[Tilidine (Valoron R) abuse and delirium in chronic neurologic pain syndromes. A case report from the neurologic-psychiatric viewpoint].
Explore the source record for details and available documents.
Cyclohexanecarboxylic Acids↗
SEARCH · Search PubMed
Results for “Neurology”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Problem solving in diagnostics and therapeutics of neurology. Treatment of patients with (neurological) disease.
Explore the source record for details and available documents.
Chronic Disease↗
The effects of methylphenidate on the soft neurological signs of hyperactive children.
The neurological examination of many hyperactive children reveals the presence of abnormal neurological signs. Of 40 hyperactive children who had three or more neurological abnormalities on an initial neurological evaluation, 29 (72.5%) showed marked improvement or complete resolution of the neurological signs following treatment with methylphenidate hydrochloride (Ritalin) for 60 days. The administration of placebo did not change appreciably the neurological status of 20 hyperactive children. Improvement in behavior, which was ascertained by the use of Conners' Abbreviated Teacher Rating Scale, did not always correspond with resolution of the abnormal neurological signs. This finding suggests that methylphenidate affects behavioral and motoric functions separately and independently. Repeat neurological assessment, looking for resolution of abnormal neurological signs, should be included as part of the follow-up medical examination in treated hyperactive children. Coupled with other objective and subjective test information, improvement of the neurological status provides supportive evidence of overall improvement in the hyperactive child who is receiving drug therapy.
Child↗
The neurological complications of cardiac transplantation.
Review of the neurological complications encountered in 83 patients who received cardiac homografts over a seven-year period leads to the following conclusions: (1) Neurological disorders are common in transplant recipients, occurring in over 50 per cent of patients. (2) Infection was the single most frequent cause of the neurological dysfunction, being responsible for one-third of all CNS complications. (3) The infective organisms were typically those considered to be usually of low pathogenicity: fungi, viruses, protozoa and an uncommon bacterial strain. (4) Other clinical neurological syndromes were related to vascular lesions, often apparently from cerebral ischaemia or infarction occurring during the surgical procedure, metabolic encephalopathies, cerebral microglioma, acute psychotic episodes and back pain from vertebral compression fractures. (5) The infectious complications and probably the development of neoplasms de novo, are related to immunosuppressive therapy which impairs virtually all host defence mechanisms and alters the nature of the host's response to infective agents or other foreign antigens. (6) Because neurological symptoms and signs were usually those of behavioural changes or deterioration in intellectual performance, the neurological examination was often of little value in diagnosing the nature or even the anatomical site of the neuropathological process. (7) The possibility of an infectious origin of the neurological manifestations must be aggressively pursued even in the absence of fever and a significantly abnormal spinal fluid examination. The diagnostic error made most frequently was to ascribe neurological symptoms erroneously to metabolic disturbances or to "intensive care unit psychosis" when they were in fact due to unrecognized CNS infection. (8) Maintenance of mean cardiopulmonary bypass pressures above 70 mmHg, particularly in patients with known arteriosclerosis, may reduce operative morbidity. (9) Though increased diagnostic accuracy is possible with routine use of a variety of radiological and laboratory techniques, two further requirements probably must be met before a significant reduction in the frequency of neurological complications will occur: the advent of greater immunospecificity in suppressing rejection of the grafted organ while preserving defences against infection; and a more effective armamentarium of antiviral and antifungal drugs.
Adolescent↗
Neurological recovery distal to the zone of injury in 172 cases of closed, traumatic spinal cord injury.
The Southwest Regional System for Treatment of Spinal Cord Injury (Good Samaritan Hospital and St Joseph's Hospital, Phoenix, Arizona) treated 325 cases of traumatic spinal cord injury during the period June 1970 through December 1975. Of these, 172 met the study population criteria of the cases reported by Frankel et al. (1969) in their paper 'The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia'. These cases are compared with those reported by Frankel et al. (1969). Cases were divided into neurological categories. The demography of the two study populations was amazingly similar as was the neurological results. The means for the reported neurological changes show that the average recovery for patients treated at Stoke Mandeville was slightly greater for each neurological category; however, this difference was statistically significant only for cervical cases (P less than 0.01). One of the differences in the treatment given by the two centres was that the Southwest Regional System performed surgery on 39% of its cases and Stoke Mandeville none. The Southwest Regional System's non-operated cervical cases showed less average neurological recovery than Stoke Mandeville cervical cases (P less than 0.001). Comparison between the Southwest Regional System non-operated cases and operated cases revealed no significant differences within any neurological category. The average neurological change reported by both centres was relatively small, documenting that from the onset of injury the majority of people sustaining spinal cord injury are committed to living with paralysis, in most cases severe, for the rest of their lives.
