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Biomedical subjects

R Inzelberg

Publications and source records attributed to R Inzelberg.

49 records · Page 3Linked to original sources
PubMed1989

Non surgical treatment of subdural hematoma in a hemodialysis patient.

The development of subdural hematoma in the course of hemodialysis treatment has been well documented in the literature. We report a case of a subdural hematoma in a patient on hemodialysis, in whom surgery was contraindicated, due to her concurrent use of anticoagulants. Good recovery was achieved by steroid treatment. Although surgical removal constitutes the essential therapeutic approach for subdural hematoma, we emphasize the importance of medical management in special cases where surgery is contraindicated.

Adrenal Cortex Hormones↗
PubMed1989

Lupus anticoagulant and late onset seizures.

Lupus anticoagulant was found in the plasma of 4 patients who presented with late-onset epileptic seizures. Three of the patients had clinical or electroencephalographic evidence of focality. No significant cerebral pathological findings were detected by the computed tomogram except for an old infarction in one case. None of the patients fulfilled the diagnostic criteria for systemic lupus erythematosus. The relationship between late-onset seizures and the presence of lupus anticoagulant is discussed. The possible etiology of an ischemic episode due to hypercoagulability, expressed uniquely by seizures, is suggested.

Aged↗
PubMed1989

Cerebrovascular symptoms in thromboangiitis obliterans.

Forty-six consecutive patients with thromboangiitis obliterans were evaluated and examined for the presence of neurological symptoms during a cumulative follow-up period of 833 patient-years. Only one patient (2%), with no other risk factor for stroke, suffered an episode of transient aphasia and right hemiparesis at the age of 59. The diagnostic difficulties in the delineation of cerebral thromboangiitis obliterans are discussed. The rarity of the cerebral manifestations make it difficult to conclude that cerebrovascular manifestations are part of this disease.

Adult↗
PubMed1988

EEG in demented and non-demented parkinsonian patients.

The electroencephalograms (EEG) of patients with Parkinson's disease (PD) were evaluated in relation to age, mental status and motor disability. Abnormalities, particularly mild slowing, were observed in 34% of 128 patients and more frequently in the elderly. While a slowing in occipital background activity was more frequent in demented patients, a statistically significant association was also observed between the degree of motor disability and the frequency of slowing in occipital background activity in mentally intact patients. This correlation may suggest that subcortical structures (involved in motor control) influence occipital background activity.

Aged↗
PubMed1987

Computed tomography brain changes in parkinsonian dementia.

In order to evaluate the relationship between brain atrophy and the motor and cognitive function in Parkinson's disease, we have evaluated CT changes in 132 consecutive patients and compared them to measures of physical and mental decline, using intercorrelations and variance analysis. The result demonstrated age as a most important factor relating to brain atrophy. After correction for this determinant, it became clear that the motor and cognitive parameters were interdependent but they affected similar CT parameters. The effect of motor decline was the stronger of the two and it was the only one which correlated with cortical atrophy. The results support the notion of subcortical changes underlying the dementia of Parkinson's disease.

Aged↗
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

Rasagiline mesylate, a new MAO-B inhibitor for the treatment of Parkinson's disease: a double-blind study as adjunctive therapy to levodopa.

Rasagiline mesylate (TVP-1012) is a potent, selective, non-reversible MAO-B inhibitor, without the tyramine-potentiating effect and with neuroprotective activities. The benefit of rasagiline as monotherapy in patients with early Parkinson's disease (PD) has already been reported. To evaluate the safety, tolerability, and clinical effect of rasagiline as adjunctive therapy to levodopa, a multicenter, double-blind, randomized, placebo-controlled, parallel-group study (0.5, 1, and 2 mg/d) was conducted for 12 weeks in 70 patients with PD (mean age, 57.4 y; mean disease duration, 5.7 y; 32 patients had motor fluctuations). A beneficial clinical effect was observed in fluctuating patients treated with rasagiline (all doses), expressed as a decrease in total Unified Parkinson's Disease Rating Scale (UPDRS) score (23.0% vs 8.5% in the placebo group). The treatment effect was still evident 6 weeks after drug discontinuation (in all doses). The safety and tolerability of rasagiline were good. Adverse events were no different than those of patients taking placebo. Almost complete platelet MAO-B inhibition was obtained at all rasagiline doses. This study has demonstrated that rasagiline (up to 2 mg/day) has a good safety profile and a beneficial clinical effect in fluctuating patients with PD when given as an add-on to chronic levodopa therapy.

Adult↗
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

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↗