Showing papers in "European Neurology in 1992"
TL;DR: Sumatriptan produced a faster improvement and resolution of migraine attacks than aspirin plus metoclopramide and Relief from nausea, vomiting, photophobia and phonophobia was similar in both treatment groups.
Abstract: In a double-blind, placebo-controlled study, the efficacy, safety and tolerability of 100 mg oral sumatriptan, given as a dispersible tablet, was compared with that of 900 mg oral aspirin plus 10 mg o
135 citations
TL;DR: This study is the first comprehensive survey of autonomic symptomatology in PD compared to elderly healthy controls and confirms that autonomic nervous system dysfunction is a pervasive problem in PD.
Abstract: Forty-eight men with Parkinson's disease (PD) were interviewed utilizing a questionnaire which evaluated autonomic function. The study population included PD patients (mean age: 65.8 years, mean duration of PD: 8 years) and 32 elderly healthy nonparkinsonian males (mean age: 70.4 years). We found a significantly higher prevalence of the following symptoms of autonomic dysfunction in the parkinsonian patients: erectile dysfunction (60.4 vs. 37.5%), sensation of incomplete bladder emptying (41.6 vs. 15.6%), urgency (45.8 vs. 3.125%), constipation (43.9 vs. 6.25%), dysphagia (22.9 vs. 6.25%) and orthostatic dizziness (21.95 vs. 0%). Eighty-nine percent of parkinsonian patients had at least one of these autonomic symptoms, compared to 43% of control subjects (p less than 0.05). This study is the first comprehensive survey of autonomic symptomatology in PD compared to elderly healthy controls and confirms that autonomic nervous system dysfunction is a pervasive problem in PD. Erectile dysfunction is a significant problem in this patient group and contributes to deterioration in the quality of life.
129 citations
TL;DR: Lamotrigine is a novel antiepileptic drug, chemically unrelated to the major anticonvulsants in current use, that tolerated patients satisfactorily and no side-effects were reported.
Abstract: We report our experience with lamotrigine add-on therapy in the treatment of 11 patients with Lennox-Gastaut syndrome. Lamotrigine is a novel antiepileptic drug, chemically unrelated to the major anticonvulsants in current use. Ten patients experienced a > 50% reduction in seizure frequency, 1 patient experienced no change in seizure frequency. All patients tolerated lamotrigine satisfactorily and no side-effects were reported.
110 citations
TL;DR: MRI has the potential to increase the accuracy of the clinical diagnosis of Alzheimer's disease and vascular dementia and selective atrophy measurements, however, failed to separate dementia syndromes.
Abstract: MRI scans of 27 patients with probable Alzheimer’s disease (mean age 68.2 years), 31 patients with vascular dementia (mean age 69.9 years) and 18 normal controls (mean age 66.3 years) were compared to
100 citations
TL;DR: Uric acid was increased and glutathione correspondingly decreased in plaques; alpha-tocopherol was lowest in plaque and highest in distant white matter in all cases, providing evidence supporting the involvement of free radicals in multiple sclerosis.
Abstract: The levels of the antioxidants ascorbic acid, cysteine, reduced glutathione and a-tocopherol, of the free-radical marker uric acid and of the amino acids tyrosine and tryptophan were measured by means
97 citations
TL;DR: Sex-related differences were highly significant for all sway components in the oldest age group in which men exhibited more spontaneous postural sway than women in the condition eyes open and with eyes closed, and age-associated differences were significant for anterioposterior sway in women.
Abstract: Detailed neurological examinations and body sway measurements with a stable force measuring platform were carried out on 30 healthy adults between 21 and 63 years of age. The results were analyzed for
93 citations
TL;DR: The presence of thymoma and severe forms of MG were associated with relapsing disease requiring prolonged corticosteroid regimens and the age at the start of therapy did not influence significantly the response to treatment.
Abstract: We studied the long-term outcome of prednisone therapy in 104 patients with myasthenia gravis (MG). At the end of the follow-up period, good therapeutic results were recorded in 85 patients (81.7%), p
69 citations
TL;DR: Cure was attained in 57 of the 59 cases of GIHM by discontinued ingestion of glycyrrhizin (licorice) and potassium supplement, and conditions leading to the onset, factors, clinical manifestations, laboratory assessments, muscle biopsy findings, treatment and outcome were discussed.
