In medicine, atony or atonia is a condition in which a muscle has lost its strength. It is frequently associated with the conditions atonic seizure, atonic colon, uterine atony, gastrointestinal atony (occurs postoperatively) and choreatic atonia. Atony can also refer to the paralyzed or extremely relaxed state of skeletal muscles in rapid eye movement sleep (REM sleep) in most warm-blooded animals. The term atony comes from the Ancient Greek ἀτονία (atonia), "slackness, debility".
|
|
Myoclonic astatic epilepsy (MAE), also known as myoclonic atonic epilepsy or Doose syndrome, is a generalized idiopathic epilepsy. It is characterized by the development of myoclonic seizures and/or myoclonic astatic seizures.
|
|
A specific antagonist is physostigmine which combines a peripheral and a central action. Carbachol can be used to treat atonic bowels and bladder. The vital functions should be monitored and stabilized. It may be necessary to treat hyperthermia with cooling blankets.
|
|
An untreated overdose may be fatal, particularly in children. Premortal signs are respiratory depression and cardiac arrest. A specific antagonist is physostigmine which combines a peripheral and a central action. Carbachol can be used to treat atonic bowel and bladder.
|
|
Biperiden mimics an atropine intoxication with mydriasis, dryness of mucous membranes, red face, atonic states of bowels and bladder, and hyperthermia in high doses. Central consequences are agitation, confusion, and hallucinations. An untreated overdose may be fatal, particular in children. Premortal signs are respiratory depression and cardiac arrest.
|
|
Currently, the surgery is a palliative treatment method for many forms of epilepsy, including atonic seizures, generalized seizures, and Lennox-Gastaut syndrome. In a 2011 study of children with intractable epilepsy accompanied by attention deficit disorder, EEG showed an improvement to both seizures and attention impairments following corpus callosotomy.
|
|
Generalized seizures can be either absence seizures, myoclonic seizures, clonic seizures, tonic-clonic seizures or atonic seizures. Generalized seizures occur in various seizure syndromes, including myoclonic epilepsy, familial neonatal convulsions, childhood absence epilepsy, absence epilepsy, infantile spasms (West's syndrome), Juvenile Myoclonic Epilepsy, Lennox-Gastaut syndrome and Generalized epilepsy with occipital semiology.
|
|
Other conditions that can present similarly include narcolepsy, atonic seizure, and hypokalemic periodic paralysis. Treatment options for sleep paralysis have been poorly studied. It is recommended that people be reassured that the condition is common and generally not serious. Other efforts that may be tried include sleep hygiene, cognitive behavioral therapy, and antidepressants.
|
|
Electroencephalography can be used to confirm diagnosis. It is rare and can be indicative of Lennox-Gastaut syndrome (see Henri Gastaut). Atonic seizures can occur while standing, walking, or sitting, and are often noticeable by a head drop (relaxing of the neck muscles). Fall injuries may result in impact to the face or head.
|
|
Attacks of the movement disorder paroxysmal dyskinesia may be taken for epileptic seizures. The cause of a drop attack can be, among many others, an atonic seizure. Children may have behaviors that are easily mistaken for epileptic seizures but are not. These include breath-holding spells, bed wetting, night terrors, tics and shudder attacks.
|
|
Following features of achalasia cardia are seen. On plain x-ray an absence of fundal gas shadow, widened mediastinum and an air fluid level in mediastinum is also seen. The gold standard investigation is a 24 hours manometry of oesophagus. It shows non-relaxation of lower oesophageal sphincter, increased tone of oesophageal sphincter, atonic oesophagus.
|
|
Atonic seizures involve the loss of muscle activity for greater than one second. This typically occurs on both sides of the body. About 6% of those with epilepsy have seizures that are often triggered by specific events and are known as reflex seizures. Those with reflex epilepsy have seizures that are only triggered by specific stimuli.
