WordNet

an unstable situation of extreme danger or difficulty; "they went bankrupt during the economic crisis"
a crucial stage or turning point in the course of something; "after the crisis the patient either dies or gets better"

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(社会上・政治上の)『重大な事態』,『難局』,危機 / (人生の)重大な転機(岐路),重大事 / 最悪状態

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/10/30 20:27:22」(JST)

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Oculogyric crisis (OGC) is the name of a dystonic reaction to certain drugs or medical conditions. The term "oculogyric" refers to rotating of eyeballs,^[1] but several other responses are associated with the crisis. Epilepsy can manifest as oculogyric seizures, also called versive seizures.^[2]

Causes

Drugs that can trigger an oculogyric crisis include neuroleptics (such as olanzapine),^[3], carbamazepine, cetirizine ^[4], chloroquine, cisplatin, diazoxide, levodopa,^{[citation needed]} lithium, metoclopramide, domperidone, nifedipine, pemoline,^{[citation needed]} phencyclidine ("PCP"),^{[citation needed]} reserpine.

Other causes can include postencephalitic Parkinson's, Tourette's syndrome, multiple sclerosis, neurosyphilis, head trauma, bilateral thalamic infarction, lesions of the fourth ventricle, cystic glioma of the third ventricle, herpes encephalitis, kernicterus and juvenile Parkinson's.

Symptoms and signs

Initial symptoms include restlessness, agitation, malaise, or a fixed stare. Then comes the more characteristically described extreme and sustained upward deviation of the eyes. In addition, the eyes may converge, deviate upward and laterally, or deviate downward. The most frequently reported associated findings are backwards and lateral flexion of the neck, widely opened mouth, tongue protrusion, and ocular pain. However it may also be associated with intensely painful jaw spasm which may result in the breaking of a tooth. A wave of exhaustion may follow an episode. The abrupt termination of the psychiatric symptoms at the conclusion of the crisis is most striking.

Other features that are noted during attacks include mutism, palilalia, eye blinking, lacrimation, pupil dilation, drooling, respiratory dyskinesia, increased blood pressure and heart rate, facial flushing, headache, vertigo, anxiety, agitation, compulsive thinking, paranoia, depression, recurrent fixed ideas, depersonalization, violence, and obscene language.

It is often not realized that in addition to the acute presentation, OGC can develop as a recurrent syndrome, triggered by stress, and exposure to the above drugs.

Treatment

Immediate treatment of drug induced OGC can be achieved with intravenous antimuscarinic benzatropine or procyclidine; which usually are effective within 5 minutes, although may take as long as 30 minutes for full effect. Further doses of procyclidine may be needed after 20 minutes. Any causative new medication should be discontinued. Also can be treated with 25 mg diphenhydramine (Benadryl).

References

^ oculogyric at eMedicine Dictionary
^ Epilepsy A to Z: A Concise Encyclopedia:Second Edition By Pierre Jallon, MD,Peter Kaplan, MB, FRCP,William Tatum, page 360
^ Praharaj SK, Jana AK, Sarkar S, Sinha VK (December 2009). "Olanzapine-induced tardive oculogyric crisis". J Clin Psychopharmacol 29 (6): 604–6. doi:10.1097/JCP.0b013e3181c00b08. PMID 19910730. http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0271-0749&volume=29&issue=6&spage=604.
^ Fraunfelder, Frederick W.; Fraunfelder, Frederick T. (February 2004). "Oculogyric crisis in patients taking cetirizine". Am J Ophthalmol 137 (2): 355-357. doi:10.1016/S0002-9394(03)00869-9. PMID 14962433. http://www.ajo.com/article/S0002-9394%2803%2900869-9/abstract. Retrieved 24 October 2012.

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

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2. ジストニアの分類および評価 classification and evaluation of dystonia
3. 眼振の概要 overview of nystagmus
4. 幼児における非てんかん性発作性障害 nonepileptic paroxysmal disorders in infancy
5. 第一世代（定型）抗精神病剤中毒 first generation typical antipsychotic medication poisoning

English Journal

Cefixime-induced oculogyric crisis.

