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Agitation

MedGen UID:
88447
Concept ID:
C0085631
Sign or Symptom
Synonyms: Agitated; Agitated behavior; Feeling agitated; Unable to keep still
SNOMED CT: Agitation (24199005); Agitated behavior (24199005); Feeling agitated (24199005); Agitated (24199005); Unable to keep still (24199005)
 
HPO: HP:0000713

Definition

A state of restlessness associated with unpleasant feelings of irritability and tension. Causes include pain, stress, fever, alcohol and nicotine withdrawal, cocaine and hallucinogenic drugs use, depression, bipolar disorders, and schizophrenia. [from NCI]

Conditions with this feature

Polyarteritis nodosa
MedGen UID:
14681
Concept ID:
C0031036
Disease or Syndrome
Childhood-onset polyarteritis nodosa is an autosomal recessive systemic vascular inflammatory disorder characterized mainly by involvement of the skin, nervous system, kidney, and gastrointestinal tract. There is considerable variability in the severity and age at onset, although most patients have onset of symptoms in the first decade. Features include recurrent ischemic stroke affecting the small vessels of the brain and resulting in neurologic dysfunction, recurrent fever, elevated acute-phase proteins, myalgias, and livedo racemosa or reticularis with an inflammatory vasculitis on biopsy. Some patients develop hypertension, aneurysms, or ischemic necrosis of the digits (summary by Zhou et al., 2014 and Navon Elkan et al., 2014). Some patients present with clinical immunodeficiency (van Eyck et al., 2014).
Sulfite oxidase deficiency
MedGen UID:
78695
Concept ID:
C0268624
Disease or Syndrome
The spectrum of isolated sulfite oxidase deficiency ranges from classic early-onset (severe) disease to late-onset (mild) disease. Classic ISOD is characterized in the first few hours to days of life by intractable seizures, feeding difficulties, and rapidly progressive encephalopathy manifest as abnormal tone (especially opisthotonus, spastic quadriplegia, and pyramidal signs) followed by progressive microcephaly and profound intellectual disability. Lens subluxation or dislocation, another characteristic finding, may be evident after the newborn period. Children usually die during the first few months of life. Late-onset ISOD manifests between ages six and 18 months and is characterized by ectopia lentis (variably present), developmental delay/regression, movement disorder characterized by dystonia and choreoathetosis, ataxia, and (rarely) acute hemiplegia due to metabolic stroke. The clinical course may be progressive or episodic. In the episodic form encephalopathy, dystonia, choreoathetosis, and/or ataxia are intermittent.
FRAXE
MedGen UID:
155512
Concept ID:
C0751157
Disease or Syndrome
FRAXE mental retardation is a form of mild to moderate mental retardation associated with learning difficulties, communication deficits, attention problems, hyperactivity, and autistic behavior (summary by Bensaid et al., 2009). FRAXE is associated with a fragile site on chromosome Xq28 and is the cause of nonsyndromic X-linked mental retardation in 1 of 50,000 newborn males. The disorder can be caused either by silencing of the FMR2 gene as a consequence of a CCG expansion located upstream of this gene or by deletion within the gene (Stettner et al., 2011).
Mental retardation 30, X-linked
MedGen UID:
163235
Concept ID:
C0796237
Disease or Syndrome
Nonsyndromic mental retardation with microcephaly, restlessness, and hyperactivity.
Familial hemiplegic migraine type 1
MedGen UID:
331389
Concept ID:
C1832894
Familial hemiplegic migraine (FHM) falls within the category of migraine with aura. In migraine with aura (including familial hemiplegic migraine) the neurologic symptoms of aura are unequivocally localizable to the cerebral cortex or brain stem and include visual disturbance (most common), sensory loss (e.g., numbness or paresthesias of the face or an extremity), and dysphasia (difficulty with speech); FHM must include motor involvement, i.e., hemiparesis (weakness of an extremity). Hemiparesis occurs with at least one other symptom during FHM aura. Neurologic deficits with FHM attacks can be prolonged for hours to days and may outlast the associated migrainous headache. FHM is often earlier in onset than typical migraine, frequently beginning in the first or second decade; the frequency of attacks tends to decrease with age. Approximately 40%-50% of families with FHM1 have cerebellar signs ranging from nystagmus to progressive, usually late-onset mild ataxia. Cerebral infarction and death have rarely been associated with hemiplegic migraine.
Frontotemporal dementia, ubiquitin-positive
MedGen UID:
375285
Concept ID:
C1843792
Disease or Syndrome
