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Biomedical subjects

G Bovim

Publications and source records attributed to G Bovim.

At least 55 records · Page 3Linked to original sources
PubMed1996

[Neurology--may recruitment cover the demand?].

New therapeutic possibilities have recently been introduced for many neurological disorders. The demand for specialists is, accordingly, increasing. To investigate the present status, and to give some ideas as to the future recruitment of neurologists, a questionnaire study has been performed among all neurological departments and their residents. In addition, figures from The Norwegian Medical Association have been analyzed. In October 1995, Norway had 209 neurologists, of whom 165 were of working age (67 years or younger). Of a total of 115 positions for neurologists in regional and county hospitals, 16 were vacant. The posts in hospitals with no neurological beds were most frequently vacant. An average of 7-8 new neurologists are now educated annually. This is slightly higher than the annual number of retirements, resulting in a net increase in the number of neurologists. However, this positive trend will be reversed as the retirement rate increases around year 2010. The residents were generally enthusiastic about working with neurological patients and wished to complete their appointments. The number of neurologists in Norway is too low compared with international standards. In order to obtain a satisfactory neurological service the recruitment rate needs to be increased.

Adult↗
PubMed1996

Natural evolution of late whiplash syndrome outside the medicolegal context.

BACKGROUND: In Lithuania, few car drivers and passengers are covered by insurance and there is little awareness among the general public about the potentially disabling consequences of a whiplash injury. We took this opportunity to study the natural course of head and neck symptoms after rear-end car collisions. METHODS: In a retrospective questionnaire-based cohort study, 202 individuals (157 men; 45 women) were identified from the records of the traffic police department in Kaunas, Lithuania. These individuals were interviewed 1-3 years after experiencing a rear-end car collision. Neck pain, headache, subjective cognitive dysfunction, psychological disorders, and low back pain in this group were compared with the same complaints in a sex-matched and age-matched control group of uninjured individuals selected randomly from the population register of the same geographic area. FINDINGS: Neck pain was reported by 71 (35% [95% CI 29-42]) accident victims and 67 (33% [27-40]) controls. Headache was reported by 107 (53% [46-60]) accident victims and 100 (50% [42-57]) controls. Chronic neck pain and chronic headache (more than 7 days per month) were also reported in similar proportions (17 [8.4%; 5-13] vs 14 [6.9%; 4-12] and 19 [9.4%; 6-15] vs 12 [5.9%; 3-10]) by the two groups. Of those who reported chronic neck pain or daily headache after the accident, substantial proportions had had similar symptoms before the accident (7/17 for chronic neck pain; 10/12 for daily headache). There was no significant difference found. No one in the study group had disabling or persistent symptoms as a result of the car accident. There was no relation between the impact severity and degree of pain. A family history of neck pain was the most important risk factor for current neck symptoms in logistic regression analyses. INTERPRETATION: Our results suggest that chronic symptoms were not usually caused by the car accident. Expectation of disability, a family history, and attribution of pre-existing symptoms to the trauma may be more important determinants for the evolution of the late whiplash syndrome.

Accidents, Traffic↗
PubMed1996

[Glossopharyngeal neuralgia. Not just pain].

Glossopharyngeal neuralgia is a rare disease characterized by severe paroxysmal attacks of pain in the distribution of the 9th cranial nerve. The most important differential diagnosis is trigeminal neuralgia. Carbamazepin is the current drug of choice in therapy, but modern neurosurgical treatment will probably become more common in the future. Autonomic disturbances may occur during pain attacks in some patients. We describe a patient suffering from glossopharyngeal neuralgia with transitory unconsciousness due to cardiac asystole and arterial hypotension accompanying the attack of pain.

Aged↗
PubMed1995

[Alcohol--bad for the brain?].

