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P Roggenkämper

Publications and source records attributed to P Roggenkämper.

At least 19 recordsLinked to original sources
PubMed2005

Efficacy and safety of a new Botulinum Toxin Type A free of complexing proteins in the treatment of blepharospasm.

NT 201 is a new development of Botulinum Toxin Type A free of complexing proteins. In this double-blind Phase III trial, we compared the efficacy and safety of NT 201 and BOTOX in patients suffering from blepharospasm. Of 304 enrolled patients, 300 patients received study medication (intent-to-treat population), and 256 patients completed the study as planned (per-protocol population). At baseline, patients received a single injection of NT 201 or BOTOX (<or=35 units per eye). No significant differences were found between NT 201 and BOTOX for all efficacy and safety variables three weeks after injection. Both the NT 201 and the BOTOX group showed a decrease in the Jankovic Rating Scale (JRS) sum score signifying an improvement in the symptoms of blepharospasm during this time period. These data show that NT 201* is an effective and safe treatment for patients suffering from blepharospasm.

Adult↗
PubMed2004

[Diagnostic value of mitochondrial DNA analysis in chronic progressive external ophthalmoplegia (CPEO)].

BACKGROUND: Chronic progressive external ophthalmoplegia (CPEO) is a mitochondrial cytopathy presenting with ptosis and external ophthalmoparesis. Mitochondrial disorders are characterized by a broad clinical spectrum and genetic background with marked genotype/phenotype variability. The routine diagnostic work-up usually includes clinical and laboratory examinations as well as histological and histochemical analysis of skeletal muscle biopsy. In our case only an additional molecular biological examination allowed the diagnosis of CPEO. PATIENT AND METHODS: We report a 35-year-old woman with a 7-years history of slowly progressive diplopia due to impaired ocular motility and bilateral ptosis. We performed ophthalmological and neurological examinations, laboratory testing, lower limb skeletal muscle biopsy including histological and histochemical investigations, biochemical analysis of respiratory chain enzymes in skeletal muscle homogenate and molecular genetic testing of skeletal muscle DNA. RESULTS: Although clinical, laboratory, histological and biochemical analyses did not give any hints suggesting a mitochondrial cytopathy, molecular genetic testing of total DNA from skeletal muscle tissue by Southern blot analysis finally revealed a 3.8 kb mitochondrial DNA deletion with a degree of heteroplasmy of 45 %. CONCLUSIONS: In patients with unexplained binocular diplopia , oculomotor deficits and/or acquired ptosis, an underlying mitochondrial cytopathy should be considered. Even in the case of inconspicuous skeletal muscle histology and biochemistry, molecular genetic testing of skeletal muscle DNA is advisable in order to establish the diagnosis.

Adult↗
PubMed1998

Primary conjunctival rhabdomyosarcoma: 2.5 years' follow-up after combined chemotherapy and brachytherapy.

BACKGROUND: The 2.5-year outcome of a 3-year-old girl with a primary intraconjunctival rhabdomyosarcoma treated by biopsy-controlled combined chemo- and brachytherapy is reported. METHODS: The patient presented with a conjunctival dermoid-like lesion which showed modest growth on 1-month follow-up. The first biopsy appointment was missed because of a viral illness. When she showed up 3 months later a further increase in size was obvious and several incisional biopsies were taken immediately. RESULTS: Light microscopy revealed an undifferentiated subepithelial small cell tumour. On immunohistochemistry the tumour reacted with vimentin and desmin antibodies. Thus, the diagnosis of an embryonal rhabdomyosarcoma was made. The patient underwent 9 cycles of polychemotherapy and the tumour mass disappeared macroscopically. However, immunohistochemistry of incisional biopsies showed residual tumour cells. The latter were eradicated by an individually shaped strontium-90 applicator. CONCLUSION: At 2.5 years after biopsy-controlled combined chemotherapy and brachytherapy the patient is free of tumour at a manageable level of complications. This new approach appears to be a good alternative in the treatment of primary conjunctival rhabdomyosarcomas since it takes advantage of the unique location of this rare tumour and avoids hemifacial retardation, known to be induced by external beam radiation.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1997

Comparison of two botulinum-toxin preparations in the treatment of essential blepharospasm.

