Morb. Sacr. (περὶ ἱερῆς νούσου, de morbo sacro)
Elizabeth M. Craik in The ‘Hippocratic’ Corpus, 2014
The ‘sacred disease’ of On The Sacred Disease cannot be regarded simply as epilepsy, with which it is commonly identified. Certainly, the clinical description of recurrent paroxysmal attacks (7) does fit this identification above all. However, passages (especially in 9) paralleled elsewhere in the ‘Hippocratic’ Corpus indicate that not only the fits of grand mal epilepsy but also other kinds of sudden seizure, including some fatal cases, might be attributed to the ‘sacred disease’. Epilepsy is not in itself a disease, but a recurrent disorder of the brain. While epilepsy is the most common cause of convulsions, other causes include certain diseases of the brain, such as meningitis, encephalitis and tumours, and also reactions to serious injuries or infections (BMD s.v.). The disease observed in animals (11) is probably to be identified with that now known as ‘sturdy’, a condition caused by a hydatid cyst in the brain of sheep and goats; another contender might be the more common ‘scrapie’, a fatal degenerative encephalopathy attacking the nervous system.
Fat-Soluble Vitamins
Luke R. Bucci in Nutrition Applied to Injury Rehabilitation and Sports Medicine, 2020
Vitamin D deficiency results in impaired intestinal absorption of calcium and impaired renal reabsorption of calcium and phosphate. Serum calcium (5 to 7 mg/dl) and phosphate levels are decreased, and serum alkaline phosphatase activity is increased. Hyperparathyroidism in response to lowered serum calcium levels ensues, and PTH and remaining 1,25OHD produce bone demineralization. Rickets occurs in growing humans (children and infants) and osteomalacia in adults. Osteomalacia is characterized by loss of bone mineral, with preservation of osteoid (unlike osteoporosis, which has decreased bone mineral and osteoid). Clinical symptoms include bone pain, muscle weakness, and bone tenderness. Usually, in adults, muscle pain (myopathy) is the foremost or only sign of vitamin D deficiency. Serum levels of CPK or aldolase are normal in vitamin D deficiency with muscle pain. Left untreated, rickets can lead to bone disfigurement, with characteristic bowing of legs and arms. Knock-knees, spinal curvature, and joint enlargement occur. Extreme symptoms of convulsions and tetany may occur.
Human Herpesvirus 6A, 6B, and 7 Encephalitis
Sunit K. Singh, Daniel Růžek in Neuroviral Infections, 2013
Long before the etiology of ES was established, it was observed that convulsions, and rarely encephalopathy, may accompany this febrile illness (Berenberg et al. 1949). Since the discovery of HHV-6 and HHV-7, the association with convulsions has been confirmed for HHV-6B and HHV-7 (Torigoe et al. 1996). Convulsions are frequently atypical, sometimes resulting in status epilepticus. In approximately 17% of pediatric populations, HHV-6B elicits undifferentiated febrile illness without rash, as well as other acute febrile illnesses. In ES, the fever is characteristically high and persists for several days. An erythematous maculopapular rash, lasting for a short period, is noted once the fever is resolved. Occasionally, this primary HHV-6B infection has accompanying neurological complications including febrile seizures and occasional cases of acute encephalitis, meningoencephalitis, or encephalopathy. Several reports of HHV-6-associated encephalitis in immunocompetent children and adults in the absence of classic roseola have been described (Yao et al. 2010). In small children, encephalitis is suspected when an altered level of consciousness or significant change in personality, cognitive dysfunction, or focal neurological symptoms not explained by cranial nerve paralysis persists for z24 h. The disease is accompanied by headache, nausea, temperature of ≥38°C, and specific laboratory results (Ibrahim et al. 2005).
Sport-related concussive convulsions: a systematic review
Published in The Physician and Sportsmedicine, 2018
Nicholas O. Kuhl, Aaron M. Yengo-Kahn, Hannah Burnette, Gary S. Solomon, Scott L. Zuckerman
Concussive convulsions are defined as an initial period of tonic stiffening followed by myoclonic jerks of all limbs [6]. They occur within seconds of impact and last for a short period of time, typically on the order of seconds. Other motor phenomena, such as asymmetrical posturing, have also been described [6]. McCrory et al. first described sport-related concussive convulsions (SRC-C) in Australian footballers nearly 20 years ago. McCrory and his colleagues’ retrospective study [5] detailed the cases of 22 adult Australian football players who, within seconds of head impact, displayed loss of consciousness followed by a brief tonic phase and subsequent bilateral myoclonic or clonic jerking of the extremities lasting no longer than 150 s. Similarly, in the group’s prospective study [7], tonic posturing without clonic movements was noted to have occurred in almost one quarter of SRCs. In both studies, short- and long-term sequelae were equally benign, and the authors concluded that SRC-C demonstrated no adverse clinical, cognitive, or neuroimaging outcomes [5,7].
A pilot study of children and parents experiences of the use of a new assistive device, the electro suit Mollii
Published in Assistive Technology, 2021
Birgitta Nordstrom, Maria Prellwitz
Cerebral palsy (CP) describes a group of permanent disorders in the development of movement and posture, causing limitations in activity due to a non-progressive neurological disorder that occurred in the developing brain. The motor disturbance is often accompanied by other disorders such as epilepsy and secondary musculoskeletal problems (Rosenbaum et al., 2007). In Sweden, one out of 400 children are diagnosed with CP, making it the most common cause of impaired motor function in children (Hägglund, 2013). Common impairments associated with CP are muscle weakness, incoordination, and spasticity, causing difficulties with everyday activities that can lead to activity limitations and restrictions in participation (Moreau et al., 2016). Restriction due to spasticity may, for example, create walking difficulties for the child (Beckung, Brogren, & Rösblad, 2002). These difficulties can negatively affect the child’s health and affect their ability to keep up with peers (Moreau et al., 2016). Spasticity generally involves sudden involuntary movements or convulsive muscle contractions. At present, there is no cure for spasticity, but there are different ways to try to manage it (Jacobs, 2001).
Fatal serotonin syndrome: a systematic review of 56 cases in the literature
Published in Clinical Toxicology, 2021
Sanjay Prakash, Chaturbhuj Rathore, Kaushik Rana, Anurag Prakash
Seizure is not reported as a common manifestation in most of the reviews on SS. The prevalence of seizures varies from 2 to 5% in different reviews [53, 61]. In this review, convulsions were observed in 20 patients (36%), and it was the second most common symptom, again indicating that it may be a poor prognostic factor. The muscle rigidity is considered less common and less severe with SS compared to NMS [56]. Sternbach’s criteria did not include rigidity as a clinical feature. Although rigidity/hypertonicity is a part of the Hunter criteria, it was not a very common and prominent symptom in their database. They considered the presence of rigidity in severe and life-threatening SS [5]. Rigidity was noted in about 27% of our cases, and it was severe in many cases, leading to trismus, hyperextended spine and legs, opisthotonus, and inelicitable deep tendon reflex/clonus. Identification of trismus is very important as these patients may need an urgent tracheostomy. Our observation indicates that severe rigidity can occur in patients with severe SS and is again a poor prognostic factor. This can also cause diagnostic confusion with NMS.
Related Knowledge Centers
- Coeliac Disease
- Encephalitis
- Meningitis
- Brain
- Epilepsy
- Skeletal Muscle
- Seizure
- NON-Epileptic Seizure
- Electrical Injury
- Spasm