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In the setting of prolonged use, high dosage, and/or kidney dysfunction, hydromorphone has been associated with neuroexcitatory symptoms such as tremor, myoclonus, agitation, and cognitive dysfunction. [23] [24] [25] This toxicity is less than that associated with other classes of opioids such as the pethidine class of synthetics in particular.
Myoclonus is a brief, involuntary, irregular (lacking rhythm) twitching of a muscle, a joint, or a group of muscles, different from clonus, which is rhythmic or regular. Myoclonus (myo-"muscle", clonus "spasm") describes a medical sign and, generally, is not a diagnosis of a disease.
Long-term opioid use occurs in about 4% of people following their use for trauma or surgery-related pain. [20] In the United States, most heroin users begin by using prescription opioids that may also be bought illegally. [21] [22] People with opioid use disorder are often treated with opioid replacement therapy using methadone or buprenorphine ...
One of the most well-known consequences of maternal opioid use during pregnancy is the risk of neonatal abstinence syndrome (NAS). NAS occurs when the newborn experiences withdrawal symptoms after birth due to exposure to opioids in the womb. Maternal opioid use during pregnancy can also have long-term effects on the child's development.
Opioid-induced hyperalgesia (OIH) or opioid-induced abnormal pain sensitivity, also called paradoxical hyperalgesia, is an uncommon condition of generalized pain caused by the long-term use of high dosages of opioids [1] such as morphine, [2] oxycodone, [3] and methadone. [4] [5] OIH is not necessarily confined to the original affected site. [6]
Myoclonus is usually classified physiologically to optimize treatment. Myoclonus is a precursor effect to myoclonus dystonia and most commonly begins in childhood or adolescence. [4] [5] Myoclonus is classified as cortical, subcortical, peripheral or spinal. Cortical myoclonus is the most common of these four and affects the upper limbs and face.
Lower rates were reported for opioid– (12% (8 – 18%)), alcohol– (9% (6 – 15%)) and sedative– (10% (7 – 15%)) induced psychoses. Transition rates were slightly lower in older cohorts but were not affected by sex, country of the study, hospital or community location, urban or rural setting, diagnostic methods, or duration of follow-up.
Lesions involving this circuit may produce palatal myoclonus, one of the few involuntary movements that do not disappear during sleep. [4] Palatal myoclonus may be seen as a component of the lateral medullary syndrome (a.k.a. Wallenberg Syndrome), if the infarction extends to involve the central tegmental tract.