Biomedical subjects
G B Murray
Publications and source records attributed to G B Murray.
Electroconvulsive therapy for post-stroke depressed geriatric patients.
Medical records were retrospectively reviewed for 20 medically ill geriatric patients who received electroconvulsive therapy (ECT) for post-stroke depression from January 1982 to January 1991 at Massachusetts General Hospital. Of the 19 patients (95%) who improved with ECT, 7 patients (37%) suffered relapses despite maintenance anti-depressant medications. Relapses typically developed approximately 4 months after ECT. Five patients (23%) developed ECT-related medical complications. Three patients (15%) developed transient interictal confusion or amnesia. No patient experienced an exacerbation of preexisting neurologic deficits. These findings indicate that ECT is a generally well tolerated and effective treatment for depressed, medically ill post-stroke geriatric patients.
Psychostimulants for secondary depression in medical illness.
The hospital charts of 198 patients with acute medical or surgical illnesses who had been treated with either dextroamphetamine or methylphenidate for secondary depression during a 5-year period at the Massachusetts General Hospital were examined. Eighty-two percent of patients showed improvement following psychostimulant treatment. Seventy percent of all patients demonstrated marked or moderate improvement in depressive symptoms. No significant differences in efficacy between the two psychostimulants or across diagnostic categories for depression were observed. Patients improved quickly, usually within the first 2 days of treatment. Adverse reactions necessitating the termination of psychostimulant treatment occurred in 10% of trials. Anorexia was not observed as a side effect of treatment.
High-dose intravenous haloperidol for agitated delirium in a cardiac patient on intra-aortic balloon pump.
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Carbamazepine-induced thrombocytopenia.
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Psychosis and water intoxication.
Three cases of psychosis, polydipsia, and water intoxication are presented as examples of a syndrome that is potentially unrecognized in psychiatric settings. Diagnostic and etiologic considerations, with particular attention to the syndrome of inappropriate antidiuretic hormone secretion (SIADH), are discussed through a review of relevant literature. A schema for a routine psychiatric evaluation is described that will minimize overlooking this association of psychosis and disturbed water balance.
Psychiatric presentation of epilepsia cursiva.
Coarse brain disease can first present as a behavioural or psychiatric disorder. Partial seizures with complex symptomatology (psychomotor or temporal lobe epilepsy) may offer particular difficulties in differential diagnosis from the "functional psychoses". The authors report a case of "running epilepsy" (epilepsia cursiva), that first presented as a behavioural problem, and review the literature on this rare form of psychomotor epilepsy.
Diazepam withdrawal: a current problem in recognition.
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Carbamazepine for central sleep apnea.
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Geriatric epilepsy: a review.
After the turn of the century, the proportion of population over 60 years of age is expected to be over 20%. Recent epidemiologic studies show a higher incidence of new-onset epilepsy in the population over 60 years of age compared with preceding decades of life. The predominant seizure type in up to 80% of these new cases of epilepsy is simple and complex partial manifestation. This paper reviews the literature documenting the increased incidence of partial seizures in the aging population, explores the known etiologies of new-onset epilepsy, and uses five case vignettes presenting with complex partial symptomatology.
[Computerizable dental record].
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