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Baroreflex Failure
Published in David Robertson, Italo Biaggioni, Disorders of the Autonomic Nervous System, 2019
During the pressor crises, the patient may experience a sensation of hot flushing, but pallor is more characteristic than redness. Diaphoresis is marked. In almost all respects, these episodes may resemble those of pheochromocytoma and the differential of baroreflex failure from pheochromocytoma is an exceedingly difficult one.
Case 49: A Teenager with Palpitations
Published in Layne Kerry, Janice Rymer, 100 Diagnostic Dilemmas in Clinical Medicine, 2017
A phaeochromocytoma, which is a rare adrenal medullary tumour secreting high levels of catecholamines, can cause hypertension, palpitations and symptoms of anxiety. Patients often describe episodes of diaphoresis, where they sweat excessively, and may notice that episodes increase in frequency over time.
State-of-the-art pharmacotherapy for autonomic dysfunction in Parkinson’s disease
Published in Expert Opinion on Pharmacotherapy, 2020
Cecilia Quarracino, Matilde Otero-Losada, Francisco Capani, Santiago Pérez-Lloret
Thermoregulation is impaired in PD, and diaphoresis is frequent [76]. Dysfunction of central, and peripheral autonomic nervous system structure has been posed as part of its pathophysiology, the same as some medications [76]. This is one of the least explored dysautonomic symptoms in PD, and there is no data about its impact on the disease. Furthermore, while there are many validated objective measures, which have been successfully applied to PD [76], there is no rating scale for assessing symptomatology. There are no clinical trials for this condition in PD. Anecdotal evidence suggests that Deep Brain Stimulation may be effective when abnormal thermoregulation is linked to off-periods [76]. All these data suggest that research in thermoregulatory abnormalities in PD should be considered as a priority. Symptomatic should be developed and appropriately validated. Impact on quality of life, morbidity, and evolution of the disease should then be assesed. Clinical trials should be performed, provided appropriate candidates are found. Antibiotics, opioids, antihistamines can help to raise corporal heat, whereas antipyretics can help reduce it.
Venomous bites during pregnancy: the black widow spider (Latrodectus mactans)
Published in Toxin Reviews, 2019
Gianmarco Troiano, Alessandra Bagnoli, Astrid Mercone, Nicola Nante
Widow venom contains α-latrotoxin, which provokes a massive presynaptic release of acetylcholine. Latrotoxin and latrodectin selectively interact with latrophilin and neurexin receptors in the lipid bilayer membrane of presynaptic terminals, resulting in the formation of cation channels allowing an influx of Ca2+ into the cell. Toxin activity causes the release of a large amount of such neurotransmitters as noradrenaline and acetylcholine, as well as calcium-independent gamma-aminobutyric acid, and has an important effect on the neuromuscular junction (Sotelo-Cruz and Gomez-Rivera 2016). After a person has been bitten, crampy muscle spasms usually occur within an hour in the chest (upper extremity bites) or the abdomen (lower extremity bites). The pain may be intense enough to mimic myocardial infarction or acute abdomen, but it is rarely life threatening and typically resolves within 48–72 h (Clark et al.1992, Juckett 2013). Nausea, weakness, local or generalized diaphoresis, and facial edema may occur (Clark et al.1992).
Sociodemographic and clinical characteristics of synthetic cannabinoid users in a large psychiatric emergency department in Turkey
Published in Journal of Addictive Diseases, 2018
Murat Yalçın, Nazlı Tunalı, Handan Yıldız, Ayşenur Oğuz, Bülent Kadri Gültekin
Many acute psychiatric and physical side effects, which can arise within minutes and continue for hours, are reported in association with SC use. Psychiatric symptoms include mood changes, behavior disorders, psychomotor agitation, aggression, suicidal thoughts, psychotic symptoms, sensory and perception disorders, anxiety, sleep disorders, deterioration in cognitive abilities, confusion and changes in consciousness. Symptoms such as excessive diaphoresis and tinnitus are also reported alongside cardiovascular symptoms such as tachycardia, hypertension, and myocardial infection; gastrointestinal symptoms such as hepatotoxicity, nausea, and vomiting; nephrotoxicity symptoms; neuromuscular symptoms such as tremor, apathy, ataxia, headache, and dizziness. There are also reports of cases of epileptic seizures. It has been thought that long-term SC usage induces acute psychosis, similar to cannabis use, in susceptible individuals. It is commonly known that, as well as acute intoxication and long-term side effects, withdrawal symptoms from SC occur at much higher rates and in a much shorter time compared to cannabis.7,9–14 Side effects observed among SC users depend on several factors, such as the type of SC used, the dosage, or susceptibility of the individual.15