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Biomedical subjects

M Trimble

Publications and source records attributed to M Trimble.

At least 19 recordsLinked to original sources
PubMed1992

Comparison of the effects of frontal and temporal lobe partial seizures on prolactin levels.

The acute effects of partial (focal) epileptic seizures on serum prolactin levels were studied in two groups of patients: (1) 10 with temporal lobe seizures and (2) 11 with seizures that arose from the frontal lobes, recorded on cable video-electroencephalographic telemetry. Six of the eight complex partial seizures of temporal lobe origin were associated with a marked rise in prolactin levels at 10 minutes after onset (rise in levels, from a mean of 279 to 534 mU/L), compared with a rise in only one of the eight frontal lobe complex partial seizures. None of the five simple partial seizures (two of temporal and three of frontal lobe origin) was associated with a marked rise in prolactin levels. This difference in prolactin response following complex partial seizures of frontal and temporal lobe origin may help in the clinical differentiation of these seizures. A failure of prolactin levels to rise does not, however, exclude a diagnosis of complex partial seizures; thus, this measurement will not help in the clinical differentiation of frontal lobe complex partial seizures from psychogenic attacks.

Adolescent↗
PubMed1991

Secondary erythrocytosis due to a cerebellar hemangioblastoma: demonstration of erythropoietin mRNA in the tumor.

Cerebellar hemangioblastoma is a rare cause of secondary erythrocytosis. Although the erythrocytosis is a result of erythropoietin (Ep) stimulation, direct evidence of Ep synthesis by the tumor has been lacking. In an erythrocytotic patient with a cerebellar hemangioblastoma we found elevated levels of Ep in the tumor cyst fluid and for the first time demonstrated Ep mRNA in the tumor by Northern blotting. This finding confirms cerebellar hemangioblastoma as a site of ectopic Ep production.

Adult↗
PubMed1991

Serotonin reuptake inhibitors, epilepsy and myoclonus.

Specific inhibitors of 5-HT reuptake are reported to have lower proconvulsive activity than other antidepressants. A patient with post-traumatic epilepsy who had remained fit-free for many years until she was given the 5-HT reuptake inhibitor fluvoxamine is reported. Changes in serotonergic function may play a more widespread role in the pathophysiology of seizure disorders than hitherto thought.

Brain↗
PubMed1990

The antiphospholipid syndrome: prevalence among patients with stroke and transient ischemic attacks.

PURPOSE: The prevalence of the antiphospholipid syndrome was determined prospectively in patients presenting with stroke and transient ischemic attacks. An attempt was made to define a subset of stroke patients at risk for this syndrome on the basis of their clinical features. PATIENTS AND METHODS: Fifty-one consecutive patients with stroke and transient ischemic attacks were assessed. Tests used for the laboratory diagnosis of the antiphospholipid syndrome included four phospholipid-dependent coagulation tests for detection of the lupus anticoagulant, and two enzyme-linked immunosorbent assays for antibodies to phospholipid. RESULTS: Three of 51 patients (6%, 95% confidence intervals 0% to 12.0%) had a lupus anticoagulant and the clinical features of the antiphospholipid syndrome. Seven patients had clinical features suggestive of the syndrome but negative laboratory tests. Those patients who were clinically unlikely to have this syndrome also had negative laboratory tests. CONCLUSION: In a series of 51 unselected patients presenting with stroke and transient ischemic attacks, three had the antiphospholipid syndrome. The clinical features of this syndrome are helpful in identifying this group of patients. The role of the lupus anticoagulant in the pathogenesis of stroke remains to be defined.

Adolescent↗
PubMed1990

The treatment of Gilles de la Tourette syndrome by limbic leucotomy.

A patient with Gilles de la Tourette syndrome and severe self-injurious compulsions who had failed to respond to drug treatment and behavioural therapy obtained a complete and sustained resolution of his destructive behaviour and improvement in his tics following bilateral limbic leucotomy.

Adult↗
PubMed1989

Psychopathology and movement disorders: a new perspective on the Gilles de la Tourette syndrome.

Attention is drawn to associations between movement disorders and psychopathology. The historical background of this is briefly reviewed, and then some recent research findings with regards to the Gilles de la Tourette syndrome are presented. In particular, associations between aggressive and obsessive compulsive disorder and Gilles de la Tourette movements are reported. Further there are associations between a family history of tics and obsessive compulsive disorder in the subsequent generation. It is concluded that the Gilles de la Tourette syndrome should not be viewed as a tic disorder, but a far more complex condition in which the tics form but one aspect.

Humans↗
PubMed1987

Abnormalities of copper in Gilles de la Tourette syndrome.

