Abstract
Recurring stupor can be caused by repeated metabolic, toxic or structural brain disturbances. Recently, cases of recurring stupor, with fast EEG activity were shown to display increased endogenous benzodiazepine-like activity during the episodes of stupor. Patients with recurring stupor underwent extensive metabolic and toxicologic screening, EEG and brain imaging. Endozepines and exogenously administered benzodiazepines were assayed in plasma and CSF by means of mass spectrometry. Flumazenil, a benzodiazepine antagonist was administered and the behavioural and EEG responses monitored. Treatment with oral flumazenil was attempted in selected cases. Twenty patients were found with recurring stupor. Episodes had begun between ages 18 and 67 years, and in nine patients, had disappeared spontaneously after 4-6 years with symptoms. Stupor lasted hours or days. Onset of the episodes and frequency were unpredictable. Patients were normal between attacks. Stupor was characterized by initial drowsiness, staggering and behavioural changes, followed by deep sleep and spontaneous recovery with post-ictal amnesia. Biochemical screening and brain imaging were always normal. Ictal EEG showed fast background activity, and flumazenil transientl...Continue Reading
Citations
Jan 8, 1999·Brain Research·M G PalmieriM D Caramia
Feb 16, 2013·Journal of Proteome Research·Oskar KarlssonEva B Brittebo
Apr 26, 2002·Neuroreport·Edwin Verstraeten, Raymond Cluydts
Apr 12, 2007·International Anesthesiology Clinics·Shuanglin HaoDavid J Fink
May 3, 2012·Journal of Cardiovascular Pharmacology·Swapnil V ShewaleMariana Morris
Dec 21, 2006·Neuroreport·Agata Adamczyk, Joanna B Strosznajder
Feb 6, 2002·Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging·Michael A Meyer, Ralitza H Gavrilova
Jan 11, 2001·Neurosurgery·C J Hodge, M Boakye
Dec 6, 2005·Reviews in the Neurosciences·François FrenoisMartine Cador
Sep 19, 2012·Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine·Rudra Prosad GoswamiAlakendu Ghosh
Nov 24, 2012·Science Translational Medicine·David B RyeAndrew Jenkins
Mar 23, 2004·The Journal of Physiology·Claire LeroyAstrid Nehlig
Dec 14, 2011·Sleep Medicine·Mark I BoulosBrian J Murray
Oct 29, 2011·Neurologic Clinics·Michael J Angel, G Bryan Young
Jun 13, 2009·Pediatric Neurology·Mario MastrangeloPaola Iannetti
Oct 26, 2005·Neurologic Clinics·Jed E BlackSeiji Nishino
Nov 23, 2006·The Psychiatric Clinics of North America·Scott M LeibowitzJed E Black
Oct 20, 2005·Sleep Medicine Reviews·Pietro CortelliPasquale Montagna
Jul 11, 1998·Lancet·R RivaC Chiabrando
Jan 5, 2001·Baillière's Best Practice & Research. Clinical Gastroenterology·A T Blei
Jan 29, 2014·Sleep·Giuseppe PlazziElio Lugaresi
Aug 29, 2013·Arquivos de neuro-psiquiatria·Fernando TensiniHélio Afonso Ghizoni Teive
Sep 9, 2005·The Neurologist·Richard P Brenner
Apr 26, 2003·Blood·Brian J Ruscito, Neil L Harrison
Sep 21, 2004·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Sharon Scott, Iftekhar Ahmed
Dec 15, 2020·Chronobiology International·Simona SherYaron Dagan
Mar 4, 2021·Animals : an Open Access Journal From MDPI·Tz-Chuen JuShyi-Kuen Yang