Arizona↗
Neurological education of nonneurologists.
In 1975, the Joint Commission of Neurology, created by the American Academy of Neurology and the American Neurological Association, published its report including recommendations on neurological education. Commission data indicated that although neurologists constitute less than 1% of all physicians, at least 5% of all ambulatory patients and 13% of all hospitalized patients had primary or secondary neurologic diagnoses, or both. Thus, the commission recommended a major effort in the education of general physicians in neurology. That advice is apparently being ignored. This situation poses a serious health care problem and urgent steps are indicated to reverse this trend.
Education, Medical↗
Identification of specific neurological disorders using double discrimination scales derived from the standardized Luria neuropsychological battery.
The Standardized Luria-Nebraska Neuropsychological Battery has been validated in a number of studies and has shown its effectiveness in making basic neuropsychological discriminations. A major advantage of this battery, compared to other test batteries, is its structure. The test consists of 269 separate items, each of which is designed to measure a different neuropsychological skill. As a result, these items can be combined in a number of ways to form scales aimed at specific neurological processes. It is the purpose of the present study to investigate whether or not the Luria Battery can be successful in discriminating specific neurological disorders by the development of what is termed "double discrimination scales." Using this process, two scales are established to diagnose any given neurological process. The first represents items in which the patients with a specific disorder do worse than a general neurological control group while the second scale represents items in which the patients with a neurological disorder do better than the general neurological control group. For a patient to be diagnosed as having a given process, the patient must score in the proper range on both scales. This method was applied to a sample of 24 multiple sclerosis patients who were compared with 74 patients diagnosed as normal, 106 psychiatric patients, and 101 brain damaged patients. Using the double discrimination procedure, the accuracy of identification of 100% was achieved in all groups. The study supported the usefulness of the double discrimination approach with the Standardized Luria Neuropsychological Battery and opens up the possibilities for scales to be developed for a wide variety of diseases in specific lateralized disorders.
Adult↗
Neurological evaluation of the newborn.
The neurological examination is an integral part of the evaluation of the newborn infant. In too many instances the infant is dismissed from the nursery as 'normal' when,in fact, little or no effort has been expended to determine the body's neurological status. The neurological deficits overlooked often do not become overt until a much later age. Early detection can prevent the mental anguish that plagues the parents who must be told that their 'normal' infant has significant neurological problems. In some instances early diagnosis may lead to a better ultimate prognosis. We have presented a simple scheme for the neurological evaluation of the full-term infant and hope that it will be useful in encouraging pediatricians to assess neurological status.
Cephalometry↗
Concepts in undergraduate neurological teaching.
Common neurological problems in family practice were determined to assess what knowledge of neurology is essential to the graduating medical student. The family practitioner's difficulties in managing these problems and needs for referral, were studied. Types of problems seen in a teaching hospital neurology service were also examined. Neurological problems are important if they are common, require therapy, or demand emergency management. However, dealing with these problems family practitioners report considerable difficulties. An approach to medical training is outlined in an effort to assist future physicians in handling the neurological problems of daily practice with competence and confidence.
Canada↗
Neurology pioneers in Japan.
The pioneers of neurology in Japan were professors Hiroshi Kawahara and Kinnosuke Miura. Kawahara published the first description of progressive bulbar palsy and wrote the first neurology textbook in Japan. Miura, on the other hand, published studies about amyotrophic lateral sclerosis, in addition to participating in the founding of the Japanese Society of Neurology. The influence of European neurology, particularly French and German, in the figures of Professor Jean-Martin Charcot and Professor Erwin Bälz, was fundamental in the consolidation of neurology in Japan.
Japan↗
Numerical grading of clinical neurological status after serious head injury.
