Stupor

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Francesco Paolo Busardo - One of the best experts on this subject based on the ideXlab platform.

Elena Antelmi - One of the best experts on this subject based on the ideXlab platform.

Fabio Pizza - One of the best experts on this subject based on the ideXlab platform.

Giuseppe Plazzi - One of the best experts on this subject based on the ideXlab platform.

  • segmental hair testing of triazolam to unmask a suspected case of idiopathic recurrent Stupor
    Journal of Clinical Sleep Medicine, 2018
    Co-Authors: Emanuela Postiglione, Elena Antelmi, Monica Moresco, Simona Pichini, Fabio Pizza, Giuseppe Plazzi, Francesco Paolo Busardo
    Abstract:

    Stupor is a diagnostic challenge at emergency department. Differential diagnosis includes idiopathic recurrent Stupor, formerly attributed to “endozepine-4” accumulation. This condition has been re...

  • Endozepine Stupor in children
    Cephalalgia, 1997
    Co-Authors: S. Soriani, Paolo Tinuper, Elio Lugaresi, Giuseppe Plazzi, M Carrozzi, L. De Carlo, Federica Provini, Jeffrey D. Rothstein, F Bouquet, Pasquale Montagna
    Abstract:

    Recurring episodes of Stupor in adults have been shown to be related to increased levels of endozepines, which are endogenous ligands for the GABAA receptors. We report here two children presenting with recurrent episodes of Stupor associated with fast EEG activity who had increased levels of endozepine-4 in plasma. Mass spectroscopy did not reveal commercially available benzodiazepines. Interictal endozepine-4 levels were normal. In one of the patients, administration of flumazenil (0.25 mg i.v.), a benzodiazepine inverse agonist, induced improvement of consciousness and attenuation of EEG fast activity. In conclusion, children presenting with recurrent episodes of Stupor and EEG fast activity should be evaluated for endozepine levels and can be effectively treated with i.v. flumazenil.

  • Transient Unresponsiveness in the Elderly: Possible Episodes of Idiopathic Recurring Stupor
    Archives of Neurology, 1995
    Co-Authors: Paolo Tinuper, Giuseppe Plazzi, Pasquale Montagna, Elio Lugaresi
    Abstract:

    We were very interested in the cases of transient unresponsiveness in elderly patients reported by Haimovic and Beresford, 1 and also in the letter by Rao et al, 2 describing three patients with transient and repeated episodes of total unresponsiveness and without any other neurologic abnormality. Having described a syndrome of recurring Stupor or coma episodes (idiopathic recurring Stupor) responsive to flumazenil and related to increased amounts of endozepine-4 in plasma, 3-5 we wonder whether the cases described by Haimovic and Beresford and Rao et al could really be cases of idiopathic recurring Stupor. Although electroencephalography is described as slow, the clinical and laboratory characteristics seem to us fairly similar to idiopathic recurring Stupor. We, therefore, suggest that these patients be challenged with flumazenil and that their plasma and cerebrospinal fluid be examined for endozepine levels.

  • Endogenous benzodiazepine receptor ligands in idiopathic recurring Stupor.
    The Lancet, 1992
    Co-Authors: Jeffrey D. Rothstein, Pietro Cortelli, Paolo Tinuper, Elio Lugaresi, Giuseppe Plazzi, Pasquale Montagna, Alessandro Guidotti, Patrizia Avoni, P. Schoch
    Abstract:

    Abstract "Endozepines" are endogenous ligands for the benzodiazepine recognition sites on gamma-aminobutyric acid A receptors in the nervous system. Idiopathic recurring Stupor (IRS) is a syndrome of spontaneous Stupor or coma that is not associated with known metabolic, toxic, or structural abnormalities but can be reversed by flumazenil, a pure benzodiazepine antagonist. We measured endozepine-2 and endozepine-4 by high-performance liquid chromatography and radioreceptor assay in serum and cerebrospinal fluid from three patients with IRS. During episodes of Stupor there was a large (up to 300-fold compared with control patients) increase of endozepine-4 content in cerebrospinal fluid and serum, but a return to normal concentrations between attacks. Endozepine-4 may contribute to, or be the cause of, IRS. The reasons for abnormal concentrations of endozepine in blood and brain are unknown.

Emanuela Postiglione - One of the best experts on this subject based on the ideXlab platform.

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