|
|
Mutations in this gene have also been found associated to cases of developmental and epileptic encephalopathies, autism spectrum disorder, and touch-related sensory processing deficits. Epilepsy in this disorder is distinctive, combining eyelid myoclonia with absences and myoclonic-atonic seizures. Seizures are often triggered by eating. A causal therapy was the first successful worldwide by the group of Prof.
|
|
With focal localized atony, the fundal region may be well contracted while the lower uterine segment is dilated and atonic, which may difficult to see with an abdominal examination. However, this may be detected on vaginal examination. The physical examination suggested above may involve obstetric ultrasound imaging. Bedside obstetric ultrasound imaging can reveal an echogenic endometrial stripe, which can exclude an obstetric laceration.
|
|
In the uterus, balloon tamponade can alleviate or stop postpartum hemorrhage. Inflating a Sengstaken–Blakemore tube in the uterus successfully treats atonic postpartum hemorrhage refractory to medical management in approximately 80% of cases. Such procedure is relatively simple, inexpensive and has low surgical morbidity. A Bakri balloonChapter 89 - Balloon tamponade and uterine packing for major PPH from South Australia, Department of Health.
|
|
Trihexyphenidyl (THP) and other antiparkinsonian drugs are known to be substances of abuse. This is true both in abusers of other substances and in chronic schizophrenics, the latter being infrequent abusers of other drugs. Trihexyphenidyl mimics an atropine intoxication with mydriasis, dryness of mucous membranes, red face, atonic states of bowels and bladder, and hyperthermia in high doses. Central consequences are agitation, confusion, and hallucinations.
|
|
Individuals with GEFS+ present with a range of epilepsy phenotypes. These include febrile seizures that end by age 6 (FS), such seizures extending beyond age 6 that may include afebrile tonic-clonic, myoclonic, absence, atonic seizures and myoclonic-astatic epilepsy. Individuals may also present with SMEI, characterized by generally tonic-clonic seizures, impaired psychomotor development, myoclonic seizures, ataxia, and poor response to many anticonvulsants.
|
|
The technique was first described in 1997. It can stop postpartum hemorrhage without the need for pelvic surgery and potentially preserving fertility. It is regarded as "the best form of surgical approach for controlling atonic PPH as it helps in preserving the anatomical integrity of the uterus." Absorbable suture can be left in situ, and would typically not lead to problems with future pregnancies.
|
|
Lesions affecting sacral segments or peripheral autonomic fibres result in atonic bladder with loss of sphincteric coordination. This results in loss of detrusor contraction, difficulty in initiating micturition and overflow incontinence. Anticholinergic side effects of certain medications (for example, certain antipsychotics and antidepressants) may cause urinary retention which may lead to overflow incontinence. Alpha-adrenergic agonists may cause urinary retention by stimulating the contraction of the urethral sphincter.
|
|
A prominent syllable or word is said to be accented or tonic; the latter term does not imply that it carries phonemic tone. Other syllables or words are said to be unaccented or atonic. Syllables are frequently said to be in pretonic or post-tonic position; certain phonological rules apply specifically to such positions. For instance, in American English, /t/ and /d/ are flapped in post-tonic position.
|
|
He first composed the game's main theme, which he felt represented what the team was trying to achieve, and used it as the demo pitch to Supermassive Games. The music was reactive; it would become louder as the player character approached a threat. While composing for the game, he mixed both melodic and atonic sounds together. The music was influenced by the work of Krzysztof Penderecki and Jerry Goldsmith.
|
|
He underwent a CT scan that revealed he had suffered a "massive subarachnoid hemorrhage" (stroke). He went into cardiac arrest but cardiac activity was restored after 20 minutes of resuscitation attempts. He was in an "atonic coma with inhibition of the functions of the brain stem" and put on a ventilator. His daughter Lola Karimova-Tillyaeva reported that he was in stable condition at an intensive care ward.
