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Biomedical subjects

M Swash

Publications and source records attributed to M Swash.

324 records · Page 18Linked to original sources
PubMed1972

Released involuntary laughter after temporal lobe infarction.

A case of sustained involuntary laughter is described, with accompanying alteration of mood, due to infarction of the inferior and lateral aspects of the left temporal lobe. The lesion was localized by the clinical findings, by electroencephalography, by a radioisotope brain scan, and by angiography. The problem of the neurology of emotional behaviour is discussed in the context of the localization of the lesion in this case.

Cerebral Angiography↗
PubMed1972

Treatment of involuntary movement disorders with tetrabenazine.

Seventeen patients with choreiform, athetoid, or ballistic involuntary movements, or with spasmodic torticollis, were treated with tetrabenazine in doses of 25 to 200 mg daily for periods varying from two weeks to more than six months. Randomized ciné film of the patients' involuntary movements, taken before, during, and after treatment was assessed individually by seven `blind' observers. Eight patients were judged improved; two had Huntington's chorea, two athetosis, two dystonia musculorum deformans, one hemiballismus, and one spasmodic torticollis. Four of the eight improved patients have continued taking the drug for longer than six months. In a second study seven patients with Huntington's chorea were treated for two weeks each with tetrabenazine (50 mg t.d.s.) and with amantadine (100 mg t.d.s.) and the results assessed by the same method. The choreiform movements of six of these patients were strikingly improved with tetrabenazine therapy, but amantadine had no effect. Tetrabenazine is an effective agent for the suppression of choreiform and ballistic involuntary movements. It is only slightly effective in the treatment of athetosis and spasmodic torticollis. Drowsiness, insomnia, and depression were the most conspicuous unwanted effects, and these may limit the clinical usefulness of the drug.

Adolescent↗
PubMed1972

Effect of tyramine in migraine: a double-blind study.

The incidence of headache and changes in the EEG after tyramine were studied in 25 migrainous patients in a double-blind placebo-controlled investigation. There were three groups of patients: the first had migraine alone, the second had migraine and epilepsy, and the third had migraine which was precipitated by food substances containing tyramine. Psychological tests showed that all the patients were more neurotic, more introverted, and more obsessional than normal subjects. Headache occurred in 12 of 50 patient sessions and 10 of these occurred in the group with dietary precipitated migraine. In this group, however, headache followed tyramine alone in only two patients. The remaining eight headaches occurred in two patients after placebo alone, and in three after both test capsules. The EEG was activated after tyramine, but not after placebo, in 11 of the 15 patients with migraine and epilepsy, and dietary precipitated migraine. This effect was observed, however, in only two of the 10 patients with classical migraine alone. There was no relation between the occurrence of headache and EEG activation. Although there was no significant relationship between tyramine ingestion and the occurrence of headache, the EEG changes observed during the study support the hypothesis that tyramine has an action on the central nervous system in some migrainous subjects.

Adult↗
PubMed1971

Invasion of cranial nerves by salivary cylindroma: four cases treated by radiotherapy.

Four cases of adenoid cystic carcinoma (cylindroma) of accessory salivary tissue are described, and the diagnostic difficulties experienced are emphasized. The tumour infiltrates cranial and other nerves and may invade the central nervous system by this route. It is highly malignant and may metastasize widely both by haematogenous and lymphatic pathways. The tumour is radiosensitive and it is suggested that the treatment of choice is radiotherapy combined, when possible, with surgical excision of the primary lesion. Metastases should be treated with radiotherapy since useful remission may occur.

Adult↗
PubMedDate not supplied

Myopathy due to epsilon amino-caproic acid.

A subacute necrotizing myopathy developed in a patient treated with epsilon amino-caproic acid (EACA) for subarachnoid hemorrhage. The muscle biopsy showed features suggesting that the muscle fiber necrosis might have been due to capillary damage. An attempt to induce EACA myopathy in the rat was made, but no abnormality developed.

Acute Disease↗
PubMedDate not supplied

The pattern of involvement of adult-onset acid maltase deficiency at autopsy.

The autopsy findings in a clinically and biochemically documented case of adult-onset acid maltase deficiency presenting with limb girdle myopathy are presented. The skeletal muscles, tongue, extraocular and smooth muscles of gut and arterioles showed a vacuolar myopathy, most severely affecting proximal skeletal muscles. Muscle spindles were severely affected in all muscles. The heart showed basophilic degeneration and a vacuolar myopathy. The visceral organs and nervous system were morphologically normal. Possible mechanisms for this differential involvement of muscles and tissues are discussed.

Glycogen Storage Disease↗
PubMedDate not supplied

Pathogenesis of longitudinal splitting of muscle fibres in neurogenic disorders and in polymyositis.

Longitudinal splitting of muscle fibres has been studied in the biopsies of eighteen patients with neurogenic disorders, and of twenty with polymyositis. In neurogenic disorders splitting predominantly affects hypertrophied fibres, and is probably due to mechanical overload induced by normal loads imposed on a weakened muscle. A similar phenomenon occurs in hypertrophied fibres in chronic polymyositis. However, in acute, or active polymyositis an appearance resembling fibre splitting can result from sequestration of necrotic segments within a fibre and also from regeneration occurring within intact sarcolemmal tubes after segmental sub-endomysial necrosis. These different processes, which can be distinguished by light and ultrastructural criteria, are important compensatory factors in neuromuscular disorders.

Adult↗
PubMedDate not supplied

Distal myopathy with focal granular degenerative change in vacuolated type 2 fibers.

A slowly progressive distal myopathy with raised blood (CK) level commencing in the second decade was associated with large vacuoles found only in type 2 fibers. The vacuoles consisted of sarcoplasmic spaces without limiting membranes, containing granular and fibrillar material. This material probably represented degenerative products derived from myofibrils. A distinction is drawn between these degenerative vacuolar changes and those reported in other cases of sporadic or hereditary distal myopathy in which autophagic vacuoles are characteristic.

Adult↗
PubMedDate not supplied

Neurofibrillary neuronal degeneration in dialysis dementia: a feature of aluminum toxicity.

Neurofibrillary material was found in cortical neurons in two patients who died with dialysis encephalopathy. The cytoplasm of these neurons contained large amounts of aluminum and whole-brain and blood aluminum levels were high. These findings suggest that in dialysis encephalopathy aluminum has a specific effect on neuronal protein synthesis, resulting in the accumulation of neurofilaments in cortical neurons. This neurofibrillary neuronal degeneration resembles that found in experimental aluminum toxicity, but differs in several respects from the neurofibrillary tangles characteristic of Alzheimer's disease.

Adult↗
PubMedDate not supplied

Lettsomian lectures. A neurologist's view of coloproctology and the pelvic floor and incontinence: new light on an old problem.

In idiopathic anorectal incontinence there is weakness of the pelvic floor sphincter muscles. This is evident on digital examination of the external anal sphincter muscle, and can be confirmed by anorectal manometry. This pelvic floor weakness is commonly associated with abnormal descent of the pelvic floor below the plane of the perineum during straining, as during the act of defaecation. This perineal descent is itself a feature of weakness of these muscles as shown by the prominent appearance of this sign in patients with cauda equina lesions. Almost all patients with this syndrome are women and there is usually a history of prolonged or difficult childbirth, often followed by a change in bowel habit, with prolonged and persistent straining at stool. However, not all affected women have experienced childbirth. In the latter a similar pattern of abnormal defaecation is present, but the reason for this is unknown. Anorectal incontinence is associated with urinary incontinence of the stress type in 10-15% of patients.

Fecal Incontinence↗