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Biomedical subjects

P Millac

Publications and source records attributed to P Millac.

At least 19 recordsLinked to original sources
PubMed1991

Dietary modification of Parkinson's disease.

To investigate the efficacy of a low-protein diet suitable for long-term use, and to observe the effect in a double-blind manner of re-introducing large neutral amino acids or an inactive placebo amino acid, eight patients with 'on-off' phenomenon were given a low-protein diet suitable for long-term use, and then the diet was supplemented with large neutral amino acids (LNAA) or placebo in a double-blind crossover trial. Five patients had improved Parkinsonian disability on a low-protein diet compared to normal diet. On supplementing the diet with LNAA or placebo, three subjects' Parkinson's disease was significantly better on placebo and there was a trend towards improvement on placebo noticed subjectively by seven patients; however, there was no overall significant difference in disability measured by mobility diaries. Thus, we have been unable to show that the improvement on a low-protein diet is due to a reduction in LNAA, rather than a placebo effect, possibly due to the paucity of subjects; however, the patients' identification of the LNAA supplement suggests that it is a genuine effect.

Aged↗
PubMed1984

Controlled trial of plasma exchange in acute inflammatory polyradiculoneuropathy.

A randomised controlled trial of exchange versus no exchange was conducted to find out whether plasma exchange would be useful in acute inflammatory polyradiculoneuropathy. It was calculated that 15 patients would be required in each group to demonstrate a worthwhile improvement in functional ability 1 month after completion of treatment. Treatment comprised five exchanges in 10 days (55 ml plasma/kg body weight/exchange). Both groups received normal supportive care and were followed up periodically for a year. Overall the treated group showed a slight but not significant benefit (p greater than 0.05); at two weeks' follow-up of patients admitted to the trial within 14 days of onset of neuropathic symptoms, p = 0.07. These results do not provide grounds for recommending plasma exchange for the treatment of severe AIP.

Acute Disease↗
PubMed1981

Autoantibody to nerve tissue in a patient with a peripheral neuropathy and an IgG paraprotein.

The antibody activity of a benign IgG lambda paraprotein to nerve tissue in a case of peripheral neuropathy has been investigated using immunohistochemical methods on tyrpsin-treated, formalin-fixed, paraffin-embedded tissue. IgG lambda was found in th sural nerve biopsy of the patient. Specific binding of the purified IgG lambda paraprotein and its isolated F(ab')2 fragment to homologous nerve and brain tissue was demonstrated. Similar activity was not demonstrable on fresh frozen cryostat sections. The results suggest that tests for autoantibodies to nerve tissue in neuropathological disorders should not be confined to fresh frozen tissue substrates.

Autoantibodies↗
PubMed1977

Diencephalic epilepsy in a patient with agenesis of the corpus callosum confirmed by computerised axial tomography.

A case of diencephalic epilepsy is described in whom stereotyped attacks of spontaneous hypothermia and diaphoresis occurred over a 20 year period. No abnormality of the hypothalamo-pituitary-adrenal axis was found, and there was no evidence of an intracranial mass lesion. Pneumoencephalography and computerised axial tomography (EMI scan) demonstrated agenesis of the corpus callosum.

Adult↗
PubMed1970

Primary neurogenic orthostatic hypotension.

Eight further cases of neurogenic orthostatic hypotension are described together with a necropsy study on one case. Three cases showed evidence of autonomic dysfunction in isolation, while in five cases this was accompanied by evidence of more diffuse central nervous system degeneration. (Parkinsonism, cerebellar ataxia, dementia, pyramidal signs, bulbar weakness, and muscular wasting were all seen in varying proportions.)The various clinical presentations, investigations, pathology, treatment, and prognosis are discussed. In the experience of the authors, when assessed, an abnormal Valsalva response is invariable, confirming the breakdown of the circulatory reflex. A normal vasopressor response is likewise invariable, eliminating an abnormality of blood vessels themselves, and confirming the lesion as neurogenic. The demonstration of loss of sweating to indirect body heating, which also is usual suggests that the defect is central or on the efferent side of the reflex and a normal pilo-erector response to acetylcholine confirms this as preganglionic. Emphasis is laid on the non-specificity of many accepted physiological tests in this disorder and on the delay in diagnosis consequent upon the variable presentation.

Adult↗
PubMed1970

Treatment of paroxysmal disorders in multiple sclerosis with carbamazepine (Tegretol).

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.

Administration, Oral↗