|
|
Presentation of these symptoms and lack of disordered eating are not enough for a diagnosis. Radiologic studies showing hypoperistalsis, large atonic stomach, dilated duodenum, diverticula, and white matter changes are required to confirm the diagnosis. Elevated blood and urine nucleoside levels are also indicative of MNGIE syndrome. Abnormal nerve conduction as well as analysis of mitochondria from liver, intestines, muscle, and nerve tissue can also be used to support the diagnosis.
|
|
Usually, anticonvulsants are given based on other symptoms and / or associated problems. Because the areas of the cerebellum which determine increases and decreases in muscle tone are close together, people experiencing atonic seizures are most likely experiencing myoclonic ones too, at some point. This may play a role in therapy and diagnostic. One surgical approach, selective posterior callostomy, can greatly decrease instances of drop attacks and improve function and behavior in patients with intellectual disability.
|
|
300px The B-Lynch suture or B-Lynch procedure is a form of compression suture used in obstetrics. It is used to mechanically compress an atonic uterus in the face of severe postpartum hemorrhage. It was developed by Christopher B-Lynch, a consultant obstetrician and gynaecological surgeon based at Milton Keynes General Hospital, Milton Keynes, Buckinghamshire, England. B-Lynch was born in 1947 in Sierra Leone with the birth name of Christopher Balogun-Lynch.
|
|
Various treatments have been shown to have some degree of efficacy. In 1997–1999, lamotrigine was found to be effective and approved by the Food and Drug Administration and Health Canada. In 1999, topiramate trials showed that topiramate decreased seizure occurrence by more than 50%. Felbamate is the treatment of last resort in the event that everything else fails, and was found to be superior to placebo in controlling treatment resistant partial seizures and atonic seizures.
|
|
An atonic seizure (also called drop seizure, akinetic seizure or drop attack) is a type of seizure that consists of partial or complete loss of muscle tone that is caused by temporary alterations in brain function. These seizures are brief – usually less than fifteen seconds. They usually begin in childhood and may persist into adulthood. The seizure itself causes no physical injury, but the loss of control, predominantly in trunk muscles, can result in direct injury from falling.
|
|
Epileptic encephalopathies are a group of conditions that result in deterioration of sensory, cognitive, and motor functions due to consistent epileptic activity. Lennox-Gastaut syndrome (LGS) is a childhood epileptic encephalopathy characterized with generalized seizures and slow spike-wave activity while awake. LGS is a combination of atonic absences, tonic seizures, cognitive deterioration, and slow spike-wave activity in the EEG. This syndrome usually results from focal, multifocal, or diffuse brain damage and can be divided into symptomatic and cryptogenic types.
|
|
It is not uncommon for children to have tonic-clonic seizures, and atonic seizures directly following the seizure. Those that are associated with hypothalamic hamartomas may occur as often as several times hourly and typically begin during infancy. Seizures that occur in infancy may include bursts of cooing, respirations, giggling, and smiling. Due to early hypothalamic-pituitary- gonadal axis activation in girls who suffer from the seizures, it is not uncommon for them to display secondary sex characteristics before the age of eight.
|
|
See García García, José, El habla de El Franco, p. 119. As is clearly evident by García García, the nasalization of vowels preceding tonic or atonic to ensure –n- in coda "tamen", or situated between nasal consonants "mañá". Vowel lengthening occurs as a result by contractions: "vou à casa" or by compensation as a result of the loss of intervocalic nasal "machacan a 'llá/lá", "Que mañá' nos traiga un bó día de solín". See García García, José, El habla de El Franco, p. 34.
|
|
Automatisms may occur, which are non- consciously-generated activities and mostly simple repetitive movements like smacking of the lips or more complex activities such as attempts to pick up something. There are six main types of generalized seizures: tonic-clonic, tonic, clonic, myoclonic, absence and atonic seizures. They all involve loss of consciousness and typically happen without warning. Tonic-clonic seizures occur with a contraction of the limbs followed by their extension along with arching of the back which lasts 10–30 seconds (the tonic phase).
