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An attack of either type may have motor, sensory andor behavioural effects, with loss of consciousness if the RAS is involved in generalized seizures. The commonest forms of generalized epilepsy are tonicclonic and absence seizures. Tonicclonic seizures are major convulsions involving spasm of all muscles. There is loss of consciousness and possibly incontinence.
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These are areas of the brain that are normally involved in behavioural and emotional functions. In addition, the chemotrigger zone of the medulla contains dopamine-containing neurones that initiate vomiting in response to noxious and possibly toxic substances. It is thought that there is an abnormality of dopamine receptors or increased release of dopamine in the mesolimbic and mesocortical pathways in schizophrenics. However, no reproducible changes in dopaminergic systems have been found in schizophrenia and the abnormality may be in another system that is somehow linked to dopaminergic neurones. More recently, it has been suggested that schizophrenia may be a developmental disorder of the prefrontal cortex where there is actually a deficiency of dopamine, which leaves dopamine activity in the mesolimbic pathway unbalanced.
Knowledge of family history can help predict who will suffer from adverse reactions. It is therefore good practice when taking a patients history to ask about incidents of adverse reactions to drugs or allergies in the family.
Salicylic acid ointment is most frequently used either on its own or in combination with coal tar or dithranol. Phototherapy is the use of ultraviolet light, which produces improvement in most patients with psoriasis but should only be done under supervision of a dermatologist.
Methylprednisolone has recently been added to the list of drugs that registered podiatrists can administer by injection into soft tissue injury. Registered physiotherapists can administer corticosteroids by injection according to patient group directions.
Authored by Dr. Tibor Moskovits, MD