A scheme to quantitate the clinical neurological status of the seriously head-injured patient has been devised. The neurological parameters used to quantify the degree of injury are based on neurological functions which have previously been accepted as indicators of the severity of the head injury. A numerical value is assigned to each parameter with emphasis on defining the level of consciousness. The accrued point total of each examination represents the neurological status of the patient at that time. Mean values and standard error from the means are determined from repeated examinations during a single 24 hour period, and are plotted against days after injury. From this graph a line which represents the rate of clinical recovery is determined by least squares analysis. General intensive care nurses were trained to score patients independently; their determinations were found to be in statistical agreement with scores derived from examinations by the attending physicians. The data presented highlight the effects of hypoxaemia in impeding the rate of neurological recovery from a serious head injury. This simple clinical analytical scheme for the quantitative assessment of patients with head injury permits evaluation of the efficacy of various modes of therapy in altering the rate of recovery.
Adult↗
The neurological deficit associated with sudden occlusion of abdominal aorta due to blunt trauma.
A review of the literature revealed five well-documented cases of abdominal aortic injury due to blunt, nonpenetrating trauma. An additional case report is offered. In all cases the level of aortic injury was at or distal to the origin of the inferior mesenteric artery. In five of these reports, including the present case, sudden traumatic occlusion of the distal abdominal aorta occurred and led to associated neurological deficit. The authors submit, based on clinical manifestations, selective angiography of spinal cord vasculature, and the operative experience of others, that these neurological deficits resulted from acute peripheral nerve ischemia and not from spinal cord ischemia as had been assumed in the past. The final neurological deficit due to acute peripheral nerve ischemia may masquerade as that seen with a "transverse" spinal cord lesion. However, the prognosis for recovery of neurological function differs markedly between the two conditions. All surviving patients experienced rapid resolution of their neurological deficits in the immediate postoperative period. Infrarenal aortic occlusion will not produce spinal cord infarction.
Abdominal Injuries↗
Neurological assessment of the hemiplegic patient.
There are more and more situations where nursing is responsible for ongoing assessment of the functioning of the hemiplegic patient who has been discharged from an acute care setting. The goal of the neurological assessment in the primary care setting is to determine the ability of the hemiplegic patient to perform activities of daily living. The objectives of this paper are to: 1) suggest a guideline for neurological examination of the hemiplegic patient in seven functional areas. The purpose is not to describe the total neurological examination, but rather to focus on the examination of pertinent neurological areas that provide data about the functioning of the patient; 2) outline potential problems derived from pertinent neurological findings in these seven areas; 3) discuss general implications these problems have for the nurse to assist the hemiplegic patient and his family, optimizing his potential. No attempt will be made to discuss details of nursing intervention.
Hemiplegia↗
Neurologic disorders following surgery for peptic ulcer disease.
The neurologic status of 2,000 veterans who had had surgery for peptic ulcer between 1952 and 1957 was evaluated. In 1970, a total of 156 of these men were examined, 97 of whom had procedures that disrupted the normal continuity of the upper gastrointestinal tract. Twenty-one had neurologic disorders, including 17 patients with peripheral neuropathies. Procedures bypassing the ampulla of Vater were performed in 15 of these. The only detected factor associated with neurologic manifestations was weight loss since surgery. A mortality study of the total population revealed 865 patients had died by the end of 1973. There were seven deaths attributed to neurologic causes, one in a patient with amyotrophic lateral sclerosis and one in another with spinal paralysis. All seven were among the 70% of the deceased who had had surgery that disrupted the continuity of the upper gastrointestinal tract. Thus, we conclude that the type of surgery influenced the likelihood of neurologic complications, but at least for motor neuron disease, the increased risk was not appreciable.
Adult↗
Carotid artery rupture. Management and prevention of delayed neurologic sequelae with low-dose heparin.
Carotid artery ligation, whether elective or an emergency, is an operation that most head and neck surgeons do with some trepidation because of the possible neurologic consequences. Of 440 major head and neck operations for cancer in which the carotid artery was exposed, 20 (4.5%) patients suffered a carotid rupture or had the vessel ligated just prior to rupture. We describe the typical patient and his management. Of these 20 patients, five died as a direct result of rupture or ligation, ten survived rupture and/or ligation with neurologic sequelae, and five survived rupture and/or ligation without neurologica sequelae. Of the ten patients with neurologic problems, four had immediate strokes, and six had delayed strokes, ie, these occurred greater than eight hours after ligation. Seven patients who required carotid artery ligation, separate from the previously mentioned group, received 5,000 units of heparin sodium subcutaneously every 12 hours in a prospective study. Of these seven patients, one died immediately postoperatively, and six survived without any neurologic sequelae. We discuss the cause of delayed neurologic problems and the rationale for the use of low-dose heparin.
