1/13. Recurrent attacks of fear and visual hallucinations in a child.The case of a 7-year-old boy suffering from recurrent nocturnal and occasional daytime attacks with intense fear and complex visual hallucinations is presented. His state was otherwise normal, as were routine electroencephalographic (EEG) and magnetic resonance imaging (MRI) investigations in the past. Several differential diagnoses such as panic disorder, pavor nocturnus, and nightmares were considered but could not be definitely established or excluded. Since the attacks appeared after the divorce of his parents, an adjustment disorder was suspected, and the patient received psychotherapy for more than 2 years without an effect on the attacks. Only when long-term video-EEG recorded two typical attacks with left temporal ictal seizure patterns was focal epilepsy diagnosed and successfully treated with antiepileptic medication. A suspected origin of seizures in the amygdala was supported by a high-resolution MRI showing a cortical dysplasia extending from the left anteromedial temporal lobe to the amygdala. The case exemplifies difficulties in the differential diagnosis of panic-like attacks and underlines the value of long-term video-EEG, which may be necessary to establish the correct diagnosis and to prevent ineffective therapeutical approaches.- - - - - - - - - - ranking = 1keywords = fear (Clic here for more details about this article) |
2/13. Violent visual hallucinations and aggression in frontal lobe dysfunction: clinical manifestations of deep orbitofrontal foci.Three patients from different racial, social, and economic backgrounds were studied because of sudden intrusive thoughts: visions or intrusions of threatening scenes--violent, aggressive, and sometimes horrifying--that lasted from seconds to minutes. Apart from the association with intense anxiety, fear, and aggression, there was no association with oculomotor, motor, sensory, or autonomic dysfunction or altered conscious state. patients had abnormal intermittent discharges that arose from frontal areas and probably did not spread further. carbamazepine was useful in two cases. The authors suggest that violent, brief hallucinations with no other epileptic sign may be manifestations of frontal lobe seizures.- - - - - - - - - - ranking = 0.2keywords = fear (Clic here for more details about this article) |
3/13. Musical hallucinations and hearing deficit in a young non-psychotic female.A case of musical hallucinations in a young non-psychotic female is described. The only presented symptoms were perceptual disturbances accompanied by the fear of having a severe mental disorder. Further investigation disclosed a perforated ear-drum, with subsequent mild hearing deficit but no signs of major psychopathology. It is suggested that a psychiatric diagnosis should be deferred in such patients, before audible deficits had been ruled out. The clinical features of musical hallucinations associated with hearing deficits are discussed.- - - - - - - - - - ranking = 0.2keywords = fear (Clic here for more details about this article) |
4/13. Hoigne's syndrome-its course and symptomatology.The study presents the clinical symptomatology of acute embolic-toxic reactions to penicillin seen in 9 patients treated with the drug. The complex of short-lasting symptoms characterized by severe agitation with confusion, visual and auditory hallucinations and dire fear is caused by accidental penetration of an amount of intramuscular penicillin injected into the venous system. The authors' experience and the data so far published reveal a much more frequent occurrence of Hoigne's (1959) syndrome than is usually thought. The syndrome does not depend upon the dose of a single injection of procaine penicillin but it may be attributed to poor technique of intramuscular injection and to great number of injections in a small area of the buttock. It is recommended that intravenous steroids in the treatment of acute symptoms of Hoigne's syndrome beside pharmacological sedation of the patient are applied.- - - - - - - - - - ranking = 0.2keywords = fear (Clic here for more details about this article) |
5/13. delusions induced by procaine penicillin: case report and review of the syndrome.A patient manifesting an acute psychosis after receiving an injection of procaine penicillin is reported. The psychosis began immediately after drug administration and gradually abated over a forty-eight-hour period. The clinical presentation was dominated by paranoid delusions and a Capgras-like syndrome. Sixty-six previously reported cases were identified and reviewed. patients manifested combinations of fear, auditory hallucinations, somatic hallucinations, visual hallucinations, and paranoid or religious delusions. The syndrome may occur with inadvertent intravenous injection of procaine and most likely reflects the action of procaine on limbic system structures.- - - - - - - - - - ranking = 0.2keywords = fear (Clic here for more details about this article) |
