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Biomedical subjects

K Sainio

Publications and source records attributed to K Sainio.

At least 91 records · Page 5Linked to original sources

Carpal tunnel syndrome in childhood.

Carpal tunnel syndrome is extremely rare in childhood and in almost all previously reported cases it has been secondary to some underlying condition. Three 13- to 14-year-old girls are described with idiopathic carpal tunnel syndrome, confirmed by EMG and relieved by surgical decompression. A noteworthy feature in children is short-lasting but severe attacks of pain, which may be the main symptom. Correct diagnosis is important to avoid unnecessary examinations and, if indicated, the syndrome can be cured by surgery.

Adolescent↗

Chronic mumps virus encephalitis. Mumps antibody levels in cerebrospinal fluid.

To study the outcome of mumps virus encephalitis 47 patients were contacted 1-15 years after the acute encephalitis associated with mumps virus infection. Twenty-three patients experienced clinical sequelae such as difficulties in memory and learning, focal motor or sensory signs, and loss of hearing and visual acuity. Lumbar puncture was performed on 8 patients. Antibodies to mumps virus were detected in 6 cerebrospinal fluid (CSF) specimens using enzyme immunoassay and in 3 patients an abnormal serum/CSF antibody ratio was observed 11, 26 and 58 (controls greater than 85); 14.3, 1.4 and 6.1 years after the acute encephalitis, respectively. Antibodies to other microbes were either undetectable in the CSF or the serum/CSF ratios were normal. The clinical sequelae in about half of the patients and the signs of intrathecal mumps antibody production are suggestive of a chronic process in the central nervous system after encephalitis associated with mumps virus infection.

Adult↗

Hereditary recurrent brachial plexus neuropathy with dysmorphic features.

A Finnish pedigree comprising 13 members in 3 generations with recurrent brachial plexus neuropathy is described. The disease was characterized by repeated attacks of pain in the upper limb/shoulder region, followed by muscle weakness and atrophy. The first episode usually occurred in childhood after a mild infection. Symptoms varied in intensity and seldom left marked neurological deficiencies. Patients had typical features including hypotelorism, small palpebral fissures and a small oral opening. The distribution of the affected members in the pedigree was compatible with autosomal dominant inheritance with high penetrance. Despite the limitation of the symptoms to the upper limbs, sural nerve biopsy showed tomaculous neuropathy in an affected member of the family. The structural changes of tomaculous neuropathy probably reflect a genetically determined generalized abnormality of the Schwann cells predisposing the patients to the recurrent palsies by exogenous factors.

Abnormalities, Multiple↗

EEG in neonatal herpes simplex encephalitis.

The EEGs of 21 newborns with herpes simplex encephalitis were analysed. The diagnosis was based on the demonstration of herpes simplex infection in association with neurological symptoms, other etiological factors being excluded. Sixteen of 21 babies (76%) showed in their EEGs electrical seizures, either focal or unilateral. These paroxysms consisted of sharp waves or slow waves repeating at pseudo-periodic intervals, usually of 0.5-2 sec. Individual paroxysms had a duration of 10-20 sec in 6 babies and 1-2 min in 10 patients. During the same period, 20 other babies displayed the same EEG finding. Of these, 11 had encephalitis of unknown etiology. In our series there appeared to exist a correlation between both the duration of the electrical seizures and the degree of EEG background abnormality and the clinical outcome. Babies with markedly abnormal background and long-lasting paroxysms tended to have a poor prognosis. It is concluded that in newborns with clinical signs of encephalitis who show in their EEGs paroxysms of the type described, the possibility of herpes simplex encephalitis should be considered.

Electroencephalography↗

Visual and spectral EEG analysis in the evaluation of the outcome in patients with ischemic brain infarction.

Serial EEGs were recorded in 15 patients with acute cerebral infarctions in order to study clinical and prognostic correlations. The EEG was recorded within 48 h from the first symptoms and thereafter weekly for 4 weeks. The EEGs were analyzed both visually and with a computerized spectral analysis. Eight of the patients recovered fully and seven had permanent neurological deficits. On admission, 87% of the patients had an abnormal EEG by visual analysis. The spectral parameters correlated well with visual findings, especially the delta and alpha bands. The spectral analysis was superior to visual in predicting the correct laterality of the lesion. It showed the correct side of the lesion in 87%, while the visual did it in only 54% of the cases. The first EEG records reliably predicted the outcome of the patients. The degree of background abnormality was most important in visual EEG analysis. In spectral analysis, parameters from single derivations were superior to the average of all derivations. A high proportion of delta or low proportion of alpha power were reliable indicators of poor outcome.

