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F Schon

Publications and source records attributed to F Schon.

At least 19 recordsLinked to original sources
PubMed2006

Is shared learning the way to bring UK neurology and psychiatry closer: what teachers, trainers and trainees think.

BACKGROUND: Rapid advances in brain sciences are challenging the validity of the traditional divide between neurology and psychiatry. The need for closer ties has been widely advocated. OBJECTIVE: To assess attitudes of neurologists and psychiatrists to closer links in general and to joint education in particular. METHODS: Postal questionnaire survey of trainees (SpRs) trainers (Members of Special Advisory Committees in Neurology and General and Old Age Psychiatry) and teachers (Undergraduate coordinators). Analysis based on 55 neurology and 50 psychiatry respondents. RESULTS: 5 general attitude questions on links showed most respondents "keen" on links and "unkeen" on current separation of disciplines. 15 topics possibly suitable for joint teaching were offered. 7 were rated between "keen" and very "keen" with maximum support for somatization, dementia, chronic pain and pharmacology. 7 were rated positively, only eating disorders was felt unsuitable. 6 options were offered for joint training opportunities. Trainees were keen on attending joint education, clinical and patient management sessions and outpatient clinics. Psychiatrists were even keener on links than neurologists with psychiatric SpRs significantly more in favour of certain items. CONCLUSIONS: The survey found widespread support from trainees, trainers and teachers for closer links. Trainees were keen to attend joint clinically focussed sessions. Psychiatrists tended to be keener that neurologists on links. This survey should encourage the establishment of closer educational links at all levels.

Attitude of Health Personnel↗
PubMed2003

"CADASIL coma": an underdiagnosed acute encephalopathy.

The main clinical features of CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy) are stroke, dementia, and migraine. A reversible acute encephalopathy was the principal presentation in six of 70 patients in a British prevalence study. The episodes lasted seven to 14 days, presenting with fever, acute confusion, coma, and fits; there was full recovery but in two cases identical episodes recurred some years later. All patients had a previous history of migraine with aura and were originally misdiagnosed as viral encephalitis. CADASIL should be considered in acute unexplained encephalopathies. MRI white matter changes, previous migraine with aura, and a family history of stroke and dementia may be useful pointers to the diagnosis.

Acute Disease↗
PubMed2002

[Evaluation of the demand for access to peridural obstetrical anesthesia in maternity units].

OBJECTIVES: This prospective study was initiated by a multicentric work. Each participating hospital, was asked to give data about 20 patients. Because of the importance of these informations for our practice, we decided to continue the evaluation, using the same inquiry, until 200 patients were enrolled. PATIENTS AND METHODS: An independent student (resident pharmacist), using a preprinted inquiry from interviewed two hundred consecutive in the, 48 hours after delivery in order to evaluate the following aspects: reasons to wish an epidural analgesia (EA) or not, modalities of achievement of EA. Statistical study: Chi-square and logistic regression. RESULTS: Among 199 analyzable files, 137 women wished for an EA (68.5%) but in only 90 the procedure was performed. Reasons for non-achievement of EA were the following: labour too advanced (43/47), obstetrical contraindication (2/47), anaesthesiologist non available (2/47). Delay between arrival at hospital and EA performance was 5 h 30 during daytime and 4 h 40 during nighttime. Delay and rate of EA achievement were not different between day and night time. Logistic regression analysis found following criteria related to: Wish for an EA analgesia: anaesthesiology consultation (OR = 193, p < 0.001), nulliparity (OR = 4, p < 0.002) and satisfactory information about EA (OR 35, p = 0.051). Achievement of EA: nulliparity (OR 38, p < 0.002), length of labour (OR = 1.01/min, p < 0.001). CONCLUSION: This study underlined the fact that one third of parturients do not wish for an epidural analgesia, mainly out of fear for neurological complications. When the obstetrician indicated an EA, our organisation allowed its achievement in 98% of cases. The latency between arrival and EA should be shortened.

Adult↗
PubMed2001

Ocular flutter associated with a localized lesion in the paramedian pontine reticular formation.