A double-blind study was performed on 212 consecutive patients (58 men, 154 women) with essential blepharospasm, who received one injection of Botox and one injection of Dysport in two separate treatment sessions (at the first session the patients randomly received one of the drugs, at the second the other drug was given. The patients' mean age was 66.4 years +/- 8.14 (range 39-86 years). The average dose of Botox per treatment was 45.4 IU +/- 13.3 (range 25-85 IU) and of Dysport 182.1 IU +/- 55.1 (range 100-340 IU). We used an empirical ratio Botox:Dysport of 1:4 (IU) in order to ensure equal doses. All patients had received botulinum toxin injections prior to the present study (mean 15.3 injections +/- 9.4; range 1-43 injections). The effect of Botox lasted 7.98 weeks +/- 3.8 (range 0-16 weeks), while the effect of Dysport lasted 8.03 weeks +/- 4.6 (range 0-22 weeks). Side effects (ptosis, tearing, blurred vision, double vision, hematoma, foreign body sensation) were observed with Botox in 36 of 212 (17.0%) of the treatment sessions and with Dysport in 51 of 212 sessions (24.1%). Ptosis was observed with Botox in 3 cases (1.4%) and with Dysport in 14 cases (6.6%). There was no statistically significant difference in the duration of the treatment effect between the two preparations (P = 0.42). The total number of side effects was lower with Botox than with Dysport; the significance of the difference was moderate (P < 0.05). However, the rate of occurrence of ptosis was significantly lower with Botox (P < 0.01). The bioequivalence, which varies between 1:3 and 1:6 (Botox:Dysport) in the literature, was found to be 1:4 in this study.

Adult↗
PubMed1997

Frontalis suspension in the treatment of essential blepharospasm unresponsive to botulinum-toxin therapy: long-term results.

Thirty-one patients with essential blepharospasm or lid opening disorder of the levator-inhibiting type, unresponsive to treatment with botulinum toxin, underwent frontalis suspension. Twenty-eight patients received bilateral surgery (three patients with bilateral complaints of different severity were operated on the more affected side; these patients were not included in the statistical analysis). The mean age was 62.4 years +/- 8.52 (range 42-80 years). The individual improvement of complaints was assessed by the patients using a percentage scale (0% = no improvement; 100% = no complaints). Objective and subjective improvement was achieved in 26 of 28 patients. The mean subjective improvement was 57.7% +/- 31.4. In 23 cases an additional treatment with botulinum toxin was administered. During follow-up period (mean 22.1 months +/- 11.6; range 5-40 months) the effect of surgery remained stable. There were no serious complications, in a 5 of 56 operated eyes suture granuloma had developed. Unlike other surgeries for treatment of blepharospasm (excision of the orbicularis muscle, resection of facial nerve branches) frontalis suspension can be considered as a minimally invasive, but very effective and (if desired) reversible procedure. Moreover, additional treatment with botulinum toxin can bring about further improvement.

Adult↗
PubMed1996

Hemangiopericytoma of the inner canthus.

PURPOSE: A 31-year-old woman with a mass at the left inner canthus was referred to our hospital. METHODS: Clinical examination failed to establish a diagnosis and the patient underwent an incisional biopsy. RESULTS: Histopathologic examination disclosed a hemangiopericytoma. CONCLUSIONS: Because the behavior of a hemangiopericytoma is unpredictable, this tumor should be included when making a differential diagnosis in lesions of the inner canthus.

Adult↗
PubMed1995

Long-term treatment of blepharospasm with botulinum toxin type A.

The treatment of essential blepharospasm with botulinum toxin has been known for a decade and is becoming increasingly more popular. To our knowledge, only a few longterm studies in major patient populations have been published. Of a total of more than 1,600 patients, results of treatment were evaluated in 115 patients (31 men and 84 women) treated continuously for a minimum of 3 years and a maximum of 8 years (mean, 5.7 years). Patients were divided into two groups. Group I represents the "good responders" and contains all patients who received only 4-10 injections over that time (n = 55). Group II represents the "poor responders, " who received at least 20 injections over that period (n = 60). Group I received a mean of 7.1 injections, whereas group II had a mean of 24.4 injections (total, 1,855). In group I the beneficial effect lasted for an average of 14.6 weeks (range, 2-52 weeks), whereas group II had a mean beneficial effect for only 6.8 weeks (range, 0-18 weeks). The time of efficacy remained statistically stable even in the case of frequent treatment (up to 36 injections in group II). Systemic or severe long-lasting local side effects were never observed; the most frequent side effects were: group I-ptosis, 5.4%; tearing, 5.1%; double vision, 1.8%; and lid lag, 1.5%; group II-ptosis, 4.3%; tearing, 3.3% lid lag, 1.9%, and double vision, 1.6%. The treatment of essential blepharospasm with botulinum toxin is a very effective therapy with minimal and transient complications. It may be used for long-term treatment without showing a decrease in efficacy.