The consumption of alcohol and other addictive drugs is quite low in Norway compared with other European countries. Nevertheless, many will experience some of the various drug effects on the brain. Alcohol, the legal substance, is responsible for most drug-related neurological effects in Norway. Alcohol use results in a variety of different effects in different parts of the central nervous system. Headache and alcohol withdrawal symptoms are frequent complaints, and atrophy of the cerebellar vermis and Wernicke Korsakoff syndrome often result in chronic sequelae. Most other drugs cause less structural damage to the nervous system than alcohol does. Clinical findings, pathogenetic mechanisms and treatment of some drug-related neurological disorders are discussed.

Alcohol Amnestic Disorder↗
PubMed1995

[Elevated intracranial pressure following brain infarction--a retrospective study].

Brain infarction is a frequent cause of emergency admission to hospital. We have made a retrospective study in order to describe patients who develop fatally elevated intracranial pressure. From 1991 to 1993, seven patients (3.3%) died within the first 96 hours after the symptoms appeared. All these patients died from elevated intracranial pressure caused by oedema in and around an infarction in the territory of the middle cerebral artery. These patients were significantly younger than the general population of patients with infarction (p < 0.01), and also younger than the patients who died from other causes during the observation period (p < 0.01). We think that these cases underline the importance of establishing effective acute treatment for ischemic cerebrovascular diseases, since this is probably the only effective way to protect against formation of oedema.

Adult↗
PubMed1995

[Elevated intracranial pressure following brain infarction--therapeutical possibilities].

Elevated intracranial pressure is a serious complication in the early phase after brain infarction. The most frequent cause of the elevated pressure is oedema following an infarction in the territory of the middle cerebral artery. Non-surgical treatment is inadequate in many of the patients. Although anecdotal, several reports concerning neurosurgical treatment seem to be optimistic. We think that such treatment could be given to selected young patients with large hemispheric infarctions and cerebral oedema.

Brain Edema↗
PubMed1995

Caffeine influence on the motor steadiness battery in neuropsychological tests.

Caffeine is a widely used drug with various biological effects. The present investigation focuses on a possible influence of caffeine upon motor steadiness performance in tests routinely used in neuropsychological testing. Twenty-four healthy females between 23 and 38 years were investigated in a randomised double-blind crossover study. A significantly poorer motor steadiness performance was found after ingestion of 300 mg of caffeine as compared to a placebo (decaffeinated coffee). Both error time and error count were increased after caffeine consumption. Caffeine also tended to reduce maze coordination test performance. We conclude that caffeine intake preferably should be avoided before neuropsychological testing of motor steadiness.

Adult↗
PubMed1994

Neck pain in the general population.

STUDY DESIGN: A randomized cross-sectional questionnaire was used to determine the prevalence of neck pain in Norwegian adults. OBJECTIVES: The frequency and duration of neck pain were assessed. SUMMARY OF BACKGROUND DATA: Reliable epidemiologic studies on the prevalence of neck pain in the general population have been sparse. METHODS: A questionnaire that inquired about neck pain within the last year was sent to a random sample of 10,000 adult Norwegians. RESULTS: Overall, 34.4% of the responders had experienced neck pain within the last year. A total of 13.8% reported neck pain that lasted for more than 6 months. CONCLUSIONS: Chronic neck pain is a frequent symptom in the general population, particularly in women. Although reservations have to be taken as to the interpretation, the reported prevalence of persisting pain after whiplash injuries is of the same magnitude as the prevalence of chronic neck pain in the general population.

Adolescent↗
PubMed1994

[Carbohydrate-deficient transferrin--a reliable marker of high alcohol consumption?].

Carbohydrate deficient transferrin has been proposed as an important marker for alcohol abuse. Using isoelectric focusing and two different radioimmunoassays we measured carbohydrate deficient transferrin throughout an alcohol withdrawal period in ten abusing men. Values within the normal range were found in two to four individuals, depending on the method. Nevertheless, carbohydrate deficient transferrin was more frequent pathologically (in two out of three methods) than any other of the common markers (glutamyl transferase, alanine transferase, aspartate transferase, mean corpuscular volume). During the withdrawal period, the carbohydrate deficient transferrin value increased in two patients after a new alcohol intake. However, it also increased on other occasions when a new alcohol intake was highly unlikely. Therefore, a single test or even repeated tests of carbohydrate deficient transferrin may give a wrong conclusion. Since the cost of the analysis is high, the clinical benefit should be evaluated more closely before the test is used in pure clinical settings.

