RESUMEN
The article describes a clinical case of catatonic syndrome. We describe the manifestations of the syndrome, its diagnostic criteria and associated scales. The modalities of the challenge test, constituting a diagnostic test, and first line treatment are detailed. Clinical and paraclinical investigations are proposed to determine the etiology. The benzodiazepine withdrawal as an etiology of catatonic syndrome is detailed.
L'article expose un cas clinique de syndrome catatonique. Nous y décrivons les manifestations du syndrome, ses critères diagnostiques et échelles associées. Les modalités du «challenge test¼, constituant une épreuve diagnostique, et le traitement de première ligne sont détaillés. Des investigations cliniques et paracliniques sont proposées afin d'en déterminer l'étiologie. Le sevrage en benzodiazépines comme étiologie du syndrome catatonique est discuté.
Asunto(s)
Catatonia , Síndrome de Abstinencia a Sustancias , Benzodiazepinas/efectos adversos , Catatonia/inducido químicamente , Catatonia/diagnóstico , Catatonia/tratamiento farmacológico , Humanos , Síndrome de Abstinencia a Sustancias/diagnóstico , Síndrome de Abstinencia a Sustancias/etiologíaRESUMEN
The goal of the article was to provide some clinical recommendations for a secure use of lithium. We described the mechanism of action of lithium, that acts as a mood stabilizer but also has anti-suicidal and neuroprotective effects. We also described the toxics effects of lithium and the toxicological tools that help to prevent and to treat those effects. We concluded that lithium remains a first choice for the treatment of bipolar disorders.
L'article fournit des recommandations cliniques pour utiliser le lithium de façon efficace et sûre. Nous décrivons les mécanismes d'action du lithium, stabilisateur de l'humeur aux propriétés antisuicidaires et neuroprotectrices. Nous détaillons les effets toxiques du lithium et les outils de toxicologie clinique qui permettent de les prévenir et de les diagnostiquer. Le lithium reste le traitement de référence des troubles bipolaires.
Asunto(s)
Trastorno Bipolar , Litio/efectos adversos , Psicotrópicos , Trastorno Bipolar/tratamiento farmacológico , Humanos , Psicotrópicos/efectos adversos , Medición de RiesgoRESUMEN
Agitation in psychiatry is defined as "a request to which an answer cannot be deferred". If some types of controllable agitation can be solved by human means or psychotropic drugs, others may require the intervention of intensivists who will contribute to the onset of crisis resolution. In addition, an organic aetiology must be carefully excluded a before considering a psychiatric origin of agitation, especially in patients with no psychiatric history and in the elderly. Indeed, acute agitation can hide serious somatic traps and be life threatening.
Asunto(s)
Agitación Psicomotora/etiología , Agitación Psicomotora/terapia , Confusión/complicaciones , Diagnóstico Diferencial , Humanos , Hipnóticos y Sedantes/uso terapéuticoAsunto(s)
Ingestión de Alimentos , Cuerpos Extraños/diagnóstico por imagen , Enfermedades Gastrointestinales/diagnóstico por imagen , Trastornos Mentales/diagnóstico , Utensilios de Comida y Culinaria , Diagnóstico por Imagen/métodos , Ingestión de Alimentos/fisiología , Ingestión de Alimentos/psicología , Femenino , Enfermedades Gastrointestinales/etiología , Hospitalización , Humanos , Joyas , Trastornos Mentales/complicaciones , Trastornos Mentales/diagnóstico por imagen , Persona de Mediana Edad , Radiografía , Recurrencia , Automutilación/complicaciones , Automutilación/diagnóstico , Automutilación/diagnóstico por imagen , Automutilación/psicologíaRESUMEN
Aside from limb tremor, bradykinesia, rigidity and gait disturbances, Parkinson's disease (PD) is also characterized by non-motor symptoms. A cognitive decline can occur early in the disease course and undoubtedly impact of the patient's quality of life. Dementia affects 80% of patients 20 years after disease onset but a small subgroup of patients remain free of dementia even after decades with PD. Risk factors and diagnosis of dementia can be easily assessed using bed-side clinical instruments. Advances in genetics and imagery will allow improving the diagnosis and therapeutic strategy dementia in Parkinson's disease.