6/13. Visual hallucinations: meaning and management.Visual hallucinations of low vision patients may serve as indicators of trauma, illness and psychological disturbance or concerns. Routine inquiry about them is suggested and two case illustrations of this procedure are presented. Primary consideration is management of patient anxiety and fear, as well as indications for referral to allied professions. The incidence of hallucinations is very likely under-reported, though detailed exploration of the parameters of hallucinations in the visually impaired population can enhance existing knowledge and often alleviate fears of mental illness.- - - - - - - - - - ranking = 0.4keywords = fear (Clic here for more details about this article) |
7/13. "Doom anxiety" and delirium in lidocaine toxicity.Of 15 patients with psychiatric reactions to lidocaine, 12 (80%) had mood changes, 11 (73%) had "doom anxiety," eight (53%) had overt confusional states, and six (40%) had hallucinations and delusions. The authors contend that morbid fears of impending doom or the belief that death has occurred are specific manifestations of lidocaine toxicity and may be mistakenly attributed to "understandable" fears about death during the course of recovery from a myocardial infarction on the coronary care unit.- - - - - - - - - - ranking = 0.4keywords = fear (Clic here for more details about this article) |
8/13. The pathophysiology of sleep disorders in pediatrics. Part II. sleep disorders in children.In this part of the chapter we have used new terminology and developed a new system for classification of sleep disorders in children. We suggest that excessive daytime sleepiness should be investigated by clinicians before troubles at school necessitate referral. The narcolepsy-hypersomnia syndrome generally has not been recognized in the pediatric age group. Symptoms of excessive fear of falling asleep need to be viewed in this context. Sleep apnea-hypersomnia has received insufficient attention in the American literature. It is a syndrome that affects both adults and children with potentially disastrous cardiovascular and pulmonary complications. The relationship of the sleep apnea-hypersomnia syndrome to the sudded infant death syndrome remains speculative, although preliminary results from our longitudinal study have indicated a possible link. Both the narcolepsy-hypersomnia and the sleep apnea-hypersomnia syndromes are reviewed in detail. In contrast, we review briefly the NREM dyssomnias, including night terrors, sleepwalking, sleep talking and enuresis. All are well known to clinicians dealing with children, and we have related them to findings emanating from the sleep laboratory. We suggest that they are physiologically rather than psychogenically based and frequently represent immaturities of the central nervous system. Finally, the insomnias of childhood are presented. We emphasize that they are rare, and after ruling out organic conditions and drug-dependency syndromes, cultural styles or family stresses generally account for the majority of complaints.- - - - - - - - - - ranking = 0.2keywords = fear (Clic here for more details about this article) |
9/13. The theme of death in complex partial seizures.The theme of death highlighted the depersonalization phenomena of four patients with complex partial seizures. These patients became preoccupied with death in association with psychomotor seizures, visual hallucinations, and altered perception of time and reality. The episodic sense of being dead or of having an appointment with death is a clue to the diagnosis of recurrent complex partial seizures even without overt motor stigmata of seizures. The syndrome differs from fear of death, steroid psychosis, the "near death syndrome," and Cotard's syndrome. Adjustment of antiseizure medication is an important therapeutic maneuver.- - - - - - - - - - ranking = 0.2keywords = fear (Clic here for more details about this article) |
10/13. Self-inflicted eye injuries: case presentations and a literature review.OBJECTIVE: The authors' aim was to determine demographic and clinical correlates of self-inflicted eye injury. methods: The authors reviewed 41 cases of patients with self-inflicted eye injuries identified through medlars searches of medical literature for the period from 1980 to 1993 and four cases from the first author's clinical practice. RESULTS: Most patients with self-inflicted eye injuries were male, about 31 years old, and had a diagnosis of schizophrenia, drug or alcohol abuse, depressive disorders, or other psychosis. Some patients experienced cognitive distortions, often involving religious and sexual ideation, and intense fear around the time they injured themselves. Thirty-three percent of the patients with self-inflicted eye injuries also showed other types of self-injurious behavior. CONCLUSIONS: Enucleation of the eye may serve as a defense against witnessing or experiencing a forbidden act. Psychodynamic theories addressing self-mutilation do not explain self-induced eye injury particularly well but may assist the therapist in understanding motivation and in restructuring patients' behavior. Management of these patients requires multidisciplinary, multimodal efforts involving medical specialists, patients, family members, and staff.- - - - - - - - - - ranking = 0.2keywords = fear (Clic here for more details about this article) |
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