Carotid Artery Diseases↗
A genome-wide analysis of the shared genetic risk architecture of complex neurological and psychiatric disorders.
Although neurological and psychiatric disorders have historically been considered to reflect distinct pathogenic entities, recent findings suggest shared pathophysiological mechanisms. However, the extent to which these heritable disorders share genetic influences remains unclear. Here we performed a comprehensive analysis of genome-wide association study data, involving nearly 1 million cases across ten neurological diseases and ten psychiatric disorders, to compare their common genetic signal and biological associations. Using complementary statistical tools, we demonstrate that a large set of common genetic variants impacts the risk of multiple neurological and psychiatric disorders, even in the absence of genetic correlations. Furthermore, genome-wide association studies on psychiatric disorders consistently implicate neuronal biology, whereas neurological diseases are associated with diverse neurobiological processes. Together, this study elucidates the genetic relationship between complex neurological and psychiatric disorders, indicating a larger degree of genetic pleiotropy than previously recognized. The findings have implications for disease classification, precision medicine and clinical practice.
Humans↗
Comparison of cell-fusing activity of brain suspensions from patients with Creutzfeldt-Jakob disease and other degenerative neurological diseases.
In vitro cell-fusing activity of brain suspensions from 33 patients with transmissible cases of Creutzfeldt-Jakob disease (CJD) was compared to activity of brains from 26 patients with a variety of other degenerative neurological diseases, and with activity of brains from 25 patients without neurological disease. A significantly higher proportion of CJD brains (61%) was positive than other neurologically diseased brains (31-35%) or the brains without neurological disease (0-4%). Although not yet sufficiently specific to be useful as a diagnostic test for human CJD, the assay nevertheless opens a line of investigation into the pathophysiology of degenerative neurological diseases and could prove immediately useful in rapidly locating material of maximum interest in purification procedures for experimental spongiform encephalopathy virus.
Brain↗
Neurologic complications of bacterial endocarditis.
(1) Neurologic complications remain a significant problem in bacterial endocarditis. Of 218 patients with endocarditis, 84 (39%) had a neurologic complication and 58% of these 84 patients died. In contrast, the mortality rate was only 20% among those endocarditis patients without neurologic complications. (2) Of the neurologic complications, cerebral embolism is the most frequent and important. An embolic stroke occurred in 37 (17%) of our patients, with 30 of these patients dying. Emboli are important not only in terms of the direct morbidity and mortality they cause via cerebral infarction, but also because of their role in the causation of mycotic aneurysms, brain abscesses, and abnormal CSF formulae. (3) Cerebral emboli are particularly common in patients with mitral valve infection, and in patients with infection due to virulent organisms, particularly S. aureus and enteric gram-negative bacilli. (4) Mycotic aneurysms occur more frequently in the course of acute endocarditis rather than late in the course of subacute disease. Management of angiographically demonstrated mycotic aneurysms is dependent upon the presence or absence of hemorrhage, the anatomic location of the aneurysm, and the clinical course of the patient. Healing of mycotic aneurysms can occur during the course of effective antimicrobial therapy, thus obviating the need for neurosurgical intervention in all such patients. (5) Macroscopic brain abscess is a rare complication of bacterial endocarditis. Miliary microscopic abscesses are more common than larger abscesses, particularly in patients with acute disease and miliary infection in other organs of the body. (6) Focal seizures occur most commonly in endocarditis patients with acute embolic disease; generalized seizures are of diverse etiologies, with metabolic factors being most important. Penicillin neurotoxicity should be considered in patients with impaired renal function who are receiving high dose penicillin. (7) With the exception of hemorrhagic complications, lumbar puncture results tend to reflect the nature of the infecting organism rather than the nature of the neurologic complication. Endocarditis due to virulent organisms such as S. aureus is usually associated with a purulent CSF formula while nonvirulent organisms, such as viridans streptococci, susually have aseptic or normal CSF formulae.
Adolescent↗