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Biomedical subjects

E Auff

Publications and source records attributed to E Auff.

At least 55 records · Page 3Linked to original sources
PubMed1998

[Speech disorders in Parkinson patients].

Parkinson's disease is not only a disorder affecting locomotion, but often also causes speech problems. Functional impairment of articulation, phonation, prosody and also respiration may occur. Speech disorder is frequent in Parkinson's disease and often has an impact on the quality of life. Speech therapy is by no means offered as a matter of course to these patients. This article outlines the different approaches of speech therapy regarding respiration, loudness, articulation, prosody, and intonation. Speech therapy seems to be useful in patients with Parkinson's disease only if there is no cognitive impairment; success also depends on motivation and eventual frequent repetition of therapy series.

Combined Modality Therapy↗
PubMed1998

Psychiatric comorbidity in patients with spasmodic torticollis.

Several studies have reported raised levels of psychopathology based on self-rating scales in patients with spasmodic torticollis. Recent publications have also proposed that psychopathology, especially symptoms of depression, might be a reaction to dystonia or constitute a nonspecific reaction pattern. To determine the actual frequency of psychiatric disorders, we evaluated 44 patients with spasmodic torticollis (20 female, 24 male; mean age 43.6 years, SD 10.4) using the standard instrument for psychiatric diagnosis in the DSM-III-R (Structured Clinical Interview Schedule, SCID). The SCID permits retrospective diagnosis for most of the major psychiatric disorders, including the time before onset of dystonia. SCID criteria for at least one psychiatric disorder were fulfilled in 65.9% of patients, including both lifetime and current diagnosis. The most frequent diagnostic categories were panic disorder with or without agoraphobia (29.5%), major depressive disorder (25%), substance abuse (13.6%), and obsessive compulsive disorders (6.8%) were diagnosed less frequently. The patient-recalled onset of psychiatric symptoms preceded onset of torticollis symptoms in 43.2% of those investigated.

Adolescent↗
PubMed1998

Transient and long-term feeding by means of percutaneous endoscopic gastrostomy in neurological rehabilitation.

In 28 patients of a neurological rehabilitation unit of a hospital the use of enteral nutrition via percutaneous endoscopic gastrostomy (PEG) tubes was reviewed. During a total observation period of 5,172 days no life-threatening complications occurred. Minor complications were observed in 12 patients (43%) in the first 2 weeks after the insertion and in 5 patients (18%) afterwards. The nutritional status stabilized in all subjects. Transient PEG feeding was performed in 11 patients (39%) with a mean duration of 150 days. We conclude that hesitation in the application of PEG feeding in neurological rehabilitation should be abandoned. The timing and monitoring of PEG feeding in patients undergoing neurological rehabilitation for acute remitting neurological disorders is discussed.

Adolescent↗
PubMed1997

Neurological monitoring of neurotoxicity induced by paclitaxel/cisplatin chemotherapy.

To evaluate the neurotoxicity of paclitaxel/cisplatin chemotherapy, we studied neurological and electrophysiological functions in 14 patients who had been treated with 1-7 courses of paclitaxel/cisplatin. The cumulative paclitaxel and cisplatin doses ranged from 175 to 1225 mg/m2 and 100-700 mg/m2, respectively. Neurological examinations as well as motor nerve conduction studies of the peroneal nerve were performed and summarised by means of a peripheral neuropathy score. Neurotoxicity with onset usually after the second treatment cycle occurred in 13 patients. 12 patients complained about sensory symptoms, 13 patients had impaired vibration sense and 8 patients developed additional muscle weakness, predominantly of the legs. Dysfunction of peroneal motor nerve conduction occurred in 13 patients. Reduction of amplitudes as well as slowing of conduction velocities were seen in 13 patients and prolonged distal latencies in 10 patients. The peripheral neuropathy score was elevated in 13 patients. Neurological symptoms, impairment of both vibration sense and tendon reflexes, and the peripheral neuropathy score increased with the cumulative doses of paclitaxel/cisplatin. Serial analysis among selected patients also revealed an increase in neurotoxicity with increasing cumulative drug doses. These data indicate the development of neurotoxicity in most patients treated with paclitaxel/cisplatin and also suggest that early signs of neurotoxicity can be detected by clinical examination with emphasis on symptoms as well as vibration sense and can be well documented by electrophysiological investigations.

Adult↗
PubMed1997

Double-blind trial of botulinum A toxin for the treatment of focal hyperhidrosis of the palms.

