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Biomedical subjects

P Wessely

Publications and source records attributed to P Wessely.

At least 91 records · Page 5Linked to original sources
PubMed1978

[Recurrence of pseudotumour cerebri (intracranial hypertension) after renal transplantation (author's transl)].

The case report is presented of a 24-year-old male who developed the clinical signs and syptoms of pseudotumour cerebri (intracranial hypertension) twice during the course of protracted rejection 1 and 4 months after renal transplantation. Clinically, headache, nausea, hypertensive crisis and, finally, severe coma with an acute mid-brain syndrome was observed. Neurologically a mild left-sided hemiparesis was found on the second occasion. Examination of the fundi revealed bilateral papilloedema. Electroencephalograms showed pathological changes of a diffuse nature, later followed by abnormal delta range activity in the right frontotemporal projection. The withdrawal of corticosteroid therapy may have been responsible for the pseudotumour cerebri in this case.

Adult↗
PubMed1978

Further clinical experiences of a phase I study with the hypoxic cell radiosensitizer misonidazole.

Since April 1976 we have performed clinical investigations with multiple doses of the hypoxic cell radiosensitizer misonidazole in 21 patients. A significant side effect of the drug was the development of peripheral sensory neuropathies in 13 patients (8 mild, 5 severe) and of a transient acute organic psychosyndrome in 2 of the 5 patients with a severe polyneuropathy. The severity of the polyneuropathies is related to the total dose of misonidazole and the overall time of drug administration. Treatment schedules designed to obtain the desired sensitizing effect without neurological side effects are under investigation.

Adolescent↗
PubMed1977

[Commotio cerebri and headache: (author's transl)].

Headaches form an essential part of the syndrome after concussion of the brain. The origin of these may be extracranial (neuralgias in scar tissue and hematomas, neuralgiform headache as a result of injury to the cervical spine) as well as diffuse in the sense of vasomotr cephalalgia which are due to central regulation disorders of the circulation caused by psychogenic mechanisms and compensatory neurosis. Methods of therapy include the use of vasoactive substances especially for vasomotor cephalalgia, immobilisation and local anesthesia in neuralgias, and psychopharmocological as well as psychotherapeutic aid in psychogenic complaints.

Brain Concussion↗
PubMed1977

[Epileptic manifestations following head injury (author's transl)].

An analysis is presented of the findings in a group of 300 patients with head injury, aged 15 years or over at the time of the accident, who subsequently developed epileptic manifestations. Early fits (including one case of immediate onset) were found in 33% of the cases (99 patients). In contrast to post-traumatic late epilepsy (PTE), which is a manifestation of a static process, early fits are triggered off by a dynamic process (brain oedema, haemorrhage) and are a sign of cerebral irritation, but do not represent a true form of epilepsy. Early fits are related to the acute traumatic state; the time limit is flexible, but lies in the region of 4 weeks following injury. Conversion of early fits to PTE (with or without a latent interval) occurred in 72% of the cases. This percentage is higher than the average incidence quoted in the literature and presumably arises partly from the selection criteria applied in this study. The time of appearance of early fits following injury is one factor which determines the prognosis. Fits appearing on the first day carry a relatively favourable prognosis and do not proceed to PTE in 41% of the cases, whereas this percentage shrinks to 15% in the case of fits appearing from the second week onwards. Early fits are an isolated occurrence in one third of the cases; progression to PTE is less frequent in these patients than following frequent, repeated convulsions. Furthermore, the incidence of early fits is dependent, to a large extent, on traumatological and clinical factors: the combination of unconsciousness of over three hours' duration, neurological signs referable to the central nervous system, persistent organic psychotic syndrome and intracranial bleeding leads to a significantly higher incidence of early fits than unconsciousness of less than three hours' duration and absence of neurological signs in patients who, moreover, do not display features of the psychotic syndrome, and shows a greater tendency to early fits even than the combination of depressed fracture of the skull with penetration of the dura. Should, however, early fits occur in spite of a favourable assessment of the traumatological factors involved, then progression to PTE occurs in a higher percentage of such cases than in patients displaying signs of a serious import following injury. The transition to PTE is markedly higher following diffuse cerebral contusion (75% of cases) than in cases displaying signs of local contusion....

Adult↗
PubMed1977

Initial clinical experience with the radiosensitizing nitroimidazole Ro 07-0582.

The 2-nitroimidazole derivate Ro 07-0582 is known from experimental studies to be a very efficient radiosensitizer of hypoxic cells. Experiences with its clinical use are very limited so far. This study reports the side effects observed in the use of this drug in 12 patients. Nine of these patients were suffering from brain tumors, 3 from extracerebral tumors. In 8 of our 12 patients a sensoric polyneuropathy occurred which was strongly related to the total dose of the drug administered. Polyneuropathy was observed on the average after a total dose of 26 grams, but was already noticed at doses as low as 22 grams. It showed a good tendency for remission after termination of the drug treatment and was reversible in all patients within 4 weeks. In one patient with a brain tumor a severe organic psychosyndrome occurred which is possibly related to the drug. This side effect was also reversible. In this small group of patients the critical dose limit seems to be 29 grams. This dose can be divided into 6 fractions of 60-80 mg/kg. Up to the present knowledge this single dose is likely to give an enhancement ratio of 1,5, which would be extremly valuable for the treatment of hypoxic tumor cells.

