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Biomedical subjects

C H Lücking

Publications and source records attributed to C H Lücking.

At least 91 records · Page 5Linked to original sources
PubMed1995

Effects of local injections of botulinum toxin on electrophysiological parameters in patients with hemifacial spasm: role of synaptic activity and size of motor units.

Ten patients with typical hemifacial spasm were examined before and after treatment with local injections of botulinum toxin type A. After a mean follow-up period of 38 days there was a reduction of the compound muscle action potential (CMAP) of the injected orbicularis oculi muscle of 40%. Ephaptic transmission studied by selective stimulation of facial nerve branches revealed a preserved delayed response of the affected mentalis muscle. However, no delayed response could be recorded in the injected orbicularis oculi muscle in nine patients. The discrepancy between complete loss of the delayed (ephaptic) response and only moderate reduction of the CMAP amplitude of the direct response may be explained by preferential uptake of botulinum toxin type A by hyperactive synapses involved in ephaptic transmission.

Action Potentials↗
PubMed1995

[Brachial plexus lesions and rhabdomyolysis following heroin abuse. Indications for an immunological cause].

On the morning after taking alcohol in large amounts together with intranasal heroin, a 25-year-old man experienced pain, swelling and blistering in both arms together with right brachial plexus paresis. Creatine kinase (1930 U/l), acute phase proteins and IgE (238 IU/ml) were elevated. The pain was largely relieved by guanethidine block (given once only), and the swelling and blisters responded to methylprednisolone (80 mg daily for 7 days, then gradually reduced). Function returned in the lower division of the brachial plexus within ten days, but the upper division was still paretic 2.5 months later. After injecting heroin intravenously, a 27-year-old man woke up next morning with fever (39 degrees C) and proximal flaccid paralysis of the right arm. In addition to leucocytosis (25,600/microliters), creatine kinase was raised to 28,890 U/l and pANCA to a titre of 1:50 (antineutrophil cytoplasm antibody, perinuclear fluorescence pattern). The cerebrospinal fluid showed increases in cell count (15/microliters) and protein (73 mg/dl). Acute renal failure supervened after two days but was successfully treated. The paresis was still present at four months, though improved. A 21-year-old woman developed an upper brachial plexus lesion after attempting suicide with intravenous heroin accompanied by flunitrazepam (20 mg by mouth) and a bottle of whisky. She had raised levels of C-reactive protein (12 mg/dl) and IgM (4.0 milligrams). The paresis cleared up within six weeks without specific therapy. In view of the immunological abnormalities it seems possible that the immune system was involved in the pathogenesis of the plexus lesions and the rhabdomyolysis.

Adult↗
PubMed1995

Abnormalities of tracking behavior in Parkinson's disease.

Tracking behavior in Parkinsonian patients and in a control group of elderly subjects was studied using a one-dimensional pursuit tracking task. The most obvious abnormality in patients with Parkinson's disease is a tendency to restrict movements to a limited range, thus "clipping" the extreme deviations of the target, reflected by movement arrests, reduced amplitude gain, and decreased velocity gain. Most of the tracking parameters were selectively sensitive to parkinsonian as opposed to age-related impairment of motor functions, the only exception being directional errors, which were more frequent in the old age group. Movement range and amplitude gain were related to general disability as reflected by the Hoehn and Yahr stage. Amplitude gain was also the single factor with the strongest influence on tracking error and was smaller for large target deviations in both groups. A reduction in target velocity caused a significant increase in amplitude gain, suggesting a compensatory strategy (amplitude/lag trade-off) as one possible cause of low-amplitude gain. Decreased peak velocity did not contribute significantly to tracking error. These findings suggest that reduced movement amplitude and slowness are independent phenomena, of which only the former has a significant influence on tracking performance in the task used. Patients with Parkinson's disease showed no impairment of motor learning on this task.

Adult↗
PubMed1995

Hand muscle reflexes following air puff stimulation.

Hand muscle reflexes following muscle stretch and electrical nerve stimulation show a typical pattern consisting of short- and long-latency reflexes. The present investigation was designed to test reflexes following pure cutaneous stimulation. Air puffs were delivered to the palmar tip and the nail bed of the first, second and fifth fingers during isotonic contraction of hand muscles. The EMGs from the thenar muscles, the first dorsal interosseous muscle and the hypothenar muscles were recorded. Reflexes were obtained in all muscles, with a typical configuration consisting of a short-latency excitatory component (cutaneous long-latency reflex I, cLLR I) and a second excitatory component (cutaneous long-latency reflex II, cLLR II), with an inhibitory component between them. The size of cLLR II differed depending on the area stimulated and the muscle recorded. We found the largest responses always in the muscle acting on the stimulated finger. The reflex size depended on the strength of air puff stimulation. Allowing small displacements of the fingers led to an additional increase in the size of the reflex. The pattern of reflexes was identical independent of whether the finger tip or the nail bed was stimulated, but the size of the reflexes was smaller following nail bed stimulation. Following blockade of the cutaneous nerve branches of the thumb with local anaesthetics, air puff stimulation of the thumb no longer elicited this reflex pattern. Hence, under our experimental conditions, cutaneous receptors were the only source of afferent input for these reflexes.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

[Intrathecal IgG synthesis: when is determination of oligoclonal bands necessary?].

