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Biomedical subjects

M K Greenberg

Publications and source records attributed to M K Greenberg.

9 recordsLinked to original sources
PubMed1995

The utility of the electroencephalogram in the evaluation of patients presenting with headache: a review of the literature.

Electroencephalography has traditionally been considered a useful adjunct to the clinical evaluation of headache. We performed a literature review to determine whether evidence supports the routine use of the electroencephalogram (EEG) for patients with headache. After excluding case reports, case series in which subjects were selected because of abnormal EEGs, abstracts with insufficient information for analysis, and reviews without original data, we found 40 articles describing EEG findings in headache patients. These articles dated from 1941 to 1994. We compared these articles against six criteria established to determine the validity of data evaluating the utility of a diagnostic test. These criteria were (1) a comparison against established diagnostic criteria, (2) the use of appropriately matched controls, (3) a study setting that minimizes biases, (4) a blinded interpretation of the EEGs, (5) a sensible interpretation of the abnormalities observed, and (6) the replicability of the techniques used. One article met all six literature criteria, three articles met five criteria, 11 met four, nine met three, seven met two, seven met one, and two met none. The only abnormality consistently reported in headache patients, as opposed to controls, in studies of relatively nonflawed design was a prominent photic driving response at high flash (the "H-response"). The H-response was less effective than clinical criteria in distinguishing patients with headaches from individuals without headaches and in distinguishing migraine from other headache types. Studies did not show that the EEG is an effective screen for structural causes of headache, nor does the EEG effectively identify headache subgroups with different prognoses.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain↗
PubMed1992

Practice parameters: strategies for survival into the nineties.

In an atmosphere of escalating medical costs, clinical practice guidelines have been proposed as a viable means of achieving cost containment. The approaches to developing standards of practice have historically been varied, and new methods of development have been proposed to incorporate current scientific knowledge and patient preferences for achieving optimal health outcomes. We review the historical, governmental, and health organization approaches to achieve scientifically sound and clinically relevant parameters. The mechanism and the mission of the American Academy of Neurology Quality Standards Subcommittee is reviewed. The Subcommittee has selected the term "practice parameter" in lieu of "practice policy" to be consistent with AMA terminology. Practice parameters may include one or more of the following types of recommendations: standards, guidelines, and options. These three terms reflect varying levels of clinical certainty as determined by the level of objective evidence.

National Institutes of Health (U.S.)↗
PubMed1992

Cases from the aerospace residents' teaching file. Case #48. A student pilot is referred for evaluation of a "head injury with post-traumatic amnesia".

A student pilot is referred for evaluation of a "head injury with post-traumatic amnesia." The case study presents a temporal association of injury and symptoms that were assumed to be related. A differential diagnosis of an amnestic syndrome is presented. Transient global amnesia is discussed as a possible etiology until an EEG revealed an epileptiform abnormality. The aeromedical implications, military and FAA, of the clinical and electrophysiologic findings are discussed.

Adult↗
PubMed1991

Mononeuropathy multiplex complicating idiopathic thrombocytopenic purpura.

Peripheral nerve hemorrhage has rarely been reported with idiopathic thrombocytopenic purpura (ITP). We describe a patient with severe ITP who developed mononeuropathy multiplex. At autopsy, multisystem hemorrhages were found, including intraneural hemorrhage, without evidence of extraneural hematoma. ITP represents an unusual cause for clinical mononeuropathy multiplex.

Humans↗
PubMed1981

Neurologic complications of lymphomatoid granulomatosis.

Lymphomatoid granulomatosis is a malignant form of pulmonary angiitis that has characteristics in common with Wegener granulomatosis and lymphoma. Neurologic symptoms occur in up to 30% of the cases and are the presenting complaints in up to 21%. CNS, cranial nerve, and peripheral nerve involvement occur singly or in combination. In the CNS there is a pathologic triad of angiitis, lymphoreticular infiltration, and necrosis. In the involved peripheral nerves there is demyelination and lymphoid cell infiltration. Neurologic involvement tends to indicate a worse prognosis. Treatment has been based on steroids and cytotoxic agents and may improve symptoms but does not seem to alter the disease process.

Adult↗