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Biomedical subjects

G Ritter

Publications and source records attributed to G Ritter.

At least 199 records · Page 11Linked to original sources

[Medical and social aspects of epilepsy (author's transl)].

A review of social aspects of epilepsy is given. Similar to the own experience the literature shows only little social prestige given to patients with epilepsy, an experience known from persons with psychiatric disorders. The prevalence rate for chronic epilepsy is 0.5%. So called genuine seizures decreased with diagnostic progress during the last years (about 50%). Lower social classes and negative social patterns are characteristic of employees with epileptic fits. Unemployed persons show normal social structure. A relation to social class and onset of epilepsy exists. Epileptics are socially immobile. Like other persons with chronic diseases epilepsy produces a special social attitude and often negative therapeutic motivation. In contrast to the literature non-hospitalized epileptics show normal intelligence. Neurotic symptoms are seen in many cases however (about 40%). Often social disturbances origin from broken home situations. There is no specific social and mental defect. According to the own experience social integration of epileptics depends upon the local economic structure. The common prejudice varies with the local area. Social drop-outs are not due to the seizures, but occur mainly in mentally retarded persons who are not able to follow therapeutic regimens. Delinquency is increased among the own patients (18%). The causes are psychoorganic syndromes, often in connection with negative therapeutic motivation and alcoholism. The tendency to specific crimes, known from the literature, could not be confirmed. Forensic problems in direct connection with epileptic fits are rare. Medical problems concerning ability to drive often occur. Many patients possess a driver licence (46.5%), gained after onset of epilepsy in 50%. But the accident rate is lower than in the general population. Special outpatient departments and therapeutic groups for epileptics--affiliated to neurological centers--can improve the exact diagnosis, therapeutic motivation and social integration.

Alcoholism↗

[Cortical blindness following arteria vertebralis angiography (author's transl)].

Six patients suffered from cortical blindness following vertebral artery angiography. A connection of the incident with the technical procedure or a particularly great amount of applied contrast material, could not be seen. Vasospasm, stasis of contrast material in the arteria calcarina and a toxic lesion seem possible explanations, because the cortical blindness was fully reversible in all cases within some hours or days. Signs for an arterial embolisation did not exist, a finding, which is consistent with the literature.

Adolescent↗

[The narrow spinal canal - medicolegal aspects (author's transl)].

The constitutional anomayl of a narrow spinal canal was found in a neuroradiological department in 31 cases. The cervical stenosis can be defined in the following way: Inside diameter of cervical canal (anterior-posterior) in relation to diameter of vertebral body. In normal cases the quotient is over 1 - in pathological narrowing under 1. Clinical symptoms mainly appear from 45th year onwards, when reactive-degenerative changes increase the space problem. In wiplash injuries or other adequate cervical trauma 7 cases were seen and described with acute incomplete tetraplegia or/and multilocular lesions of cervical roots, resulting from cervical stenosis combined with degenerative changes in 6 patients. Myelography revealed multilocular deformities of the spinal subarachnoidal space in the abnormal narrow cervical canal. The referred cases were not complicated with forensic aspects. The prognosis quod sanationem was poor. A chronic cervical myelopathy results. Pretraumatic clinical alterations of cervical roots and/or the myelon in the referred cases were absent, existing in other patients. Predominantly men and hard working people with narrow cervical canal became ill. Early symptoms were pain in extremities. Dysesthesia and loss of sensation combined with signs of pyramidal lesion occured later. Defects in nerve roots sometimes overlayed the myelon symptoms. Unspecific CSF-Alterations were common. The EMG showed abnormalities in cases of root involvement. Operative treatment was tried to remove the reactive processes, but could not alter the constitutional anomaly. The resulting immobilisation of myelon and nerve roots involves in the case of trauma a direct mechanical lesion and secondary vascular complications via Arteria vertebralis, spinalis anterior and radicularis, namely in patients with degenerative alterations of the cervical spine, these including a further narrowing behind the constitutional anomaly. Our experience seems to recommend that more attention should be paid a cervical narrow spinal canal in medicolegal implications.

Adult↗

[Blood-CSF kinetics of penicillin G in neurosyphilis (author's transl)].

Measurements of the penicillin concentration in serum and cerebrospinal fluid patients with neurosyphilis showed that conventional therapy can attain effective treponemocidal levels for only a short time or not at all in the CSF and brain-tissue, the regions where the treponemas are found in this particular stage of disease. Intravenous infusions with high doses (0,5 mega unit penicillin-G/kg body weight in 24 hours) over more than one generation phase of the treponemas (35-43 hours) considerably improve the recovery. 16 patients were treated in this way and been followed over 2-3 years clinically and immunologically.

Antibodies, Bacterial↗

[Thrombosis of A. cer media in Werlhof's disease (author's transl)].

Apoplectiform incidents, particularly in young patients, can be an exceptional problem for neurologists and internists, even when every technical aid for diagnosis is available. This paper is intended to point out that even in a basic disease like Werlhof's disease, which is accompanied by an increased hemorrhagic tendency, several additive or potentiating unfavorable factors can produce a thrombosis in the region of a cerebral vessel and for this reason they should be included in the differential diagnostic considerations.

Adult↗

[Constitutional narrowing of the cervical spinal canal. Radiological and clinical findings].

A constitutional narrowing of the cervical spinal canal was seen in 31 patients with neurological disorders. The ratio of the inner diameter of the spinal canal to the diameter of the vertebral body was smaller than 1 (normal greater than 1). Clinical signs were observed from 45 years upwards where reactivedegenerative changes cause additional narrowing. The majority of patients were male, predominantly heavy manual labourers. There is often a trauma preceding. On myelography multilocular deformations of the spinal subarachnoid space and nerve roots are seen. On the mechanical narrowing of the spinal canal a vascular factor supervenes, caused by exostoses, intervertebral disc protrusions, and fibrosing processes. Clinically a chronic progressive spinal transection syndrome (cervical myelopathy) dominates besides a multilocular root involvement. Posterior column sensibility is predominantly lost. Pain in the extemities and the cervical column is an early symptom. Non-specific CSF changes occur frequently. In case of root involvement the electromyogram is pathological. The prognosis is bad. Operation can only remove reactive processes but not the constitutional anomaly.

Adult↗