The spectrum of frontotemporal dementia associated with GRN (also known as PGRN) mutation (FTD-GRN or FTD-PGRN) includes the behavioral variant (FTD-bv), primary progressive aphasia (PPA; further subcategorized as progressive non-fluent aphasia [PNFA] and semantic dementia [SD]), and movement disorders with extrapyramidal features such as parkinsonism and corticobasal syndrome. A broad range of clinical features both within and across families is observed. The age of onset ranges from 35 to 87 years. Behavioral disturbances are the most common early feature, followed by progressive aphasia. Impairment in executive function manifests as loss of judgment and insight. In early stages, PPA often manifests as deficits in naming, word finding, or word comprehension. In late stages, affected individuals often become mute and lose their ability to communicate. Early findings of parkinsonism include rigidity, bradykinesia or akinesia (slowing or absence of movements), limb dystonia, apraxia (loss of ability to carry out learned purposeful movements), and disequilibrium. Late motor findings may include myoclonus, dysarthria, and dysphagia. Most affected individuals eventually lose the ability to walk. Disease duration is three to 12 years.
Mental retardation, X-linked, syndromic 10
MedGen UID:
335353
Concept ID:
C1846168
Disease or Syndrome
Insulin-like growth factor 1 resistance to
MedGen UID:
338622
Concept ID:
C1849157
Disease or Syndrome
Tissue unresponsiveness to insulin-like growth factor-I.
Cushing syndrome
MedGen UID:
347456
Concept ID:
C1857451
Disease or Syndrome
ACTH-independent macronodular adrenal hyperplasia (AIMAH) is an endogenous form of adrenal Cushing syndrome characterized by multiple bilateral adrenocortical nodules that cause a striking enlargement of the adrenal glands. Although some familial cases have been reported, the vast majority of AIMAH cases are sporadic. Patients typically present in the fifth and sixth decades of life, approximately 10 years later than most patients with other causes of Cushing syndrome (Swain et al., 1998; Christopoulos et al., 2005). Approximately 10 to 15% of adrenal Cushing syndrome is due to primary bilateral ACTH-independent adrenocortical pathology. The 2 main subtypes are AIMAH and primary pigmented nodular adrenocortical disease (PPNAD, see 610489), which is often a component of the Carney complex (160980) and associated with mutations in the PRKAR1A gene (188830) on chromosome 17q23-q24. AIMAH is rare, representing less than 1% of endogenous causes of Cushing syndrome (Swain et al., 1998; Christopoulos et al., 2005). See also ACTH-independent Cushing syndrome (615830) due to somatic mutation in the PRKACA gene (601639). Cushing 'disease' (219090) is an ACTH-dependent disorder caused in most cases by pituitary adenomas that secrete excessive ACTH. Genetic Heterogeneity of ACTH-Independent Macronodular Adrenal Hyperplasia AIMAH2 (615954) is caused by germline mutation of 1 allele of the ARMC5 gene (615549) coupled with a somatic mutation in the other allele.
Cluster headache, familial
MedGen UID:
350040
Concept ID:
C1861513
Disease or Syndrome
The classification for headache disorders of the International Headache Society (1988) listed the following criteria for cluster headache (CH): at least 5 attacks of severe unilateral orbital, supraorbital, and/or temporal pain, lasting 15 to 180 minutes, associated with at least 1 of 8 local autonomic signs, and occurring once every other day to 8 per day. Approximately 85% of CH patients have the episodic subtype, in which the headaches occur in cluster periods lasting from 7 days to 1 year and separated by attack-free intervals of 1 month or more. The remainder of patients have the chronic subtype, in which attacks recur for greater than 1 year without remission or with remissions lasting less than 1 month (Lipton et al., 2004).
Pigmented nodular adrenocortical disease, primary, 1
MedGen UID:
400627
Concept ID:
C1864846
Disease or Syndrome
Primary pigmented micronodular adrenocortical disease is a form of ACTH-independent adrenal hyperplasia resulting in Cushing syndrome. It is usually seen as a manifestation of the Carney complex (CNC1; 160980), a multiple neoplasia syndrome. However, PPNAD can also occur in isolation (Groussin et al., 2002). Genetic Heterogeneity of Primary Pigmented Micronodular Adrenocortical Disease See also PPNAD2 (610475), caused by mutation in the PDE11A gene (604961) on chromosome 2q31; PPNAD3 (614190), caused by mutation in the PDE8B gene (603390) on chromosome 5q13; and PPNAD4 (615830), caused by a duplication on chromosome 19p13 that includes the PRKACA gene (601639).
Pigmented nodular adrenocortical disease, primary, 2
MedGen UID:
355843
Concept ID:
C1864851
Disease or Syndrome
Spastic paraplegia 4, autosomal dominant
MedGen UID:
401097
Concept ID:
C1866855
Disease or Syndrome
Spastic paraplegia 4 (SPG4; also known as SPAST-associated HSP) is characterized by insidiously progressive bilateral lower-limb gait spasticity. More than 50% of affected individuals have some weakness in the legs and impaired vibration sense at the ankles. About one third have sphincter disturbances. Onset is insidious, mostly in young adulthood, although symptoms may start as early as age one year and as late as age 76 years. Intrafamilial variation is considerable.
Mental retardation, autosomal recessive 46
MedGen UID:
863720
Concept ID:
C4015283
Disease or Syndrome

