Sensory Disturbances Following Insulin Treatment of Psychoses

Stern, Karl; Dancey, Travis E.; McNaughton, Francis L.

doi:10.1097/00005053-194202000-00006

Cited by 7 publications

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“…67:145-154, 1952.that the insulin shock may involve also the peripheral nervous system, as indicated by the observations of Stern, Dancey, and McNaughton 15. Hoagland, H.; Cameron, D. E., and Rubin, M. A.: The Electroencephalogram of Schizophrenics During Insulin Treatments, Am.…”

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confidence: 98%

Reflexes in Insulin Coma

Kral¹,

Smith²

1953

Arch NeurPsych

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THE DIFFICULTIES of ascertaining the depth of an insulin shock as currently used in the treatment of psychoses are well known. They are inherent in the hypoglycemic condition itself. After the insulin injection in a dosage high enough to produce hypoglycemic coma, the blood sugar level drops in the first two hours to from 20 to 30 mg. per 100 cc. No further drop occurs during the following hours, although the deepening coma and a number of neurological and vegetative signs indicate a continuous and progressive depression of brain activity. Himwich 1 demonstrated this to be a result of a decrease in the oxygen metabolism of the brain. Accordingly, different clinical pictures may be present with the same blood sugar level.Clinicians have tried to find practical methods by which to assess the depth of an insulin shock, since with increasing experience the dangers connected with too deep a shock became known. Considerable attention has been devoted to the degree of impairment of consciousness present in the individual hypoglycémie condition. A survey of the literature, however, shows that complete agreement has not been reached about what should be called an "insulin coma." Some authors divide the comatose condition into "pre-coma" and "coma." In the former some reaction may be obtained on stimulation, whereas in the latter the patient does not respond even to strong stimulation. Kalinowsky and Hoch 2 stress the practical usefulness of such a differentiation.Loss of consciousness, however, is only one, although perhaps the most impres¬ sive, sign of depression of brain function. Frostig 3 has pointed out that after loss of consciousness has occurred other objective signs are necessary to determine the depth of the underlying condition. Reflex changes, spontaneous neurological and vegetative phenomena, may thus be used for this evaluation.Lups and Kramer i believe that reflex changes develop in a certain sequence and offer clear evidence of the depth of the insulin shock at any given moment. According

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Reflexes in Insulin Coma

Kral¹,

Smith²

1953

Arch NeurPsych

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Hypoglycemic Peripheral Neuropathy

Danta¹

1969

Archives of Neurology

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Neurological Complications of Insulin Shock Therapy With Electroencephalographic Studies

Halle¹

1951

AMA Arch NeurPsych

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THERE are numerous reports of neurological and psychiatric changes occurring as result of hypoglycemia. Many of these are described as complications of insulin overdosage in diabetic patients1 or of hyperinsulinism in patients with pancreatic adenoma.2In the literature on insulin coma treatment of schizophrenia there are also many such reports. These have been collected and summarized by Spencer.3 In his thorough collation he includes reports of confused, stuporous states; motor and sensory aphasias; various paralyses, such as monoplegias, facial pareses and hemiplegias, and dysarthrias and rotary movements. There is no general agreement on the incidence of such complications. Fleeting sensory disturbances, such as numbness and tingling of extremities and impairment of taste, have also been reported as occurring as a possible transient change in the central nervous system of patients receiving insulin or as result of vitamin B deficiency. These complications may occur as sequelae to a prolonged coma or may appear immediately after termination From the Veterans Administration Hospital, Cleveland.

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Sensory Disturbances Following Insulin Treatment of Psychoses

Cited by 7 publications

References 0 publications

Reflexes in Insulin Coma

Reflexes in Insulin Coma

Hypoglycemic Peripheral Neuropathy

Neurological Complications of Insulin Shock Therapy With Electroencephalographic Studies

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