thiopental and Tremor

Excitatory movements have been observed during induction of anesthesia with etomidate, thiopental, methohexital, and propofol. We studied the frequency of these excitatory effects and correlated movements with electroencephalographic (EEG) findings in 67 unpremedicated patients (mean age 66.1 yr, range 45-82 yr). Excitatory effects, including myoclonus, tremor, and dystonic posturing, occurred in 86.6% of patients receiving etomidate; 69.2% of the patient responses were myoclonic. Multiple spikes appeared on the EEG in 22.2% of the etomidate patients. The frequency of excitatory effects was 16.6% after thiopental, 12.5% after methohexital, and 5.5% after propofol. None of the patients receiving thiopental, methohexital, or propofol developed myoclonic or seizure activity. In most patients, the excitatory movements were coincident with the early slow phase of the EEG which corresponds to the beginning of deep anesthesia. We conclude that perhaps caution should be exercised when administering etomidate to patients with a history of seizures as the myoclonic activity is associated with seizure activity. The incidence of excitatory movements after administration of propofol is very low.

Topics: Aged; Aged, 80 and over; Anesthesia, Intravenous; Dystonia; Electroencephalography; Etomidate; Humans; Methohexital; Middle Aged; Movement Disorders; Myoclonus; Ophthalmologic Surgical Procedures; Propofol; Thiopental; Tremor

Topics: Adult; Anesthesia; Benperidol; Blood Pressure; Depression, Chemical; Electrocardiography; Female; Fentanyl; Heart Rate; Histamine Release; Humans; Hypotension; Male; Preanesthetic Medication; Propanidid; Stimulation, Chemical; Thiopental; Tremor; Vomiting

We report the case of a 57-year-old man who experienced life-threatening myoclonic status after the administration of gabapentin. Based on familial data, the patient was determined to be a member of a previously described family with benign adult familial myoclonic epilepsy (BAFME). The myoclonic status did not respond to benzodiazepines, but resolved after discontinuing the gabapentin. As for other idiopathic generalized epilepsies, gabapentin may precipitate myoclonic status in a benign syndrome, such as BAFME, as is reported herein for the first time. A correct diagnosis and prompt discontinuation of the drug may reverse a potentially severe, life-threatening condition.

Topics: Acute Disease; Amines; Anticonvulsants; Benzodiazepines; Cyclohexanecarboxylic Acids; Drug Resistance; Electroencephalography; Epilepsies, Myoclonic; Gabapentin; gamma-Aminobutyric Acid; Haplotypes; Humans; Male; Middle Aged; Pedigree; Severity of Illness Index; Status Epilepticus; Thiopental; Tremor

The effects of levocabastine (R 50 547; CAS 79516-68-0) on the central nervous system were studied in comparison with those of diphenhydramine, ketotifen and azelastine. At high doses, levocabastine caused a decrease in locomotor activity, prolongation of thiopental-induced sleep, depression of acetic acid-induced writhing in mice and inhibition of active avoidance response in rats, but these adverse effects were much less potent than those seen in diphenhydramine, ketotifen and azelastine. Oxotremorine-induced tremor and salivation in mice were delayed after extremely high dosage of levocabastine; however, these were much less effective than those seen after diphenhydramine and ketotifen. Levocabastine did not affect the tonic extensor seizure induced by maximal electroshock in mice which is different from that of diphenhydramine. In EEG analysis, levocabastine at a dose of 20 mg/kg caused no significant changes in the EEG recorded from the frontal cortex, occipital cortex, hippocampus and amygdala in rats with chronic electrodes.

Topics: Acetates; Animals; Avoidance Learning; Central Nervous System; Electroencephalography; Histamine H1 Antagonists; Male; Mice; Mice, Inbred Strains; Motor Activity; Oxotremorine; Pain; Piperidines; Rats; Rats, Inbred Strains; Salivation; Sleep; Thiopental; Tremor

Topics: Anesthesia, Intravenous; Anesthetics; Humans; Methohexital; Nausea; Thiopental; Tremor; Vomiting

Topics: Anesthesia; Anesthetics; Barbiturates; Humans; Shivering; Thiopental; Tremor