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At least 19 recordsLinked to original sources
PubMed1990

Two children with lethargy and intussusception.

The cases of two patients with lethargy as the predominant symptom of intussusception are described. The first patient was admitted to the pediatric ICU with unexplained lethargy. The diagnosis of intussusception was made after he developed right lower quadrant abdominal tenderness and heme-positive stool. The second patient was diagnosed after presenting to the emergency department with intermittent lethargy, right lower quadrant abdominal tenderness, and heme-positive stool. The presence of gastrointestinal symptoms or signs in association with lethargy should alert the physician to the possibility of an intussusception.

Abdominal Pain↗
PubMed1992

Neonatal idiopathic cerebral venous thrombosis: an unrecognized cause of transient seizures or lethargy.

Seven neonates who presented with either lethargy (four infants) or seizures (three infants) were found by magnetic resonance (MR) phase imaging to have idiopathic cerebral venous thrombosis (CVT). Examination showed only hypotonia or hyperreflexia. The presence of CVT was suggested by unenhanced cranial computed tomographic (CT) scans. Conventional MR T1- and T2-weighted images often indicated more extensive thromboses than were suggested by cranial CT. In all infants, MR phase imaging confirmed thromboses by establishing absence of blood flow in cerebral veins or sinuses. No infant received anticoagulation. Lethargy slowly resolved and seizures did not recur. Normal development has been observed thus far in brief follow-up. The occurrence of seven infants with idiopathic neonatal CVT within a 3-month period indicates that CVT may be a cause of neonatal seizures or lethargy of unclear cause. MR phase imaging provides a powerful, noninvasive means of confirming the diagnosis. Treatment with anticoagulants does not appear necessary.

Cerebral Veins↗
PubMed2000

Brainstem-type Lewy body disease presenting with progressive autonomic failure and lethargy.

The authors report an autopsy case characterized by progressive lethargy and autonomic failure with a distinctive pattern of occurrence of Lewy bodies. Autonomic dysfunction such as sleep apnea, orthostatic hypotension, dysuria, and hypohidrosis predominated with lethargy, whereas parkinsonism was not apparent. Numerous Lewy bodies were widely evident microscopically in brainstem nuclei and the intermediolateral cell columns of the spinal cord, as well as in the sympathetic ganglia, but were rare or absent in the cerebral cortex and other supratentorial structures. Marked neuronal loss was seen in the locus ceruleus, raphe nuclei, dorsal vagal nuclei, and intermediolateral cell columns, but neurons in the substantia nigra, other brain regions, and sympathetic ganglia appeared undiminished. This case represents a specific clinicopathologic form of Lewy body disease occurring predominantly in the brainstem, spinal cord, and sympathetic ganglia.

Autonomic Nervous System↗
PubMedDate not supplied

L-carnitine as a treatment of lethargy in children with chronic neurologic handicaps.

We present five cases of children with severe neurologic handicaps whose management was complicated by excessive lethargy. Treatment with L-carnitine in a dosage range of 35-50 mg/kg/day resulted in a marked improvement in alertness and arousability. In four cases, when L-carnitine was discontinued for a month, they all promptly became lethargic. When L-carnitine was re-started, the lethargy resolved and the improvement has been maintained for up to 14 months. In three children who were tested, serum carnitine levels (total and free) were normal before starting L-carnitine treatment.

Adolescent↗
PubMed1993

Hyperammonemia secondary to valproic acid as a cause of lethargy in a postictal patient.

Hyperammonemia has been described as a complication of valproic acid therapy but may often be overlooked as a cause of lethargy in the postictal patient who presents to the emergency department. We present the case of a postictal patient with lethargy, hyperammonemia, otherwise normal liver function tests, and a therapeutic valproic acid level. Based on our experience and on previously published data, serum ammonia levels appear to be indicated in all ED patients on valproic acid therapy who present with altered mental status. To the best of our knowledge, this has not been reported previously in the emergency medicine literature.

