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Biomedical subjects

A D Rothner

Publications and source records attributed to A D Rothner.

At least 37 records · Page 2Linked to original sources
PubMed1995

Retinal changes associated with neurofibromatosis 2.

INTRODUCTION: Neurofibromatosis (NF) is now known to be more than one disease. NF2, formerly classified as central neurofibromatosis, is characterized by bilateral vestibular schwannomas, previously termed "acoustic neuromas", and is much less common than NF1. Lens opacities at an early age have been described in approximately 85% of NF2 patients. PURPOSE: To determine the frequency of retinal abnormalities in NF2 patients. METHODS: We prospectively examined 15 consecutive patients who met the diagnostic criteria of NF2. RESULTS: We observed an epiretinal membrane in the macular or paramacular area in 12 of 15 patients, and a combined pigment epithelial and retinal hamartoma in the macula of one patient who also had an epiretinal membrane in the macula of the other eye. Additionally, 11 patients had central posterior cortical, subcapsular, or peripheral cortical lens opacities. CONCLUSIONS: Children or young patients with epiretinal membranes, combined pigment epithelial retinal hamartoma, and lens opacities that are not the result of other ocular disorders should have a neurologic evaluation and a careful family history for NF2.

Adolescent↗
PubMed1995

Supplementary motor area seizures presenting as stumbling episodes.

A healthy young boy presented with brief stumbling episodes of recent onset. Evaluation with prolonged EEG-video monitoring led to the diagnosis of supplementary motor area epilepsy. Focal seizures arising from the medial fronto-parietal cortex may present unusual diagnostic pitfalls in their clinical semeiology as well as their EEG characteristics.

Brain Mapping↗
PubMed1995

The evaluation of headaches in children and adolescents.

The importance of a thorough evaluation of each patient with headache is stressed. Details of the data base, pertinent information regarding the physical examination, and thoughts concerning selection of laboratory tests are provided. The majority of headache types seen in pediatric practice can correctly be identified using these methodologies.

Adolescent↗
PubMed1995

Chronic nonprogressive headaches in children and adolescents.

Chronic nonprogressive headaches are common in adolescents. The features of this syndrome are distinct from those of migraine. Chronic nonprogressive headaches have received less attention and study than migraine headaches. The prevalence of this syndrome is not clear. A structured psychological interview with the patient and the parents of the patient coupled with psychological testing of the patient will usually identify factors playing a role in the continuing headache. Counseling, biofeedback, and cognitive training, combined with judicious use of medication, will frequently lead to resolution of the headache.

Adolescent↗
PubMed1995

Miscellaneous headache syndromes in children and adolescents.

This article reviews headache syndromes that are uncommon and not discussed in previous articles in this issue. Cluster, temporal-mandibular joint dysfunction, occipital neuralgia, and indomethacin responsive headache, as well as several other syndromes, are discussed. Proper identification of these disorders often leads to specific treatment, resulting in dramatic relief of discomfort and pain.

Adolescent↗
PubMed1995

Pathophysiology of recurrent headaches in children and adolescents.

The classification and pathophysiology of headache syndromes in children and adolescents is reviewed. The most important issues are classifying the headache type and determining the etiology of the child's headache. This is best accomplished with a thorough history and physical examination, coupled with selected laboratory tests. The pathophysiology of the underlying headache as reviewed usually will allow the choice of appropriate treatment modalities.

Adolescent↗
PubMed1993

Management of headaches in children and adolescents.

Deciding whether a child's headache is functional or organic is difficult for even the experienced physician. This review examines the diagnosis and management of headache syndromes in children and adolescents. A systematic history and examination together with selected laboratory data will enable the practitioner to establish the correct diagnosis.

Acute Disease↗
PubMed1993

Epilepsy in the setting of neurocutaneous syndromes.

The neurocutaneous syndromes are characterized by congenital dysplastic abnormalities involving the skin and nervous system. The commonest neurocutaneous syndromes manifesting epilepsy are tuberous sclerosis and the Sturge-Weber syndrome. Neurofibromatosis and other lesser-known entities, such as epidermal nevus syndrome, are also known to be accompanied by epilepsy. These syndromes are not related to one another. This article reviews what has been learned about the epileptic syndromes in these disorders.

Adolescent↗
PubMed1992

Ocular findings associated with neurofibromatosis type II.

BACKGROUND: Neurofibromatosis has been recently acknowledged as consisting of a number of different diseases. Neurofibromatosis (NF) type I and NF type II are the most clearly defined. Type II is characterized by bilateral acoustic neuromas and is rare (its incidence is 1/50,000). The previously reported ocular associations of NF type II are posterior subcapsular cataracts, Lisch nodules, and combined hamartomata of the retinal pigment epithelium and retina. In this study, the authors attempt to define further the ocular manifestations of NF type II. METHODS: The authors prospectively examined 9 patients who met the diagnostic criteria for NF type II (age, 18 to 38 years; mean, 25 years). RESULTS: Seven of nine patients had epiretinal membranes in the posterior pole. None of these epiretinal membranes were visually significant. In addition, five patients had central posterior cortical cataracts and five had peripheral wedge-shaped cortical cataracts. CONCLUSION: The presence of epiretinal membranes in young patients may represent another clinical finding associated with NF type II. Epiretinal membranes, central posterior cataracts, peripheral cortical cataracts, or combined hamartoma of the retinal epithelium and retina in young patients should alert the ophthalmologist to include NF type II in the differential diagnosis in patients with stigmata of NF type II.