Adult↗
PubMed1994

Tension headache: botulinum toxin paralysis of temporal muscles.

The pathogenetic mechanism of tension headache (TH) is still unknown. The role of pericranial muscle tension in TH is also enigmatic. To evaluate this factor in chronic TH, pericranial muscles were paralysed in 6 chronic TH patients, using botulinum toxin. All patients fulfilled the IHS criteria of chronic TH associated with involvement of the pericranial muscles, but not the current criteria for cervicogenic headache. The patients were followed-up regularly with evaluation of the paralysis, changes in pain intensity, and pressure pain threshold measurements. We primarily only injected the temporal muscle on the one side, using the other side as a control. Contralateral muscles were in some cases injected at a later stage. In our study, we did not find any significant reduction in pain intensity, as measured by the visual analogue scale, nor any changes in pressure pain threshold, as measured by an algometer. On the basis of our observations, we conclude that muscle tension in these muscles possibly plays a minor role in the genesis of chronic TH. In our study, however, we have only treated a limited number of patients, and only one pericranial muscle has been injected systematically. Further studies of various neck/posterior head muscles ought to be performed in order to further evaluate a possible effect of tension in the pericranial musculature in producing this type of pain.

Adult↗
PubMed1994

Idiopathic normal pressure hydrocephalus: the CSF tap-test may predict the clinical response to shunting.

A follow-up study was performed in nine patients with idiopathic normal pressure hydrocephalus (NPH) 37 months (mean) after shunting and 10 non-operated controls with comparable degrees of ventricular enlargement, gait disorder, and dementia. Five operated patients vs. no controls reported sustained general improvement (p < 0.02). Objectively improved gait at follow-up (compared with preoperative status) was found in five of the six tested NPH-patients vs. none of the controls (p < 0.005). Improved gait and/or psychometric function was found in four of six NPH vs. none of eight control patients (p < 0.02) after drainage of 40 ml cerebrospinal fluid (CSF tap-test). Improved gait during the CSF tap-test predicted continued improvement at follow-up. Temporal horn size was the only radiological variable which showed a (moderate) positive correlation with resistance to CSF absorption and rate of pressure increase. The size of the third ventricle diminished in parallel with clinical improvement.

Adult↗
PubMed1994

Quantitative electroencephalography in idiopathic normal pressure hydrocephalus: relationship to CSF outflow resistance and the CSF tap-test.

Quantitative electroencephalography from the occipito-parietal region, gait, and psychometric tests were performed in patients with idiopathic normal pressure hydrocephalus (NPH) before and after drainage of 40 ml CSF. The results were compared to those in demented controls. The EEG results were also analyzed with respect to possible correlations with clinical, CSF dynamics, and psychometric variables. Significant differences between NPH patients and demented controls were not found neither in baseline EEG variables nor regarding the CSF tap-test-related change in EEG. The EEG-response to the CSF tap-test did not often exceed the day-to-day test-retest variability. In NPH patients, EEG slowing (relative delta and theta power) correlated significantly with CSF outflow-resistance (p < 0.002). Relative theta power correlated with the Thurstone's Identical Forms test (p < 0.05). Significant correlations between EEG and Bingley's Memory Test were found for the control group but not among NPH patients (p < 0.05). Thus, EEG band-power variables seem to reflect some of the pathophysiology involved in idiopathic normal pressure hydrocephalus, particularly increased resistance to CSF outflow. The practical value of the presently applied EEG method in NPH-diagnosis and prognostic evaluation seems to be limited, however.

Adult↗
PubMed1993

[Therapeutic possibilities in acute cerebral infarction].

Drug treatment of acute ischemic stroke may be divided into four categories: antithrombotic treatment, thrombolytic treatment, neuronal protection, and other forms of treatment. Until now, no drug treatment has been properly documented as effective. However, several treatment programmes are currently being evaluated. Maintenance of the cerebral perfusion pressure and early mobilisation are important factors when treating acute stroke.