Adult↗
PubMed1988

[Psychopathologic pictures in HIV infection: AIDS lethargy and AIDS dementia].

The paper describes the psychiatric status on the basis of 76 patients with acquired immune deficiency syndrome. There is considerable difference between the different stages of the disease. The disorders are divided into groups following the German and French psychopathological tradition, where the incidence is dependent on the underlying complaint. 50% of the patients suffered from chronic psychoorganic disorders (34% organic personality disorders, 16% dementia). 9% suffered from an acute psychosis caused by complications and founded on substantial physical illness. 3 patients showed symptoms of a (under given circumstances) hitherto unknown endoform psychosis. In 9% of the patients, psychoreactive disturbances (anxiety and reactive depression) were observed. Two infants had congenital development deficiencies. 25% of the patients were without any psychopathology. Patients showing organic personality disorders mostly resemble each other to such a degree as to form a separate group. We suggest to name this group according to the most prominent psychopathology as "AIDS-lethargy". This status is characterised by a specific apathy, tiredness and indolence of the patients combined with the lack of emotional participation related to their own destiny. AIDS-lethargy is the first manifestation in appearance of the HIV infection of the brain itself. Another sequel of the brain infection is AIDS dementia which can be classified as "subcortical dementia" and differs from the more current forms of dementia clinically. Affected are mainly neuropsychologic functions like arousal, attention, mood and motivation, whereas the hallmarks of cortical involvement-aphasia, agnosia and apraxia-are not present. Supplementary findings (EEG, CCT, CSF): The group of patients with chronic psychoorganic disorders differs significantly from the group with psychoreactive disorders and normals. Pathological EEG and CCT are more frequent in psychoorganic disorders. CSF-test-including the intrathecally synthesized antibodies against HIV-does not show traceable variation in either group. There are four problems which may be combined in a given acute psychopathological HIV-syndrome: 1. Being member of a risk group with its reactive, psychosocial and personality problems. 2. Individual mental and emotional reaction to the fact of infection 3. Chronic psychoorganic disturbances. 4. Acute organic psychoses as a result of complications and other physical illness.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Intussusception. A case that suggests a new cardinal symptom--lethargy.

Intussusception is an uncommon condition, but it is the most frequent cause of bowel obstruction in infants and children aged 3 months to 5 years. If undiagnosed, it can result in bowel necrosis, perforation, and even death. Four cardinal signs and symptoms (abdominal pain, rectal bleeding, vomiting, and abdominal mass) are described in patients with intussusception, but these manifestations are not always present and their absence may lead to misdiagnosis. Lethargy might be considered a fifth cardinal symptom. As demonstrated in this case, lethargy may be a significant presenting feature in an infant with no history of abdominal pain, and in association with the other cardinal symptoms, it may be an early indication of a significant illness such as intussusception. Awareness of this association may result in an earlier diagnosis and an improved outcome in patients with intussusception.

Female↗
PubMed1986

Lethargy as a presenting symptom in patients with intussusception.

The author's experience with lethargy in pediatric patients with intussusception was reviewed retrospectively over a 10-year period and proved to be a symptom elicited on admission in half of the patients. The results indicate that lethargy is an important symptom in patients with intussusception when occurring in association with vomiting, melena, or a palpable abdominal mass, or all three.

Child, Preschool↗
PubMedDate not supplied

Intussusception presenting as lethargy in a 6-month-old infant.

A case of intussusception in a 6 month old with lethargy as the initial and predominant system is presented. Children presented to the Emergency Department with otherwise unexplained lethargy should have intussusception as part of the differential diagnosis. A plain film of the abdomen should be obtained. A rectal exam should be done, and a stool checked for occult blood. Radiologic and surgical consultation should be sought simultaneously. Delay in diagnosis and treatment may be associated with decreased success rates of reduction by barium enema, and increased rates of complications of perforation, peritonitis, sepsis, and death.

