PubMed Health⌕ Search

Biomedical subjects

V Eapen

Publications and source records attributed to V Eapen.

35 records · Page 2Linked to original sources

HMPAO SPET does not distinguish obsessive-compulsive and tic syndromes in families multiply affected with Gilles de la Tourette's syndrome.

BACKGROUND: Gilles de la Tourette's syndrome (GTS) is a familial neuropsychiatric disorder characterized by tics and obsessive-compulsive behaviours (OCB). Previous HMPAO SPET studies of subjects with GTS have shown hypoperfusion of striatal and frontal areas. Studies of patients with primary obsessive-compulsive disorder have shown, in contrast, hyperperfusion of similar areas. METHODS: Twenty subjects from five families affected by GTS, including individuals with OCB but no tics, were examined using HMPAO SPET. RESULTS: There were abnormalities of regional cerebral perfusion in individuals with GTS, OCB and tics. Hypoperfusion was in striatal, frontal and temporal areas. There was no hyperperfusion. CONCLUSIONS: Regional cerebral blood flow patterns in individuals with OCB in families affected by GTS are comparable to their relatives with GTS and differ from individuals with primary OCD in the absence of a family history of tic disorders.

Adolescent↗

Frontal glioma presenting as anxiety and obsessions: a case report.

A 53-year-old gentleman is described, who presented with acute onset of anxiety and obsessional symptoms. The clinical picture was complicated by the presence of mild alcohol withdrawal symptoms and history of excessive drinking for 20 years. A month later, he developed right hemiparesis. CT scan revealed a left frontal tumour, and on histology this was found to be Grade 4 astrocytoma.

Brain Neoplasms↗

Mass hysteria in an Arab culture.

In this report we describe the circumstances surrounding an outbreak of mass hysteria among first year female university students. The outbreak was precipitated by a state of panic over the possibility of a fire which turned out to be harmless fumes from a locally used burning perfume. Twenty-three cases presented to the emergency room with symptoms of respiratory distress associated with marked emotional reactions. The outbreak was controlled by separating the patients, and the lack of media coverage facilitated this process. Cases with persistent and severe symptoms were those having physical and psychological problems prior to the occurrence of the outbreak. Individual vulnerability factors deserve special consideration in the management of mass hysteria since they are likely to influence the response to treatment.

Adolescent↗

Sex of parent transmission effect in Tourette's syndrome: evidence for earlier age at onset in maternally transmitted cases suggests a genomic imprinting effect.

Parent of origin effects caused by genomic imprinting may influence the phenotypic expression of a number of heritable human disorders. To test this phenomenon in Tourette's syndrome (TS), we studied 437 first degree relatives systematically ascertained through 57 probands. We compared age at onset, age at diagnosis, and phenotypic expressions as observed in the diagnosis of TS, chronic motor tics, and obsessive compulsive behavior in the offspring of affected males with the offspring of affected females. Of the 437 subjects, 16.7% had matrilineal inheritance and 13.9% had patrilineal inheritance, as determined by family history methodology. Chi-square analysis of the different phenotypic expressions and sex of the transmitting parent failed to provide evidence of significant group differences. We found no significant differences in the age at diagnosis either. However, the maternally transmitted offspring showed a significantly earlier age at onset. This points to a parent of origin effect on the putative TS gene that could be explained by meiotic events or even intrauterine environmental influences. These findings may help explain the hitherto conflicting reports about the nature of genetic transmission in TS, and suggest a need to re-examine family data separately for maternally and paternally transmitted cases, taking into account the possible role of imprinting.

Age of Onset↗

Tourette syndrome, epilepsy, and emotional disorder, a case of triple comorbidity.

We present a case report illustrating the complexity encountered in the diagnosis and treatment of patients with multiple diagnoses. The clinical presentation in Tourette syndrome, and the behavioural manifestations in some cases of complex partial seizures can both be misunderstood and misdiagnosed. The paper, within the framework of a case, emphasises the need for a multidisciplinary approach in the assessment and management of such cases.

Affect↗

The use of fluoxetine in Gilles de la Tourette syndrome and obsessive compulsive behaviours: preliminary clinical experience.

1. Obsessive Compulsive Behaviours (OCB) occur in more than 50% of patients with the Gilles de la Tourette Syndrome (GTS) and in some cases these behaviours are more disabling than the tics themselves. 2. Fluoxetine, a specific serotonin reuptake inhibitor (SSRI) has been demonstrated to be effective in patients with Obsessive Compulsive Disorder. 3. The authors report on their clinical experience of fluoxetine in 30 GTS patients with OCB, in an open retrospective study. 4. There was an overall improvement in OCB as judged by the clinician in 76% of cases. Most patients received fluoxetine at a daily dose of 20 to 40mg for an average period of 6 months (24 +/- 4 weeks). In general, fluoxetine was well tolerated and further studies are indicated.

Adolescent↗

Stimulus induced behaviours in Tourette's syndrome.

