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The EEG of a 2 1/2-year-old female with a severe cerebral insult showed trifocal periodic lateralized epileptiform discharges (TRIPLEDs). We believe this is the first such record reported. As with BIPLEDs, the physical findings associated with this EEG appear to represent a diffuse cerebral insult. The most frequent causes of BIPLEDs are diffuse anoxic encephalopathy and CNS infection. In this patient, the TRIPLEDs are apparently due to a severe anoxic insult suffered in utero. As is true with BIPLEDs, the presence of TRIPLEDs represents a poor prognosis.

Objective: To report a case of ciprofloxacin-induced psychosis and to discuss occurrence rates, risk factors, possible etiologies, preventive measures, and treatment courses for this adverse reaction., Data Sources: Case reports and review articles identified by MEDLINE., Data Extraction: Data from pertinent published sources were reviewed and abstracted., Data Synthesis: A 49-year-old man developed symptoms of severe psychosis concomitant with ciprofloxacin (250 mg bid) treatment. Central nervous system effects secondary to ciprofloxacin treatment are uncommon and usually consist only of minor dizziness or mild headache, although rare occurrences of seizures and hallucinations have been reported. The mechanism by which ciprofloxacin causes these adverse effects is not fully understood. It has been suggested that quinolones may produce an epileptogenic effect by inhibiting the binding of gamma-aminobutyric acid to its receptor sites in the brain. There is yet no explanation for the occurrence of hallucinations or psychosis., Conclusions: Caution should be exercised when using ciprofloxacin in the treatment of patients with personality abnormalities or symptoms of psychosis.

The perfusion of intact cat skin by a saline solution of bis(glycinato) copper(II), labelled with Cu64, has been studied in a diffusion cell. It has been shown by counting the activity that the copper(II) complex perfuses the skin and over a period of 6-7 hr reaches the isotonic saline solution underneath. After this inaugural delay period a steady rate of penetration was maintained and after 24 hr about 1 mg of the complex perfused the skin. Skin samples, taken before and after, were fixed in buffered formalin and embedded in paraffin. Five micron sections were taken, stained with rubeanic acid and counterstained with 1% Eosin Y solution. Histological examination showed that copper was present in all layers of the perfused skin. This work is relevant to the solubility of metallic copper in human sweat and to the possible therapeutic value of the "copper bracelet".