Abstract: Fifty-nine cases of glycyrrhizin (licorice)-induced hypokalemic myopathy (GIHM), 2 females treated in our departments (85 and 73 years old) and 57 cases reported in the literature were studied, and co
63 citations
TL;DR: TGA prognosis was shown to be better than that of RIA and lacunar patients and the death rate showed no difference from that of sex- and age-matched subjects.
Abstract: A long-term follow-up study was performed on patients with transient global amnesia (TGA) in order to evaluate the prognosis, the recurrence rate and the occurrence of stroke and dementia. 102 patient
52 citations
TL;DR: The regional lucency score is increased, and blood flow and oxygen consumption decreased in the frontal white matter of severely demented patients, and frontal leukoaraiosis contributes to dementia and is probably of ischemic origin, while parietal and occipital leukoaraosis is due to wallerian degeneration.
Abstract: The present study evaluates the origin, severity and location of leukoaraiosis in senile dementia and in normal ageing. The regional white-matter lucency scores, determined on computed-tomographic scan of the brain, are compared to the regional blood flow, oxygen extraction rate and oxygen consumption, determined by the [15O] steady-state technique with positron emission tomography. Thirty patients, classified according to the presence or absence of leukoaraiosis and their mental status, are examined. The occurrence and severity of dementia appear to be mainly correlated to decreased blood flow and oxygen metabolism in the frontal, temporal and parietal cerebral cortex. Leukoaraiosis in demented and nondemented patients is associated with lowered blood flow in the frontal and parietal white matter. The regional lucency score is increased, and blood flow and oxygen consumption decreased in the frontal white matter of severely demented patients. Frontal leukoaraiosis contributes to dementia and is probably of ischemic origin, while parietal and occipital leukoaraiosis is due to wallerian degeneration.
49 citations
TL;DR: MRI can be considered as a useful tool to differentiate optic neuritis together with visual and brainstem auditory evoked potentials in patients with different clinical stages of Leber's disease.
Abstract: The authors describe magnetic resonance imaging (MRI) findings in 15 subjects with different clinical stages of Leber’s disease. A few and no characteristic abnormalities of the optic nerve signal wer
TL;DR: A review of the literature shows hiccup as a neurogenic dysfunction of the 'valve function' between the inspiratory complex and the glottis closure complex.
Abstract: Every new empiric observation made over two millenia fueled the dispute as to whether hiccup (Hc) is a digestive or a respiratory reflex. A review of the literature, focusing attention on the probable
TL;DR: A rapid and easy DNA diagnostic method employing the polymerase chain reaction revealed an asymptomatic homozygous TTR gene carrier in a Japanese family with type I FAP, where his 72-year-old mother was supposed to start amyloid deposition in her late sixties.
Abstract: Type I familial amyloid polyneuropathy (FAP) is a molecular disorder with a mutation of the transthyretin (TTR) gene, and most patients previously examined were reported to be heterozygous for this mutant gene In the present study a rapid and easy DNA diagnostic method employing the polymerase chain reaction revealed an asymptomatic homozygous TTR gene carrier in a Japanese family with type I FAP The level of the variant TTR (methionine instead of valine at position 30) in his serum was much higher than that usually found in type I FAP patients However, the histological findings of the biopsied rectum and abdominal fat tissues failed to demonstrate amyloid deposits, and the autonomic nerves from his rectal mucosa were normally preserved Moreover, his 72-year-old mother (a TTR gene heterozygote) was supposed to start amyloid deposition in her late sixties It is suggested that in addition to the mutant TTR gene some other factors control the development of the disease
TL;DR: Paroxysmal IPS responses, when analyzed in association with these variables, proved to be significant and increased the predictive value for prognosis of associated factors.
Abstract: Anticonvulsant therapy was stopped in 191 epileptic children (109 males and 82 females) after a seizure-free period of at least 2 years, independent of EEG findings, followed up for a minimum of 2 yea
TL;DR: Out of 16 patients, spinal leptomeningeal neoplastic disease was diagnosed by MRI in 4 patients, myelography in 14 patients and CT myelographers in 12 cases, and MR was superior to myelopathy in 2 patients.
Abstract: Out of 16 patients, spinal leptomeningeal neoplastic disease was diagnosed by MRI in 4 patients, myelography in 14 patients and CT myelography in 12 cases. MR was superior to myelography in 2 patients
TL;DR: It is hypothesized that both treatment modalities improve the nerve conduction safety factor and thereby prevent the occurrence of a conduction block, which is believed to be the mechanism underlying the Uhthoff symptom.
