Emotion stress

Episodic ataxia (EA) is an autosomal dominant disorder that brief episodes of ataxia can be triggered by physical or emotional stress. The symptom can occur several times during the day, last for seconds to minutes, and be associated with dysarthria and motor neuron activity, which causes muscle rippling (myokymia) between and during attacks. It is caused by a mutation in a neuronal voltage dependent Ca2+ channel. 

Raynaud s phenomenon is an exaggerated vascular-response to cold temperature or emotional stress. Clinical symptoms are sharply demarcated color-changes in the skin of the digits. The underlying disorder consists of abnormal vasoconstriction of digital arteries and cutaneous arterioles due to a local defect in normal vascular responses. 

An arrhythmia may occur as a result of heart disease or from a disorder that affects cardiovascular function. Conditions such as emotional stress, hypoxia, and electrolyte imbalance also may trigger an arrhythmia An electrocardiogram (ECG) provides a record of the electrical activity of the heart. Careful interpretation of the ECG along with a thorough physical assessment is necessary to determine the cause and type of arrhythmia The goal of antiarrhythmic drug therapy is to restore normal cardiac function and to prevent life-threatening arrhythmias. 

When the patient experiences emotional stress, infection, surgery, pregnancy, or an acute illness... 

Hypothalamic dysfunction (anorexia nervosa, physical or emotional stress)... 

Patients with variant or Prinzmetal angina secondary to coronary spasm are more likely to experience pain at rest and in the early morning hours. Pain is not usually brought on by exertion or emotional stress nor is it relieved by rest the electrocardiogram (ECG) pattern is that of current injury with ST-segment elevation rather than depression. 

Dysarthria A disturbance of speech and language due to emotional stress, to brain injury, or to paralysis, incoordination, or spasticity of the muscles used for speaking. 

The physical condition determines the psychic disposition and vice versa. Consider gravely wounded combatants in war, oblivious to their injuries while fighting to survive, only to experience severe pain in the safety of the field hospital, or the patient with a peptic ulcer caused by emotional stress. 

Adverse effects. Cardiovascular crises are a possible risk emotional stress of the patient may cause sympathoadrenal activation with epinephrine release. The resulting rise in blood pressure can be all the more marked because persistent depression of sympathetic nerve activity induces supersen-sitivily of effector organs to circulating catecholamines. 

These compounds are dispersed in the body in large quantities during physieal or emotional stress, and they play a huge role in the adaptation of the body to stressful situations. 

Also indicated for management of anxiety, tension, and psychomotor agitation in conditions of emotional stress. 

Wigger A, Neumann ID (1999) Periodic maternal deprivation induces gender-dependent alterations in behavioural and neuroendocrine responses to emotional stress in adult rats. Physiol Behav 66 293-302... 

Wotjak CT, Kubota M, Liebsch G, Montkowski A, Holsboer F, Neumann I, Landgraf R (1996) Release of vasopressin within the rat paraventricular nucleus in response to emotional stress a novel mechanism of regulating adrenocorticotropic hormone secretion J Neu-rosci 16 7725-7732... 

A high risk of relapse is inherent to schizophrenic psychoses. A relapse is often triggered by emotional stress. It is very important to prevent a relapse by either maintaining low-dose oral medication or by switching to a depot antipsychotic. In some cases, this cannot be avoided. Especially when compliance is a problem, a depot medication may help to keep the patient free of psychotic symptoms. Frequently used depot antipsy-chotics are haloperidol-decanoate, fluphenazine-decanoate, and fluspirilene, which are given in relatively low dosages (see Table 41.4). In EOS, relapse prevention is more important than in adulthood, as the majority of patients have not yet finished school or started a professional career. 

The edternative to a one-to-one confrontation is to involve the whole group or team, as is exemplified by the case history in Box 7.3. This example has been chosen, partly because I have first hand knowledge of the episode, but more particularly because it was handled by an internal manager rather than by an external third party. Not only does It illustrate well the simplicity of the principles involved, it also shows that this sort of intervention can be done perfectly competently by an ordinary manager. Although the procedure is simple, the emotional stress involved in undertaking such a confrontation, and the self-confidence required too, should not be underestimated. 

An unusual feature of the herpes viruses is their preference for nerve cells. Stress to the nervous system, such as emotional stress or sunburn, can cause the virus to replicate, which leads to an outbreak through the skin. When they are not replicating, these viruses remain in nerve cells where they are not detected by the body s immune system, which has little activity in nerve cells. While remaining dormant in the nervous system, the viruses evade not only the immune system but antiviral drugs as well. 

Normal levels of serum cholesterol vary widely. For males, total cholesterol is in the range 130 to 320 mg/100 mL and HDL cholesterol ranges from 30 to 70 mg/100 mL. For females, the corresponding ranges are 130 to 295 and 35 to 80 mg/100 mL, respectively. Cholesterol levels depend on such factors as sex, age, diet, and emotional stress. Typical ranges at various age intervals are shown in Table El 1.1. 

Although there may be no demonstrable alteration in the function of the cardiovascular system or the kidneys of such patients, other than the sustained elevation of blood pressure when they are at rest, the extreme responsiveness of these systems to emotional stress is remarkable. There may be no alteration of the inherent ability of an organ or tissue to respond to a stimulus. Instead, their greater reactivity is to an increased transmission of nerve impulses in response to what may be a psychogenic stimulus. Wolf, Pfeiffer, Ripley, Winter, and Wolff (166) have demonstrated such changes in their patients admirably, and two of their figures from a recent publication illustrate this point. 

EA2, similar to FHM1, is an autosomal dominant disorder associated with mutations in the CACNA1A gene, but is clinically quite distinct. EA2 patients experience spontaneous episodes of ataxia (poor muscle coordination) that last for hours to days. In between attacks, patients often experience gaze-evoked or down-beat nystagmus (rapid, involuntary eye oscillations). Approximately 50% of patients experience migraine-like symptoms, and cerebellar atrophy is common (Lorenzon and Beam, 2000). Attacks are often initiated by emotional stress, exercise, or alcohol. Most patients respond well to treatment with acetazolamide (reviewed in (Jen et al., 2004)). EA2 is genetically variable and has been associated with missense, truncation and alternative splice site mutations. 

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