Drug-induced encephalopathy is a disease entity often caused by impaired cerebral metabolism that is not attributed to structural brain lesions. However, some drug-induced encephalopathies can develop structural lesions and share other underlying pathophysiological mechanisms (table 2). Leading symptoms are acute or chronic disturbances of consciousness, brain function and personality changes w...

WHAT IS YOUR DIAGNOSIS? A 57–year-old male presented with dark pigmentation around the eyelids, of one-year duration. He also had joint pain and weight loss for the same duration. A general physical examination revealed pedal edema and pallor, while a systemic examination showed ascites, pleural effusion (right), and asterixis. A dermatological examination revealed violaceous pigmentation on bo...

Metastatic tumors to the liver resulting in fulminant hepatic failure are a rare occurrence and have not been previously described in patients with gastrointestinal stromal tumor (GIST). A 70 year-old man was referred to hospital with postprandial discomfort. On examination a 19.5 cm large epithelioid GIST of the stomach was diagnosed. The mass exhibited unfavorable prognostic features: mitotic...

Valero, A., Airoy, G., Eisenkraft, B., and Itskovitch, J. (1974). Thorax, 29, 703-709. Ammonia metabolism in chronic obstnuctive pulmonary disease with special reference to congestive right ventricular failure. A study of 36 patients was undertaken to evaluate the role of raised blood and CSF ammonia in the production of central nervous manifestations in chronic obstructive pulmonary disease (C...

Clinical and electrical evidence of peripheral neuropathy may result from long term treatment with phenytoin or barbiturates, especially in combination, or after repeated exposure to toxic blood concentrations of either drug. Prolonged acute toxicity with phenytoin may rarely lead to permanent residual ataxia. Reversible dystonia may occasionally be precipitated by phenytoin or carbamazepine; a...

Despite steady progress in therapeutics of liver disease, portal systemic encephalopathy remains to be a great challenge for clinicians because of the heterogeneity of neuropsychiatric symptoms, multiple risk factors and complexity on achieving a sustained response. We aimed to evaluate the efficacy of L-Ornithin, L-Aspartate versus lactulose in Mexican patients with hyperammonemic hepatic ence...