Adolescent↗
PubMed1991

Headaches in adolescents. Diagnosis and management.

A thorough history, general physical examination, neurologic evaluation, and charting of the temporal pattern of the headache will allow the correct diagnosis to be made under most circumstances. Laboratory testing is tailored to the specific headache syndrome. Psychological factors are important in all forms of adolescent headache and should be evaluated in each and every case. Once the correct diagnosis has been made, a comprehensive approach to the patient's problems, medical and psychological, will usually result in improvement.

Acute Disease↗
PubMed1991

A practical approach to headaches in adolescents.

A thorough history, general physical examination, and neurologic evaluation coupled with the charting of the temporal pattern of the headache will allow the correct diagnosis to be made under most circumstances. Laboratory testing is tailored to the specific headache syndrome. Psychological factors are important in all forms of adolescent headache and should be evaluated in each and every case. Once the correct diagnosis has been made, a comprehensive approach to the patient's problems will usually result in improvement.

Acute Disease↗
PubMed1990

Psychogenic seizures in children and adolescents: outcome after diagnosis by ictal video and electroencephalographic recording.

Psychogenic seizures in 21 nonepileptic children and adolescents, aged 8 to 18 (mean 14.5) years, were recorded by means of video recording and electroencephalography. The episodes included thrashing movements, limb jerking, or staring, with unresponsiveness. Ictal and interictal electroencephalograms showed no abnormalities after antiepileptic medication was discontinued. Fifteen patients had psychogenic seizures spontaneously during recording, and six had seizures in response to suggestion and intravenous saline injection. After the video-electroencephalographic evaluation, patients and families were told that the episodes were emotional in origin. All patients but 1 agreed to remain without antiepileptic medication, and 16 patients (76%) agreed to begin psychiatric treatment. At 6 to 66 (mean 30) months' follow-up, 14 of 18 (78%) were free of episodes. These data indicate that the majority of young patients with psychogenic seizures have a good outcome. A firm diagnosis is critical so that the episodes can be classified and emphasized as medically not worrisome, permitting a shift away from antiepileptic medication and toward psychiatric treatment.

Adolescent↗
PubMed1989

Partial seizures in children: clinical features, medical treatment, and surgical considerations.

Partial seizures are not uncommon in children. They are classified into two types: simple partial, without impairment of consciousness, and complex partial, with impaired consciousness. For both types, the hallmark is onset of the seizure from a portion of one cerebral hemisphere, as indicated by focal spikes or sharp waves on EEG. The symptoms of simple partial seizures may include focal motor or somatosensory phenomena, special sensory phenomena, autonomic symptoms, or psychic symptoms, and these symptoms may occur alone or they may progress into a complex partial seizure with alteration of consciousness. The complex partial phase may include simply an arrest of ongoing activity with altered awareness and a blank empty stare, or there may also be automatisms, including movements which are gestural, alimentary, mimicking, verbal, or ambulatory. Automatisms are predominantly seen in complex partial seizures arising from temporal areas, but they also may be seen in seizures with extratemporal onset. If the epileptic discharge spreads throughout both cerebral hemispheres, the child will have a secondarily generalized tonic-clonic convulsion. EEG should be performed in any child who is suspected of having partial seizures. If there are focal spikes or sharp waves, then there is strong supportive evidence for a diagnosis of partial seizures in the proper clinical setting. It should be remembered, however, that a normal routine EEG cannot be used to "rule out" a diagnosis of epilepsy in patients who have episodes that sound like simple or complex partial seizures. An underlying etiology may be found in a significant percentage of children with partial seizures. Most of these etiologies are static, and the seizures are the result of a previous cerebral insult, but some patients may have slow-growing gliomas or other mass lesions. MRI or CT is indicated in essentially any child with partial seizures. Medical treatment is based on the idea of using single drugs to maximally tolerated doses, if needed, before beginning with two-drug regimens. If the child continues to have seizures despite aggressive trials of medication, then it is important to consider epilepsy surgery, either temporal lobectomy or other cortical resection. When children are identified as candidates for epilepsy surgery, they should be referred to specialized centers for further testing.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1989

Headaches in children and adolescents.

The diagnosis and management of various HA syndromes in children and adolescents have been reviewed. The decision as to whether a child's HA is organic or functional may be a difficult one, but a thorough and systematic history and examination coupled with selected laboratory tests will usually guide the examiner to the correct diagnosis.

Adolescent↗