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Biomedical subjects

G Haferkamp

Publications and source records attributed to G Haferkamp.

17 recordsLinked to original sources

[Pharmacotherapy of voice and articulation disorders in aphasia].

The phonation and articulation disorders in a group of aphasics with aphonia/dysarthrophonia could be considerably reduced by the use of medication. The group consisted of 10 apoplectic patients whose resulting aphasia could not be classified because of the vocal impairment. Extrapyramidal motion disorders were proved by laryngoscopy and stroboscopy. A definite improvement of phonation and articulation was observed after L-dopa medication.

Aphasia

Influence of artificial blood contamination of the analysis of cerebrospinal fluid.

The influence of artificial blood contamination on the quantitative values obtained in the routine examination of the CSF was investigated. On the basis of dilution series from CSF and blood, the correlation between the number of added erythrocytes and the results of leukocyte counts, protein, glucose and IgG estimation was studied. In addition, the influence of the time between CSF sampling and investigation on erythrocytes and leukocytes, IgG, glucose, pH value and ammonia content in CSF contaminated with blood was investigated. The following data relevant to routine examinations resulted: there are linear correlations between the number of erythrocytes artificially added to the CSF and the leukocyte count, the total protein and the IgG content, whereas glucose is unaffected by the artificial admixture of blood. With regard to the time between sampling and investigation of the CSF, it was shown that the IgG values in blood-contaminated and blood-free CSF do not change. A correct IgG estimation is hence possible even several days after lumbar puncture. The cell count decreases exponentially with time, whereas the total protein rises with progressive cytolysis. The glucose values decrease both in native and in artificially blood-contaminated CSF, whereas the pH values rise rapidly, evidently due to release of ammonia and primary amines from the proteins and amino acids present in the CSF.

Ammonia

Central nervous system involvement in Whipple's disease.

A case of Whipple's disease is presented manifesting itself predominantly with neurological and mental symptoms but without gastrointestinal complaints. Although the first cranial CT in the fourth year of the disease was normal, the second, 1.5 years later, revealed intensive hypodensity of the white matter and cortical enhancement. CT findings are compared with autopsy results and a review of the pertinent literature is given.

Adult

[Refsum's syndrome (author's transl)].

Heredopathia atactica polyneuritiformis (Refsum's syndrome) is an autosomal recessively inherited lipidosis characterized by the following signs: peripheral hypertrophic polyneuropathy, cerebellar ataxia, atypical retinitis pigmentosa with night blindness and concentric limitation of the visual fields, anosmia, inner ear hearing disturbances, skeletal anomalies, ichthyotic skin changes, raised protein in the CSF without a cellular increase, and non-specific ECG changes. Biochemically it is a lipidosis with atypical increase of phytanic acid in blood, CSF, and tissues. The metabolic defect results from a degradation disturbance of exogenous phytanic acid. The report of a patient whose clinical picture plus chemical, neurophysiological and histological results led to the diagnosis of Refsum's syndrome is presented. Using a low phytol- and phytanic-acid diet a marked decrease of phytanic acid in the serum and an improvement of the clinico-neurological signs were observed.

Eye Manifestations

[Sporadic recurrent hypertrophic polyneuropathy. Clinical-histological contributions on differential diagnosis].

The authors report about an own case of recurrent sporadic hypertrophic polyneuropathy and describe the clinical course and histologic picture with reference to the literature. The disease is characterized by recurrences of subacutely occurring polyradiculoneuropathy and sequent nearly complete remission. Clinical examination discloses preferentially symmetrically and distally occurring motor paresis while sensibility in most cases is less affected. The peripheral nerves may be enlarged after a few relapses and frequently painful to pressure during the bout. Excessive increase in CSF proteins is found only during the bout. Motor nerve conduction velocity is considerably reduced. Histological pictures typically present an onion bulb formation of the Schwann cells with marked proliferation of connective tissue. There frequently younger individuals are involved; the relation female to male is 3:1. Differentiation has to be made concerning hereditary and symptomatic forms of hypertrophic polyneuropathy. Etiological factors of the disease are discussed.

Adrenocorticotropic Hormone

[Course and prognosis of unilateral carotid artery occlucion (author's transl)].

In 80 patients with unilateral carotid artery occlusions who had neurological symptoms, course and prognosis without anticoagulant or surgical therapy were analyzed. 17.5% of these patients died within 4 weeks, 43% of this group from extracerebral complications. The survival-time of those patients, surviving the acute stage, was also shortened: one year later only 67% of the patients were still alive, 5 years later 58% and after 10 years only 42%. Many cases died from further cerebrovascular strokes. In most of the patients carotid artery occlusion is only one of the symptoms of a generalized artery disease, i.e. arteriosclerosis. Resulting poor collateral circulation may be the crucial factor leading to the poor prognosis as to survival and rehabilitation: only 3.8% of the patients returned to work, 19% are able to walk, and 55% need nursing. These facts demand prophylactic measures: first a decisive therapy with respect to the risk factors of stroke, second an alertness to transitory ischemic attacks or small strokes. The latter were found in 56% of our patients. The literature and value of different therapeutic measures will be discussed.

Arterial Occlusive Diseases

Lacunar brain infarction. Diagnosis and prognosis.

"Lacunar stroke" is described and 4 characteristic lacunar syndromes are presented. These small infarcts frequently occur in patients with essential hypertension. At their peak they cause a relatively minor neurologic deficit and are followed by almost complete recovery. Arterigraphic examination is not indicated as only the small arteries are involved. Treatment consists exclusively of control of hypertension. The prognosis is usually good. The small infarcts arise from pathologic changes and occlusions of penetrating arteries. Localization of the pale softenings which produce the typical lacunar syndromes is briefly discussed.

Aged

[Angiokeratoma corporis diffusum (Fabry's disease). Biochemical diagnosis in plasma].

In a 35-year-old man with the full picture of Fabry's disease there was an almost fourfold increase of trihexosylceramide concentration in plasma and a decrease in the alpha-galactosidase activity to 13 percent as compared with the values from a control group. Using the same biochemical methods it could be shown that two nephews of the patient are hemizygote carriers and that two sisters and the mother of the patient are heterozygote carriers. Causative treatment of the disease is unknown. In this patient the attacks of pain could be permanently improved with phenytoin and carbamazepin.

Adult