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Biomedical subjects

B Ashworth

Publications and source records attributed to B Ashworth.

At least 19 recordsLinked to original sources

Severe amnesia after hypoglycemia. Clinical, psychometric, and magnetic resonance imaging correlations.

OBJECTIVE: To determine the correlation between clinical, psychometric, and magnetic resonance imaging (MRI) findings after an episode of hypoglycemic coma resulting in amnesia. RESEARCH DESIGN AND METHODS: Detailed psychometric assessment, especially memory testing, performed with MRI in a man with severe amnesia after hypoglycemic coma. RESULTS: Psychometric testing confirmed impaired immediate recall. MRI findings were consistent with a lesion in the left temporal lobe. CONCLUSIONS: This is the first description of MRI in determining the neurological damage in hypoglycemic coma.

Adult

Visual function in multiple sclerosis.

126 patients with multiple sclerosis and normal visual acuity were submitted to a battery of tests of visual function. The investigation included visual evoked potential, contrast sensitivity by three methods, and a segment of the Farnsworth-Munsell 100 Hue test. 22 of the patients gave a history of unilateral acute optic neuritis and in these the abnormalities were greater in degree. Contrast sensitivity emerged as the most useful test and was abnormal in 92.2% of eyes. Visual evoked potential was delayed in 35.6% and colour vision was abnormal in less than a third. In general, contrast sensitivity was depressed at all frequencies and most of the abnormalities could be identified by testing at a single frequency of 4 cycles/degree.

Acute Disease

Primary cerebral lymphoma presenting with cranial diabetes insipidus.

A 30 year old woman with an 8-year history of thirst and polyuria was found to have cranial diabetes insipidus. There were no neurological abnormalities at presentation but she subsequently developed diverse signs and died 26 months later. Autopsy revealed a diagnosis of diffuse primary cerebral lymphoma. Cranial diabetes insipidus with otherwise minimal abnormality of hypothalamic/pituitary function has not previously been reported as a presentation of this neoplasm.

Adult

Lipid storage myopathy associated with low acyl-CoA dehydrogenase activities.

A man with a painful proximal myopathy had excess lipid deposition in skeletal muscle, excretion of dicarboxylic acids in urine and low acyl-CoA dehydrogenase activities in skeletal muscle mitochondria. In addition he had little immunoreactive short-chain and medium-chain acyl-CoA dehydrogenase enzyme protein compared with normal controls. Following treatment with riboflavin there was considerable improvement in his clinical condition which was confirmed by further biochemical and morphological investigations.

Acyl-CoA Dehydrogenases

The pupil.

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Autonomic Nervous System Diseases

Migraine, head trauma and sport.

In some people an attack of migraine may be provoked by heading a football or a blow on the face in a rugby tackle. The attack is sometimes alarming and clearly cannot be explained on a basis of trauma alone. Some people only have attacks in this particular circumstance but the majority have spontaneous episodes at other times. The presentation is usually in childhood or early adult life. The syndrome is discussed in relation to reports of seven patients to illustrate the variations which include migraine without headache and persistent features after the attack. The condition is benign but may cause the patient to give up playing football.

Adolescent

Delayed visual evoked potentials with bilateral disease of the posterior visual pathway.

A man of 51 years presented with sudden onset of a confusional state and marked visual deterioration. The computerised transaxial tomogram showed a mass in the corpus callosum which had spread to involve both cerebral hemispheres. The visual evoked potential to pattern stimulus was delayed by about 20 ms. Necropsy confirmed the presence of an astrocytoma of the corpus callosum involving the optic radiation and occipital cortex on both sides. The anterior visual pathway was normal.

Astrocytoma

Evidence of osteomalacia in an outpatient group of adult epileptics.

A review of 50 adult epileptics who had taken anticonvulsant drugs for 10 or more years showed a decrease in the concentration of serum phosphate and calcium and an increase in the activity of alkaline phosphatase in 22% of the patients. Plasma albumin and gamma-globulin levels were higher than in control subjects. All the patients lived at home and the dietary intake of calcium and vitamin D was often borderline normal or low. Six patients were submitted to bone biopsy and of these, 4 showed histological osteomalacia. Gastrointestinal disease did not appear to be a significant factor. None of the patients had symptoms or signs attributable to osteomalacia which does not seem to be of serious significance. All the patients were taking at least two drugs and it was not possible to assess the relative importance of the various drugs. A prospective study is needed. Measurements of serum calcium, phosphorus, and alkaline phosphatase should be performed at intervals on patients who are receiving anticonvulsant therapy. Treatment with calciferol may be indicated.

Adult

Ocular myotonia.

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Adolescent