Involuntary Muscle Movements Research Articles

Partial seizures and behavioral changes

In veterinary medicine, seizures have been classified in many ways. One broad method is to classify seizures into two categories: (1) major motor, and (2) partial or behavioral. Examples of major motor seizures are familiar to all veterinarians: distemper fits, epibw, active and postbrain damage. These seizures are typified by quick, widespread, symmetrical, involuntary muscle movements. This presentation deals with the other category known as partial seizures, which are not as well known to the practitioner. A classification of partial seizures can be made: (a) partial motor seizures, (b) partial sensory seizures, and (c) automatisms. This work is relatively new in veterinary medicine, with scant literature reference available. There are many unanswered questions. However, this might explain some of the undiagnosed motor and behavioral problems seen in practice daily. Many of the patients with aberrant behaviors were studied electroencephalographically. Abnormal EEG patterns were found in a significant percentage of the cases, e.g. abnormal spindle activity, shape and duration of the basic wave form, burst suppression and trains of synchronous activity. Examples of the peculiar behavior noted are: looking at imaginary objects, spontaneous running fits and rage, partial motor movements, e.g. torticollis, teeth and jaw trismus, hallucinations, constant tasting and sniffing, and periodic intestinal dysfunction (bloat Schnauzer). Treatments consisting of anticonvulsants for motor phenomena, corticotrophin and progesterone for spontaneous rage and aggressive attitudes, and phenobarbital for intestinal involvement, have proved beneficial in many cases. The conclusion reached is that many behavioral problems in dogs and cats result from structural or biochemical changes in the brain and not just environmental influences. BEHAVIOR MODIFICATION FOR CAR SICKNESS J.L. ALBRIGHT Department of Animal Science, Purdue University, Lafayette, Ind. 47907 (U.S.A.)

RESPIRATORY EFFECTS OF ETOMIDATE

The respiratory effects of etomidate 0.3 mg/kg were studied in patients premedicated with either diazepam and atropine or papaveretum and hyoscine. The incidence of apnoea was 40% in those who received the non-narcotic premedication, compared with 27% in those who received the opiate. Those premedicated with diazepam and atropine showed a significant increase in respiratory frequency which was associated with a significant increase in minute volume 4 min after induction of anaesthesia. No such increase occurred in those premedicated with papaveretum and hyoscine. It would appear that the effects of etomidate on respiration are less than those of other i.v. induction agents, but involuntary muscle movement during induction remains a problem.

EFFECT OF DOSE AND PREMEDICATION ON INDUCTION COMPLICATIONS WITH ETOMIDATE

The induction characteristics of etomidate, a new i.v. hypnotic agent, were studied in 400 patients. Two hundred were premedicated with atropine and anaesthesia was induced with 0.2, 0.25, 0.3 or 0.35 mg/kg of etomidate. The remainder received one of four standard premedications and anaesthesia was induced with etomidate 0.3 mg/kg. Involuntary muscle movements occurred in more than 60% of patients receiving atropine alone. The frequency was reduced in the second group, but remained unacceptable in over 8% of patients. The incidence of other excitatory phenomena, such as cough and hiccup, was 10% approximately. Cardiovascular changes were minimal and no serious allergic phenomena were observed. Nausea and vomiting occurred after surgery in up to 30% of patients and was unrelated to the dose of etomidate or to premedication. Pain on injection occurred in up to 80% of patients when the drug was injected into small peripheral veins and occurred in more than 7% when using more normal veins.

ALTHESIN IN OUTPATIENT DENTAL ANAESTHESIA

The use of Althesin for outpatient dental anaesthesia in 99 patients is described. Dose requirements, duration and side effects are discussed. A slightly longer period of effective anaesthesia and an increased incidence of involuntary muscle movement were evident when Althesin was compared with other, similar anaesthetic agents.

A COMPARISON OF ALTHESIN AND METHOHEXITONE IN PAEDIATRIC ANAESTHESIA

The minimum sleep doses of Althesin and methohexitone were determined in two age groups of children. In the 2–10 years age group, the dose of Althesin was 0.07 ml/kg, and that of methohexitone was 1.1 mg/kg. In the 10–16 years age group, the dose of Althesin was 0.05 ml/kg, and that of methohexitone was 1.2 mg/kg. Althesin has the advantages of small injection volume and a painless injection. However, involuntary muscle movement on injection was found to be more frequent and more severe with Althesin than with methohexitone.

