Search PubMed⌕ Search

Biomedical subjects

W Grisold

Publications and source records attributed to W Grisold.

At least 55 records · Page 3Linked to original sources
PubMed1996

[Multifocal motor neuropathy with conduction block--a clinico-neuropathologic case report].

Descriptions on patients with multifocal motor neuropathy with conduction block (MMNCB), including histology, nerve fiber teasing and electron microscopy on nerve biopsy, are rare. We report a 64-year old female patient with progredient weakness of the upper extremities without sensory deficit. Electrophysiology shows conduction blocks up to 80% in several examined motor nerves. A biopsy of the sensory sural nerve reveals features of a mixed axonal and de- and remyelinating neuropathy. Thus sural nerve biopsy contributes here significantly to differential diagnosis and supports an immune mediated pathogenesis of MMNCB.

Amyotrophic Lateral Sclerosis↗
PubMed1995

Cytomegalovirus infection of the brain in AIDS: a clinicopathological study.

Based on neuropathological findings, a retrospective case control study of 39 patients with acquired immune deficiency syndrome (AIDS) and confirmed cytomegalovirus (CMV) infection of the brain is presented. Since 1989, the incidence has increased progressively and, in 1994, CMV was the most frequent opportunistic central nervous system (CNS) infection. Of the patients with CMV infections of the brain 16 had one or more coexisting secondary opportunistic and/or tumorous lesions in the CNS. Cerebral involvement by CMV was more frequent in patients with multiple extracerebral organ infections, while 7 among the 39 reported cases showed isolated CMV infection of the brain. The evaluation of the clinical records of 21 patients revealed neuropsychiatric signs and symptoms in 10, while these were absent in 11. All of these patients revealed various types of cerebral lesions related to CMV infection: ventriculitis, focal lesions, and microglial nodule encephalitis. The extent and distribution of cerebral lesions showed no significant correlations with clinical, radiological, or laboratory findings. Further clinicopathological studies are warranted to recognize CMV infections of the CNS and to allow earlier and more efficient treatment of this rather frequent complication of AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1995

[Dangerous intoxication from extreme serum concentrations of methaqualone metabolites. Detection and quantification of biosynthesis with gas chromatography-mass spectrometry].

CLINICAL COURSE: We present a potentially fatal case of acute methaqualone (M) poisoning with very low serum concentrations of M but extremely high levels of its metabolite, 2-methyl-3-(2-hydroxymethyl-phenyl)-4 (3H)-chinazoline (Met-1). A 23-year-old man was admitted to the intensive care unit 2 days after ingestion of 4-5 g M in an suicidal attempt. On admission he was somnolent and poorly responsive to painful stimuli. Physical examination revealed a heart rate of 95 bpm, a blood pressure of 125/65 mmHg, and a normal body temperature. His chest was clear to auscultation, respirations were shallow, and the skin was cyanotic. The electrocardiogram was unremarkable. The chest radiograph showed a normal heart size without pulmonary infiltrates or venous congestion. The pupils were dilated but reactive to light. The neurologic examination was further remarkable for increased limb reflexes, myoclonia, and positive pyramidal signs. During the next 2 days the patient became comatose and developed respiratory insufficiency due to non-cardiogenic pulmonary oedema, which was confirmed by chest radiograph and haemodynamic investigations by means of right heart catheterisation. He required mechanical ventilation for 6 days. Finally, he recovered completely and was discharged in good condition. DIAGNOSTICS: A lumbar puncture revealed neither blood nor pleocytosis in the cerebrospinal fluid. Cranial computed tomography was carried out on an emergency basis, but no abnormality was disclosed. An electroencephalogram did not exhibit any significant pathological findings. Testing for infectious diseases or porphyria gave negative results. Toxicological screening based on enzyme immunoassays (ELISA) was negative for alcohol, tricyclic antidepressants, benzodiazepines, barbiturates, and morphine, but gave a positive result for M. From the moment of admission daily blood samples were taken and analysed by combined gas chromatography and mass spectrometry. These showed very low levels of M but extremely high levels of Met-1. THERAPY: After gastric lavage, continuous enteric lavage with activated charcoal and mannitol was initiated to minimise intestinal absorption. Since M was hardly detectable in the serum, haemoperfusion was not regarded as indicated for drug elimination and treatment was restricted to general supportive measures. To rule out a central anticholinergic syndrome, an anticholinesterase drug (physostigmine) was administered but remained without therapeutic effect. CONCLUSIONS: The presented case is the first report of a life-threatening intoxication after M ingestion primarily caused by Met-1. It supports the significance of this metabolite for the toxic effects of the drug. A toxicological screening test based on ELISA proved helpful due to its cross-reactivity with metabolites. In cases similar to ours, resin haemoperfusion may be indicated to remove the metabolites despite low detectable concentrations of the parent substance in the serum.

