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P Nisipeanu

Publications and source records attributed to P Nisipeanu.

35 records · Page 2Linked to original sources
PubMed1995

Long-term tolerability and efficacy of cabergoline, a new long-acting dopamine agonist, in Parkinson's disease.

Motor fluctuations constitute a severe complication of chronic levodopa therapy. The addition of dopamine agonists may partially alleviate these responses; however, due to the short half-life of these drugs, several daily doses are required. Cabergoline is a new dopamine agonist with a long half-life and can be given in a single daily dose. Seventeen patients with severe fluctuations were treated with cabergoline, seven of them for > 1 year (up to 39 months). The motor status ameliorated and the percentage of "off" hours significantly decreased in the first year and did not increase significantly later during long-term follow-up. Cabergoline is a promising treatment for parkinsonian patients with motor fluctuations.

Aged↗
PubMed1994

Familial levodopa-responsive parkinsonian-pyramidal syndrome.

We present four patients--two pairs of siblings--followed for many years, with pyramidal and parkinsonian features, who responded consistently to levodopa therapy. The patients belong to two unrelated consanguineous families, suggesting that this condition is genetically determined and recessively inherited.

Adolescent↗
PubMed1993

Psychological stress as risk factor for exacerbations in multiple sclerosis.

We prospectively evaluated the relationship between a common psychological stressor and relapses in multiple sclerosis (MS) in a group of 32 MS patients exposed to the threat of missile attacks during the Persian Gulf War of 1991. The number of relapses during the war and the following 2 months was significantly lower than expected based on the frequency during the preceding 2 years, suggesting that not all stress conditions increase the risk of exacerbations in MS.

Adult↗
PubMed1992

Interferon-related cortical blindness.

The term cortical blindness indicates loss of sight due to bilateral lesions in the occipital lobes. It is a rare but severe side effect produced by chemotherapeutic agents. Cortical blindness was diagnosed in a 75-year-old man who had been treated with alpha-interferon for metastatic renal-cell carcinoma. The absence of focal neurological signs and of abnormal findings as determined by two repeated computed tomography (CT) scans of the brain, which excluded structural damage to the occipital lobes, suggest that metabolic or toxic reactions may have caused the cortical blindness diagnosed in our patient. The temporal relationship between the treatment with alpha-interferon and the development of cortical blindness indicates that this substance may have been the causative agent for this phenomenon.

Aged↗
PubMed1976

[Myocardiopathy of progressive muscular dystrophy].

The authors have effected a clinical, radiological, electrocardiographic and apexocardiographic survey in 13 patients with progressive muscular distrophy (PMD) and in 6 healthy subjects belonging to families affected by the disease, in parallel with a group of 11 patients with severe myasthenia and 23 healthy subjects. Comparing the results with those found in the literature lead to the following results: 1) The ECG modifications and above all the abnormalities of the ventricular complex develop precociously in the PMD and express the pleiotropism of the myopathic gene. 2) The myocardial dyssynergia represents a link in the physiopathological chain of the cardiac distress. 3) The precociousness of electro and apexocardiographic modifications and their presence in healthy parents recommend these investigations in the genetic enquiry. 4) Clinical, histological and haemodynamic data individualize the myocardial distress as a true myocardiopathy.

Adolescent↗
PubMedDate not supplied

Clinical features of oculopharyngeal muscular dystrophy among Bukhara Jews.

Oculopharyngeal muscular dystrophy (OPMD), a late onset autosomal dominant myopathy, is common among the French-Canadians and the Jews from Bukhara (Uzbekistan); most clinical histologic and genetic data published until now, as well as the recently suggested diagnostic criteria, are based on studies among the former. We studied 79 patients with OPMD belonging to the newly described Jewish-Bukhara cluster. The disease began between the ages of 21 and 78 yr (median 53 yr). In 11 patients (15%) it began before the age of 40. Ptosis was the first symptom in 59 patients and dysphagia in the remaining 20. Eight patients (10%) were monosymptomatic (ptosis) after more than 7 yr from the start of the disease; however, other family members had additional signs/symptoms. The patients belong to 29 families; in 26 age-dependent autosomal dominant inheritance could be documented. Among them there is certain evidence for genetic anticipation. This clinical study is the largest published concerning patients other than French-Canadians.

