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Biomedical subjects

P Wessely

Publications and source records attributed to P Wessely.

At least 73 records · Page 4Linked to original sources
PubMed1981

[Report on the results achieved over the past 10 years in the neuro-orthopaedic out-patient department (author's transl)].

A short abstract of the pathophysiology of pain and its conduction is followed by a discussion of the importance of neurological-orthopaedic cooperation for the diagnosis and the treatment of pain syndromes arising from the locomotor apparatus. The examination of the spine from the functional, i.e. segmental point of view is pointed out. The main reflex answer of the spine to irritation is the restriction of movement or hypermobility. Therefore, neuro-orthopaedic reflex treatment consists of so-called "test treatment" by means of manipulation to overcome the restriction of movement or by local curative anaesthesia, or by a combination of both methods. The results over the past decade of treatment in 1008 patients suffering from various pain syndromes are presented and differentiated.

Adolescent↗
PubMed1981

[Neurological signs in diphenylhydantoin intoxication (case reports and review) (author's transl)].

Five patients who were treated with long-term diphenylhydantoin for epilepsy developed neurological signs of poisoning. In 4 cases the symptoms appeared following treatment of status epilepticus with additional phenytoin medication. All patients had an acute symptomatic psychosis and a diffuse slowing of the curves in the EEG. All 5 patients showed cerebellar signs and two of them complained additionally of objective polyneuropathy, a third case complaining of itching only. An axonal polyneuropathy with minimal reduction in motor nerve conduction and a considerable extension of distal latency and diminution of compound action potential was found. In one case the biopsy showed concentric lamellar bodies coming from the axon, with intact myelin sheaths. All alterations were reversible. The pathogenesis of toxicity is discussed. Cumulation of toxic products in the plasma arising from delayed elimination of DPH metabolites is pointed out. However, one case with cerebellar signs had normal DPH levels.

Adult↗
PubMed1981

[EEG in phenytoin intoxication (author's transl)].

Four patients had Phenytoin intoxications, whereby 3 of them suffered from acute and one from subacute symptoms (in all of them reversible cerebellar symptoms and acute organic brain syndrome and in one of them an axonal polyneuropathy which lasted a bit longer). The clinic-neurologic symptoms, the Phenytoin blood levels and the current EEG changes were compared. Three patients had blood levels in a high toxic range, the fourth one had levels within the therapeutic range. The EEG changes of acute phase of intoxications showed in each case nonspecific mostly diffused slowing of the traces with theta- and delta-activity over the convexity (Tab. 1a, 2c, d). Although the EEG changes were reversible, they lasted longer than the clinical intoxication phase. These EEG changes were already manifest several days before the clinical symptoms. We feel therefore that the EEG examination is indicated especially in doubtful cases because it is easier to execute than the blood level estimation, - even though the changes are nonspecific. One case (Nr. 1), which was more closely explores, did not develop any epileptic fits, instead the fits were retrospectively seen as stemming from a psychogenic origin, which was treated with Phenytoin. The EEG of this patient showed generalised irregular SW-paroxyms (Tab. 1b) as the medication blood level was receding (120 muMol/l). This would be a manifestation of an independent Phenytoin effect in the high toxic dosage respectively in withdrawal.

Adult↗
PubMed1981

[Clinical and angiographic findings in vascular medullary syndromes (author's transl)].

Eleven cases presenting a syndrome of the medulla oblongata are discussed with reference to the findings of clinical and angiographic investigation. The diagnosis of Wallenberg's syndrome is justified when the classic symptoms are apparent (Horner's syndrome, nystagmus, dysphonia and dysphagia, ataxia, ipsilateral sensory impairment of the face and contralateral elsewhere, and accompanying vegetative disturbances). If additional symptoms such as a facial or extra-ocular muscle paresis, especially hemiparesis, exist, another, more lateral or medial, syndrome of the oblongata should be considered. Angiographic findings vary considerably, ranging from a normal vertebral artery or posterior inferior cerebellar artery (PICA) to an occlusion of these arteries (in three and two of the 11 cases respectively). Modification are often seen in the anterior inferior cerebellar artery (AICA). A kind of complementary supply in the PICA-AICA region must occasionally exist. Localised processes affecting these vessels rather than diffuse multifocal vascular processes would lead to Wallenberg's syndrome. It is difficult to conclude from the clinical picture where a possible responsible vascular narrowing or obliteration may lie, even if pareses of the limb were present.

Adult↗
PubMed1980

[Correlation between clinical and angiographic findings in cases of transient cerebral circulatory disturbances (author's transl)].