Abstract: The Uhthoff symptom, a transient impairment of visual function after exercise, is demonstrated in 2 multiple sclerosis patients. Following exercise, impairment of visual function, as documented most c
TL;DR: In this article, the authors investigated the ability of the MAO inhibitor, selegiline (deprenyl), and of the free-radical scavenger, tocopherol, to delay the onset of disability requiring levodopa therapy (primary end point) in patients with early PD.
Abstract: The pathogenesis of Parkinson's disease (PD) has been linked to oxidative-mediated events including increased monoamine oxidase (MAO) and free-radical generation. We are investigating the ability of the MAO inhibitor, selegiline (deprenyl), and of the free-radical scavenger, tocopherol, to delay the onset of disability requiring levodopa therapy (primary end point) in patients with early PD. Eight hundred patients with early, untreated PD were enrolled in the multi-center placebo-controlled, double-blind clinical trial 'Deprenyl and Tocopherol Antioxidative Therapy of Parkinsonism (DATATOP)'. Subjects were assigned by 2 x 2 factorial design to receive selegiline (10 mg/day), tocopherol (2,000 IU/day), a combination of both drugs, or placebo, and followed to determine if and when disability occurred requiring levodopa therapy. After 12 +/- 5 months of observation, independent monitoring prompted a preliminary analysis indicating that selegiline 10 mg/day significantly extended the time to the primary end point. Selegiline therapy, alone or in combination with tocopherol, resulted in a 57% reduction in the rate of developing disability requiring levodopa therapy (p < 10(-10)) and a 50% reduction in the rate of loss of full-time employment (p = 0.01). Deterioration of motor and mental features was significantly less in selegiline-treated subjects. Adverse effects were minor and infrequent. We conclude from these preliminary results that selegiline (10 mg/day) delays the onset of disability associated with early, otherwise untreated PD. It remains unclear whether these benefits derive from mechanisms that are symptomatic (dopaminergic), protective (anti-neurotoxic), or both. The DATATOP study is ongoing to examine the long-term effects of selegiline and the independent and interactive effects of tocopherol.
TL;DR: A patient who had isolated retrograde amnesia of 1-year duration without anterograde amnesia after recovery from encephalitis is described and single photon emission computed tomography using 123I-IMP revealed that left temporal lobe abnormality.
Abstract: We describe a patient who had isolated retrograde amnesia of 1-year duration without anterograde amnesia after recovery from encephalitis. Single photon emission computed tomography using 123
TL;DR: An academically superior teenage boy who presented with sagittal sinus thrombosis, papilledema, transient right hemiparesis, and pneumothoraces is reported and Pyridoxine-unresponsive homocystinuria is diagnosed.
Abstract: Thrombotic and thromboembolic complications are the main causes of morbidity and mortality in patients with homocystinuria. However, it is unusual for thrombosis to be the single clinical feature leading to investigation for homocystinuria. We report an academically superior teenage boy who presented with sagittal sinus thrombosis, papilledema, transient right hemiparesis, and pneumothoraces. Pyridoxine-unresponsive homocystinuria was diagnosed by aminogram, enzyme assay, and clinical trial. Treatment has been with methionine restriction and betaine. Homocystinuria should be considered in patients with unusual vascular lesions or premature thromboembolism.
TL;DR: Clinical results were less impressive, but also favorable in patients affected by spasmodic torticollis and by hemifacial spasm, although the incidence of drug-induced paresis was much higher than that observed in patients with blepharospasm.
Abstract: Fifty-two patients affected by focal dystonia or hemifacial spasm were treated with repeated injections of botulinum toxin. A clinical improvement was observed in all patients with blepharospasm; clin
TL;DR: A more efficient inhibition of dopamine formation from levodopa (resulting in higher 3-OMD levels) by Madopar HBS was consistent with the superior tolerability observed for the Madopars HBS formulation as compared to Sinemet CR.
Abstract: The multiple-dose (200 mg levodopa t.i.d.) pharmacokinetic profile of two controlled-release products of levodopa (Madopar® HBS and Sinemet® CR) was compared to conventional Madopar capsules in 18 hea
TL;DR: Serum IgG in a patient with chronic polyneuropathy after Mycoplasma pneumoniae infection reacted with ganglioside GM1, GD1b and asialo-GM1 on thin-layer chromatograms, suggesting that the galactosyl (beta 1-3)N-acetylgalactosaminyl moiety could be a target antigen in this patient.