Adult↗
PubMedDate not supplied

A comparison of dopamine agonists and catechol-O-methyltransferase inhibitors in Parkinson's disease.

To compare the efficacy and tolerability of three dopamine agonists--pergolide (PRG), pramipexole (PRX), and ropinirole (ROP)-and two catechol-O-methyltranferase (COMT) inhibitors-tolcapone (TOL) and entacapone (ENT)-as add-on therapies to levodopa (L-Dopa) in Parkinson's disease, we analyzed randomized, double-blind, placebo-controlled, multicenter studies. To our knowledge, they had not yet been evaluated in comparison with each other. Statistical analyses used odds ratios, numbers needed to harm, and Fisher's inverse chi2 method. Seven studies meeting the inclusion criteria included treatment of 1,756 patients. The common efficacy measures were the reduction of L-Dopa dose and "off' duration. The reported reduction in L-Dopa dose was significant for all drugs in relation to placebo, but was most significant for PRX and ENT (p < 0.0001). The most significant reduction in "off' duration was with PRG, PRX, and ENT (p < 0.001). The common tolerability measures were the percentage of patients withdrawn because of side effects, because of any reason, and because of the development of dyskinesias. Ropinirole, PRX, and ENT caused fewer withdrawals related to side effects. Pergolide was better than other analyzed drugs concerning withdrawals for any reason. All drugs caused more dyskinesias than placebo (p < 0.0001), with overlapping confidence intervals, except for TOL 600 mg, which caused more dyskinesias than dopamine agonists and ENT. Pramipexole and ENT had the best efficacy and tolerability profile in this analysis.

Catechol O-Methyltransferase Inhibitors↗
PubMedDate not supplied

Acute mania and hemichorea.

A 61-year-old man suddenly became euphoric and talkative. Later the same day, he developed hemichoreic movements of the left limbs. The patient fulfilled the DSM-IV criteria for a manic episode by abnormally and persistently elevated mood, decreased need for sleep, high distractibility, pressured speech, increased goal-directed activity, and hypersexuality. The mood changes persisted for several weeks. Magnetic resonance imaging of the brain showed a right thalamic infarction. The co-occurrence of hemichorea and mania caused by focal thalamic lesion is very rare. It may be explained by dysfunction in basal ganglia thalamocortical circuitry.

Acute Disease↗
PubMedDate not supplied

Lingual seizures.

A 73-year-old patient with hyperglycemia and rheumatoid arthritis presented with attacks of involuntary lingual movements that were associated with pain at the base of the tongue, often followed by aversion of head and eyes to the left with clonic contractions of the left corner of the mouth. Seizures could be induced by a combination of specific movement and somesthetic stimuli. Ictal EEG recording revealed a focal epileptiform discharge in the right centrofrontal area, thus confirming that the patient had lingual seizures, an extremely unusual manifestation.

Aged↗
PubMedDate not supplied

Juvenile segmental muscular atrophy.

Unilateral upper limb atrophy is a rare entity that has been described mainly in Asia. Isolated cases were reported in the Western countries but never in the Middle East. Herein, we review the literature and describe two illustrative cases which presented typically with brachial atrophy of insidious onset. No involvement of cranial nerves, pyramidal tracts or sensory system occurred over a period of several years. The clinical and EMG features were consistent with a localized anterior horn cell lesion in the cervical spinal cord. The neuroimaging studies (CT, myelography, MRI) were normal. The benign outcome of this entity underscores the importance of its recognition.

Adolescent↗