Adult↗
PubMed1994

Orbicular synkinesis after facial paralysis: treatment with botulinum toxin.

Involuntary lid closure not rarely accompanies aberrant regeneration of nerve fibers after different types of facial paralysis. 23 patients with such synkinesis were treated with botulinum toxin injections into the orbicularis oculi muscle. After periocular injections all patients showed much improvement: a period of, on the average, 13 symptom-free weeks was followed by a period of minimal symptoms. There were only minor complications. Whenever repeated treatment is necessary, botulinum toxin proves to be an effective therapy for involuntary lid closure after defective healing following facial paralysis.

Adult↗
PubMed1993

[Development of endocrine orbitopathy in pregnancy].

A report is given on an endocrine orbitopathy in a 24-year-old female in which the disease deteriorated from the 3rd month of pregnancy, with a severe restriction of motility, exophthalmia (Hertel exophthalmometer both eyes 28 mm), severe visual field defects and a decrease of visual acuity to 20/200 both eyes. Therefore--despite of certain restraints of the pharmacologic therapy during pregnancy--glucocorticoid-treatment was started. After delivery, the condition deteriorated, despite of a higher steroid dose. Therefore, a retrobulbar irradiation was begun on the 12th day post partum (telecobalt 10 Gy). From that time on all signs improved over the next months (visual acuity 20/25; exophthalmometer both eyes 20 mm, normal visual field). In the literature, endocrine orbitopathy (Graves' ophthalmopathy) during pregnancy has been mentioned sporadically, but to our knowledge such a severe case, as reported here, has not been described before.

Adult↗
PubMed1993

Ligneous conjunctivitis. Ten years follow-up.

Ligneous conjunctivitis is a rare chronic conjunctivitis of unknown origin occurring predominantly in young girls. Persistent whitish membranes, 1-2 mm in thickness, are present on the upper and, less frequently, on the lower tarsal conjunctiva. The authors present a 12-year-old girl who is suffering from this disease since the age of four months. The diagnosis was confirmed histologically. Multiple recurrences were observed and were treated either conservatively with hyaluronidase eyedrops or surgically. At the present time, the disease has settled to a tolerable level.

Child↗
PubMed1993

Frontalis suspension for essential blepharospasm unresponsive to botulinum toxin therapy. First results.

We performed frontalis suspension in 12 patients presenting with essential blepharospasm or "apraxia" of eyelid opening who did not respond sufficiently to botulinum toxin injections. An improvement could be observed in 9 patients. During the follow-up period (4-18 months) the effect of surgical intervention remained stable. As opposed to other surgical procedures (excision of the orbicularis muscle, resection of facial nerve branches), frontalis suspension can be considered as a minimally invasive and even reversible treatment.

Aged↗
PubMed1992

[Congenital facial hemiatrophy. Report of two pediatric cases].

In facial hemiatrophy two different types are known: the progressive acquired type, which is relatively more common, and the rare congenital non progressive form. Two children--both with congenital facial hemiatrophy--are presented, both showed a (horizontally and vertically) smaller lid fissure and antimongoloid configuration of the lid. In addition in one case we could observe: small corneal diameter, staphyloma posticum, paving stone degeneration of the retina, convergent strabismus, and vertical deviation, in the other case: ptosis, major astigmatism, and latent divergent strabismus.

Child↗
PubMed1991

[Magnetic stimulation in patients with essential blepharospasm].

In 31 patients with an essential blepharospasm investigations were undertaken with transcranial cortical and cisternal magnetic stimulation of the facial nerve. Cortical stimulation was performed contralaterally, whereas cisternal stimulation was ipsilateral; the latencies and amplitudes of the potentials were determined. However, the extracranial part of the facial nerve was stimulated in the region of the stylomastoid foramen for neuromyography electrically. In most measurements the response potentials in the orbicularis oculi muscle and the levator labii muscle were determined. Cisternal stimulation yielded normal latencies, whereas cortical stimulation showed an increase of latency in some blepharospasm patients. A difference between the orbicularis oculi muscle and the levator labii muscle as known in patients with hemifacial spasm (20) could not be observed. The mean values of all latencies after cortical stimulation were normal. The method of transcranial magnetic stimulation is an important part of the complete investigation of patients with facial hyperkinesias as shown here in blepharospasm patients.

Blepharospasm↗