The results are presented of angiographic investigations in 85 patients suffering from transient ischaemic cerebral circulatory disturbances. Transient ischaemic attacks (TIA) were observed in 45 patients, reversible ischaemic neurological defects of longer duration (PRIND) were diagnosed in 40 patients. The mean age of all patients at the time of angiography was 49.9 years. Transfemoral cerebral panarteriography was performed in all cases, including studies both of the aortic arch and of the cranio-cervical vessels. The mean interval between the first manifestation of cerebrovascular disease and angiographic investigation was approximately 2 years. 10.6% of all patients showed normal angiograms; in 35.3% of all cases diffuse vessel wall alterations were found; 37.6% showed minor stenoses (vessel diameter reduced to 80-34%), whilst 16.5% showed major stenoses (vessel diameter reduced to 33-1%) or occlusions. There was poor correlation between clinical-neurological localization of the ischaemic lesion and the angiographically-verified stenoses or occlusions. The angiographic findings corresponded to the clinically affected regions in only 52.2% of all patients suffering from stenoses of occlusions. A good correlation was found in 71.4% of the cases when only major stenoses and occlusions were evaluated. Consequently, angiographic studies of the aortic arch, as well as of all extra- and intracranial vessels are a precondition for the surgical treatment of the cranio-cervical vessels in every patient. It is possible by these means only to achieve a comprehensive assessment of the haemodynamic processes in the cerebral circulation.

Adolescent↗
PubMed1980

[Comparative results of neuropsychological investigations, computer tomography and electroencephalography in post-traumatic epilepsy (author's transl)].

Clinical-neurological and neuropsychological investigations, as well as cranial computerized tomography (CT) and electroencephalography (EEG) were performed in 33 patients suffering from verified post-traumatic epilepsy. The purpose of this study was to compare the neuropsychological test scores (dementia, psycho-organic syndrome, decreased vigilance) with the results of CT and EEG. There was no significant correlation between the neuropsychological scores and the EEG results. On the other hand, a significant correlation was found between decreased vigilance (measured by CFF) and the results of CT, both in the case of focal lesions or diffuse brain atrophy.

Adolescent↗
PubMed1980

[Clinical experience with daily doses of misonidazole (author's transl)].

In this pilot study daily low doses of misonidazole (in the range of 1 to 2 g) up to cumulative doses between 7 and 19 g/m2 were used. Serum levels were analysed at different times after administration and according to several dose regimens. We related the cumulative doses to the incidence and severity of the observed peripheral neuropathies. The aim was to find an effective daily low-dose schedule of misonidazole with a clinically acceptable incidence of side effects. Some impressive clinical responses were observed.

Adult↗
PubMed1979

The value of CT and EEG in cases of posttraumatic epilepsy.

The results of the clinical neurological investigation were compared with those of electroencephalography (EEG) and computed tomography (CT) in 64 patients suffering from verified posttraumatic epilepsy. Only 18 patients (28%) showed central neurological features with corresponding focal disorders on CT (15 cases) and EEG (11 cases). The combined application of both methods led to positive results in 94% on the part of at least one accessory examination. The clinical neurological investigation as well as the EEG and CT were normal in only 3 cases, although the traumatic etiology of epilepsy was beyond doubt. In addition to the clinical neurological investigation, EEG and CT are most important accessory examinations for the diagnosis and followup studies in cases of posttraumatic epilepsy.

Adolescent↗
PubMed1979

Electroneurographic investigations of misonidazole polyneuropathy.

13 patients with malignant tumors were treated by the radiosensitizer misonidazole (Ro 07-0582), total dosage 20-29 g. The electrophysiological investigations showed (1) an early increase of distal latency, the motor nerve conduction velocity (NCV) of the peroneal nerve and the NCV of the sural nerve remaining normal or only signlty reduced, and in a few cases a marked reduction of the compound action potential or of the nerve action potential (NAP), indicating a primary axonal neuropathy; (2) greater changes in the parameters of sensory nerves (n. suralis) than of motor nerves; (3) the distal latency is a good indicator of subclinical neuropathies; (4) the electrophysiological parameters showed a normalization 6 months after the end of therapy. The mechanisms possibly responsible for the misonidazole neuropathy are discussed.

Action Potentials↗
PubMed1979

The significance of combined risk factors for the incidence of posttraumatic early fits and epilepsy.

After a brief outline of autonomic incidence of posttraumatic early fits as compared to "real" posttraumatic epilepsy, such traumatologic and neurologic factors are compared that lead much more frequently to early fits. Furthermore, the conditions of early fits and their relation to the occurrence of chronic posttraumatic epilepsy are investigated. Statistically and prognostically reliable data are only found when combined groups of high risk factors of different valence rather than individual data are considered. Such a statistically proved combination is the connection of intracranial hematomas, posttraumatic amnesia of more than 3 hours, neurologic dysfunctions and a persisting organic psychosyndrome.

Adult↗