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Biomedical subjects

E Mauch

Publications and source records attributed to E Mauch.

28 records · Page 2Linked to original sources
PubMed1991

[Subacute organic psychosyndrome as a clinical manifestation of infection with stage II Borrelia burgdorferi without further neurologic manifestations].

A 60-year old man developed a subacute psychoorganic syndrome over four weeks. CCT was normal, except a slight atrophy of the cerebellar superior vermiform process. In the CSF we found 1696/3 cells, suggesting a lesion of the hemato-encephalic barrier, an autochthonous IgG production and an increased specific antibody-titre (10.3) for Borrelia burgdorferi. Based on these data a Lyme-Neuroborreliosis being diagnosed. Treatment with Cefotaxim and Gentamycin was successful, a complete remission of the psychopathological symptoms had been obtained. This case is an uncommon manifestation of a Borrelia-burgdorferi-infection of the CNS with psychopathological symptoms but no neurological deficit. We conclude that an affection of the CNS with Borrelia burgdorferi must always be taken into consideration in patients presenting a subacute psychoorganic syndrome of unknown etiology.

Borrelia burgdorferi Group↗
PubMed1990

[Communication for patients with severe motor handicaps--clinical experience with a new electronic communication aid].

The use of "Komhilf", a newly developed communication aid for persons with severe physical handicap, is described on the example of two patients with amyotrophic lateral sclerosis. Aside individual letter input, it provides input of complete phrases signifying basic needs or common request, without a need for letter-by-letter spelling. After a short familiarization period, both patients were able to communicate up to two to three hours daily via "Komhilf". Psychic stabilization and increased levels of activity were observed in the patients, which subsequently also entailed increased compliance with other therapeutic measures. Additional features include good transportability, use in lying and sitting (wheelchair) patients alike, easy-to-learn operation, and, not least, a competitive price.

Aged↗
PubMed1990

[Clinical value of antibody titers to Borrelia burgdorferi and titer course in neurologic disease pictures].

Over a period of 3 years, antibody titres against Borrelia burgdorferi in serum were determined for 492 patients with a wide spectrum of neurological diseases. Using the ELISA technique, we found elevated titres against Borrelia burgdorferi in about 20% of these patients. Cranial nerve paresis was often the leading symptom of an acute Neuroborreliosis. In a number of cases the diagnosis was indicated only by an elevated IgG titre in the patient's serum, or a decrease in the titre level following antibiotic treatment. The IgG titres are, however, unsuitable for control of therapy. Non-specific parameters of inflammation such as blood sedimentation rate (BSC), C-reactive protein (CRP), serum-electrophoresis or leucocyte count are also unsuitable in evaluating the therapeutic effect or for confirming the diagnosis. The most important diagnostic criterion is the demonstration of Borrelian antibodies, synthesised locally in cerebrospinal fluid (CSF). A spirochaete index above 2 suggests autochthonous intrathecal antibody production. This procedure corresponds to the determination of intrathecally produced Treponema pallidum antibodies in neurolues from quantitative TPHA values and total IgG in serum and CSF (ITpA Index according to Prange).

Adolescent↗
PubMed1989

Effective treatment of chronically progressive multiple sclerosis with low-dose cyclophosphamide with minor side-effects.

Twenty-one multiple sclerosis (MS) patients with a chronically progressive course were treated with a low dose of cyclophosphamide (CY). The control group consisted of 21 MS patients with a chronically progressive course who received the standard treatment (ACTH or cortisone). The control group consisted of patients who preferred the standard therapy because of its beneficial effects. In contrast, the patients of the CY group wanted to try a new therapy because the standard therapy was not effective. Thus before starting the study the progression of the disease was faster in the CY group than in the standard therapy group. As regards age, sex and degree of disability, the two groups were comparable. For 20 of the 21 patients in the CY group the degree of disability (Kurtzke scale) remained stable over 1 year; for 2 of the 20 stable patients there was even an improvement. In the standard therapy group, 7 out of 21 patients were stable over 1 year, while 14 showed progressive disability. A quantitative neurological score at the beginning and 1 year after the therapy showed a nearly identical difference between the CY group and the control group. The changes of the patients' abilities in daily-life activities (which were observed and recorded by the nurses) were similar to the Kurtzke scale data obtained by the physicians. The beneficial effect of CY in chronically progressive MS was thus highly significant (P less than 0.001). The side-effects of low-dose CY were fewer than those of ACTH.

Adult↗
PubMed1987

[Unilateral sensory neuropathy of the trigeminal nerve as the leading symptom of primary Sjögren syndrome ("sicca syndrome")].

We report a case who presenting with a progressive numbness and mild hyperpathia in the second cutaneous division of the left trigeminal nerve as the leading symptom of Primary Sjögren's Syndrome. Further typical features of this autoimmune disorder are keratoconjunctivitis sicca and xerostomia. A symmetrical, predominantly sensory polyneuropathy can be revealed by sensory nerve conduction studies of the median and sural nerves. Laboratory findings mostly include elevated erythrocyte sedimentation rate, hypergammaglobulinemia and hypercomplementemia. The presence of the precipitating antinuclear antibodies SS-A and/or SS-B is pathognomonic for Sjögren's Syndrome. As long as the disease remains benign, treatment should be symptomatic. Malignant exacerbations require immunosuppressive treatment.

Adult↗
PubMedDate not supplied

Cerebral magnetic resonance imaging pathology and cerebro-spinal fluid protein in sporadic amyotrophic lateral sclerosis (sALS).

In 3 out of 20 patients with sporadic amyotrophic lateral sclerosis (sALS), cranial magnetic resonance imaging detected multiple demyelinating lesions. All 3 patients died from definite upper and lower motor neuron degeneration. In all 3 cases total cerebro-spinal fluid (CSF) protein remained within normal ranges, and a blood-CSF barrier dysfunction was not detectable. In one of the patients multifocal CNS demyelination coincided with an intrathecal synthesis of immunoglobulin-G and autochthonous CSF oligoclonal IgG banding (OCB) early in disease. Neither absolute or age-corrected survival nor disease progression differed for patients with and without cerebral MR lesions, or normal vs. elevated CSF total protein. Evaluating the CSF in an extended patient sample (n = 29), we found the total CSF protein elevated in 5 of 16 men and none of 13 women (p < 0.05). The mean age-corrected CSF protein content [practical reference limit = (age x 3.3) + 300 mg/l] was higher in male (465 mg/l +/- 32 SE) than in female (350 mg/l +/- 26 SE) sALS patients (p < 0.01). This coincides with a male preponderance in sALS.

Adult↗