Bayram E, Bayram MT, Hiz S, Turkmen M.SourceFrom the Departments of *Pediatric Neurology and †Pediatric Nephrology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
Pediatric emergency care.Pediatr Emerg Care.2012 Jan;28(1):55-6.
ABSTRACT: Oculogyric crisis is a neurologic adverse event characterized by bilateral dystonic, usually upward, conjugate eye deviations. Cefixime is a third-generation cephalosporin and is widely used in clinical practice in childhood. Confusion, encephalopathy, coma, myoclonus, nonconvulsive status
PMID 22217888

Oculogyric crisis in a midbrain lesion.

Della Marca G, Frisullo G, Vollono C, Dittoni S, Losurdo A, Testani E, Colicchio S, Gnoni V, Rizzo D, Riccardi R, Batocchi AP.SourceDepartment of Neurosciences, Catholic University, and Pediatric Hospital Bambino Gesù, Rome, Italy. dellamarca@rm.unicatt.it
Archives of neurology.Arch Neurol.2011 Mar;68(3):390-1.
PMID 21403028

Oculogyric crises secondary to lamotrigine overdosage.

Veerapandiyan A, Gallentine WB, Winchester SA, Baker J, Kansagra SM, Mikati MA.SourceDivision of Pediatric Neurology, Duke University Medical Center, Durham, North Carolina 27710, USA.
Epilepsia.Epilepsia.2011 Mar;52(3):e4-6. doi: 10.1111/j.1528-1167.2010.02967.x. Epub 2011 Feb 14.
We report four patients with no preexisting movement disorders who developed oculogyric crises secondary to lamotrigine toxicity and had resolution of these crises after dose reduction. Episode numbers ranged from 1-20 per day and episode duration from 2 s to several hours. Mean plasma concentration
PMID 21395567

Japanese Journal

Disorders of monoamine metabolism: inherited disorders frequently misdiagnosed as epilepsy

Lee Wang-Tso
Epilepsy & Seizure 3(1), 147-153, 2010
… However, the episodic dystonia and oculogyric crisis manifested in these patients are frequently misdiagnosed as epilepsy, and multiple anti-epileptic drugs (AEDs) may be given. …
NAID 130000255302

Acute Oculogyric Crisis in a Patient Taking Clebopride

Kim Woojun,Lee Kwang-Soo,Kim Yeong-In,Kim Joong-Seok
Internal Medicine 47(6), 551-552, 2008
… We present a 21-year-old woman with an oculogyric crisis following the administration of clebopride. … Based on the temporal relationship of the administration of clebopride to the occurrence of the event and the absence of other possible etiologies, clebopride is implicated as the cause of this acute oculogyric crisis, despite the fact that a cause-and-effect relationship cannot be confirmed. …
NAID 130000080087

Related Pictures

★リンクテーブル★

リンク元	「眼球回転発作」「注視痙攣」「注視発作」「注視けいれん」

「眼球回転発作」

Oculogyric crisis
	Classification and external resources
ICD-10	H51.8
ICD-9	378.87
eMedicine	emerg/338

　　[★]

英: oculogyric crisis
同: 注視発作性クリーゼ oculogyric spasm

[show details]

眼球回転発作 : 約 11,300 件
眼球上転発作 : 約 2,880 件
注視発作 : 35 件
注視痙攣 : 95 件
注視けいれん : 25 件

「注視痙攣」

　　[★]

英: oculogyric crisis
関: 注視発作、注視けいれん

「注視発作」

　　[★]

英: oculogyric crisis
関: 注視痙攣、注視けいれん

「注視けいれん」

　　[★]

英: oculogyric crisis
関: 注視発作、注視痙攣

[0] oculogyric at eMedicine Dictionary

[1] Epilepsy A to Z: A Concise Encyclopedia:Second Edition By Pierre Jallon, MD,Peter Kaplan, MB, FRCP,William Tatum, page 360

[pmid19910730-2] Praharaj SK, Jana AK, Sarkar S, Sinha VK (December 2009). "Olanzapine-induced tardive oculogyric crisis". J Clin Psychopharmacol 29 (6): 604–6. doi:10.1097/JCP.0b013e3181c00b08. PMID 19910730. http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0271-0749&volume=29&issue=6&spage=604.

[pmid14962433-3] Fraunfelder, Frederick W.; Fraunfelder, Frederick T. (February 2004). "Oculogyric crisis in patients taking cetirizine". Am J Ophthalmol 137 (2): 355-357. doi:10.1016/S0002-9394(03)00869-9. PMID 14962433. http://www.ajo.com/article/S0002-9394%2803%2900869-9/abstract. Retrieved 24 October 2012.

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案内

oculogyric crisis