Two quantitative methods of determining the intrathecal synthesis of IgG were tested for their usefulness in deciding about the necessity of further investigations of oligoclonal bands (OCB) in the CSF. For this purpose, in 2003 patients with various neurological diseases the intrathecal synthesis of IgG was determined by Reiber's formula and by the IgG index, as well as by the demonstration of OCB by isoelectric focusing (IEF). While OCB could be detected in no patient with an IgG index < 0.45, these bands were always demonstrated in patients with an index > 0.80. Even though arrange of 0.45-0.8 OCB was only detected in 268/1316 patients (20.4%), in 190/268 samples (70.8%) OCB were the only criterion for intrathecal synthesis of IgG. Calculation of intrathecal synthesis of IgG by Reiber's formula was less helpful in deciding about the necessity for IEF. Even though they had no intrathecal synthesis of IgG, as calculated by Reiber's formula, 189/1472 patients (12.8%) had OCB in the CSF. OCB were always detected if local production of IgG was > 12%. In patients with a severe damage of the blood-CSF barrier, calculation of the IgG index gave more false-positive results than calculations using Reiber's formula.

Adult↗
PubMed1995

[A case of gustatory sweating and facial pain].

We report a case of a patient with gustatory sweating, a unilateral hyperhidrosis following a gustatory stimulus and an accompanying thermoregulatory hypohidrosis in the same area. Unusual features in this case are a possible association with a face pain and that the causing lesion can be localized in the brain-stem by neurological-topical reasoning. Most cases of gustatory sweating are caused by damage to the parotid gland.

Aged↗
PubMed1994

Prolonged MRI T2 times of the lentiform nucleus in idiopathic spasmodic torticollis.

Using high-field MRI, we investigated possible morphologic changes in the basal ganglia of 22 patients with clinically diagnosed idiopathic spasmodic torticollis (iTs) compared with 28 age-matched normal controls. Two patients were found to have distinct basal ganglia lesions and were excluded from further analysis. The frequency of gross morphologic changes (atrophy, enlarged Virchow-Robin spaces) in patients was not significantly higher than in controls. However, T2 values calculated for the putamen and pallidum on both sides were significantly higher in the lentiform nucleus of the patients compared with the controls. In contrast, other well-defined subcortical regions did not exhibit a similar abnormality, nor did the optical or quantified signal analysis of various regions of interest show any differences. This finding suggests a morphologic abnormality in iTs that is not associated with a gross structural lesion. It could reflect focal gliosis and might correspond to earlier sporadic pathoanatomic descriptions of gliosis in idiopathic dystonia.

Adult↗
PubMed1994

[Corticobasal degeneration. The significance of clinical criteria for establishing the diagnosis].

Neuropathological studies show that about 20% of all patients suffering from an acinetic-rigid syndrome can not be given the diagnosis of idiopathic Parkinson's disease. Among these non-idiopathic Parkinson-syndromes the corticobasal degeneration (CBD) can be regarded as a separate disease entity. The pathological findings of moderate predominantly frontal and parietal cerebral atrophy, cortical Pick-cells and specific corticobasal inclusion bodies are considered valuable features which support the diagnosis. The clinical Characteristics of CBD are demonstrated in 3 patients including an acinetic-rigid syndrome, limb apraxia and "alien limb"-syndrome, as well as reflex myoclonus. Eye movement disorders, dementia and other rare symptoms may also be present. Electrophysiological reflex-testing helps to corroborate diagnosis. These findings and a summary which includes the previously published cases of CBD show that CBD in most cases can be diagnosed intra vitam.

Aged↗
PubMed1994

[Post-polio syndrome with isolated dysphagia].

The case of a 69 year old, male patient with slowly progressive dysphagia and an acute exacerbation is presented. He was referred to rule out an organic origin to his disorder. Apart from mild residual weakness of both legs after an acute paralytic poliomyelitis at the age of 20, the physical examination was essentially normal. No upper motor neuron pathology was found. Electromyography showed prevalent spontaneous and chronic denervation of bulbar and skeletal muscles. X-ray cinematography revealed abnormalities of bolus passage. On the basis of history and the benign clinical course over a 2 year follow-up period we assume a post-polio syndrome presenting with only dysphagia.

Aged↗
PubMed1994

Tremors in Parkinson's disease: symptom analysis and rating.