Three cases of Gilles de la Tourette's syndrome (GTS) who experienced different tic related behaviours in response to both external and internal stimuli are described. Such behaviours might represent sensory tics, reflex motor tics, exaggerated startle responses, or obsessive compulsive behaviours. It is suggested that there is a continuum of stimulus induced behaviours, and that, in some cases, separations into individual descriptive entities may be difficult. There also seems to be a continuum between internal and external phenomena that induce the behaviours. Implications for the relation between GTS and obsessive compulsive disorder are also discussed.

Acoustic Stimulation↗

Bilineal transmission in Tourette's syndrome families.

We assessed the frequency of bilineal (from maternal and paternal sides) transmission of Tourette's syndrome (TS) in two groups of pedigrees: (1) 39 high-density families in which five or more relatives were reported to have TS, and (2) the families of 39 consecutively ascertained probands referred for evaluation of TS. We used two designations for the TS phenotype (tics, tics or obsessive-compulsive behavior [OCB]), and we attempted to verify bilineal transmission with direct examinations. For the high-density pedigrees, bilineal transmission was evident in 33% (considering tics) and 41% (considering tics or OCB) of families, which was confirmed by examination in 77% of the kindreds. For the consecutive pedigrees, bilineal transmission was seen in 15% (tics) and 26% (tics or OCB) of families, which was verified by examination in 66% of the kindreds. Both parents of the proband were affected (tics or OCB) in 38% of the high-density pedigrees and 10% of the consecutive pedigrees. For the high-density families only, the frequency of bilineal transmission appeared to be related to the proband's severity of TS, and for both pedigree groups, the frequency of both parents being affected was higher in families in which the proband's symptoms were most severe. Our findings support the contention that bilineal transmission and homozygosity are common in TS. These genetic phenomena might play a role in determining severity of illness and may explain current difficulties in localizing the gene defect by linkage analysis.

Fathers↗

Evidence for autosomal dominant transmission in Tourette's syndrome. United Kingdom cohort study.

Complex segregation analyses were performed on families ascertained through 40 unselected consecutive patients with Tourette's syndrome to examine the hypothesis that its transmission is consistent with genetic inheritance. Analyses were done using several diagnostic classifications. All results were consistent with an autosomal dominant gene with high penetrance. The penetrances ranged from 0.882 to 1.000 for males and 0.452 to 0.980 for females, depending upon the specific classification scheme incorporated into the analyses.

Adolescent↗

Pharmacologic controversy of CNS stimulants in Gilles de la Tourette's syndrome.

The controversy of the use of stimulants in Gilles de la Tourette's syndrome (GTS) can only be understood by examining the relationship between GTS and attention deficit-hyperactivity disorder (ADHD), because the relationship between the two disorders is complex, and stimulants are used in the one (ADHD) and may be contraindicated in the other (GTS). This relationship therefore has to be viewed from several perspectives, including clinical, genetic, neurobiochemical, neurophysiological, and treatment strategies, to highlight the complexities involved, and reasons for controversy. The present review will examine these relationships, and thus the evidence for and against the treatment of GTS with stimulants.

Adolescent↗

Gilles de la Tourette syndrome in India: two cases.

Two cases of Gilles de la Tourette syndrome from India are presented. The symptomatology of Tourette syndrome is the same as that documented in western populations which suggests biological factors in the aetiology of the syndrome.

Adolescent↗

Attempted suicide and the lunar cycle.

An analysis of 383 cases of attempted suicide presented to the Accident and Emergency Department during 12 complete lunar cycles (one year) gave no support for an association between attempted suicide and the lunar cycle, especially the full moon. No control for weekends or holidays was made.

Cross-Sectional Studies↗

Psychiatric morbidity in HIV infected individuals.

Forty six subjects infected with the human immunodeficiency virus (HIV) were followed up, for recording psychiatric morbidity if any, before and after the information regarding their HIV status was revealed to them. Among these, four patients had the AIDS syndrome, while 42 individuals were HIV carriers. The pre-information morbidity in the AIDS group included two individuals who presented with delirium and one with an adjustment disorder. The psychiatric diagnosis among the HIV carriers revealed one patient with major depression, four with adjustment disorders and four with alcohol dependence syndrome. The additional morbidity after the diagnoses was revealed included major depression and adjustment disorders which could be managed by psychological intervention and counselling in most cases. The individual who developed major depression later, committed suicide. The study though preliminary in nature, suggests that it may be beneficial to include psychiatric management as part of the general care of individuals with HIV infection.

Acquired Immunodeficiency Syndrome↗

Some risk factors for hypertension in the United Arab Emirates.

A case-control study evaluated the relationship between hypertension and socioeconomic and lifestyle factors in Al-Ain city. The survey included 426 hypertensive adults aged 20-65 years attending urban and semi-urban clinics and a randomly selected sample of 436 normotensive controls. Hypertension among cases was higher for men, age 40-49 years, non-UAE nationals, urban living, currently married, having children, illiterate, administrative/professional job, living in traditional house and low income. There were significant differences between cases and controls with regard to obesity, raised cholesterol level, low physical activity and family history of heart disease, kidney disease or diabetes. Multivariate logistic regression analysis revealed that obesity, medium/high income, history of diabetes, low physical activity and having 3+ children were significantly associated with hypertension.

Adult↗