|
|
Controlled release carbamazepine appears to work as well as immediate release carbamazepine, and may have fewer side effects. In the United Kingdom, carbamazepine or lamotrigine are recommended as first-line treatment for focal seizures, with levetiracetam and valproate as second-line due to issues of cost and side effects. Valproate is recommended first-line for generalized seizures with lamotrigine being second-line. In those with absence seizures, ethosuximide or valproate are recommended; valproate is particularly effective in myoclonic seizures and tonic or atonic seizures.
|
|
The World Health Organization recommends the use of a device called the non-pneumatic anti- shock garment (NASG) for use in delivery activities outside of a hospital setting, the aim being to improve shock in a mother with obstetrical bleeding long enough to reach a hospital. External aortic compression devices (EACD) may also be used. Uterine balloon tamponade can improve postpartum bleeding. Inflating a Sengstaken–Blakemore tube in the uterus successfully treats atonic postpartum hemorrhage refractory to medical management in approximately 80% of cases.
|
|
Epilepsy is also currently treated by a less invasive process called vagus nerve stimulation. This method utilizes an electrode implanted around the left vagus nerve within the carotid sheath in order to send electrical impulses to the nucleus of the solitary tract. However, corpus callosotomy has been proven to offer significantly better chances of seizure freedom compared with vagus nerve stimulation (58.0% versus 21.1% reduction in atonic seizures, respectively). If a focal area in the brain is generating severe seizures, it can sometimes be removed.
|
|
Patients typically begin to experience seizures between three and six months of age, but some occur much later. Other seizure types may occur, including generalized tonic clonic, focal, myoclonic, atypical absence, atonic, or unclassified. Mothers of infants with this disorder usually have uneventful pregnancies and deliveries, with the child appearing normal and within typical birth weight and length ranges. Infants with GLUT1 deficiency syndrome have a normal head size at birth, but the growth of the brain and skull is slow, in severe cases resulting in an abnormally small head size (microcephaly).
|
|
In all events, this as well as other potent synthetic EP3 receptor antagonists have the realized or potential ability to promote the beneficial effects of prostaglandin EP3 receptor activation. Sulprostone (as well as other prostanoids receptor agonists) is in use for inducting medical abortion and ending pregnancy after fetal death, for the treatment of severe atonic postpartum hemorrhage after vaginal delivery, and for removal of the placenta in patients with retained placenta. Currently, sulprostone along with SC-46275, MB-28767, ONO-AE-248 and other EP3 receptor agonists are in development as drugs for the possible treatment of stomach ulcers in humans.
|
|
In the present tense, the stress fluctuates between the root and the termination. As a rule of thumb, the last radical vowel (the one that can be stressed) will retain its original pronunciation when unstressed (atonic) and change into , (subjunctive or indicative 1st pers sing/infinitive), or (subjunctive or indicative 1st pers sing/infinitive) – depending on the vowel in question – in case it is stressed (is in a tonic syllable). Other vowels (u, i) and nasalized vowels (before closed syllables) stay unchanged, as well as the verbs with the diphthongs -ei, -eu, -oi, -ou; they always keep a closed-mid pronunciation; e.g. deixo (deixar), endeuso (endeusar), açoito (açoitar), roubo (roubar), etc.
|
|
Lamotrigine is considered a first-line drug for primary generalized tonic-clonic seizures (includes simple partial, complex partial, and secondarily generalized seizures such as focal-onset tonic-clonic seizures). It is also used as an alternative or adjuvant medication for partial seizures, such as absence seizure, myoclonic seizure, and atonic seizures. A 2020 review on the use of Lamotrigine as an add-on therapy for drug resistant generalized tonic-clonic seizures was unable to come to conclusions to inform clinical practice. Although low-certainty evidence suggest that it reduces generalized tonic-clonic seizures by 50% the level of uncertainty indicates that the actual findings could be significantly different.