The Gilles de la Tourette syndrome is a disorder whose etiology and pathogenesis are little understood. The number of biochemical abnormalities described in this disorder is minimal. Ten of a total of 80 patients were found to have an abnormally low serum copper. A report is presented on two patients who consented to further detailed investigation and in whom copper radioisotope studies were carried out. Both exhibited abnormalities of copper handling, in that we observed an abnormally fast disappearance of copper from the plasma and an abnormally slow uptake by the liver. The rates of intestinal absorption and urinary excretion were normal. We did not identify an abnormal site of sequestration of the metal in the body.

Adult↗
PubMed1987

Bradyphrenia in Parkinson's disease and psychomotor retardation in depressive illness. An experimental study.

Thirty newly diagnosed patients with Parkinson's disease and 30 patients with primary depressive illness showed slowing of response on a computerized digit symbol substitution test when compared with 30 matched normal control subjects. Significant slowing was related, in the parkinsonian patients, to structural brain disorder and affective impairment and, in the depressed patients, to motor impairment. A second computerized test, cognitively simpler but requiring the same motor response, was also administered to each subject. Both cognitive and motor slowing seemed to contribute to slowing of response in the digit symbol test in both parkinsonian and depressed patients. The tests were repeated after about six months in 12 subjects from each group. The parkinsonian patients, on dopaminergic treatment, showed neither significant change in motor or affective impairment, nor improvement in response time for the digit symbol test, but change in response time was related to change in depression rating. The depressed patients, on conventional treatment, showed significant improvement in both affective and motor impairment and improvement in response time for the digit symbol test, due to improvement in cognitive slowing. It is proposed that bradyphrenia in Parkinson's disease and psychomotor retardation in depressive illness are closely related, and that impairment of dopaminergic systems may be involved in both.

Brain↗
PubMed1984

Abnormal illness behaviour: the nursing contribution.

Patients who suffer from physical symptoms with no apparent organic pathology often receive inappropriate care in the general hospital. Many terms have been used to describe such patients, often derogatory. More careful assessment, systematic description and treatments are required from all staff. In this study a sample (N = 79) of patients with various 'hysterical' complaints, other than pain, were interviewed, and completed a set of psychological instruments to detect any personality or mood disturbance. These data were also collected from two comparison groups from a psychiatric clinic (34) and a neurological setting (36). The main purpose of this study, to identify differences between these groups, was achieved. Patients in the main sample were found to have a high frequency of affective disturbance, being moderately anxious and depressed. Most understood that their problems may have been psychological but had an unrealistic view of their coping strategies and life problems. Nurses in both general and psychiatric settings could have an immensely important role in both identifying such patients and their needs and in providing appropriate guidance and treatments.

Adult↗
PubMed1983

Antidepressant drugs, convulsions and epilepsy.

1 Evidence concerning the convulsant effects of non-monoamine oxidase inhibitor antidepressant drugs has been reviewed. 2 Mianserin is convulsant in therapeutic doses but seizures have not been reported following overdose. 3 The convulsant effects of mianserin are probably no greater than for other non-monoamine oxidase inhibitor antidepressant drugs. 4 Enzyme-inducing anti-epileptic drugs can reduce the peak plasma concentration of mianserin and shorten its elimination half-life, probably by inducing its metabolism.

Antidepressive Agents↗
PubMed1981

Anticonvulsant drugs, behavior, and cognitive abilities.

The literature concerning the relationship of anticonvulsant drugs to disturbances of behavior and cognitive abilities has been reviewed. It is indicated that although completed studies are sparse and although many of the techniques currently used for evaluating the effects os such drugs on patients are inadequate, certain conclusions may be drawn. With regard to the effects on cognitive abilities, the drugs not only impair performance on psychological tests, but some drugs--particularly phenytoin--are associated with a progressive decline of intellectual abilities, which is often insidious and unrecognized. There is little systematic evidence to indicate which anticonvulsant drugs have adverse effects on behavior, but several studies have indicated improvements in behavior associated with carbamazepine and sulthiame. The possible reasons why anticonvulsant drugs should have those effects are discussed, and particularly the relationship of the drugs to abnormal folic acid and monoamine and metabolism are highlighted.

Animals↗
PubMed1981

Phenytoin and cognitive function: effects on normal volunteers and implications for epilepsy.

Despite the widespread use of phenytoin in the treatment of epilepsy, few studies have examined its effects on cognitive functioning. We report here the results of an investigation into the effects of phenytoin on the performance of non-epileptic volunteers, on a series of specially designed psychological tests. Subjects received placebo or phenytoin 300 mg per day for two weeks in a double-blind crossover design and measures were taken of phenytoin serum levels. The results demonstrate a deleterious effect of phenytoin upon several important aspects of cognition, including memory, concentration, mental and motor speed. The implications of our findings for the treatment of patients with epilepsy are discussed.

Adolescent↗