Evaluation of baclofen (Lioresal) for spasticity in multiple sclerosis.
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Biomedical subjects
Publications and source records attributed to M L Espir.
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A familial myopathy affecting a man, his three daughters, and one of his brothers is reported. The quadriceps muscle was predominantly involved, with aching pain as an early feature, and later prominent areas of hypertrophy projecting from patches of atrophy gave the quadriceps a most striking and unusual appearance. Presentation was in adult life, and the course was relatively benign, pelvic girdle and hand muscles becoming involved later. The evidence suggests a hereditary selective muscular dystrophy rather than polymyositis, although a hereditary form of spinal muscular atrophy could not be excluded entirely.
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Four out of five members of a team of farmworkers who had been using various herbicides and pesticides in intensive agriculture became impotent. Sexual function recovered after further contact with the chemicals was stopped and hormone therapy had been given, though in one case this took about a year. We have not been able to incriminate one particular substance, but with the circumstantial evidence and the lack of any other obvious cause it seems likely that the impotence was due to the toxic effects of one or more of the chemicals being used.
During an eight year period, 32 patients with definite or suspected multiple sclerosis (MS) were seen with paroxysmal neurological disturbances, which included tonic seizures, paroxysmal dysarthria, paraesthesiae and pain in the limbs, as well as trigeminal neuralgia. In 21 of these patients the paroxysmal disorders were treated with carbamazepine, and in six the effect was compared with placebo. In the majority carbamazepine was effective in controlling the paroxysmal symptoms. Side-effects were troublesome in a few patients, but they could usually tolerate small doses, which still gave relief. Although the patho-physiological basis for these paroxysmal disorders remains unexplained, their response to carbamazepine suggests a common mechanism.
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