Humans↗
PubMed1987

[Regulation of endocrine pancreas secretions (insulin and glucagon) during the periodic lethargy-waking cycle of the hibernating mammal].

In winter, hibernating mammals enter a long phase of lethargy which is characterized by low body temperature, depressed metabolism and minimal release of metabolic substrates from endogenous fuel stores. Periodically, they spontaneously warm themselves to regain the euthermic state. These arousals are, by contrast, times of high release and consumption of endogenous substrates. Insulin and glucagon may contribute to the control of both contrasting metabolic periods. The secretion and metabolic effects of these two hormones were investigated in two hibernators: the hedgehog (Erinaceus europaeus) and the edible dormouse (Glis glis). During lethargy, blood glucose, insulin and glucagon concentrations were low. In vivo and in vitro studies showed that the secretion of both hormones was markedly depressed by low temperatures. Insulin secretion was not stimulated by glucose, although glucagon secretion remained reactive to arginine. Blood glucose was not regulated by insulin but pharmacological doses of glucagon increased blood glucose concentrations. The tissues were found to be highly insulin-resistant, preventing the fall of blood glucose and consequently limiting the depletion of glucidic substrates during the long periods of starvation. During arousal, blood glucose, insulin and glucagon levels increased at the end of rewarming while glucose turnover gradually increased above a body temperature of 15 degrees C. The effects of glucagon and insulin on glucose metabolism increased markedly beyond this stage. Thus the metabolic effect of both hormones are temperature-dependent. Insulin and glucagon allow an increase in glucose availability for the active metabolic processes which occur during arousal.

Animals↗
PubMed2002

CD8 lethargy in the absence of CD4 help.

CD4 T cell help was proposed to have a pivotal role in orienting CD8 T cell responses to antigen stimulation. By activating antigen-presenting cells (APC), CD4 cells would induce their expression of costimulatory molecules, the "signal two" required to induce full CD8 activation, preventing CD8 tolerance. Recent data on this subject is contradictory, as the absence of help did not always result in CD8 tolerance. These differences were attributed either to the presence of residual CD4 help or, respectively to the type of antigen stimulation, the peptide affinity, the CTL frequencies, and/or the strength of the response. We therefore reassessed the role of CD4 help in CD8 responses using a system where CD4 cells are absent and APC not activated. This system can be manipulated to induce CD8 tolerance (at high antigen concentrations) or CD8 memory (at low antigen concentrations). We found that the presence of CD4 help did not prevent tolerance induction. On the other hand, the absence of CD4 help did not induce CD8 tolerance, but rather led to differentiation stage intermediate between naive/memory/tolerant cells that we call "lethargy". These findings indicate that role of CD4 help in CD8 responses does not follow a simple on-off rule, as previously suggested. They also reveal that the "tolerance versus memory" dichotomy fails to account for all possible states/properties of antigen-experienced CD8 cells. Depending on the priming conditions, other intermediate stages of differentiation may occur.

Animals↗
PubMed2002

Second place winner. Absorption of topical ophthalmic medications presenting as lethargy and apnea in an infant.

The case of a previously healthy 3-week-old infant with lethargy and apnea resulting from topical absorption of ophthalmic antiglaucoma medications is described. This case illustrates the importance of including topical drugs in medication histories and considering them as potential causes of systemic toxicity. It also emphasizes the high level of vigilance that is needed in monitoring infants and small children when prescribing concentrated topical medications that are usually given to adults.

Absorption↗
PubMed2003

Social exclusion and the deconstructed state: time perception, meaninglessness, lethargy, lack of emotion, and self-awareness.