The object of the present study was to evaluate the hand tremor occurring under various conditions in 81 patients with Parkinson's disease (PD) and to statistically analyze their relation to clinical rating items. We found that resting and action tremor have to be separated, whereas postural tremor can be related to either one of them. Resting tremor does not correlate with disability items or performance items except for an item rating social handicaps. Action tremor shows some influence on performance items. Current rating scales of PD represent a valid measure of resting tremor but are less valid for the measurement of action tremor.

Adult↗
PubMed1993

Intrathecal synthesis of IgM and IgA in neurological diseases: comparison of two formulae with isoelectric focusing.

The intrathecal IgM and IgA immune response was studied by detecting oligoclonal IgM and IgA bands in CSF and by determining both the IgM/IgA indices as well as the intrathecal production of IgM and IgA by the Reiber formula. A good correlation was found between the demonstration of oligoclonal IgM (r = 0.890) and IgA bands (r = 0.927) and the Reiber formula. Compared with the finding of oligoclonal IgM/IgA bands calculation of an intrathecal IgM/IgA synthesis by the Reiber formula was less sensitive (86%). In two out of 22 controls and in 12 of 19 patients with polyradiculitis IgM and IgA indices were elevated while the other evaluation methods were negative. Even though oligoclonal IgM and IgA bands are considered to be a useful diagnostic tool in detecting intrathecal synthesis of IgM and IgA, i.e. in meningoencephalitis or neuroborreliosis for clinical practice, the Reiber formula provides reliable results. Detection sensitivity of assays for CSF-IgM and -IgA should be at least 1.0 mg/l.

Adolescent↗
PubMed1993

Different effects of 1-methyl-4-phenyl-pyridinium (MPP+) on monoamine oxidase of dopaminergic terminals in caudate nucleus slices from pigmented and from albino rabbits.

Slices of caudate nucleus from pigmented and from albino rabbits were preincubated in vitro for 24 h with different concentrations of the neurotoxic compound MPP+. Subsequently, endogenous dopamine (DA) in the slices was determined by HPLC. MPP+ (1 and 3.2 mumol/l) was more effective in diminishing DA levels in caudate nucleus slices from albino than in slices from pigmented rabbits. Following 24 h pretreatment with MPP+, the accumulation of [3H]-DA in caudate nucleus slices from pigmented rabbits was either enhanced (at 0.32 mumol/l, 1 mumol/l and 3.2 mumol/l MPP+) or reduced (at 32 mumol/l MPP+). In contrast, MPP+ did not enhance the accumulation of [3H]-DA in caudate nucleus tissue from albino rabbits and was more potent in reducing the [3H]-DA content in slices from albino than in slices from pigmented rabbits. When the selective type A monoamine oxidase (MAO) inhibitor clorgyline was present during pre-incubation, but not when the selective type B MAO inhibitor deprenyl was, the concentration-response curve for MPP+ with caudate nucleus slices from pigmented rabbits was similar to that obtained with slices from albino rabbits. Clorgyline and deprenyl did not change the effects of MPP+ in caudate nucleus slices from albino rabbits. These findings are compatible with the hypothesis that the MAO within dopaminergic terminals in the caudate nucleus of pigmented, but not of albino, rabbits is of type A since MAO-A is preferentially inhibited by MPP+. In line with this hypothesis, the accumulation of the preferential MAO-A substrate [3H]-5-HT in caudate nucleus slices from pigmented rabbits was about 39% lower than that in slices from albino rabbits.(ABSTRACT TRUNCATED AT 250 WORDS)

1-Methyl-4-phenylpyridinium↗
PubMed1993

Guillain-Barré syndrome following streptokinase therapy.

Clinical and laboratory data from a patient with Guillain-Barré syndrome indicated a probable etiological correlation of polyradiculitis to the intravenous administration of streptokinase. Oligoclonal IgG bands in the cerebrospinal fluid and serum were shown to be specific for streptokinase. Serum titers of streptokinase were elevated 64-fold for IgG, 16-fold for IgM, and 4-fold for IgA compared to controls. Clinical symptoms of Guillain-Barré syndrome are thought to result from streptokinase antibody complex mediated damage to the local blood-nerve barrier. The pathogenic relevance of autoantibodies to albumin and proteins of the central and peripheral nervous systems, occurring early after onset of symptoms, remains to be determined.

Autoantibodies↗
PubMed1993

Primary antiphospholipid antibody syndrome and cerebral ischemia: report on acute intervention in two cases and literature review with emphasis on therapeutic options.

In two patients with primary antiphospholipid antibody syndrome and acute cerebrovascular ischemic events, local intraarterial fibrinolysis and intravenous heparin therapy, respectively, resulted in a limitation of persisting neurological deficits. On the basis of the 35 case reports available a combination of anticoagulation with warfarin, plus immunosuppression with steroids and/or cyclophosphamide or azathioprine, appears to be the best treatment to prevent further cerebral ischemic events. The therapeutic options are reviewed and discussed.

Adult↗