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Biomedical subjects

E A Sanders

Publications and source records attributed to E A Sanders.

At least 55 records · Page 3Linked to original sources
PubMed1989

Visuospatial problem solving, conceptual reasoning and sorting behaviour in multiple sclerosis out-patients.

Visuospatial problem solving, conceptual reasoning and shifting of set were studied in out-patients with definite and probable MS. The sample of MS patients was homogeneous with respect to 2 important dimensions. All were out-patients, leading a normal although handicap-restricted social life. Furthermore, in all patients relapse or obvious instability of the disease were absent for at least a month. On Raven's Progressive Matrices, the Category test and the Wisconsin Modified Card Sorting test, no significant differences were found between the group of MS patients and a control group of healthy volunteers. However, 18% of MS patients and 4% of controls were rated as performing slightly below the expected levels of cognition. Stepwise regression analysis failed to reveal effects of illness variables, and no difference between patients with definite and probable MS could be detected. Clearly, most socially integrated MS patients in stable disease stages are capable of normal visuospatial problem solving, abstract reasoning and shifting of set.

Adolescent↗
PubMed1988

Reaction time in ambulant multiple sclerosis patients. Part I. Influence of prolonged cognitive effort.

Reaction times (RT) were measured in 39 multiple sclerosis (MS) patients and 25 healthy controls, before and after comprehensive neuropsychological assessment lasting at least 4 h. The assessment required prolonged mental effort, which was assumed to induce fatigue. Simple and disjunctive RT were measured for visual and auditory stimuli. RT before and after prolonged effort were significantly longer in MS than in control subjects (with exception of auditory RT). This effect was related to disease duration and to simultaneous presence of brainstem, cerebellar and/or pyramidal signs. Age did not significantly contribute to the explanation of RT increase. In female patients, increasing distribution of functional lesions in the central nervous system was related with greater RT increase than in male patients. RT of MS and controls changed after prolonged mental effort and effort-related fatigue was experienced subjectively. Yet no differences in direction or degree of change in RT were found between controls and ambulant patients with stable MS who apparently had resources to overcome fatigue.

Adolescent↗
PubMed1988

Reaction time in ambulant multiple sclerosis patients. Part II. Influence of task complexity.

Effects of task variables on reaction time (RT) were investigated in 39 multiple sclerosis (MS) patients and 25 matched control subjects, based on the premise that RT is sensitive to (subtle) changes of cognitive efficiency. The hypothesis to be tested held that inefficient cognitive processing in MS would be reflected in differences between RT patterns of MS and control subjects, and in inordinate RT increase in MS patients with increase of task complexity. No difference was found between MS patients and controls, or between MS subgroups, in (1) response to time uncertainty of stimulus presentations, (2) RT behaviour over stimulus presentations, and (3) RT change from simple to more complex conditions. No evidence of slowed cognitive processing was found in this sample of outpatients with relatively mild and stable MS. It is emphasised that executive and cognitive slowness have to be disentangled in research on MS and on so-called 'subcortical dementia', of which mental slowing is a key concept.

Adolescent↗
PubMed1987

Guillain-Barré syndrome after varicella-zoster infection. Report of two cases.

Two patients developed Guillain-Barré syndrome after varicella-zoster infection; a 4-year-old boy after chickenpox and a 74-year-old man after shingles. Both had decreased CD8-positive lymphocytes in the blood during the course of their illness. These cases and others reported in the literature suggest that varicella-zoster infection is a significant but rare trigger factor of Guillain-Barré syndrome. An alteration in the balance of helper and suppressor lymphocytes may be an important pathogenetic mechanism.

Aged↗
PubMed1987

Residual lesions and early recurrent stenosis after carotid endarterectomy. A serial follow-up study with duplex scanning and intravenous digital subtraction angiography.

In 109 internal carotid endarterectomies a complete serial follow-up study with ultrasonic duplex scanning was performed at 3, 6, and 12 months after operation. A duplex scan was also performed 2 years postoperatively in 75 cases. Moreover, the state of the endarterectomized carotid bifurcations was documented by intravenous digital subtraction angiography during hospitalization and at 12 months. At 3, 6, 12, and 24 months after operation the rate of significant recurrent stenosis was 6%, 12%, 6%, and 8%, respectively. Approximately half of the arteries with a significant stenosis at 1 year already demonstrated this lesion with intravenous digital subtraction angiography performed 1 week after operation. Persistent significant recurrent stenosis in the remaining arteries was probably the result of excessive myointimal proliferation. This occurred with a higher frequency in women (14.8%) than in men (4.1%). The greater number of the arteries with minimally or mildly disturbed spectral waveforms 3 months after endarterectomy spontaneously normalized or remained stable during the follow-up period. On the other hand, 40% of the arteries with a significant stenosis (diameter reduction of 50% or more) at the three-month control follow-up period increased to a more severe degree of stenosis during the first postoperative year. Most of the operated arteries did not significantly change during the second year.

Carotid Artery Diseases↗
PubMed1987

Visual function and pattern visual evoked response in optic neuritis.