Abstract: Serum IgG in a patient with chronic polyneuropathy after Mycoplasma pneumoniae infection reacted with ganglioside GM1, GD1b and asialo-GM1 on thin-layer chromatograms using an immunostaining technique as well as an enzyme-linked immunosorbent assay, suggesting that the galactosyl (beta 1-3)N-acetylgalactosaminyl moiety could be a target antigen in this patient. Serum IgG reacting with these glycolipids may be involved in the pathogenesis of both motor and sensory neuropathies in this patient.
TL;DR: A 57-year-old woman with hyperlipidemia, treated with lovastatin and gemfibrozil, was admitted to the hospital for evaluation of muscular weakness in her legs and neck who developed a rapidly progressive necrotizing myopathy.
Abstract: Lovastatin has been used with increasing frequency over the past few years to reduce serum cholesterol. The onset of muscle weakness, one of the most serious side effects of long-term treatment with t
TL;DR: Comparison of calculations on decreased peripheral blood cell counts and increased brain cell counts in MS patients revealed that sequestration of blood cells into the MS brain is a possible explanation of these findings.
Abstract: The median percentages of peripheral blood immunoglobulin-positive (Ig+) lymphocytes (8%, n = 46), CD8+ (12%, n = 49) and CD57+ cell numbers (5%, n = 37) of patients s
TL;DR: The results of the 5-year multicentric collaborative study on the long-term effects of bromocriptine in the patients with Parkinson's disease support the view that the early combination of bROMOCriptine with levodopa is superior to levodOPA alone in the treatment of Parkinson's Disease.
Abstract: Final results of the 5-year multicentric collaborative study on the long-term effects of bromocriptine in the patients with Parkinson’s disease are reported This prospective study started in May 1985
TL;DR: A woman who developed chronic meningitis and a brain abscess due to Mycobacterium avium, without immunosuppressed state, died 4 years after first becoming ill.
Abstract: We report the case of a woman who developed chronic meningitis and a brain abscess due to Mycobacterium avium, without immunosuppressed state. She was treated with antituberculous drugs but the infection progressed and she died 4 years after first becoming ill. The occurrence of CNS infection with M. avium in the absence of acquired immunosuppression is rare. Its diagnosis is difficult, delaying clinical recognition and appropriate therapy.
TL;DR: A case of thoracic hematomyelia secondary to anticoagulant therapy is presented and a high index of suspicion may lead to a quick diagnostic procedure and successful decompressive surgery.
Abstract: A case of thoracic hematomyelia secondary to anticoagulant therapy is presented. Clinical features, similar to 2 other previously reported cases, are discussed. A high index of suspicion may lead to a quick diagnostic procedure and successful decompressive surgery.
TL;DR: The clinical status and computed and positron tomographic findings were compared in 10 patients with sequelae of hypoxic-ischemic encephalopathy after cardiopulmonary arrest and successful resusci as discussed by the authors.
Abstract: The clinical status and the computed and positron tomographic findings were compared in 10 patients with sequelae of hypoxic-ischemic encephalopathy after cardiopulmonary arrest and successful resusci
TL;DR: A 48-year-old man with a long-standing history of communicating hydrocephalus is reported, and ventriculoperitoneal shunting led to clinical improvement, but symptoms recurred despite surgical re-exploration switching the shunt to an atrial drainage.
Abstract: A 48-year-old man with a long-standing history of communicating hydrocephalus is reported. Ventriculoperitoneal shunting led to clinical improvement, but symptoms recurred despite surgical re-exploration switching the shunt to an atrial drainage. Ten months after the last surgical procedure, an acute myelopathy developed. Concomitant pharyngeal granuloma examination identified Histoplasma capsulatum (Hc) yeasts. Despite initial response to amphotericin B, Hc was isolated from cerebrospinal fluid (CSF), valve reservoir and distal catheter after two courses of therapy. Fluconazole successfully sterilized CSF, but transverse myelopathy persisted unchanged, and shunting was needed to control hydrocephalus.
TL;DR: A 40-year-old Japanese woman, formerly diagnosed as having Vogt-Koyanagi-Harada disease, developed a consciousness disturbance and MRI showed multiple focal lesions, verifies parenchymatous involvement of CNS in VKH.
Abstract: A 40-year-old Japanese woman, formerly diagnosed as having Vogt-Koyanagi-Harada disease (VKH), developed a consciousness disturbance. There were nuchal rigidity and mild right facial weakness. Ophthalmological findings were compatible with VKH. Lumbar puncture revealed moderate pleocytosis. MRI showed multiple focal lesions. This case verifies parenchymatous involvement of CNS in VKH.