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Biomedical subjects

K Lühdorf

Publications and source records attributed to K Lühdorf.

5 recordsLinked to original sources

Grand mal-provoked hyperuricemia.

A significant increase in S-urate was found postictally in 17 patients with two or more grand mal seizures within 24 h. In six patients S-urate was above the level at which hyperuricemic renal failure may develop. Impaired renal function was observed in two patients who had extremely high S-urates. It is proposed that prophylactic procedures against hyperuricemic renal failure should be carried out in all patients with repetitive convulsions.

Acute Kidney Injury

Phenytoin-induced hyperkinesia.

Previously described cases of phenytoin-induced hyperkinesia are reviewed. Three new cases are reported, in one of which hyperkinesia persisted for 5 years, although serum phenytoin on several occasions was in the therapeutic range. Similarities between phenytoin-induced hyperkinesia and hyperkinesia in Huntington's chorea and in neuroleptic- and L-DOPA-treated patients are discussed. It is pointed out that the frequency of organic cerebral damage seems to be high among patients with phenytoin-induced hyperkinesia. The hypothesis is presented that phenytoin induces hyperkinesia by increasing dopaminergic and serotonergic activity in the basal ganglia, and that patients with preexisting basal ganglia damage are the most susceptible.

Adolescent

Does alexia without agraphia always include hemianopsia?

A patient with alexia without agraphia (pure alexia) is reported. Bedside examination of the visual fields disclosed no abnormalities; but perimetric examination demonstrated an incomplete right homonymous hemianopsia with some sparing of the peripheral part of the visual field. The literature on pure alexia without hemianopsia is reviewed and it is concluded that this syndrome has hardly been described with certainity.

Dyslexia, Acquired

The effect of L-dopa on young patients with simple schizophrenia, treated with neuroleptic drugs: a double-blind cross-over trial with Madopar and placebo.

Thirteen out of 18 young out-patients with simple schizophrenia under neuroleptic treatment completed a double-blind cross-over trial with Madopar [L-Dopa + benserazid (a peripheral decarboxylase inhibitor)] and placebo. Nine patients were given 900 mg L-Dopa + 225 mg benserazid daily, 1 patient received 600 mg L-Dopa + 150 mg benserazid, and 3 patients, 300 mg L-Dopa + 75 mg benserazid. In these doses, L-Dopa was effective against emotional withdrawal, blunted affect, tendency to isolation and apathy, without inducing or aggravating productive, accessory symptoms. The activity score, according to the specific activity-withdrawal scale, was significantly increased (P less than 0.05), whereas the total BPRS score (Brief Psychiatric Rating Scale) was slightly, but significantly reduced (P less than 0.05). In cases where L-Dopa had to be limited to 600 and 300 mg daily, a tendency to anxiety, distortion of thinking, and a sense of unreality were observed, depending on the dose of L-Dopa. In no case were gastrointestinal, cardiovascular or neurological side-effects observed.

Adult

Peroral and parenteral administration of long-acting neuroleptics: a double-blind study of penfluridol compared to flupenthixol decanoate in the treatment of schizophrenia.

Fifty-six out of 60 schizophrenic patients completed a double-blind study of two long-acting neuroleptics, penfluridol (peroral) and flupenthixol decanoate (parenteral). Half of the patients were on maintenance therapy of flupenthixol prior to the study, the other half on penfluridol. The actual double-blind study (12 weeks) was commenced after a preliminary period of 4 weeks, the patients in the two main groups being randomly divided into two further groups, one continuing the medication unchanged, the other changing to the alternative drug. It was found possible to make a sudden switch from penfluridol to flupenthixol decanoate and vice versa without any significant change in the condition of the patient. The same dosage (in 70% of the patients from 40 to 80 mg) of penfluridol was used per week as was employed for flupenthixol decanoate per fortnight. Changes in the intensity of the symptoms (total Brief Psychiatric Rating Scale (BPRS) score) were moe pronounced in the preliminary period (during unchanged treatment) than on changed medication in the blind period. Both drugs induced approximately the same degree of akathisia, Parkinsonism and autonomic side effects. The practical consequences of equipotent therapeutical effect of a peroral and parenteral long-acting neuroleptic are briefly discussed.

Administration, Oral