Adult↗

Salla disease: a new lysosomal storage disorder with disturbed sialic acid metabolism.

Salla disease is a lysosomal storage disorder associated with increased urinary excretion of free sialic acid. The main clinical features in 34 patients were severe psychomotor retardation of early onset, ataxia, athetosis, rigidity, spasticity, and impaired speech. Growth retardation, thick calvarium, and exotropia were present in about half the patients. The amplitude of EEG decreased progressively with increasing age. Life span appears to be normal; the age range of the patients was 3 to 63 years. Genealogic studies suggest an autosomal mode of inheritance. A thin-layer method is described for the detection of increased urinary free sialic acid excretion. The basic defect is so far unknown.

Adolescent↗

Late irradiation-induced lesions of the lumbosacral plexus.

Lumbosacral plexus lesions developed in two women 8 and 14 years, respectively, after operation and irradiation for carcinoma of the uterus. In both patients, a left femoral nerve lesion was the presenting sign. The irradiation dose was about 5,000 rad on both sides in patient 1 and 8,400 rad on the affected side in patient 2. Both patients had low-frequency periodic discharges in the EMG.

Adult↗

Pneumatic tourniquet paralysis. Case report.

We describe a 31-year-old man in whom a paresis and sensory defect of the left arm developed after amputation of the index finger. The operation was performed in a bloodless field, using a pneumatic tourniquet. The sensory defect resolved in two months and the paresis in five and a half months. We consider that direct pressure produced by the tourniquet caused the nerve lesion. It is probable that the tourniquet was inflated to a pressure of 500 millimetres of mercury instead of the intended 250 millimetres of mercury because of a faulty gauge. In order to avoid this rare complication, it is advisable to check the tourniquet gauge each time before use.

Adult↗

Is chronic brain damage in boxing a hazard of the past?

Of fourteen boxers with a mean age of 31 years who had been Finnish, Scandinavian, or European champions, only one showed deficits in neurological status and he and one other had had episodes of inappropriate behaviour which were attributed to boxing. However, computed tomography revealed pathological findings attributable to brain injury in four of six professional and one of eight amateur boxers. Two of the professionals and four of the amateurs had electroencephalographic abnormalities which may have been caused by brain injury. Twelve of the boxers had psychological test results which suggested brain injury, although only two professionals had definite deviation from normal. The results indicate that modern medical control of boxing cannot prevent chronic brain injuries but may create a dangerous illusion of safety. The only way to prevent brain injuries is to disqualify blows to the head.

Adolescent↗

A variant of Jansky-Bielschowsky disease.

A series of 18 patients with Jansky-Bielschowsky disease is presented. Two children only showed the classical features of the disorder, whereas the remaining 16 differed from the cases previously published in the following respects. Clinically: later onset of age, early onset of visual failure and an intermediate course of the disease. Neurophysiologically: spikes in response to intermittent stimulation appeared by the age of 7-8 years and disappeared after 11 years. The visual evoked response was extinct at an advanced stage of the disorder. Morphologically: accumulation of cytosomes with curvi-linear and fingerprint profiles in solid tissues, but lymphocytes showed no storage material. Electron microscopy of the lymphocytes revealed nothing abnormal.

Child↗

Acute effects of alcohol on the peripheral nerves in diabetic polyneuropathy: a clinical and neurophysiological study.

Acute effects of alcohol on the peripheral nerves of seven patients with diabetic polyneuropathy and 13 healthy subjects were examined neurophysiologically. Ethanol (1 g/kg) caused a slight increase in skin temperature and motor conduction velocity in both groups. Motor distal latencies decreased in the healthy subjects, but increased among polyneuropathic patients after the consumption of alcohol. Diabetic nerves appear most susceptible to the acute effects of alcohol.

Adult↗

Acute encephalitis. A survey of epidemiological, clinical and microbiological features covering a twelve-year period.

