Search PubMed⌕ Search

Biomedical subjects

F Erbguth

Publications and source records attributed to F Erbguth.

54 records · Page 3Linked to original sources
PubMed1995

Botulinum toxin: influence on respiratory heart rate variation.

Remote adverse effects of local intramuscular botulinum toxin were investigated in a prospective follow-up study. Twenty-six patients with spasmodic torticollis were examined (18 women, eight men, 45 +/- 13 years). Respiratory heart rate variation (HRV) was investigated by a computerized method. Different parameters were recorded (beats per minute, coefficient of variation, root mean square successive difference (RMSSD), spectral analysis, difference and quotient between maximum and minimum RR intervals, mean circular resultant). After one intramuscular injection of 12.5 ng botulinum toxin (Porton Products Ltd., England), no significant influence on HRV was seen. After the second injection, a significant attenuation was seen of four parameters (coefficient of variation, Rmax - Rmin, Rmax divided by Rmin, mean circular resultant) that lasted up to several months. No clinically manifest remote side effects and no cardiac arrhythmia were seen for several months of botulinum toxin treatment. Our investigation proves an effect of local intramuscular botulinum toxin on autonomic cardiac innervation.

Adult↗
PubMed1995

[Purulent meningoencephalitis--studies of disease progression and prognosis].

The course of acute purulent meningitis and meningocephalitis was investigated in 101 patients using records and a questionnaire directed to all patients. Patients who survived meningoencephalitis were asked to come to a neurological examination. Neuropsychological status, EEG and Tc-HMPAO-Spect were also performed in these patients. The patients were treated with a combination of three antimicrobial agents which was commonly used at our hospital during the investigation time consisting of penicillin, a cephalosporine of the third generation and an aminoglycoside. 40% of the patients suffered from more or less severe neurologic sequelae; remaining cognitive deficits were also frequent. On the whole there was a tendency towards improvement in patients who suffered from less severe deficits at the time of discharge from hospital, patients with more severe deficits also showed slight improvement but generally did not reach a restitutio ad integrum. Regarding this, in our opinion a broad initial antimicrobial therapy should be used, although a statistically significant improvement of the patient's outcome by this could not be shown. Lethality as well as the frequency of complications do not seem to differ over many years although antimicrobial and intensive care treatment were improved. Thus, the outcome seems to depend largely on the occurrence of secondary focal complications or brain oedema.

Adult↗
PubMed1994

[Cerebral sinus-venous thrombosis in protein S deficiency].

The coagulation inhibitor protein S is a cofactor for the protein C, which inactivates the factors V and VIII. In very rare cases a congenital or acquired protein S deficiency leads to a cerebral sinus or venous thrombosis. Guided by an own case report the other 15 cases of the literature are described. In most cases there was a thrombosis of the sinus sagittalis superior. Usually the active form, which is not bound to protein in plasma, is reduced. Women are more frequently involved than men. Partly there are additional risk factors to inheritance, such as pregnancy, puerperium or anticonceptive pills. In the acute stage the patients have to be treated with heparin, afterwards for a long time with dicumarol.

Adult↗
PubMed1993

[Oculomotor paralysis as the leading symptom of meningovascular syphilis. Report of two patients and review of the literature].

A brain stem infarction in the area of the nerve fascicle of the oculomotor nerve could be demonstrated by NMR to be the cause of a complete oculomotor nerve palsy in a patient with neurosyphilis. A second case presented the very rare finding of an isolated bilateral incomplete oculomotor nerve paresis with external paresis on the right and internal paresis on the left side.

Brain Stem↗
PubMed1992

Neurotoxicity of solvent mixtures in spray painters. II. Neurologic, psychiatric, psychological, and neuroradiologic findings.

A multidisciplinary cross-sectional study was performed to examine the chronic neurotoxicity of organic solvents. Participating in the study were 105 persons employed as spray painters and having long-term solvent exposure (10-44 years) and a control group consisting of 58 construction workers, electricians, and plumbers without occupational contact to solvents. Samples were matched for age, preexposure intelligence level, occupation, and socioeconomic status. After controlling for potentially non occupational confounding factors (neuropsychiatric diseases, metabolic disorders, high blood pressure, alcohol intake) 83 spray painters and 42 controls were entered finally into the study. The evaluation included work history, self-rating questionnaire, neurologic investigation, psychiatric analysis using the Present State Examination (PSE), psychological testing, and computerized axial tomography (CAT) of the brain. Physical and neurologic examinations demonstrated no case of overt disorders of the central or peripheral nervous system. An important result of the psychiatric analysis was that the syndromes "special features of depression" and "loss of interest and concentration" occurred significantly more frequently among spray painters than among controls. Further analyses demonstrated an association with chronic exposure over 30 years and repeated acute neurotoxic effects during solvent exposures. Neither psychological nor performance tests demonstrated any statistically significant differences in the performance sets after adjustment according to premorbid intelligence level; this finding supports the presumption of only a low grade of mental dysfunction. Correlation analyses indicated a relationship between subjective health complaints and long-term solvent exposure; however, the effect of age cannot be completely ruled out.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Treatment of spasmodic torticollis with local injections of botulinum toxin A].

