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Biomedical subjects

A D Rothner

Publications and source records attributed to A D Rothner.

At least 73 records · Page 4Linked to original sources
PubMed1984

Pancreatitis associated with valproic acid therapy.

Four patients had pancreatitis associated with valproic acid therapy. Three patients received valproic acid at usual doses, and all were free of other symptoms of toxic reactions, with serum levels of valproic acid in the usual therapeutic range. Two patients underwent exploratory laparotomy prior to diagnosis. Complications included pseudocyst, pericardial effusion, laparotomy wound infection, and coagulopathy. All patients recovered with discontinuation of valproic acid therapy and enteral feeding and administration of intravenous fluids. After recovery, a valproic acid regimen was restarted uneventfully (in one patient). All were asymptomatic with normal serum amylase levels after five to 14 months. Pancreatitis is a serious complication of valproic acid therapy that must be considered in any patient receiving valproic acid who experiences severe abdominal pain and vomiting.

Abdomen↗
PubMed1984

Familial multisystem atrophy with possible thalamic dementia.

We studied a family with progressive dementia, optic atrophy, and spastic paraparesis. Autopsy of one family member revealed multisystem atrophy with widespread degeneration of the thalamus and marked attenuation of hemispheric white matter to account for the dementia. This family may suffer from a unique disorder, but the findings overlap with other reported cases of thalamic dementia or familial spastic paraparesis.

Adolescent↗
PubMed1982

Valproic acid in the treatment of intractable absence seizures in children: a single-blind clinical and quantitative EEG study.

A 12-week single-blind study used valproic acid in the treatment of refractory, simple and complex absence (petit mal) seizures in 17 children. The clinical seizure control was compared with the number and duration of electrical discharges on six-hour EEG recordings before and during therapy. Sixteen patients showed clinical improvement. Fourteen had greater than 75% clinical improvement and ten patients became free of absence seizures. Side effects were mild, but two patients experienced transient, asymptomatic thrombocytopenia. Good correlation between clinical response and decreasing seizure activity on the EEG occurred in the seizure-free patients.

Adolescent↗
PubMed1982

Submersion accidents in children with epilepsy.

The risks of submersion accidents, both drowning and near-drowning, for children with seizure disorders were calculated from the present study of six children with epilepsy in a total group of 100 children with postsubmersion syndrome and from five other reported studies. Analysis of data shows that the risk for patients with seizure disorders is four times that of the normal population. Persons with epilepsy should never swim without a lifeguard or competent swimmer being aware of the diagnosis and keeping close surveillance while they are swimming. Hyperventilation, a normal occurrence while swimming, may predispose patients with epilepsy to seizures and submersion accidents by increasing the propensity to seizures. In this study, three of the victims had at least one anticonvulsant drug level within the therapeutic range immediately after the submersion accident. Therapeutic drug levels are no guarantee that seizures will not occur during swimming.

Adolescent↗
PubMed1982

Benign focal epileptiform discharges in childhood migraine (BFEDC).

Interictal EEGs were studied in 100 children, ages 3 to 15 years. Records were interpreted independent of history; 89% were normal, 9% had benign focal epileptiform discharges (BFEDC), one had temporal spikes, and one had background slowing. The nine patients with BFEDC did not differ from the others. None had epilepsy. This incidence of 9% is higher (p less than 0.0001) than the incidence of BFEDC in the normal population (1.9%). The significance of this finding is not clear, but migraine and benign focal epilepsy of childhood may be genetically linked, or the vascular abnormality of migraine may cause brain injury to produce sharp waves of low epileptogenicity. These results do not suggest that headaches are epileptic.

Adolescent↗
PubMed1981

Eaton-Lambert myasthenic syndrome: long-term treatment of three patients with prednisone.

Three patients with the myasthenic syndrome of Eaton-Lambert (ELS) were treated with prednisone for 6 and 12 months and more than 3 years, respectively. Muscle strength increased considerably in all, reaching a peak after 3 to 4 months, and was accompanied by simultaneous electromyographic improvement. Reduction of prednisone led to deterioration in all 3 patients; strength was regained when the higher dosage of prednisone was resumed. Prednisone is an alternative form of treatment for ELS, although the mechanism for its action is unclear.

Adolescent↗
PubMed1980

Cerebellar ataxia, opsoclonus, and occult neural crest tumor. Abdominal computerized tomography in diagnosis.

A 9-month-old female with opsoclonus and ataxia was examined. Computerized axial tomography (CT) of her abdomen identified a retroperitoneal mass of neural crest origin that was not recognized by more conventional roentgenographic methods. The syndrome of cerebellar ataxia, myoclonus, and opsoclonus, and its relationship to neural crest tumors is reviewed along with the usefulness of abdominal CT.

Cerebellar Ataxia↗
PubMed1980

Status epilepticus.

Status epilepticus may end fatally or may leave serious sequelae. Thus the physician must act quickly and appropriately to stop convulsions using the methods described. Supportive measures--maintenance of airway, protection from harm, maintenance of vital functions--must be accomplished before drug therapy is started. Metabolic abnormalities must be corrected. Striving for levels of antiepileptic drugs in the upper therapeutic range is best, and the physician must be prepared to deal with the side-effects and complications of these medications.

Anesthesia, General↗
PubMed1980

Calcification of the choroid plexus visualized by computed tomography.

Physiologic calcification of the choroid plexus increases in frequency and extent with age. As demonstrated in this report, it is visualized nine to 15 times more frequently with computed tomography (CT) than with plain skull radiography. Calcification involving the temporal horns is associated with neurofibromatosis. Young patients with exuberant calcification in the region of the glomerula, or with calcification extending into the bodies of the lateral ventricles should be evaluated for conditions associated with pathological calcification of the choroid plexus. This also applies to patients of any age in whom calcification of the choroid plexus in the roof of the third ventricle or in the region of the foramen of Monro can be visualized with routine CT center and window levels.

Adolescent↗
PubMed1980

Paroxysmal choreoathetosis: report of five cases and review of the literature.

Paroxysmal choreoathetosis is a rare, involuntary movement disorder. Attacks occur spontaneously or may be induced by movement, startle, or anxiety. The movements are tonic, dystonic, or choreoathetotic. Sporadic and, more commonly, familial cases have been reported. Onset occurs most often during childhood, and the course is nonprogressive. Response to anticonvulsant therapy is usually excellent. Five cases of the sporadic form of paroxysmal choreoathetosis are reported. Three of the five patients had attacks after initiation of movements such as rising from a chair. Results of physical examination were normal in four patients. One child had mild hemiatrophy and unilateral hyper-reflexia. Results of laboratory studies, including determinations of serum calcium and ceruloplasmin levels, EEGs and CAT scans of the head, were normal. The attacks ceased in all patients after treatment with either phenytoin or carbamazepine.

Adolescent↗