28 research outputs found
Medical and Bioethical Issues in a Pregnant Woman with Epilepsy: Case Report
A case report of a minor, pregnant girl with epilepsy caused by a brain tumour is presented. There are several aspects which make the presented case complex from medical, but also from the bioethical point of view. The decision about keeping the pregnancy or not is the most important bioethical dilemma for the patient and family. A detailed medical multidisciplinary approach and later balanced explanation of the medical situation to the patient are of extreme value for helping the patientās decision. It is also important to enhance the activities in pregnancy counselling for a woman with epilepsy which will result in a planned pregnancy as a prerequisite for a positive pregnancy outcome
Medical and Bioethical Issues in a Pregnant Woman with Epilepsy: Case Report
A case report of a minor, pregnant girl with epilepsy caused by a brain tumour is presented. There are several aspects which make the presented case complex from medical, but also from the bioethical point of view. The decision about keeping the pregnancy or not is the most important bioethical dilemma for the patient and family. A detailed medical multidisciplinary approach and later balanced explanation of the medical situation to the patient are of extreme value for helping the patientās decision. It is also important to enhance the activities in pregnancy counselling for a woman with epilepsy which will result in a planned pregnancy as a prerequisite for a positive pregnancy outcome
DEPRESSIVE DISORDER AND ALOPECIA
Psychophysical dermatitis is frequently manifested in patients that suffer from psychiatric illnesses and disorders as well as in patients that suffer from depressive disorders. These diseases occur or worsen after acute stress that may trigger them. Difficulties in expressing feelings or impossibility to verbalise them are connected to somatic diseases. In order to emphasize their importance, we
will present a case of a 58 years old woman who has been suffering from alopecia areata that developed after her husbandās death.
The patient doesnāt function well since then - she is socially isolated, she has lost self confidence and self esteem. As she has realised it was impossible to live like that, she decided to seek psychiatric help.
The patient should be examined through the prism of the interdisciplinary treatment and as an integral structure of the mind and body
Cluster Headache
Cluster glavobolja je oblik snažne, intermitentne glavobolje iskljuÄivo hemikraniÄne lokalizacije, karakterizirane razdobljima svakodnevna viÅ”ekratnog javljanja bolova i prateÄe istostrane autonomne simptomatologije Å”to se izmjenjuju s asimptomatskim razdobljima neodreÄena trajanja. U nomenklaturi postoji mnoÅ”tvo sinonima od kojih se najÄeÅ”Äe koristi naziv cluster headache. Patofiziologija cluster glavobolje predmet je mnogih istraživanja. U posljednje vrijeme veÄa pažnja pridaje se teoriji o ulozi supstancije P u patogenezi cluster glavobolje, no toÄan patofizioloÅ”ki mehanizam joÅ” nije definiran. Na osnovi karakteristiÄne simptomatologije dijagnoza se postavlja relativno lako. NajÄeÅ”Äe je potrebno diferencijalno-dijagnostiÄki razlikovati klasiÄnu i obiÄnu migrenu, neuralgiju trigeminusa i kroniÄnu paroksizmalnu hemikraniju. ProvoÄenje dopunskih pretraga opravdano je u atipiÄnoj kliniÄkoj slici ili modificiranoj simptomatologiji cluster glavobolje. Jasna kliniÄka slika ne zahtijeva dopunsku obradu. Medikamentozna terapija cluster glavobolje je podijeljena na simptomatiÄku i profilaktiÄku. NeurokirurÅ”ko lijeÄenje se provodi jedino u sluÄaju kad prethodna medikamentozna terapija nije dovela do poboljÅ”anja. Djelotvorne terapijske sheme nema, pa je lijeÄenje potrebno prilagoditi epizodnom, odnosno kroniÄnom obliku bolesti
ALLERGIC REACTIONS - OUTCOME OF SERTRALINE AND ESCITALOPRAM TREATMENTS
The treatment of dysthymia in itself poses a problem in the everyday psychiatric practice and it can be further hindered when
accompanied by pronounced personality traits (which are indicative of disorder). Due to its pathology and duration dysthymia
interferes with the patient\u27s quality of life and the ability to function in some segments of everyday life. These interferences enticed
our patient to opt for psychiatric treatment.