The authors hypothesize that socially excluded individuals enter a defensive state of cognitive deconstruction that avoids meaningful thought, emotion, and self-awareness, and is characterized by lethargy and altered time flow. Social rejection led to an overestimation of time intervals, a focus on the present rather than the future, and a failure to delay gratification (Experiment 1). Rejected participants were more likely to agree that "Life is meaningless" (Experiment 2). Excluded participants wrote fewer words and displayed slower reaction times (Experiments 3 and 4). They chose fewer emotion words in an implicit emotion task (Experiment 5), replicating the lack of emotion on explicit measures (Experiments 1-3 and 6). Excluded participants also tried to escape from self-awareness by facing away from a mirror (Experiment 6).

Adolescent↗
PubMed2003

Components of feed efficiency in broiler breeding stock: is improved feed conversion associated with increased docility and lethargy in broilers?.

Two trials were conducted to test the hypothesis that broilers classified as good rather than poor feed converters (low vs. high feed-to-gain ratios, respectively) would show decreased activity (increased lethargy) and reduced fear of human caretakers. In both trials birds were reared to juvenile selection age when the 192 males with the "best" breast and leg conformation were placed into individual bird cages (46 x 60 cm), and their feed conversion ratio (FCR) was measured. In trial 1, birds remained in the cages for 7 d for assessment of feed conversion. During the feed conversion testing period, the birds were subjected to three behavioral tests. First, approach-avoidance responses to a novel object placed in the feeder were observed when feeding would be expected. Second, behavior patterns of individual birds were assessed by recording feeding, drinking, walking pecking, preening, standing, and resting. Third, the 20 birds showing the best FCR and the 20 showing the worst were induced into tonic immobility (TI). Feed conversion was not related to either the novel object or the TI measures of fearfulness. Neither was FCR related to feeding, drinking, walking, or pecking. However, FCR was positively correlated with both standing and preening and negatively correlated with resting behavior. In trial 2, the FCR test lasted for 11 d. The birds were assessed for behavioral patterns (feeding, drinking, walking, pecking, preening, standing, and resting) as in the previous trial. As in trial 1, FCR was positively correlated with standing and negatively correlated with resting behavior. Contrary to expectations, the results of these two studies suggest that broilers with good FCR were actually less lethargic and no more fearful than those that showed poor FCR values.

Animal Feed↗
PubMed1997

November 1996--premature baby with lethargy and coma.

A premature male baby (28 weeks gestational age) was delivered by Cesarean section and required ventilation for respiratory distress syndrome during the first postnatal week. Four weeks postnatally, he had an episode of transient renal failure followed by lethargy leading to coma. Ultrasound changes were interpreted as intraventricular hemorrhage, grade 2. The baby died 31 days after birth. Autopsy showed bilateral thrombosis of the deep cerebral veins.

Cerebral Veins↗
PubMed2003

Lethargy in a newborn: lithium toxicity or lab error?

Lithium medication during pregnancy is uncommon and the problems of a neonate who has been exposed to lithium represents a rare situation in neonatology. The clinical presentation and management of a newborn whose mother received lithium during pregnancy is presented. The newborn manifested a four day course of lethargy with unexplained high lithium levels in the adult toxic range. The infant improved clinically under intravenous hydration therapy, nevertheless lithium serum levels increased again and we did not know for certain if our clinical instinct or the actual figures were correct. Finally we noticed that our confusion had resulted from test tubes containing lithium heparine.

Adult↗
PubMed1990

Association between exposure to a stenching agent in a herbicide packing plant and the occurrence of headache and lethargy.

This study quantifies the relationship between subjective complaints of symptoms and certain work activities and exposures in a plant where herbicide is packed. Data relating to symptoms were collected from 27 subjects (20 men and 7 women) on a daily basis with the use of a questionnaire. In addition, data were collected relating to work activity and exposure to the stenching agent added to the herbicide, atmospheric levels of which were measured with personal monitoring, on a daily basis. Although associations were found between the occurrence of lethargy and certain factors of job history, there was no significant association with exposure to the stenching agent as measured by personal monitoring during the study.

Environmental Monitoring↗