The disparity between clinical visual function and pattern visual evoked response (VER) was studied in 53 patients who had suffered an attack of optic neuritis (ON) more than six months before. The visual functions tested included Snellen visual acuity, colour vision, visual field, and contrast sensitivity. The effect of pattern presentation, check size, and luminance was tested by recording VERs with several stimulus configurations. VER amplitudes were found to be associated with the outcome of all four clinical tests, independently of check size, luminance, or the presentation method used. On the other hand VER latencies were hardly ever related to the results of any of the four clinical visual tests. These findings support the idea that VER amplitude provides information about visual spatial perception, while VER latency is more related to the extent of demyelination.

Adolescent↗
PubMed1986

The diagnosis of multiple sclerosis. Contribution of non-clinical tests.

A group of 89 patients in whom multiple sclerosis (MS) has been clinically diagnosed with varying degrees of certainty, and 25 patients with optic neuritis (ON), were subjected to the following electrophysiological tests: visual evoked response (VER), auditory brainstem-evoked response (ABER), somatosensory-evoked response (SSER), blink reflex and electronystagmography (ENG). All these patients also underwent computerized tomography (CT scan) and analysis of cerebrospinal fluid (CSF). A new diagnostic procedure is proposed, combining optimum detection of definite MS with optimally economical use of the above-mentioned non-clinical tests. The results for the MS patients show that definite MS can be diagnosed much more frequently (72%) if abnormal results in the above-mentioned tests are accepted as evidence of a (subclinical) CNS lesion. Application of the clinical diagnostic criteria of McAlpine yielded "definite MS" only in 27% of our patient material. Our diagnostic criteria showed evidence for MS in 36% of the patients clinically diagnosed as having ON. The test results were inconclusive as regards the possibility of the remaining ON patients developing MS in the future.

Adult↗
PubMed1986

Paraesthesiae in multiple sclerosis.

The clinical features of paraesthesiae were analysed in 127 patients with clinically definite multiple sclerosis (MS). Fifty-one of these patients (40%) mentioned paraesthesia as a presenting symptom and 107 (84%) had persistent paraesthesiae by the time of this study. Paraesthesiae were frequently associated with sensory loss in the same region. However, this association was not statistically significant nor was that between the occurrence of paraesthesiae and abnormal somatosensory evoked responses (SSER). Statistically significant associations were found between abnormal SSER and abnormal sense of vibration, abnormal SSER and diminished sense of touch, and abnormal SSER and diminished sense of pain.

Adolescent↗
PubMed1986

Sex distribution, age of onset and HLA profiles in two types of multiple sclerosis. A role for sex hormones and microbial infections in the development of autoimmunity?

Fifty-four patients with clinically definite multiple sclerosis were typed for HLA-A, B, C, DR and DQ antigens. HLA-DQ was not a better disease marker than the previously described HLA-DR and B markers. The patients were subdivided according to the clinical evolution of their disease, age at onset and sex. HLA-DR2 was significantly associated with females having a relapsing-remitting course of the disease and HLA-B8 and B35 were significantly associated with males having a chronic-progressive course of the disease. A role is postulated for defects in the sex hormone balance in females and for microbial infections in males as dominant environmental triggers in the development of autoreactivity.

Adult↗
PubMed1986

Presenting signs and symptoms in multiple sclerosis.

The disability outcome related to the presenting signs and symptoms was studied retrospectively in 193 patients with definite multiple sclerosis (MS). Patients whose first sign was motor weakness were found to be more severely disabled, at all stages throughout the course of the disease, than patients with other presenting signs or symptoms. Patients whose disease manifested initially with sensory disturbances or paraesthesiae proved to be less seriously disabled than other patients at all stages of the disease. A similar tendency was found in patients presenting with optic neuritis (ON) for the first 20 years of the disease; after that, their disability was comparable to that of patients with other presenting complaints. The difference during the first 20 years of the disease is mainly due to the asymptomatic period after initial manifestation of optic neuritis.

Adult↗
PubMed1986

Cerebral vasculitis as presenting symptom of systemic lupus erythematosus.

A 42-year-old woman developed right-sided hemiparesis due to left-sided encephalomalacia revealed by CT scan. Subsequent angiography revealed vasculitis of several intra-cranial arteries. The ESR was 65 mm/h. Further laboratory tests revealed no evidence of systemic disease so that no causal diagnosis could be posed. Treatment with prednisone (3 X 30 mg daily) led to complete cure of the hemiparesis within 6 weeks. Sixteen months later, the patient developed cutaneous lesions in the neck. Histological examination of these lesions indicated the presence of systemic lupus erythematosus (SLE). Neurological presentation of SLE is exceptional, while cerebral vasculitis as initial symptom of SLE has never been described before.

Adult↗
PubMed1986

Estimation of visual function after optic neuritis: a comparison of clinical tests.

A group of 53 patients who had suffered an attack of unilateral (n = 45) or bilateral (n = 8) optic neuritis more than six months before were subjected to a battery of tests to determine their spatial contrast sensitivity, visual field, and colour vision. The 106 eyes investigated were classified according to their clinical status and visual acuity at the time of the study into unaffected (n = 45), recovered (n = 33), and non-recovered (n = 28). At least one of the three tests gave an abnormal result in 67%, 88%, 100% of the three groups respectively. The results obtained with these three tests showed a significant statistical association.

Adolescent↗