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Biomedical subjects

S I Oftedal

Publications and source records attributed to S I Oftedal.

At least 19 recordsLinked to original sources

Electroencephalography, visual evoked potentials, and cerebral CAT-scan as diagnostic tools in senile dementia of Alzheimer type.

The usefulness of a cerebral computed tomogram (CAT-scan), an electro-encephalogram (EEG), and flash visual evoked responses (FVER) as diagnostic tools in dementia was studied in 36 mentally impaired and 32 unimpaired persons aged 75 yr and above, who were recruited from a random sample of elderly people living at home. The clinical diagnosis of dementia was made after a full psychogeriatric assessment supplemented by a follow-up 18 mo later. When the measures of cortical atrophy from a cerebral CAT-scan, the presence/absence of diffuse slow activity on a standard EEG, and FVER P200 and FVER P100 latencies were introduced in a logistic regression model, the clinical diagnoses being the dependent variable, an effective prediction of senile dementia of Alzheimer type (SDAT) was obtained (sensitivity 93%, specificity 86%, misclassification rate 12%). We conclude that the use of FVER, an EEG, and a cerebral CAT-scan may facilitate the diagnosis of senile dementia of Alzheimer type.

Aged↗

The treatment of spasticity in multiple sclerosis: a double-blind clinical trial of a new anti-spastic drug tizanidine compared with baclofen.

The anti-spastic effect of a new drug, tizanidine, was compared with that of baclofen in a double-blind clinical trial; 40 seriously handicapped patients with multiple sclerosis (MS) were randomly allocated treatment with one or the other drug for a 6-week period. The antispastic effect was evaluated by clinical criteria. The optimal daily dose of both drugs varied considerably from patient to patient, and was on the average 23 mg for Tizanidin and 59 mg for baclofen. To the extent an antispastic effect was observed, the 2 drugs appeared to be equally effective when given at a 1:2 ratio (mg tizanidine: mg baclofen). Side effects of both drugs were sleepiness, muscular weakness and dry mouth. Tizanidine had a mild depressive effect on blood pressure. Sudden withdrawal of both drugs was accompanied by a transient relative increase of spasticity in approximately half the patients. There were no other changes suggesting physical or psychological dependence. The present study underscores that neither baclofen nor tizanidine are ideal antispastic drugs, and emphasize the need for further research.

Adult↗

Late sequelae after meningococcal disease. A controlled study in young men.

The occurrence of sequelae 3-15 years after meningococcal disease has been investigated in a study on 71 patients and 64 controls. The patients were young men, aged 18 to 24 years at the time the disease was contracted. Participants filled in a questionnaire on possible symptoms. Audiometry and EEG were also carried out. The response rates were 84% among patients and 75% among controls. We found that 61% of the patients had one or more symptoms of possible sequelae compared to 20% in the control group (p less than 0.001). The symptoms were generally light and of mental or neurological type. Among the patients 13% stated that they had obvious complaints commonly attributed to meningococcal disease, compared to 2% only in the controls (p less than 0.05). Twenty-nine per cent of the patients stated that the disease had affected their education or working capacity. No statistical differences between patients and controls were demonstrated by audiological or EEG examinations. In only one single ear could deafness unequivocally be attributed to the disease.

Adolescent↗

Late sequelae after meningococcal disease as related to anamnestic and clinical factors recorded during the acute illness.

In 71 males who survived acute meningococcal disease 3 to 15 years ago at an age of about 20, associations between acute clinical conditions (including a few pre- and post-admission variables) and late sequelae have been studied. There was a higher rate of sequelae symptoms (mainly light neurological and mental disturbances) among survivors from meningitis (76%) than among those who had had both meningitis and septicemia (58%) or pure septicemia (50%). Twenty percent of control persons experienced such symptoms. "Changed Life" because of serious educational and working problems followed in 29% of the meningitis cases and 70% of the septicemia cases. Most of the clinical and laboratory factors separately examined were not significantly correlated to the sequelae rates. However, less than 2.5 mmol/l glucose in the cerebrospinal fluid (CSF) on admission (p less than 0.01), more than 1000 X 10(6) white blood cells per 1 in the cerebrospinal fluid (p less than 0.05), fever for more than 8 days (p less than 0.05), and probable cerebral symptoms the first week (p less than 0.05), were all positively correlated to a high rate of late sequelae. Well documented early sequelae correlated with serious late sequelae (p = 0.05). No conspicuous associations between acute antibiotic treatment and late sequelae were found. A combination of CSF glucose, blood thrombocytes, and cells in CSF on admission yielded a multiple regression score which seems to be a moderately reliable predictor of sequelae (R = 0.46). Hospital treatment should both aim at avoiding death and escaping residual effects. Because many prognostic factors for sequelae on admission are different from those for lethality, scoring for sequelae may be helpful in such secondary prevention of sequelae. Early standardized registration of sequelae may also be of value in tertiary prevention.

Acute Disease↗

First clinical trial with iohexol in myelography.

This is a report of the first clinical trial with iohexol in lumbar myelography. The investigation was carried out as an open, non-comparative study in 30 patients and was part of a multicentre trial. Iohexol doses of 10 to 15 ml (180 mg I/ml) were used and clinical and laboratory tests were performed before and during 48 h after myelography. Spinal repuncture 6 or 24 h after myelography was done in all patients. Only minor side effects of temporary duration were recorded in 8 patients. No seizures or spikes on EEG were seen. There was no significant increase in CSF parameters such as white cell counts, protein or IgG.

Cerebrospinal Fluid Proteins↗

Effect of levomepromazine on EEG and on clinical side effects after lumbar myelography with metrizamide.

In patients with lumbago-sciatica levomepromazine is a potent supplement to analgetics in pain treatment. The hypothesis that neuroleptics increase the risk of epileptic seizures after metrizamide myelography was not confirmed in a series of 77 patients, 26 with and 51 without levomepromazine medication, before and after lumbar metrizamide myelography. No differences existed between the groups with regard to the appearance of EEG abnormalities such as slow waves or spikes. Mild side effects were more frequent in the levomepromazine group, except nausea and vomiting. Lumbar metrizamide epidurography in 30 patients did not cause any abnormal EEG.

Drug Interactions↗