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Biomedical subjects

P Kruszewski

Publications and source records attributed to P Kruszewski.

24 records · Page 2Linked to original sources
PubMed1991

Short-lasting unilateral neuralgiform headache attacks with conjunctival injection, tearing, etc. (SUNCT): III. Another Norwegian case.

"SUNCT" is a recently reported head pain syndrome characterized by shortlasting, unilateral neuralgiform paroxysms with conjunctival injection and tearing, and to a lesser extent nasal secretion, and (subclinical) sweating. Another case--that of a 56 year old male--is reported herein. The attacks lasted 1/2-1 min. and occurred only infrequently, i.e. once or twice in 1-4 weeks, except for a week recently when there were up to 20 or more typical attacks per day, with the usual ipsilateral, autonomic accompaniments. Due to the benign nature and low frequency of attacks, the diagnosis would have been most difficult to establish prior to the occurrence of this shortlasting period with more marked symptoms. A variety of precipitation mechanisms were present, partly concerning the V 2-3 areas, partly concerning the neck. Precipitation mechanisms in "SUNCT" to some extent seem to differ from those in trigeminal neuralgia. It is remarkable that all four hitherto reported cases are males.

Conjunctiva↗
PubMed1991

Shortlasting, unilateral, neuralgiform headache attacks with conjunctival injection, tearing, and subclinical forehead sweating ("Sunct" syndrome): II. Changes in heart rate and arterial blood pressure during pain paroxysms.

The recently described "Sunct" syndrome is a rare picture of unilateral, shortlasting headache attacks accompanied by autonomic phenomena (conjunctival injection, tearing, etc.) on the symptomatic side. Heart rate and blood pressure were monitored in two elderly "Sunct" patients during and outside headache attacks. An ultrasound Doppler servo method was used for the non-invasive, continuous, beat-to-beat determination of instantaneous arterial blood pressure. In a third patient, systolic and diastolic blood pressure, both outside and during pain paroxysms, were assessed using the standard Korotkoff method. Heart rate was found to be significantly decreased during pain paroxysms. Systolic blood pressure was observed to be significantly increased during attacks, when compared with the inter-attack period, while a less consistent pattern was observed for diastolic blood pressure. Some of the changes in the cardiovascular system seemed to start prior to pain onset. Therefore, it seems unlikely that these changes were caused by pain activation of the sympathetic nervous system or the oculocardiac reflex.

Aged↗
PubMedDate not supplied

Trigeminal neuralgia and "SUNCT" syndrome: similarities and differences in the clinical pictures. An overview.

SUNCT is a recently described unilateral headache with frequently occurring, shortlasting pain attacks in the ocular area accompanied by ipsilateral conjunctival injection, lacrimation, and (subclinical) forehead sweating. In some patients, attacks may be triggered by cutaneous stimuli. In this communication, SUNCT patients (n = 5) are compared with the considerable clinical series of trigeminal neuralgia in the literature (e.g. Harris, 1940, 1433 cases). In several respects (unilaterality, triggering, brevity and frequency of paroxysms), SUNCT shows similarity to trigeminal neuralgia. SUNCT seems to differ clearly from trigeminal neuralgia in other respects: sex distribution (SUNCT patients are often males), pain localization (SUNCT patients have the pain in the ocular area), the carbamazepine effect, presence of conjunctival injection, lacrimation, etc. SUNCT may accordingly altogether seem to be distinct from trigeminal neuralgia.

Carbamazepine↗
PubMedDate not supplied

Sympathetic functions in parkinsonism treated with stereotactic surgery: observations in ten patients.

Ipsilateral sympathetic deficits, that is symptoms and signs consistent with a diagnosis of Horner's syndrome, have been described in patients who have undergone thalamotomy for dyskinesia as well as for parkinsonism. The present patient material consists of 10 patients with parkinsonism who had undergone stereotactic surgery. Since anhidrosis and miosis are two integral components of Horner's syndrome, forehead sweating and pupillometric response to sympathicomimetic agents have been investigated in this preliminary work. The tests were carried out a considerable time postoperatively. Sweating was stimulated in two different ways: by body heating and by parenterally administered pilocarpine. OH-amphetamine and phenylephrine (an indirectly and a directly acting sympathicomimetic agent) were used in the pupillometric tests. The results were compared with those obtained in a healthy control group. With the OH-amphetamine test, there were some indications of a changed sympathetic activity on the surgical side. However, when comparing these results with those obtained by the phenylephrine test, the inference seems to be allowable that parkinsonian patients operated in this way (target area: ventro-oral thalamic nuclei (Voa and Vop) and the reticular thalamic nucleus) show no definite sympathetic supersensitivity at the late postoperative stage. Our data suggest that the response pattern of the pupils and the sweat glands may be related to the surgical method used and/or to the interval from operation to investigation.

Aged↗
PubMedDate not supplied

Sinus arrhythmia and pupil size in Chiari I malformation: evidence of autonomic dysfunction.

In a prospective study on latent autonomic dysfunction in the Chiari type I malformation, 15 patients were examined for degree of sinus arrhythmia in the supine and the sitting positions with a deep breathing test, and for pupil size and function with electronic pupillometry after sympathicomimetic eyedrop stimulation. The 5 patients with brainstem signs had a marked disturbance of sinus arrhythmia, which was more pronounced in the supine than in the sitting position. The clinical signs suggested a dysfunction of the reflex centers in the medulla rather than of the lower cranial nerves. The patients also tended to have more anisocoria than healthy controls, but no clear-cut pattern existed as to pupil dysfunction. Of the 4 patients with syringomyelia, however, the two with the most extensive cord cavitations had a Horner-like pupil reaction ipsilaterally to a marked hand wasting, indicating a sympathetic lesion at the T1 level of the cord.

Adult↗