Publications by authors named "Lorraine Arias"

Electroconvulsive therapy (ECT) is a highly effective treatment for certain psychiatric disorders with relatively few serious adverse effects or complications. Tardive seizures are one of these rare but potentially fatal complications. Recognizing and treating tardive seizures is essential to prevent prolonged postictal confusion, progression to status epilepticus and associated soft tissue injury, anoxia, aspiration, and death.

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Postictal agitation after electroconvulsive therapy is a common and serious condition and when severe, requires prompt intervention to safeguard the patient and medical staff from the potential for mayhem and physical harm. We present a case report on the successful use of dexmedetomidine, an alpha2 agonist, in the postictal management of severe agitation in a 34-year-old morbidly obese woman, after prior modes of intervention had failed to deliver ideal conditions.

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Obstructive sleep apnea (OSA) is common and increasingly so in countries experiencing an epidemic of obesity. The rate of OSA is likely as high or higher in psychiatric patients and patients receiving electroconvulsive therapy (ECT) as compared with the general population. Obstructive sleep apnea can be detected by maintaining a high degree of suspicion in patients with risk factors, symptoms, and typical physical findings.

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Clinically significant pseudocholinesterase deficiency is a relatively uncommon disorder, but when present, it presents clinicians with challenges regarding medication administration. This is especially true in cases of patients receiving electroconvulsive therapy (ECT), as the presence of pseudocholinesterase deficiency limits the use of certain muscle relaxants. The authors describe a patient receiving ECT for treatment of his depression, who also possessed an unsuspected pseudocholinesterase deficiency.

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Bilateral anterior cingulumotomy has been used to treat psychiatric diseases and chronic pain. We report an interesting case involving a young woman who underwent cingulumotomy for the treatment of intractable total body pain secondary to generalized reflex sympathetic dystrophy. Her initial response after two procedures was excellent though 1 year later her pain recurred and was resistant to a subsequent cingulumotomy.

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