![]() ![]() Small pupils may be a sign of misusing prescription opioids, which may require addiction treatment services. Opioids are also highly addictive, and account for dozens of overdose deaths every day.Ĭommonly abused prescription opiates include: Narcotics such as prescription opioids are commonly given to people to relieve chronic pain from illnesses or injuries. ![]() There are several drugs, both illicit and prescription, that may cause pupils to pinpoint. If you suspect that a loved one may be using drugs, it can be helpful to know some of the physical signs of drug use, and which drugs cause pupil constriction. Several drugs cause pupils to pinpoint, or constrict, a condition known in clinical terms as eye miosis. One of the most visible signs that a person may be abusing certain drugs is a change in their pupil size. When a person ingests illicit or prescription drugs, they may experience a range of behavioral, mental, and physical side effects. In some cases, small pupils may indicate a drug overdose or other drug interaction. With it and a thorough history and physical, aided by the above red flags, we make the diagnosis of psychogenic nonepileptic seizures with a high degree of certainty.Pinpoint pupil size may occur with the use of certain drugs such as heroin, morphine, fentanyl and other opioids. "The gold standard diagnostic test is video EEG. "Patients pay a price physically, socially, and financially as long as their psychogenic nonepileptic seizures remain undiagnosed and improperly treated," Dr. These characteristics can help guide the emergency doctor to the correct diagnosis, said Martin Holtkamp, M.D., of Charite-University Medicine Berlin, and colleagues. ![]() Compared to those with epileptic seizures, those with psychogenic nonepileptic seizures were more likely to be less than 30 years old, to have a port system implanted for administration of IV drugs (likely because of repeated emergency presentations with psychogenic nonepileptic seizures), and to have lower blood levels of the enzyme creatine kinase, which normally rise after epileptic seizures, the study found. "Our findings suggest that the development of physical ill health, especially when it has been frightening to the patient, may be an important triggering factor for non-epileptic seizures in a subset of patients," said Roderick Duncan, Ph.D., of the West of Scotland Regional Epilepsy Service in Glasgow, and colleagues.Ī small, German study examined 18 patients seen in the emergency room for continuous seizures, or status epilepticus, that did not respond to epilepsy medication. The late onset group was also more likely to report health-related traumatic experiences (47% compared with 4% P<.0001) and less likely to report a history of sexual abuse (4% versus 32% P=.008). The researchers found that those with late-onset psychogenic nonepileptic seizures were more likely to be male (42% compared with 23% P=.029) and have severe health problems (42% versus 8% P<.001). Two other studies, published in the same issue of Neurology, also provided information to help clinicians distinguish psychogenic nonepileptic seizures from epilepsy:Ī study in Scotland compared 26 patients whose psychogenic nonepileptic seizures began when they were 55 or older to 241 people whose psychogenic nonepileptic seizures started when they were younger than 55. Some even covered their eyes with their hands at times. "Most of them closed their eyes for the entire duration of the seizure, and a few closed their eyes forcefully with facial frowning," the authors said. Of the 52 patients with psychogenic nonepileptic seizures, 50 closed their eyes during the seizure, the investigators reported. Chung and colleagues retrospectively reviewed videos of seizures of 208 patients with either psychogenic nonepileptic seizures or epilepsy. When their seizures do not abate, they are prescribed more antiepileptic drugs, sometimes to the point of toxicity."ĭr. "During that time, while they are being treated for epileptic seizures, patients are prescribed antiepileptic drugs that do not treat their disorder. "There is an average of seven years delay between the onset of seizures and the correct diagnosis of psychogenic nonepileptic seizures, the editorialists wrote. Benbadis, M.D., of the University of South Florida in Tampa said a quick and accurate way to distinguish psychogenic nonepileptic seizures from epilepsy is crucial. Curt LaFrance, Jr., M.D., of Brown Medical School in Providence, R.I., and Selim R. ![]()
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