Neurological Complications of Insulin Shock Therapy With Electroencephalographic Studies

Halle, L

doi:10.1001/archneurpsyc.1951.02320060046005

Cited by 7 publications

(1 citation statement)

References 25 publications

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“…In contrast to uncomplicated ICT, irreversible hypoglycemic coma is often accompanied or followed by manifestations Irreversible Coma: of disturbance of many nervous system functions, including status epilepticus, focal neurological syndromes, organic mental syndromes of the Korsakoff type, EEG changes, impaired psychological test performance, and high death rate (88,120,140,174,195,227). In most cases, the blood sugar level is normal or even elevated in the comatose state, which may last for days or weeks (3, 1 2 2 ) .…”

Section: Clinical Aspectsmentioning

confidence: 99%

Insulin shock treatment.

Hoch¹,

Pennes²

1958

Schizophrenia: A Review of the Syndrome.

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Nervous and Mental Diseases (1957) and a former Chairman of the Committee on Therapy of the American Psychiatric Association. A native of Budapest, Hungary, Dr. Hoch received his medical training at the University of Gottingen in Germany. Following an internship at the University Hospital in Gottingen, he began his psychiatric service at the Psychiatric Clinic in Zurich, Switzerland in 1928 and the following year served in the neuropsychiatric clinic of the University of Gottingen. From 1930 to 1933 he directed the outpatient department and the brain research division of that clinic. Dr. Hoch began his career in state service in 1933 at Manhattan State Hospital and became head of the then newly created shock treatment unit. Prior to his appointment as Commissioner of Mental Hygiene, Dr. Hoch was principal research scientist (psychiatry) at the New York State Psychiatric Institute. He joined the staff of the Institute in 1943 and became director of the Department of Experimental Psychiatry in 1948. Dr. Hoch has held a number of teaching posts at the College o f Physicians and Surgeons of Columbia University and at present is Professor of Clinical Psychiatry. He is Associate Editor of the American Journal of Psychiatry and Psychosomatic Medicine and has had numerous articles published in psychiatric and other professional journals. He has written and edited eleven books on psychiatric subjects.

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Section: Clinical Aspectsmentioning

confidence: 99%

Insulin shock treatment.

Hoch¹,

Pennes²

1958

Schizophrenia: A Review of the Syndrome.

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Serial Electroencephalographic and Clinical Studies in a Case of Prolonged Insulin Coma

Shagass¹

1954

Arch NeurPsych

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PROLONGED coma is one of the important complications of insulin shock treatment for schizophrenia. With a normal or elevated blood sugar, induced by administration of dextrose, the patient remains comatose. Temperature becomes elevated, pulse becomes rapid, and there is a shifting neurological picture. Coma may persist from a few hours to several days, and when consciousness is recovered, there are frequently disturbances in the sensorium, memory changes, and other mental alterations of an organic type. The etiology is not clearly understood.1Cases of prolonged coma obviously provide an excellent opportunity to study the brain potential correlates of reversible neurological and mental changes, usually severer and of longer duration than any which may be induced in humans by deliberate experimental manipulation. Since prolonged coma may occur in one-sixth of all patients subjected to a course of insulin coma therapy,2 it is surprising that few EEG studies have so far been reported. The most extensive series are described in the recent papers of Yeager, Simon, Margolis, and Burch 3 on 12 cases and of Revitch * on 5 cases. Single cases have been reported by Proctor and Easton,5 Goldfarb, Laughlin, and Kiene," and Fister.7 The findings of these authors have been relatively uniform. Diffuse slowing of rhythms was found associated with altered sensorium or organic confusion, and the EEG returned to normal as clinical recovery took place. There seemed to be a correlation of length of coma, degree of organic confusion, remission of mental symptoms, and degree of EEG abnormality. EEG changes accompanying neurological complications of insulin have been described by Allan and Crommelin 8 in a juvenile diabetic and by Halle and Ross 9 in four cases undergoing coma therapy. The latter found localized EEG abnormal¬ ities, related to the neurological signs, which disappeared when the signs cleared up. Wyke 10 reported detailed serial studies, correlating clinical, EEG, and blood sugar observations, on a 9-year-old girl with hypoglycemia due to islet cell tumor of the pancreas. Wyke considered that the frequency spectrum of the EEG bore a more direct relation to the clinical picture than did the blood sugar level.The present paper is a report, with serial EEG studies, of a particularly interest¬ ing case of prolonged coma. Most of the important cerebral complications following coma were observed in this case, and it was possible to correlate state of conscious¬ ness with EEG changes.

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Intoxikationen

Pentschew

1958

Nervensystem

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Neurological Complications of Insulin Shock Therapy With Electroencephalographic Studies

Cited by 7 publications

References 25 publications

Insulin shock treatment.

Insulin shock treatment.

Serial Electroencephalographic and Clinical Studies in a Case of Prolonged Insulin Coma

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