The 191 adult patients with acute encephalitis who attended the Department of Neurology, University Hospital, Helsinki, during the 12-year period 1967-78, were analyzed for epidemiological, clinical, and microbiological features. Young healthy adults of either sex under 30 years of age were the most susceptible. The duration of symptoms varied from some hours to more than one month (less than or equal to 5 days in half of the patients). Prodromal symptoms were observed in 37.7%, meningeal signs or symptoms in 93.2%, features indicating brain involvement in 84.3% and clear effects on consciousness in 27.7% of the patients. Half (50.8%) recovered, while 43 (22.5%) were left with at least moderate disability after the acute phase. Twelve patients (6.3%) died. Lower socioeconomic status and age over 35 years were associated with increased mortality. The 10 patients with proven or presumptive herpes simplex virus (HSV) etiology had a mortality of 40% and only one recovered satisfactorily. There were 14 further cases suggestive of HSV. Mumps, Coxsackie B, adeno, and measles were the most frequent identifiable causes after HSV. Other etiological factors, including bacteria, appeared occasionally. The etiology remained obscure in 58.6% of the cases.

Adolescent↗

Herpes simplex virus encephalitis: new diagnostic and clinical features and results of therapy.

Six patients with herpes simplex virus (HSV) encephalitis underwent diagnostic and clinical evaluation. The HSV or its antigenic material was found in three brain biopsy specimens. In the remaining three cases, the diagnosis was supported by detection of HSV antibodies in the CSF. Cell count and total protein concentration in the CSF reached a maximum level at three weeks and two months, respectively. The IgG index and HSV antibody level in the CSF often remained constant after reaching maximal values. In three patients, a transient low serum sodium level was observed. Characteristic EEG changes were present five to 11 days after the onset of symptoms. Computerized tomographic scanning revealed a temporal low-density lesion. Three patients became deeply comatose and had respiratory failure. The patient without vidarabine therapy and one of the five patients treated with vidarabine died.

Antibodies, Viral↗

EEG and end-tidal carbon dioxide concentration in the hyperventilation syndrome.

The hyperventilation syndrome (HVS) is a functional disorder with repeated involuntary hyperventilation attacks together with symptoms of respiratory alkalosis. We have studied the EEG and end-tibial pCO2 in the resting state and during hyperventilation activation in 12 HVS patients in order to find out whether there is a greater susceptibility to cerebral vasoconstriction in HVS patients than in controls, as indicated by slowing of the EEG. A surprisingly high proportion (58%) of abnormal resting EEGs was found in HVS patients, although the patients were neurologically normal. More theta and beta background activity was usually revealed in a quantitative computer analysis, especially frontally. Although the hyperventilation activation caused the same degree of hypocapnia in HVS patients and in controls, peripheral symptoms like tingling and numbness of fingers, as well as carpopedal spasms, occurred much more often in HVS patients. However, the EEG changes due to hyperventilation were similar in both HVS patients and normal controls, and it thus seems that the reason for cerebral symptoms in HVS patients is not a greater susceptibility to cerebral vasoconstriction.

Adult↗

Transient effect of L-tryptophan in progressive myoclonus epilepsy without Lafora bodies: clinical and electrophysiological study.

A double-blind crossover trial with 2 g L-tryptophan and placebo was carried out with five familial and two sporadic patients with progressive myoclonus epilepsy (PME) without Lafora bodies. L-Tryptophan improved the clinical condition in six out of seven patients. Clinical improvement in ambulation, myoclonic jerks, and general condition was most evident. The change was statistically significant. In visual assessment of EEGs, the amount of paroxysmal activity and dysrhythmia of the background activity decreased in six out of seven patients on L-tryptophan. The quantitative EEG revealed a decrease in the power bands of theta, alpha, and beta activity in five of six patients on the second day of L-tryptophan treatment. In familial PME cases, the responses were consistently beneficial. With long-term L-tryptophan therapy, the effect disappeared or was even reversed in three of seven patients after 3 to 4 weeks. These findings indicate that therapy with serotonin precursors is worthy of further trial in PME and that deficient tryptophan metabolism may play a part in the etiology of PME without Lafora bodies.

Adolescent↗

Gyrate atrophy of the choroid and retina with hyperornithinemia: tubular aggregates and type 2 fiber atrophy in muscle.

We studied 21 patients with gyrate atrophy of the choroid and retina and hyperornithinemia. Although the patients were not weak, type 2 muscle fibers were almost universally atrophic and had tubular aggregates. Gyrate atrophy is the first disease in which females are shown to have tubular aggregates; the sexes were affected equally. In gyrate atrophy the number of type 2 fibers decreases with age. The muscle and eye changes are probably related to abnormal creatine synthesis, caused, in gyrate atrophy, by the increased body pool of ornithine; muscle abnormalities may also be present in other tapetoretinal dystrophies.

Adolescent↗