Ocular flutter is a rare horizontal eye movement disorder characterized by rapid saccadic oscillations. It has been hypothesized that it is caused by loss of "pause" neuronal inhibition of "burst" neuron function in the paramedian pontine reticular formation (PPRF); however, there have been no imaging studies confirming such anatomical localization. We report the case of a woman with an acute attack of multiple sclerosis associated both with ocular flutter and a circumscribed pontine lesion, mainly involving the PPRF on magnetic resonance imaging. As she recovered from the attack, both the midline pontine lesion and the ocular flutter dramatically improved. This case is the first clear evidence that at least some cases of ocular flutter are due to lesions involving the PPRF.

Adult↗
PubMed2000

Isolated finger flexion: a novel form of focal neuromyotonia.

Two almost identical elderly women are described who presented with gradually progressive painless involuntary flexion of the ring and middle fingers over 12 months, leading eventually to contractures. The flexion deformity persisted during sleep and was the sole neurological abnormality. Both patients had advanced chronic obstructive pulmonary disease and were on long term salbutamol and oxygen. Neurophysiological studies indicated that this was due to neuromyotonia mainly involving flexor digitorum superficialis muscles without evidence of underlying peripheral neuropathy, proximal conduction block, or generalised neuromyotonia. Voltage gated potassium channel antibodies were negative. The clinical and neurophysiological picture remained static over a 2 year follow up period. It is suggested that this is a novel form of acquired focal neuromyotonia and speculate both on its cause and distribution.

Aged↗
PubMed1999

Long term use of desmopressin for urinary symptoms in multiple sclerosis.

The benefit of desmopressin (DDAVP) in the treatment of the urinary symptoms of multiple sclerosis has until now only been shown in short crossover studies of up to 6 weeks. We report 19 patients who have used the drug for an average of 2 years and 4 months, 18 of whom confirmed continued dramatic benefit without any obvious change in dosage used or efficacy and with few side effects. Ten of the 19 patients had also used DDAVP during daytime for special occasions with notable success. This is the first study to suggest that DDAVP is safe and effective in long term use in MS.

Adult↗
PubMed1997

Median nerve injury: an underrecognised complication of brachial artery cardiac catheterisation?

OBJECTIVE: To describe the local neurological complications associated with cardiac catheterisation via the right brachial artery. METHODS: A follow up study to determine the mechanism of injury and outcome of patients who sustained a high median nerve palsy after this procedure. Five right handed patients were identified in a 24 month period. Each was assessed clinically and electrophysiologically at presentation. All were followed up initially (range six to 22 months) clinically, electrophysiologically, and using components from the Chessington occupational therapy neurological assessment battery (COTNAB) functional hand assessment. RESULTS: The incidence of this complication was between 0.2 and 1.4%. Three mechanisms of injury were identified. These included direct nerve compression due to formation of antecubital fossa haematoma, direct nerve trauma, and ischaemia secondary to brachial artery occlusion. The initial neurological and nerve conduction deficits improved with time. However, all cases had persistent disability in hand function as documented clinically and on the dexterity and stereognosis subcomponent of the COTNAB test. CONCLUSION: This is an uncommon, but probably underrecognised complication. Those performing cardiac catheterisation via the right brachial artery should be aware of the potential risks of damage to the median nerve. They should evaluate hand function after the procedure and take prompt action if median nerve dysfunction is noted. Damage to the median nerve results in appreciable long term disability, which may have medicolegal relevance.

Aged↗
PubMed1996

Myasthenia gravis and elderly people.

Myasthenia gravis is probably commoner than previously suspected, the annual incidence being nearer 9-10/million than earlier figures of 2-4/million. The current study found an annual incidence in Croyden of 9.1 per million (95% confidence limits 5.7-13.8 per million). Of the 22 patients (59%) seen in Croyden with newly diagnosed myasthenia gravis during the past 7 years, 13 were aged over 60. In a separate study of the age distribution of positive acetylcholine receptor antibody assays, 51% were 60 years or above in 1991, and 64% in 1994. The peak age in both sexes was 70-80, and numbers were greatest in men aged 60-80.

Adolescent↗