Fat embolism syndrome is a rarely seen complication of skeletal trauma, and it is seen at a rate of 2-5% after fractures of the long bones of the lower extremities. Its classic triad-+consists of hypoxemia, petechial bleedings on the skin and neurological findings. These neurological findings are highly variable and non-specific, and they can present with lethargy, irritability, delirium, stupo...

Growing chicks maintained on a diet consisting of milk powder, casein, starch, yeast, cod liver oil, salts and filter paper develop ataxia, tremors, retraction or twisting of the head, clonic spasms of the legs, and stupor. These symptoms may appear suddenly, usually between the 18th and 25th day, and may end in death. If recovery takes place, the chicks may go on to normal development. Definit...

A functional, insulin-secreting pancreatic (islet cell) carcinoma was diagnosed in a 17-year-old male Siamese cat. Diagnosis was made on the basis of clinical signs (i.e., seizures and stupor) that resolved temporarily after correction of hypoglycemia with feeding or intravenous administration of glucose, the finding of an inappropriately increased serum insulin concentration in the face of hyp...

The Diabetes Control and Complications Trial (DCCT) convincingly demonstrated that intensive insulin therapy reduces the microvascular complications associated with diabetes, including retinopathy, neuropathy, and nephropathy. However, intensive insulin therapy that lowers blood glucose towards normal levels also significantly increases the risk for hypoglycemia. Moderate hypoglycemia can acute...

Background Hypercalcemia is a common complication of adult malignancies, but uncommon in childhood cancers. The mechanism leading to hypercalcemia varies with the primary tumour and can include the following: 1) Increased osteoclastic activity at the site of the tumour in the bone marrow 2) A paraneoplastic phenomenon secondary to PTH-related peptide (PTHrP) secretion or 1,25–dihydroxyvitamin D...

The concept of catatonia was first described by Kahlbaum (1874). Catatonic stupor is one of the most dramatic psychiatric presentations, but is becoming increasingly rare in the Western world. However, it has been suggested that catatonia is under-recognised and under-diagnosed (Van der Heijden et al, 2005). Although the introduction of antipsychotics has reduced the incidence of catatonia, it ...

Patients with stupor or coma from fulminant hepatic failure were found to have high cerebrospinal fluid concentrations of homovanillic acid (HVA) and 5-hydroxyindole acetic acid (5-HIAA), metabolites of dopamine and serotonin respectively. Excessive amounts of their precursors-phenylalanine and tyrosine and free tryptophan-were found in the patients' plasma. Methionine, which participates in do...

Recent advances in the method of application and monitoring of Electroconvulsive therapy (ECT) has facilitated its use even in the presence of serious physical illness. This case report b of a patient in catatonic stupor who developed an acute respiratory crisis, and in whom the use of ECT led to quick recovery not only from the psychiatric state but also helped recovery from the medical illnes...

A 75‐year‐old male, with no history of any medical or neuropsychiatric disease, was admitted with acute coronary syndrome. He was investigated and found to have non-ST-elevation myocardial infarction, with normal left ventricular ejection fraction of 60% and mild mitral regurgitation. The patient was stabilized with antianginal medications. Elective coronary angiogram revealed 60% left main cor...

A 54-year-old woman with a history of alcoholism presented with stupor. Brain MRI disclosed extensive callosal and widespread extracallosal white matter and cortical lesions (figure) suggestive of MarchiafavaBignami disease (MBD). After 4 weeks of treatment with thiamine and corticosteroids, a complete resolution of brain MRI lesions along with a good clinical recovery was observed. In MBD, whi...