred By Alcohol Withdrawal].
[So] Source:Turk Psikiyatri Derg;28(3):217-220, 2017.
[Is] ISSN:1300-2163
[Cp] Country of publication:Turkey
[La] Language:tur
[Ab] Abstract:INTRODUCTION: Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiological entity characterized by headache, altered mental status, epileptic seizures, visual disturbances and typically transient changes in posterior cerebral circulation areas. In this article, we present a case of alcohol withdrawal accompanied by PRES. CASE PRESENTATION: A 53-year-old male patient presented to the emergency department with visual hallucinations and meaningless speech. History from his relatives revealed that he has been consuming alcohol for about 35 years and the last consumption was 3 days before the admission. On neurological examination, there was limited cooperation and disorientation was evident to person, place and time. The speech was incoherent. No localizing sign was observed. Cranial magnetic resonance imaging (MRI) revealed bilateral hyperintense areas in medial occipital cortices and in subcortical white matter extending partly into parietal region. Treatment for alcohol withdrawal was started. Signs and symptoms regressed on the 7th day of the treatment as well as the lesions on MRI. DISCUSSION: The clinical presentation, characteristic MRI features together with the reversible nature of the syndrome suggest the diagnosis of PRES. The precise pathophysiological mechanism of PRES still remains unclear. Hypertension, clinical conditions that are associated with impaired cerebral auto-regulation as well as alcohol use which increases the levels of reactive oxygen species and nitric oxide may lead to the disruption of endothelial cells and blood-brain barrier breakdown. Overall, in our case, we think chronic alcoholism and alcohol withdrawal might have caused endothelial dysfunction leading to PRES.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1709
[Cu] Class update date: 170922
[Lr] Last revision date:170922
[St] Status:In-Process

  9 / 1169 MEDLINE  
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[PMID]: 28753046
[Au] Autor:Lee T; Warrick BJ; Sarangarm P; Alunday RL; Bussmann S; Smolinske SC; Seifert SA
[Ad] Address:a Department of Emergency Medicine , University of New Mexico Hospital , Albuquerque , NM , USA.
[Ti] Title:Levetiracetam in toxic seizures.
[So] Source:Clin Toxicol (Phila);:1-7, 2017 Jul 28.
[Is] ISSN:1556-9519
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND/OBJECTIVES: The use of levetiracetam (LEV) in the management of drug-induced seizures has not been systematically investigated. Repetitive and continuous seizures that do not respond to benzodiazepines require second line therapy. Levetiracetam has a unique receptor binding site, rapid absorption, no known cardiac effects at therapeutic doses, and is theoretically a good candidate for use in drug-induced seizures. We evaluate the safety of LEV and its association with seizure cessation in this retrospective chart review of patients who received LEV as a control agent in drug-induced seizures. METHODS: We identified the medical records of patients presenting to an urban, level 1 trauma center between 1 January 2010 and 31 May 2015 by ICD-9 codes based on the following: (1) a poisoning diagnosis, (2) a seizure diagnosis, and (3) administration of LEV. We included patients with a drug-induced seizure based on history, electroencephalogram results, blood alcohol concentrations, urine drug screens, and adequate documentation. We excluded patients with alcohol withdrawal, anoxic brain injury, subtherapeutic concentrations of other antiepileptics, hypoglycemia, and pseudoseizures. Primary outcomes of interest included cessation of active seizures or the prevention of seizure recurrence. We assessed safety by the presence or absence of adverse drug effects (ADE) attributed to the administration of LEV. RESULTS: Thirty-four patients met inclusion and exclusion criteria. Half of the study cohort (17) presented with generalized tonic-clonic seizures (TCS); half (17) presented in generalized convulsive status epilepticus (GCSE). Six patients in GCSE received LEV during their seizures; 2 also received fosphenytoin. One improved immediately following LEV administration, and the remaining 5 had seizure control. Eleven GCSE patients (65%) remained seizure free after LEV therapy. The patients with TCS (17) received LEV after seizure(s) control. Sixteen (94%) were seizure-free during their hospital course. We found no adverse drug effects. In total, 27 of 34 patients (79%) had a return to baseline neurological and physical health. Six had long-term sequelae; none of which are known LEV side-effects. We identified 46 toxic substances and 22 known seizurogenic agents (48%). The median length of stay was 3.7 days (0.4-96), and the median duration of in-hospital LEV therapy was 1.6 days (0-49). CONCLUSIONS: Levetiracetam used as a second-line agent was associated with control of drug-induced seizures and prevention of seizure recurrence without obvious adverse effects. A prospective study is needed to confirm these results.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1707
[Cu] Class update date: 170728
[Lr] Last revision date:170728
[St] Status:Publisher
[do] DOI:10.1080/15563650.2017.1355056

  10 / 1169 MEDLINE  
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[PMID]: 28736097
[Au] Autor:Luthe SK; Sato R
[Ad] Address:Department of Anesthesia, Urasoe General Hospital, Okinawa, Japan.
[Ti] Title:Alcoholic Pellagra as a Cause of Altered Mental Status in the Emergency Department.
[So] Source:J Emerg Med;53(4):554-557, 2017 Oct.
[Is] ISSN:0736-4679
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Pellagra, which is caused by a deficiency of niacin and tryptophan, the precursor of niacin, is a rare disease in developed countries where alcoholism is a major risk factor due to malnutrition and lack of B vitamins. Although pellagra involves treatable dementia and psychosis, it is often underdiagnosed, especially in developed countries. CASE REPORT: In Japan, a 37-year-old man presented to the emergency department with altered mental status and seizures. Wernicke encephalopathy and alcohol withdrawal were suspected. The patient was treated with multivitamins, which did not include nicotinic acid amide, and oral diazepam. Despite medical treatment, his cognitive impairment progressively worsened, and eventually, pellagra was suspected. His response to treatment with nicotinic acid amide was substantial, and he was discharged without any long-term sequelae. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Despite the treatable dementia and psychosis, pellagra is often underdiagnosed, especially in developed countries and alcoholic patients. Pellagra should be routinely suspected in alcoholic patients because the response to appropriate treatment is typically dramatic.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1707
[Cu] Class update date: 171028
[Lr] Last revision date:171028
[St] Status:In-Process


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