Adult↗
PubMed1995

Anti-tumour therapy in paraneoplastic neurological disease.

Paraneoplastic neurological syndromes have attracted attention in recent years. Detection of auto-antibodies directed against CNS and PNS structures have suggested an autoimmune etiology. This review is based on reports from the past 10 years and summarizes the therapeutic results in 258 patients suffering from paraneoplastic neurological disease including paraneoplastic encephalomyelitis, sensory neuronopathy, cerebellar degeneration, motor neurone disease and stiff man syndrome. The results show that in some entities such as Lambert-Eaton syndrome successful treatment can be expected. In other syndromes such as subacute sensory neuronopathy or paraneoplastic cerebellar degeneration therapeutic success varies from 5 to 10%.

Antineoplastic Agents↗
PubMed1995

Diaphragmatic paresis in newborns due to phrenic nerve injury.

Phrenic nerve lesions as a result of birth trauma have been reported as a cause of acute respiratory distress infrequently. We report recent diagnostic and therapeutic experiences in four newborns with birth-traumatic phrenic nerve injury: one bilaterally, and three unilaterally, all right-sided. In each case, mechanical ventilation was required for at least 16 days. Ultrasound examination of the diaphragm and phrenic nerve conduction studies turned out to be the diagnostic methods of choice. Spontaneous recovery occurred in two children and two became asymptomatic after operative treatment. One improved after plication of diaphragm and one after autologous nerve transplantation.

Birth Injuries↗
PubMed1995

Phrenic neuropathy in chronic renal failure.

BACKGROUND: Peripheral neuropathy and alterations in diaphragmatic muscle function are frequently caused by uraemia. Phrenic nerve function in patients with end stage renal failure, however, has not been examined to date. METHODS: An electrophysiological study of the phrenic nerve was performed to determine its possible involvement in 32 nondiabetic patients with end stage renal disease undergoing chronic haemodialysis. RESULTS: Seventeen patients had electrophysiological signs of peripheral neuropathy in at least one of the investigated nerves and 14 of the 17 showed pathological phrenic nerve latencies. Delayed phrenic nerve latencies correlated clearly with pathological peroneal nerve conduction velocities. CONCLUSIONS: Phrenic neuropathy is a frequent complication of uraemia.

Adolescent↗
PubMed1995

[Dermatomyositis: successful therapy with high dosage intravenous 7S immunoglobulins].

This report describes the successful administration of high dose, intravenous 7S immunoglobulins (IG) to an 11 year-old girl with corticosteroid-resistant dermatomyositis. Clinical symptoms improved immediately and the pathological laboratory findings normalized within 10 days of commencement of immunoglobulin therapy. After three cycles of IG the patient showed complete remission of the muscular and dermatological findings. On follow-up examination after one year the patient remained symptom-free in the absence of any therapy and was leading a normally active life. The efficacy of IG therapy in this case is reviewed in the light of the literature.

Child↗
PubMed1995

[Paraneoplastic neurologic syndromes. Classification and diagnosis].