During a three-year period, despite all the efforts made by psychiatrists in this comprehensive and challenging dysthymia
treatment (psychotherapy, group psychotherapy, psychopharmacotherapy), the expected outcomes of the treatment did not occur.
The patient\u27s goals and expectations included lifestyle change, achieving life satisfaction and mood improvement. The patient was
refusing suggested psychopharmaca until confronted, in psychotherapy, with the fact that she is the one prolonging her own
helplessness and directing her passive agression at the members of the group.
In the end the patent agreed to take psychopharmaca. Therefore, sertraline was introduced in the treatment, but the patient
experienced a severe allergic reaction (Qiuncke\u27s oedema). After four months the second attempt was made and escitaloptam was
introduced, which resulted in urticaria. Due to these allergic reactions to antidepressants, the patient decided not to pursue the
psychopharmacological treatment
Cluster Headache
Cluster glavobolja je oblik snažne, intermitentne glavobolje iskljuÄivo hemikraniÄne lokalizacije, karakterizirane razdobljima svakodnevna viÅ”ekratnog javljanja bolova i prateÄe istostrane autonomne simptomatologije Å”to se izmjenjuju s asimptomatskim razdobljima neodreÄena trajanja. U nomenklaturi postoji mnoÅ”tvo sinonima od kojih se najÄeÅ”Äe koristi naziv cluster headache. Patofiziologija cluster glavobolje predmet je mnogih istraživanja. U posljednje vrijeme veÄa pažnja pridaje se teoriji o ulozi supstancije P u patogenezi cluster glavobolje, no toÄan patofizioloÅ”ki mehanizam joÅ” nije definiran. Na osnovi karakteristiÄne simptomatologije dijagnoza se postavlja relativno lako. NajÄeÅ”Äe je potrebno diferencijalno-dijagnostiÄki razlikovati klasiÄnu i obiÄnu migrenu, neuralgiju trigeminusa i kroniÄnu paroksizmalnu hemikraniju. ProvoÄenje dopunskih pretraga opravdano je u atipiÄnoj kliniÄkoj slici ili modificiranoj simptomatologiji cluster glavobolje. Jasna kliniÄka slika ne zahtijeva dopunsku obradu. Medikamentozna terapija cluster glavobolje je podijeljena na simptomatiÄku i profilaktiÄku. NeurokirurÅ”ko lijeÄenje se provodi jedino u sluÄaju kad prethodna medikamentozna terapija nije dovela do poboljÅ”anja. Djelotvorne terapijske sheme nema, pa je lijeÄenje potrebno prilagoditi epizodnom, odnosno kroniÄnom obliku bolesti
Epilepsy in the Elderly and Depression
Epilepsy is one of the most common neurological problems affecting approximately 1% of the worldās population with
higher incidence among elderly individuals. Although depression is a common comorbid condition in patients with epilepsy,
there is a paucity of information regarding depression in geriatric patients with epilepsy. This study analysed a
group of 83 patients affected by different epilepsy phenotypes accompanied by mental disorders, especially depression.
Antiepileptic and antipsychotic drug treatment has been evaluated, particularly a positive effect of the new antiepileptics
(monotherapy and polytherapy) both on the reduction of seizures and mental disorders
WEIGHT GAIN - AS POSSIBLE PREDICTOR OF METABOLIC SYNDROME
Rapid weight gain among patients with mental disorders can further compound psychological distress and negatively influence
compliance. Weight gain associated with treatment with atypical antipsychotic medication has been widely recognized as a risk
factor for the development of diabetes type II and cardiovascular diseases.
This paper describes a 33-year old female patient treated for schizoaffective disorder. Within two months after introducing
quetiapine the patient experienced considerable weight gain amounting to 19 kg. The replacement of antipsychotic during inpatient
psychiatric care resulted in weight loss
Dilemma of Antiepileptic Drugs Withdrawal in Symptomatic Epilepsy
A successful treatment of epilepsy depends on numerous factors such as etiology, genetics and environmental impact.
An exact diagnosis, treatment and an adequate selection of antiepileptic drugs (AED) are important from the very beginning.
The patient with symptomatic epilepsy caused by the brain tumor (low-grade astrocytoma in the left parietal lobe,
surgically removed 17 years after the first manifestation of illness) is presented in this study. He has been seizure free for
6 years. The represented case study deals with the risk-benefit analysis of the discontinuation of the prescribed antiepileptic
treatment that has lasted for 23 years