We performed a randomized double-blind study within-group comparison in 11 patients to study the effect of subcutaneous injections of botulinum A toxin in focal hyperhidrosis of the palms. A total dose of 120 mU (mouse units) of botulinum A toxin (Dysport) was injected into six different sites on one palm, whereas the other was injected with sterile saline. Objective quantification of sweat production was performed using digitized ninhydrin-stained sheets. Three weeks after treatment, the mean reduction of sweat production in the botulinum A toxin-treated palms was 26% (P < 0.001), after 8 weeks 26% (P = 0.002) and after 13 weeks 31% (P < 0.001). Subjective assessment of sweat production by the patients using a visual analogue scale showed a 38% improvement in the botulinum A toxin-treated palms at 3 weeks (P = 0.002), 40% at 8 weeks (P = 0.002) and 38% at 13 weeks (P = 0.002). Neither the objective measurement nor the subjective rating showed a statistically significant reduction of sweating in the placebo-treated palms. Three patients reported reversible minor weakness of powerful handgrip after injection at the toxin-treated site, lasting between 2 and 5 weeks.

Adult↗
PubMed1996

Long-term follow-up in cerebral Whipple's disease.

OBJECTIVE: To evaluate the long-term outcome in patients with cerebral Whipple's disease. PATIENTS: We reviewed the literature and contacted authors who had reported on cerebral Whipple's disease within the last 10 years. Fifteen patients were evaluated, including one patient treated at our hospital and the one presented in this paper. The mean observation period was 41 +/- 37 months (minimum 1 month, maximum 120 months). RESULTS: Four patients had improved and were able to pursue an independent lifestyle, three patients had improved but are still dependent on help with simple activities of daily life, one patient was unchanged, and seven patients had died. Patients with initial penicillin alone had a worse prognosis than patients with initial penicillin plus streptomycin. CONCLUSION: Third generation cephalosporins have been shown to be beneficial in cerebral Whipple's disease, therefore initial antibiotic treatment of Whipple's disease should consist of ceftriaxone (instead of penicillin) combined with streptomycin. Since five of 12 patients (40%) treated with co-trimoxazole (trimethoprim plus sulphamethoxazole) did not respond, we conclude that the combination of trimethoprim and sulphamethoxazole does not prevent or cure central nervous system (CNS) involvement in all patients with Whipple's disease. If CNS relapse occurs during treatment with trimethoprim and sulphamethoxazole, oral third generation cephalosporins might be a useful alternative.

Anti-Bacterial Agents↗
PubMed1996

[Subjective disability caused by physical and psychological complaints in long-term follow-up after transient ischemic attacks or "minor stroke"].

Fifty-nine patients with transient ischaemic attacks or minor strokes were re-evaluated after a mean observation period of 16 months. The aim of this study was to assess their somatic and/or psychic complaints semiquantitatively. Judging from the Beschwerdenliste and the Depressivitätsskala (von Zerssen) filled in by the patients, they exhibited hardly more complaints than healthy controls; their scores were considerably lower than those of patients suffering from other organic or psychiatric diseases. Patients who not only suffered from cerebrovascular disease but also from coronary heart disease showed significantly higher scores on both scales than patients with cerebrovascular disease without clinically manifest coronary heart disease. Patients under observation for more than 2 years exhibited considerably fewer psychic complaints than those under observation for shorter periods of time. The Beschwerdenliste and the Depressivitätsskala (von Zerssen) proved useful for assessing somatic and/or psychic complaints in patients after transient ischaemic attacks or minor strokes.

Activities of Daily Living↗
PubMed1995

[Parkinson disease and neurologic rehabilitation].

Modern rehabilitation is becoming more and more "social integration" instead of "going back to work". Therefore rehabilitation is also a matter in chronic disease and in old people. Parkinson patients are somewhat disabled in nearly every aspect of their life, although the extent is related to the stage of the disease. Moreover, symptoms do not respond equally to drug treatment, balance (with succeeding falls) and swallowing being special problems for anti-parkinsonian drug treatment, but also vegetative symptoms, dysarthria, motor skills etc. Apart from medication patients get relief also from adjuvant therapy like physiotherapy, occupational therapy, and speech therapy, which all can lead to improvement of quality of life. Rehabilitation needs team effort. Patient and family supporting groups (like Parkinson Disease Society and others) are an important factor for all needs of neurological rehabilitation.

Activities of Daily Living↗
PubMed1995

[Increased residual urine volume after local injection of botulinum A toxin].

After major head trauma, a 28-year-old male patient developed tetraparesis with marked left-sided contractions of the leg adductors. Spasticity was resistant to antispastic drugs and intensive physiotherapy. Therefore, we injected 12.5 ng botulinum A toxin (Dysport) in the left adductor longus and adductor magnus. Eight measurements of the post-micturition residual urine of the bladder before botulinum-A-toxin administration gave no evidence for urinary retention. Between day 5 and 14 after injection we measured pathologically increased urinary volumes up to 130 ml at five different points of time. This case report indicates possible subclinical side effects on the autonomic nervous system of the urinary bladder.