Recent clinical studies

Etiology

de Berardis D, Fornaro M, Orsolini L, Iasevoli F, Tomasetti C, de Bartolomeis A, Serroni N, Valchera A, Carano A, Vellante F, Marini S, Piersanti M, Perna G, Martinotti G, Di Giannantonio M
Int J Mol Sci 2017 Feb 8;18(2) doi: 10.3390/ijms18020349. PMID: 28208695Free PMC Article
Gu Y, Perinpanayagam H, Kum DJ, Yoo YJ, Jeong JS, Lim SM, Chang SW, Baek SH, Zhu Q, Kum KY
Photomed Laser Surg 2017 Feb;35(2):71-77. Epub 2016 Nov 3 doi: 10.1089/pho.2016.4125. PMID: 27929924
Gagnon DJ, Fontaine GV, Smith KE, Riker RR, Miller RR 3rd, Lerwick PA, Lucas FL, Dziodzio JT, Sihler KC, Fraser GL
J Crit Care 2017 Feb;37:119-125. Epub 2016 Sep 11 doi: 10.1016/j.jcrc.2016.09.006. PMID: 27693975
Rosenthal LJ, Francis BA, Beaumont JL, Cella D, Berman MD, Maas MB, Liotta EM, Askew R, Naidech AM
Psychosomatics 2017 Jan - Feb;58(1):19-27. Epub 2016 Aug 5 doi: 10.1016/j.psym.2016.07.004. PMID: 27665997
Bauer JØ, Stenborg D, Lodahl T, Mønsted MM
Nord J Psychiatry 2016 Nov;70(8):599-605. Epub 2016 Jun 10 doi: 10.1080/08039488.2016.1188982. PMID: 27284637