Acute Disease↗
PubMed1993

[Mononucleosis and neurological manifestations].

Infectious mononucleosis is a relatively common disease. In this paper, three patients with neurological symptoms related to infectious mononucleosis are described. Patient no. 1 had myelitis, one of the most frequent neurological complications. Patient no. 2 had cerebellar symptoms, with ataxia and disturbance of gait. In this case magnetic resonance revealed vermis atrophy, a finding which, to the best of our knowledge, has not been reported before. Patient no. 3 had bilateral optic neuritis. Repeated serologic tests may be necessary to confirm the diagnosis. Infectious mononucleosis should be considered in younger patients with neurological symptoms of uncertain origin.

Adult↗
PubMed1993

[Physician's statement concerning whiplash injuries. Significance of supplementary information].

The frequency of insurance cases following traffic accidents involving the whiplash mechanism is increasing in Norway. The economic consequences are obviously great, both for the individual patient and for society. Declarations by medical specialists may be of vital importance when assessing the degree of medical invalidity. We have investigated some of the information provided by 27 patients who were submitted for assessment of medical invalidity after traffic accidents. In eight of these cases, the information in reports from their usual doctor or physiotherapist varied from the case history described by the patient. In all these cases, a previous history of neck pain was found in the health reports, but was not mentioned, and was partly denied, by the patients. Our results underline the importance of supplementary information.

Accidents, Traffic↗
PubMed1993

The prevalence of delayed and advanced sleep phase syndromes.

To determine the prevalence of the delayed sleep phase syndrome (DSPS) and the contrasting advanced sleep phase syndrome (ASPS), a cross-sectional nationwide epidemiological study was performed in Norway. Screening questionnaires were sent to a random sample of 10,000 adult individuals (18-67 y), of both sexes, taken from the National register of Norway. The response rate was 77%. Diagnoses of DSPS and ASPS were based on International Classification of Sleep Disorders (ICSD) criteria. All individuals suspected of having DSPS or ASPS were requested to fill out a second questionnaire, and a sleep log for four weeks. Subjects for whom the suspicion of DSPS or ASPS could be upheld were contacted by telephone for a final confirmation. Of the 129 possible DSPS cases identified from the screening questionnaires, 17 (9 f; 8 m) remained with the confirmed diagnosis of DSPS. The prevalence was calculated to be 0.17% (95% Confidence Intervals: 0.10-0.28). Thirteen individuals had a mild to moderate DSPS and four had a severe DSPS. The mean age of onset was 15.4 y, and mean duration was 19.2 y. There was no significant correlation between prevalence and age. A sleep phase delay (MSPD) induced by social/environmental or psychological factors was found in 55 subjects (prevalence = 0.72%). Using strict ICSD criteria, no case of ASPS was detected, confirming earlier assumptions of the extreme rarity of this condition.

Journal Article↗
PubMed1993

Cervicogenic headache: responses to nitroglycerin, oxygen, ergotamine and morphine.

The responses in cervicogenic headache to four different agents have been studied. Nitroglycerin was given sublingually to 27 patients. Eighteen patients got more than 20% increase of their headache. Of those with any headache increase at all, 12 got bilateral and 12 unilateral pain. The typical late cluster headache response to nitroglycerin was not seen in cervicogenic headache. The provocative effect of nitroglycerin seemed less marked in cervicogenic than in cluster headache. Oxygen inhalation, a frequently used treatment for cluster headache, was given to 14 patients with cervicogenic headache. In general, the effect seemed uncertain and probably clearly inferior to the effect in cluster headache. Ergotamine treatment (given to 13 patients) also seemed to be of little avail in cervicogenic headache. Morphine injections given to 11 cervicogenic headache patients resulted in "marked" improvement in 4, but complete pain freedom was only seen in 2 cases. In our opinion, the present results add further evidence to the view that different etiologic and pathogenetic factors underlie cervicogenic headache and cluster headache.

Ergotamine↗