Adult↗
PubMed1994

Initiation of visual-guided random saccades and remembered saccades in parkinsonian patients with severe motor-fluctuations.

We studied the initiation of saccades to visual-guided random time and remembered targets in a group of nine Parkinsonian patients with severe motor fluctuations and in 9 age matched control subjects. In contrast to a marked skeletomotor improvement during the "on" condition, saccadic latencies for both visual-guided random saccades and remembered saccades were increased in the patients during the "on" condition compared to the "off" condition. This result of dissociation between skeletomotor and oculomotor function indicates that common concepts of saccadic initiation in parkinsonian patients do not hold true in patients with severe fluctuations since dopaminergic stimulation seems to increase saccadic latencies in these patients.

Aged↗
PubMed1994

[Therapeutic use of botulinum A toxin in neurology].

The highly potent neurotoxins produced by Clostridium botulinum lead to botulism when ingested in appreciable amounts. However, botulinum toxin injections delivered intramuscularly in very small quantities can produce a therapeutically intended focal paresis while producing only negligible local or systemic side effects. Over the past several years, various neurological disorders, especially those involving increased muscle tone and/or abnormal movements, have been successfully treated with local botulinum A toxin injections. The success of this method has led to a general change in the management of blepharospasm, torticollis spasmodicus, hemifacial spasm, and other disorders. Treatment is usually effective for 4 to 12 weeks; if symptoms recur, the injections can be repeated over a period of several years, usually with the same success. Side effects depend on the site of the injections, and are rare at the optimal dosage and always reversible. For optimum therapeutic results, this treatment must be restricted to specialized centers.

Botulinum Toxins↗
PubMed1993

Physical activity and sports in patients suffering from Parkinson's disease in comparison with healthy seniors.

Physical activity during lifetime was investigated among 32 Parkinson patients (age 65.6 +/- 8.1 yrs, mean +/- SD) retrospectively by means of a structured interview. Data were compared with 31 healthy controls (age 61.7 +/- 5.8 yrs). An objective score was obtained by presenting a list of all kinds of sports, subjective estimation of physical activity was done by visual analogous scales. Until the occurrence of the first symptoms (mean = 58.5 yrs) the patients did not differ from controls. During the course of disease a striking reduction in physical activity but no complete abandonment of sports was found. Swimming, hiking and gymnastics were the favoured sports in both groups. Learning of new sports seemed to be impossible for the patients.

Aged↗
PubMed1993

Circadian secretion pattern of melatonin in de novo parkinsonian patients: evidence for phase-shifting properties of l-dopa.

Aim of this study was the characterization of the circadian melatonin profile in de novo Parkinson patients (N = 9, age 60.0 +/- 3.2 years, mean +/- SEM) and the comparison of these profiles with those of controls and Parkinson patients treated with l-dopa/decarboxylase inhibitor (l-dopa/DCI). We collected 14 venous blood samples during a period of 24 hours and measured the serum melatonin levels by a radioimmuno assay. De novo Parkinson patients displayed the nocturnal melatonin peak (acrophase) at the same time as controls and significantly later than l-dopa/DCI treated patients (1:54 +/- 15.6 min [average clock time +/- SEM in minutes] vs. 1:45 +/- 15.6 min vs. 0:13 +/- 40.8 min). The amount of secreted melatonin did not differ among the three groups. Stage and duration of Parkinson's disease did not correlate with the amount of secreted melatonin. Patients of the tremor subgroup, however, secreted more melatonin than patients presenting only with rigidity and akinesia. The phase advance in Parkinson patients treated with l-dopa/DCI is possibly due to a central nervous dopaminergic effect elicited by l-dopa administration and not inherent to Parkinson's disease per se.

Aged↗
PubMed1991

Essential tremor: functional disability vs. subjective impairment.

78 patients with essential tremor (ET) were investigated to uncover correlation and discrepancies between functional (motor) disabilities and subjective impairment. Various self-rating scales (Zung, v. Zerssen etc.) were used for the assessment of the latter: 2/5 of the patients rated themselves as severely impaired; 1/3 was depressive. Patients who showed nearly the same functional (motor) disability felt very differently subjectively impaired. Semiquantitative clinical scores of action tremor correlated best with the subjective impairment in activities of daily living. Objective measurements of motor disability were performed with the "Motorische Leistungsserie nach Schoppe" (motor performance test) and showed good correlation to the subjective impairment in simple tasks of every day life, such as drinking from a glass, eating soup, and writing. Asking for the subjective impairment in these tasks allows to estimate the objective disability correctly. This may be of value in long-term studies of essential tremor.

Aged↗