Diagnosis

de Berardis D, Fornaro M, Orsolini L, Iasevoli F, Tomasetti C, de Bartolomeis A, Serroni N, Valchera A, Carano A, Vellante F, Marini S, Piersanti M, Perna G, Martinotti G, Di Giannantonio M
Int J Mol Sci 2017 Feb 8;18(2) doi: 10.3390/ijms18020349. PMID: 28208695Free PMC Article
Gu Y, Perinpanayagam H, Kum DJ, Yoo YJ, Jeong JS, Lim SM, Chang SW, Baek SH, Zhu Q, Kum KY
Photomed Laser Surg 2017 Feb;35(2):71-77. Epub 2016 Nov 3 doi: 10.1089/pho.2016.4125. PMID: 27929924
Bauer JØ, Stenborg D, Lodahl T, Mønsted MM
Nord J Psychiatry 2016 Nov;70(8):599-605. Epub 2016 Jun 10 doi: 10.1080/08039488.2016.1188982. PMID: 27284637
Yesavage JA, Taylor JL, Friedman L, Rosenberg PB, Lazzeroni LC, Leoutsakos JS, Kinoshita LM, Perlow MJ, Munro CA, Devanand DP, Drye LT, Mintzer JE, Pollock BG, Porsteinsson AP, Schneider LS, Shade DM, Weintraub D, Lyketsos CG, Noda A; CitAD Research Group.
J Psychiatr Res 2016 Aug;79:4-7. Epub 2016 Apr 16 doi: 10.1016/j.jpsychires.2016.04.004. PMID: 27115509Free PMC Article
Nikolac Perkovic M, Svob Strac D, Nedic Erjavec G, Uzun S, Podobnik J, Kozumplik O, Vlatkovic S, Pivac N
Prog Neuropsychopharmacol Biol Psychiatry 2016 Aug 1;69:131-46. Epub 2016 Feb 4 doi: 10.1016/j.pnpbp.2016.02.002. PMID: 26851573

Therapy

de Berardis D, Fornaro M, Orsolini L, Iasevoli F, Tomasetti C, de Bartolomeis A, Serroni N, Valchera A, Carano A, Vellante F, Marini S, Piersanti M, Perna G, Martinotti G, Di Giannantonio M
Int J Mol Sci 2017 Feb 8;18(2) doi: 10.3390/ijms18020349. PMID: 28208695Free PMC Article
Gu Y, Perinpanayagam H, Kum DJ, Yoo YJ, Jeong JS, Lim SM, Chang SW, Baek SH, Zhu Q, Kum KY
Photomed Laser Surg 2017 Feb;35(2):71-77. Epub 2016 Nov 3 doi: 10.1089/pho.2016.4125. PMID: 27929924
Lam RP, Yip WL, Wan CK, Tsui MS
Am J Emerg Med 2017 Apr;35(4):665.e1-665.e4. Epub 2016 Nov 3 doi: 10.1016/j.ajem.2016.11.004. PMID: 27842924
Gagnon DJ, Fontaine GV, Smith KE, Riker RR, Miller RR 3rd, Lerwick PA, Lucas FL, Dziodzio JT, Sihler KC, Fraser GL
J Crit Care 2017 Feb;37:119-125. Epub 2016 Sep 11 doi: 10.1016/j.jcrc.2016.09.006. PMID: 27693975
Bauer JØ, Stenborg D, Lodahl T, Mønsted MM
Nord J Psychiatry 2016 Nov;70(8):599-605. Epub 2016 Jun 10 doi: 10.1080/08039488.2016.1188982. PMID: 27284637

Prognosis

Rosenthal LJ, Francis BA, Beaumont JL, Cella D, Berman MD, Maas MB, Liotta EM, Askew R, Naidech AM
Psychosomatics 2017 Jan - Feb;58(1):19-27. Epub 2016 Aug 5 doi: 10.1016/j.psym.2016.07.004. PMID: 27665997
Johnson JM, Wu CY, Winder GS, Casher MI, Marshall VD, Bostwick JR
J Dual Diagn 2016 Jul-Dec;12(3-4):244-251. Epub 2016 Oct 6 doi: 10.1080/15504263.2016.1245457. PMID: 27710762
George C, Jacob TR, Kumar AV
Asian J Psychiatr 2016 Feb;19:68-72. Epub 2015 Dec 13 doi: 10.1016/j.ajp.2015.11.010. PMID: 26957342
Rosenberg PB, Drye LT, Porsteinsson AP, Pollock BG, Devanand DP, Frangakis C, Ismail Z, Marano C, Meinert CL, Mintzer JE, Munro CA, Pelton G, Rabins PV, Schneider LS, Shade DM, Weintraub D, Newell J, Yesavage J, Lyketsos CG; CitAD Research Group.
Int Psychogeriatr 2015 Dec;27(12):2059-67. Epub 2015 Aug 25 doi: 10.1017/S1041610215001106. PMID: 26305876Free PMC Article
Weintraub D, Drye LT, Porsteinsson AP, Rosenberg PB, Pollock BG, Devanand DP, Frangakis C, Ismail Z, Marano C, Meinert CL, Mintzer JE, Munro CA, Pelton G, Rabins PV, Schneider LS, Shade DM, Yesavage J, Lyketsos CG; CitAD Research Group.
Am J Geriatr Psychiatry 2015 Nov;23(11):1127-33. Epub 2015 May 19 doi: 10.1016/j.jagp.2015.05.006. PMID: 26238225Free PMC Article