|
|
After delivery of the baby, a uterus that is not contracting (atonic uterus), ruptured uterus, remaining parts of placenta or baby or infected remaining parts of placenta or baby can cause severe bleeding. Postpartum bleeding is usually managed preventatively by massaging the lower abdomen (fundal massage), which increases contraction of the uterus and stops bleeding. Additionally, steady traction is applied to the cord to prevent trauma, cord avulsion (tearing of the umbilical cord), uterine inversion, and retained placental products, all of which can increase blood loss and/or the risk of infection. Postpartum hemorrhage is defined by loss of more than 500 mL blood within 24 hours after delivery.
|
|
She was diagnosed with neurasthenia (general exhaustion of the nervous system) or Beard's disease. Symptoms of neurasthenia, as described by nineteenth-century physicians, include "sick headache, noises in the ear, atonic voice, deficient mental control, bad dreams, insomnia, nervous dyspepsia (disturbed digestion), heaviness of the loin and limb, flushing and fidgetiness, palpitations, vague pains and flying neuralgia (pain along a nerve), spinal irritation, uterine irritability, impotence, hopelessness, claustrophobia, and dread of contamination." Amanda America Dickson Toomer died on June 11, 1893, with "complications of diseases" being the cause of death listed on her death certificate. Amanda America Dickson Toomer's funeral took place at the Trinity Colored Methodist Episcopal Church in Augusta, Georgia.
|
|
The process is complemented by local hemostatic factors such as tissue factor type-1 plasminogen activator inhibitor as well as by systemic coagulation factors such as platelets, circulating clotting factors. The physiological increase in clotting factors during labor helps to control blood loss after separation of the placenta. The myometrium can become atonic and have inadequate contraction in response to endogenous oxytocin that is released in the course of delivery. It leads to postpartum hemorrhage (PPH) as delivery of the placenta leaves disrupted spiral arteries which are uniquely void of musculature and dependent on contractions to mechanically squeeze them into a hemostatic state. Blood loss up to 500 mL at delivery is regarded as 'physiological’.
|
|
Symptoms of Lafora disease begin to develop during the early adolescent years, and symptoms progress as time passes. In the years before then, there is generally no indication of the presence of the disease, though in a few cases, the disease presents as a learning disorder around 5 years of age. In extremely rare cases, symptoms may not show at all until as late as the 3rd decade of life, though these cases have slower progression than typical LD. The most common feature of Lafora disease is seizures that have been reported mainly as occipital seizures and myoclonic seizures with some cases of generalized tonic-clonic seizures, atypical absence seizures, and atonic and complex partial seizures. Other symptoms common with the seizures are drop attacks, ataxia, temporary blindness, visual hallucinations, and a quickly-developing and dramatic dementia.
|
|
In Egypt and Nigeria, in separate and combined analyses, findings showed that women treated with the NASG fared much better than women who were not treated with the NASG. Results showed significant reductions in blood loss, rate of emergency hysterectomy and incidence of morbidity and mortality. Analyses examining the use of the NASG on cases of uterine atony, postpartum hemorrhage, and non- atonic etiologies (ante and postpartum) found similar results. Other analyses found that the NASG additionally resulted in a more rapid recovery from shock, helped women overcome treatment delays and had a similarly strong ameliorative effect on women in severe shock. A combined analysis on 1442 women recently published, examined the effect of the NASG on women with obstetric hemorrhage. Despite being in a worse condition at study entry, negative outcomes were significantly reduced in the NASG phase: mean measured blood loss decreased from 444 mL to 240 mL (p<0.001), maternal mortality decreased from 6.3% to 3.5% (RR 0.56, 95% CI 0.35–0.89), severe morbidities from 3.7% to 0.7% (RR 0.20, 95% CI 0.08–0.50), and emergency hysterectomy from 8.9% to 4.0% (RR 0.44, 0.23–0.86).
|
|