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Biomedical subjects

H Munitz

Publications and source records attributed to H Munitz.

At least 91 records · Page 5Linked to original sources

The neuroleptic malignant syndrome: agent and host interaction.

This review comprises an exhaustive analysis of 120 case reports of neuroleptic malignant syndrome (NMS) representing the majority of published clinical data on this syndrome. Epidemiological, clinical and biological parameters, as well as those concerning the agent and the treatment of the syndrome, are critically evaluated on the basis of this data. The rate of neuroleptic loading is shown to play a cardinal role in the development of NMS. Rechallenge and aftercare of patients who need anti-psychotic treatment after NMS are considered.

Adolescent↗

Bradycardia due to trihexyphenidyl hydrochloride.

A chronic schizophrenic patient was treated with an anticholinergic drug, trihexyphenidyl hydrochloride. The patient developed, paradoxically, sinus bradycardia. The reaction was specific to trihexyphenidyl and not to other anticholinergic drugs. This antidyskinetic drug is widely used in clinical psychiatric practice and physicians should be aware of this side effect.

Adult↗

Conversion without hysteria: a case report and review of the literature.

The term 'conversion' implies a correlation between conversion symptoms, hysteria, and hysterical personality. A clinical case of conversion related to chronic post-traumatic disorder, with paranoid features, was successfully treated by anti-psychotic drugs; it illustrates the non-specific nature of conversion symptoms. Mechanic's concept of 'illness behaviour' is a frame-work that meets the need for a broader understanding of conversion symptoms.

Aged↗

Koro in an Israeli male.

The Koro syndrome, a 'special cultural psychiatric syndrome', is encountered in South China, Malaysia and Indonesia, especially among people of Chinese origin. There are only eight case reports of Koro from the Western hemisphere. We present a typical primary Koro patient from Israel. Jewish cultural mores are a contributory factor.

Anxiety, Castration↗

Penicillamine therapy for schizophreniform psychosis in Wilson's disease.

A hospitalized 22-year-old woman had suffered from Wilson's disease for the past 11 years. The diagnosis was confirmed by hepatic nonspecific changes, high copper urine excretion, and low to zero serum ceruloplasmin, but psychiatric symptomatology was the main manifestation of the disease. The history of treatment modalities and a controlled trial with penicillamine revealed a clear priority of this drug over phenothiazines in abolishing the psychotic features of the disease. The effective dose in this case was found to be over 1650 mg/day. The mental state, as measured by the Brief Psychiatric Rating Scale, was clearly correlated to the dose of penicillamine. In addition, there was a tendency to increased copper excretion with penicillamine treatment. This case suggests a connection between copper brain poisoning and the related acute psychotic features, which responded well to penicillamine treatment.

Adult↗

Contribution of adverse drug reaction to admission rates in an acute psychiatric ward.

The relative contribution of adverse drug reactions (ADR) to the admission rate of an acute psychiatric ward was examined prospectively. Among 321 patients hospitalized over a period of 17 months, adverse drug reactions were the main cause for hospitalization in 7.5%. Extrapyramidal side effects - mainly resistant akathisia - account for half of these patients. The population at high risk was that of the elderly and those suffering from organic brain syndromes.

Adolescent↗

The aftercare of the patient with the neuroleptic malignant syndrome.

The neuroleptic malignant syndrome (NMS) is an idiosyncratic reaction to neuroleptic drugs, made up of hyperthermia, muscular rigidity, disturbance of level of consciousness and autonomic dysfunction. It is potentially lethal and should be kept in mind whilst using anti-psychotic drugs; as most patients treated by them require further anti-psychotic treatment, the clinician faces the problem of treating those patients after a NMS episode, yet reports in the literature have generally neglected the problem of late management. A patient suffering from a psychosis and NMS is presented, and a rationale for management offered.

Adult↗