Sixty patients (30 men, 30 women, mean age 45.5 [18-71] years) with various forms of spasmodic torticollis were treated with local injections of botulinus A toxin. The results of treatment were assessed on an arbitrary scale (0-4) by the patients, by an examiner and by a neurologist who studied video recordings without knowing at what stage they had been recorded. After the first course of injections (a maximum of three injections of 10-40 ng in four weeks) 50 patients (83%) reported a better than 50% improvement; the mean score on the four point scale fell from 3.6 to 1.85 (P less than 0.001). The severity of the disorder as judged from the video recordings fell from a mean of 3.23 to 1.71 (P less than 0.001). The effect lasted for an average of 14 weeks. 6 patients developed mild dysphagia, in two further cases severe dysphagia occurred which lasted for up to four weeks. Twenty patients were followed up for more than one year: in nine of them the interval between courses of injections, the dose being unaltered, remained the same (12-14 weeks), but thereafter the abnormal movements returned with the same severity as before treatment. In eight patients the intervals between courses grew longer and the abnormal movements became less severe. Two patients have been symptom free for 20 and 13 months respectively, but one female patient failed to respond owing to the presence of antibodies against botulinus A toxin. The results indicate that local injection of botulinus toxin is a successful treatment for spasmodic torticollis.

Adolescent↗
PubMed1991

Diagnosis and treatment of deep cerebral vein thrombosis.

Three cases of deep cerebral vein thrombosis are reported. In all three cases focal neurological deficits and impaired consciousness occurred after a short period of non-specific clinical manifestations. Computed tomography revealed bilateral hemorrhagic infarctions of thalamus and basal ganglia. The CSF analysis which was performed in two cases showed pleocytosis, increased protein level, disturbed blood-brain barrier, and signs of necrosis and hemorrhage. In two cases the diagnosis was confirmed by transfemoral carotid angiography. MRI was performed in one case only and showed thrombosis of the internal venous system. All patients were treated with high-dose heparine in spite of hemorrhage. Good recovery was seen in all patients with almost complete improvement of neurological deficits. No complications were observed during treatment. Because of these promising therapeutic results, bilateral thalamic lesions should alert the physician to consider the possibility of deep cerebral vein thrombosis.

Cerebral Veins↗
PubMed1989

[Disseminated polyneuropathy after coma].

An acute polyneuropathy developed during intensive-care treatment of three young men who had sustained severe multiple traumas and of one woman with bacterial meningoencephalitis. In the first case there was a predominantly distal paraparesis of the legs; in the second, flaccid neurological deficits occurred particularly in the areas of the left ulnar, peroneal and tibial nerves combined with paralysis of cranial nerves IX, X and XII. A symmetrical sensorimotor polyneuropathy with tetraplegia and cranial nerve deficits occurred in the third case, and an asymmetrical sensorimotor polyneuropathy in the female patient. In all four patients electrophysiological tests demonstrated the pattern of neurogenic damage. All patients had respiratory failure, malnutrition, septic fevers and acute renal failure requiring haemodialysis for two to five weeks. It is assumed that the polyneuropathy was of multifactorial genesis.

Adult↗
PubMed1989

Fat deposition surrounding intracerebral hemorrhage in a patient suffering from Zieve syndrome.

In a 42-year-old man, admitted a few hours after an acute cerebrovascular event, CT demonstrated a hyperdense hemorrhage surrounded by a hypodense rim similar to perifocal edema or liquefying blood, thus raising doubts about the acuteness of the event. Laboratory findings revealed Zieve-syndrome (alcoholic hyperlipemia, hemolytic anemia, and alcoholic fatty liver) and negative Hounsfield Unit measurement of the hypodense rim finally identified it as a layer of fat around the clot.

Adult↗
PubMed1989

[Acute hemorrhage and ischemic necroses in hypophyseal tumors: hypophyseal apoplexy].

Acute enlargement of pituitary adenomas due to haemorrhage or ischaemic necrosis in the tumour was described as "pituitary apoplexy" by Brougham et al. in 1950. Since then, more than 200 cases have been reported, but--especially in the German literature--the syndrome has caught only little attention. Therefore, in a series of 12 own patients, typical findings and clinical characteristics are demonstrated and the literature is discussed. 9 patients had a haemorrhage into the tumour, 3 an acute ischaemic necrosis. The guiding symptom was the acute onset with ophthalmoplegia (11 of 12 patients). Only in one case the adenoma was known before the apoplexy. Other symptoms were headache, blurred vision, drowsiness and, in severe cases, hemiparesis, coma, and hypothalamic disorder. Most important is the acute endocrinological substitution with hydrocortisone; this may be life-saving. Neuroophthalmological recovery depends on early operation: cases of oculomotor palsy require an operation within the first 2 weeks after the acute event. An emergency operation is required only by an acute amaurosis. In general there will be enough time for careful clinical endocrinological and radiological investigations.

Adenoma↗
PubMed1989

[Serodiagnosis of Lyme borreliosis: antibody titer and specificity in the IFT and western blot].

Out of 334 sera from healthy persons from northern Bavaria 6% reacted positive in the indirect immunofluorescence test (IFT, titre greater than or equal to 1:64). The percentage of positive cases in patients with erythema chronicum migrans (ECM), meningoradiculitis (M. Bannwarth), or acrodermatitis chronica atrophicans (ACA) was 43, 83 and 78%, respectively. In other patients with less characteristic symptoms in which an infection with B. burgdorferi was suspected the number of positive cases was only about 20%. A positive IgM-IFT was most often associated with ECM and M. Bannwarth; however, even in these cases IgM was only found in 30%. The serodiagnosis of Lyme disease required simultaneous serum testing of T. pallidum antibodies (TPHA) to exclude a syphilis with cross-reacting antibodies. In cases with a positive B. burgdorferi-IFT and TPHA the final diagnosis of Lyme disease was possible on the basis of Western blot analysis. The prominent antigens detected by sera from patients with Lyme disease--but not with syphilis--had molecular weights of 18, 22, 41 and 60 K; IgM antibodies were mainly directed against the 22 K and 41 K antigens. The antigen pattern was not characteristic for different disease stages.

Acrodermatitis↗