Adolescent↗
PubMed1977

[Symptomatology and treatment of post-hypoxemic myoclonisms].

After a brief description of the complex symptoms of myoclonias reference is made to the different systems of classification, and mention is made of the particular areas in which myoclonias appear after hypoxemic cerebral damage and which can be observed more frequently as a result of modern intensive therapy techniques. The 12 cases observed here form the basis for a description of the clinical and electronencephalographic symptoms and a discussion of the differential diagnosis; additionally, 2 autopsy results are discussed. In the cases at hand the myclonias seem to arise from subcortical areas. Finally, reference is made to the therapeutic measures quoted in recent literature and to the experiences gained by the authors, primarily with benzodiazepine.

Adolescent↗
PubMed1976

[Therapeutic problems in status epilepticus (author's transl)].

A review is given of the present state of knowledge and current concepts of the causative factors involved in, and the pathological mechanisms underlying status epilepticus. A synopsis of the commonly-applied therapeutic methods is presented. A step-wise therapeutic procedure is advised for the different stages of status epilepticus. Treatment is directed towards a lowering of cerebral excitability (hydantoin, diazepam), the prevention of brain oedema (osmotherapy, positive pressure respiration) and the avoidance of the development of secondary complications (antibiotics, intensive care). In every case the requisite investigations should be undertaken in order to clarify the aetiology.

Anticonvulsants↗
PubMed1976

[Finger Microtremor--an experimental study (author's transl)].

This paper deals with the recording of finger microtremor using a self-constructed apparatus (amplitudes 0.5 to 0.05 mm). 32 healthy subjects aged 7 to 60 years were examined by means of a test set permitting the exact recording of the amplitudes and frequencies of the right middle finger movement. Special attention was given to the vertical plane of the tremor in order to permit more exact demonstration. Frequencies of 5 to 12 cps. were recorded, the mean frequency being 7.55+/-1.12 cps. The minimum amplitude was 0.02 and the maximum recorded amplitude amounted to 1.4 mm, with a mean amplitude of 0.12+/- 0.07 mm. No significant differences in amplitude or frequency were noted with respect to age or sex. This method is useful in the accurate quantitative assessment of every kind of tremor.

Action Potentials↗
PubMed1976

[Treatment of Spastic Gait Disorders Using an "Electro-Gait-Stimulator ("Schrittstimulator") (author's transl)].

A short historical outline of electric treatment of spasticity is given. A specially developed management with a "gait-stimulator" is described. Four muscles of each lower extremity being mainly engaged in walk were electrically stimulated in the physiological sequences according to the normal gait. The used electric impulses were of a duration of 0,25 msec and an intensity up to 700 V. Using such a "gain-stimulator" in spastic-paraparetic patients a reduced spasticity has been achieved. Positive effect of this treatment has been mostly pronounced, when the programming of impulses was adjusted to the end of the expected physiological contraction of the corresponding muscles. Physiological and pathological data of the "Silent period" is proposed to be mostly involved. The application of impulses in physiological sequences seems to reactivate normal reflex - mechanisms which are disturbed by supraspinal laesion. The results indicate that the electric impulses activates muscle-sensory - organs and that impulses on these organs produce a pace-making function on the spinal cord, which lessens spasticity.

Adult↗
PubMed1976

[Influence of alcohol on photomyoclomus and photoconvulsive response (author's transl)].

In some subjects with increased light sensitivity to intermittent photic stimulation it could be observed: (1) a photomyoclonic response (PMR)--(in the EEG: muscular and ocular artefacts and probably spikes) including twitching of the facial, and sometimes muscles (Fig. 1 and 2) a photoconvulsive response (PKR), which deals in EEG with paroxismal cerebral potentials (Fig. 2). 20 min after consumation of small doses of alcohol (60 ml brandy) the PMR persists, while the photomyoclunus response gets extinguished (Fig. 3). In special terms there can be a development of epileptic seizures without alcohol (Fig. 4a-b), which fail to appear after alcohol up to 3 hours. This effect is demonstrated in six cases (Tab. 1). A partial anticonvulsive effect of alcohol is possible to be involved, especially in cases of fits with motoric actions (myoclunisms). The cilical valence of PMR and PKR seems to be the same, as a conductive factor to the liability to cerebral fits.

Adult↗
PubMed1976

[The "residual syndrome" in alcoholics after 5 years' abstinence].

Residual deficiency of brain performance in chronic alcoholics after a 5-year abstinency. Brain performance of a group of 43 chronic alcoholics abstinent since 5 years was tested. Some aspects of higher intellectual performance were found to be reduced as compared to a control population. The performance was also better than that of a group of chronic alcoholics abstinent for only one year. The residual deficiency of performance could be interpreted as a "functional psychosyndrome", resulting from chronic sensory deprivation on the base of the alcoholism.

Alcoholism↗