Paraneoplastic neurologic syndromes may be the presenting symptoms of cancer or appear during the course of the disease. Current knowledge of paraneoplastic syndromes is discussed on the basis of Henson and Urich's classification. The recognition of antineuronal antibodies in some neurologic paraneoplastic syndromes has had an impact on diagnostic possibilities. Additionally, there are new considerations relating to pathogenesis and therapy. Although the value and diagnostic yield of antineuronal antibodies are the subject of major discussion, they are already of significant diagnostic value in the diagnosis of paraneoplastic neurologic syndromes.

Autoantibodies↗
PubMed1995

[Inflammatory demyelinating neuropathy in neuroborreliosis].

A patient with acute onset of radicular pain developed an asymmetric neuropathy within a few weeks. Neurophysiology and nerve biopsy findings revealed a demyelinating neuropathy. Cerebrospinal fluid showed mild pleocytosis, increased protein levels and elevated antibody titers against Borrelia burgdorferi suggesting Lyme neuroborreliosis. Although peripheral nervous system complications of Lyme borreliosis are common, the association with chronic demyelinating neuropathy has not been described before.

Antibodies, Bacterial↗
PubMed1995

[Neurosyphilis. A case report and review of the literature on differential neuroborreliosis diagnosis].

A 35-year old man was presented with organic psychosyndrome. Anamnestic reports informed about changes in his behaviour like loss of interest, reduced concentration and short-term-memory loss within the last 2 years. The practicing psychiatrist diagnosed a depressive syndrome in conjunction with a borderline syndrome and administered antidepressive and neuroleptic therapy. Specific serologic tests were not done. Neurologically, there was a picture of influent and slurred speech, and ataxic gait. Muscle tonus was normal, muscle reflexes were of the same diminished intensity on both sides. The psychic status revealed a person mostly oriented in time, location and situation but with severe disorders of recognition, concentration, and memory. Laboratory diagnosis proved the suspected diagnosis of neurosyphilis. Additionally, there were antibodies to Borrelia burgdorferi (Bb) in serum and CSF and a positive CSF/serum index of 9.0 (threshold: 1.9). The neuroradiologic examination (CCT, NMR, SPECT) showed an intense, diffuse, frontotemporal atrophy of the cortex. By NMR, massive gliosis was found in both hippocampi. Angiographically, an aneurysma (1 cm in diameter) of the medial cerebral artery was demonstrated. Specific treatment was performed with Na penicillin (5 Mio. i.v./4 h over 21 days). No remission could be achieved.

Adult↗
PubMed1994

Intravascular lymphomatosis: a clinicopathological study of three cases.

In patients with intravascular lymphomatosis (IL) a broad spectrum of neuro-psychiatric disorders including dementia, focal neurological signs and seizures has been reported. Clinical diagnosis is difficult since neuroimaging findings are nonspecific. The clinical histories, biopsy and autopsy findings of three patients with IL, one with brain biopsy, are described. Two of them presented with rapidly progressive, fluctuating dementia. The third patient suffered from seizures followed by aphasia. Histology revealed large-cell lymphoma of the B cell type. The prognosis of IL, in general, is poor.

Aged↗
PubMed1994

A noninvasive functional evaluation following peripheral nerve repair with electromyography in a rat model.

A new bipolar surface electrode array was designed and constructed for a noninvasive "closed" functional evaluation with electromyography following sciatic nerve transection in a rat model. This "closed" method was compared with a conventional one-shot "open" measurement. Nerve conduction velocity and distal latency were calculated. Data obtained from the recordings from different animals as well as from the same animal at different points in time yielded excellent reproducibilities. There is no difference in the mean values whether nerve conduction velocity and distal latency are obtained by "closed" or "open" measurements. Correlation was significant (p < 0.01; rNCV = 0.77, rDL = 0.63) between these two methods. The results lead to the conclusion that the noninvasive functional evaluation with the parameters of nerve conduction velocity and distal latency introduced in the present study could be employed as a reliable method for serial functional evaluations following nerve transection in a long-term study in a rat model.

Animals↗