CLINICAL STUDIES OF INDUCTION AGENTS XL: ALTHESIN WITH VARIOUS PREMEDICANTS

SUMMARY Althesin, the new steroid anaesthetic, has been given to patients having minor gynaecological operations after six different premedicant combinations. Atropine, which had been studied previously, was a satisfactory premedicant in terms of both induction and recovery and diazepam 10 nag was not very different. Hyoscine, given before Althesin 50 μl/kg, increased the incidence of involuntary muscle movements and the combination was quite unacceptable for induction of anaesthesia. Three opiate combinations reduced slightly the incidence of induction side effects but, like the other sedatives, delayed recovery and, overall, had little to recommend them. Postoperative sickness is rare after this drug so that anti-emetics are of little benefit; the emetic action of opiates is a disadvantage.

STUDIES OF DRUGS GIVEN BEFORE ANAESTHESIA VIII: MORPHINE 10 MG ALONE AND WITH ATROPINE OR HYOSCINE

Comparing the effects of morphine 10 mg with morphine-atropine and with morphine-hyoscine it seems, from almost every standpoint, that this last combination is to be preferred. Pre-operatively, it produces better sedation and reduces the incidence of nausea and vomiting. During anaesthesia it reduces the frequency of hiccough without leading to an alarming amount of involuntary muscle movement. Postoperatively, there is a high incidence of nausea and vomiting following morphine alone which is much lower after morphine-hyoscine. Morphine-atropine is intermediate in most of its actions and, except when the tachycardia is particularly desired, has no particular value.

STUDIES OF DRUGS GIVEN BEFORE ANAESTHESIA V: PETHIDINE 100 MG ALONE AND WITH ATROPINE OR HYOSCINE

Comparing the effects of morphine 10 mg with morphine-atropine and with morphine-hyoscine it seems, from almost every standpoint, that this last combination is to be preferred. Pre-operatively, it produces better sedation and reduces the incidence of nausea and vomiting. During anaesthesia it reduces the frequency of hiccough without leading to an alarming amount of involuntary muscle movement. Postoperatively, there is a high incidence of nausea and vomiting following morphine alone which is much lower after morphine-hyoscine. Morphine-atropine is intermediate in most of its actions and, except when the tachycardia is particularly desired, has no particular value.

AN INTRODUCTION TO FBA.1420: A new Non-barbiturate Intravenous Anaesthetic

SUMMARY The action of a new intravenous non-barbiturate anaesthetic FBA.1420 (propanidid) has been studied in 550 patients. The period of narcotic action is short and recovery is rapid and uneventful. A brief hypotensive phase occurs during induction of anaesthesia. Coincident with the hypotension a period of hyperpnoea occurs which is usually followed by a period of respiratory depression. The respiratory depressant effect of suxamethonium was found to be enhanced by the presence of FBA.1420 but preliminary cat nerve-muscle and human electromyographic studies suggest that this interaction is not a neuromuscular phenomenon. Involuntary muscle movements were rarely marked. Laryngeal spasm did not occur but hiccough and coughing were occasional accompaniments of induction. The incidence of thrombophlebitis was low. Hepatotoxic and haematological investigations showed no significant abnormalities. The overall conclusion is that the eugenol derivative FBA.1420 is a safe short-acting intravenous anaesthetic.

Preoperative chlorpromazine in poor-risk and uncooperative mentally deficient patients; use in patients requiring minor surgical or dental care.

Introduction Chlorpromazine * has been used in a variety of conditions, and many reports have appeared in the literature in recent years. 1-18 Between March and September of 1956 the drug was tried in uncooperative and poor-risk mentally deficient patients with the hope that its use would make surgery possible under local anesthesia. The work was carried out at Pacific State Hospital, a state institution for the mentally deficient in California, with an average patient population of 2800, ranging in age from 1 to 75 years and in intelligence quotients from 2 to the high 70's. Mentally deficient patients often resist even minor procedures under local anesthesia, and necessary cooperation cannot be obtained from them. Many have severe superimposed handicaps, manifested by involuntary muscle movements which interfere with treatment, although their relative high I. Q.'s should permit voluntary cooperation. General anesthesia or heavy sedation was therefore often necessary. The physical condition