Clinical prediction guides

Gu Y, Perinpanayagam H, Kum DJ, Yoo YJ, Jeong JS, Lim SM, Chang SW, Baek SH, Zhu Q, Kum KY
Photomed Laser Surg 2017 Feb;35(2):71-77. Epub 2016 Nov 3 doi: 10.1089/pho.2016.4125. PMID: 27929924
Gagnon DJ, Fontaine GV, Smith KE, Riker RR, Miller RR 3rd, Lerwick PA, Lucas FL, Dziodzio JT, Sihler KC, Fraser GL
J Crit Care 2017 Feb;37:119-125. Epub 2016 Sep 11 doi: 10.1016/j.jcrc.2016.09.006. PMID: 27693975
Rosenthal LJ, Francis BA, Beaumont JL, Cella D, Berman MD, Maas MB, Liotta EM, Askew R, Naidech AM
Psychosomatics 2017 Jan - Feb;58(1):19-27. Epub 2016 Aug 5 doi: 10.1016/j.psym.2016.07.004. PMID: 27665997
Williamson DR, Frenette AJ, Burry L, Perreault MM, Charbonney E, Lamontagne F, Potvin MJ, Giguère JF, Mehta S, Bernard F
Syst Rev 2016 Nov 17;5(1):193. doi: 10.1186/s13643-016-0374-6. PMID: 27855720Free PMC Article
Bauer JØ, Stenborg D, Lodahl T, Mønsted MM
Nord J Psychiatry 2016 Nov;70(8):599-605. Epub 2016 Jun 10 doi: 10.1080/08039488.2016.1188982. PMID: 27284637

Recent systematic reviews

Williamson DR, Frenette AJ, Burry L, Perreault MM, Charbonney E, Lamontagne F, Potvin MJ, Giguère JF, Mehta S, Bernard F
Syst Rev 2016 Nov 17;5(1):193. doi: 10.1186/s13643-016-0374-6. PMID: 27855720Free PMC Article
Dundar Y, Greenhalgh J, Richardson M, Dwan K
Hum Psychopharmacol 2016 Jul;31(4):268-85. Epub 2016 May 5 doi: 10.1002/hup.2535. PMID: 27151529
Millán-Calenti JC, Lorenzo-López L, Alonso-Búa B, de Labra C, González-Abraldes I, Maseda A
Clin Interv Aging 2016;11:175-84. Epub 2016 Feb 22 doi: 10.2147/CIA.S69484. PMID: 26955265Free PMC Article
Garriga M, Pacchiarotti I, Kasper S, Zeller SL, Allen MH, Vázquez G, Baldaçara L, San L, McAllister-Williams RH, Fountoulakis KN, Courtet P, Naber D, Chan EW, Fagiolini A, Möller HJ, Grunze H, Llorca PM, Jaffe RL, Yatham LN, Hidalgo-Mazzei D, Passamar M, Messer T, Bernardo M, Vieta E
World J Biol Psychiatry 2016;17(2):86-128. doi: 10.3109/15622975.2015.1132007. PMID: 26912127
Luauté J, Plantier D, Wiart L, Tell L; SOFMER group.
Ann Phys Rehabil Med 2016 Feb;59(1):58-67. Epub 2015 Dec 14 doi: 10.1016/j.rehab.2015.11.001. PMID: 26700025

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