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PubMed1983

[Benzodiazepines, alcohol and effects on vigilance].

It is evident, and has been confirmed by epidemiological and experimental data, that ingestion of alcohol can reduce alertness and disturb the concentration of drivers. However, there is still some confusion on this question, since it is impossible to predict what will be the exact level of alcoholemia following ingestion of a given quantity of alcohol, and because disturbances in alertness vary greatly from one individual to another for the same level of alcoholemia . The essential distinction between acute alcoholisation and chronic alcoholisation (due to notions of alcohol tolerance and dependance ) must also be taken into account. Similar difficulties exist in interpreting the relation between ingestion of benzodiazepines and vehicule driving, but they are further complicated by other factors, notably the large number of drugs. Of course, it is possible to show by laboratory experiments, that some benzodiazepines (dipotassium clorazepate, for example) do not disturb the concentration of drivers when given alone, in normal doses and for the recommended indications. But in reality, epidemiological data show that, statistically speaking, drivers taking benzodiazepines have a higher risk of accident than the average drivers. It would appear from this that, for a driver ingesting both alcohol and benzodiazepines, the risk of accident is greatly enhanced. It is also clear that the difficulties in interpreting this risk are multiplied. To summarize very briefly, it appears that there is potentiation when the two substances are ingested together in cases of acute alcoholisation (with an increase in benzodiazepine blood levels), and attenuation in cases of chronic alcoholisation (due to acceleration in clearance provoked by hepatic microsomial induction).

Accidents, Traffic↗
PubMed1982

[Disturbances of equilibrium in the aged].

The occurrence during the last year of vestibular disorders, faints and drop attacks was investigated in 150 patients consecutively admitted to a geriatric hospital. The clinical features of these episodes were recorded by means of a proper questionnaire. True vertigo and/or feeling of unstable equilibrium were referred by 54,6% of the patients inquired into, whereas episodes interpretable as faints and drop attacks showed by far lower prevalences, respectively 13,3% and 6%. The Authors call attention to the difficulties in differential diagnosis among these three kinds of phenomena in the current practice.

Aged↗
PubMed1984

Predicting recovery after acute stroke.

Patients, relatives, and doctors need to know the prognosis after acute stroke. In recent years, more scientific methods of predicting the level of recovery have become available.

Age Factors↗
PubMed1978

[Treatment of reactive stuporous states with L-DOPA].

The paper presents the results of L-dopa use for the treatment of patients with reactive stuporous states. The assumption concerning curability of these patients is based on the similarity of a number of their clinical and biochemical manifestations with an akynetic-rigid form of parkinsonism where L-dopa is very effective. From 25 patients with reactive psychoses 7 demonstrated recovery, 3 patients--significant improvement, 5 patients--improvement and 10 patients--absence of the effect. The drug is the most effective in the stuporous depth of psychomotor inhibition in persons with a monomorphic structure of stuporous syndromes, rather "frequent" depressive disorders and a decrease of a background level of dopamine excreation with urine. Use of L-dopa in schizophrenic stuporous states (5 patients) was ineffective.

Adult↗
PubMed1984

[Meningioma following irradiation for vascular nevus. A case report].

A case of meningioma that developed 37 years after irradiation therapy for vascular nevus of the scalp over the right frontoparietal region was reported. A 49-year-old male was admitted to the hospital of Gifu University on October 26, 1979, because of a generalized seizure. He had been born with a vascular nevus affecting the right frontoparietal scalp, for which he began receiving local irradiation at the age of 12. The total dose was not known because the only source of information regarding this treatment was the patient's memory. From the age of 17, the suffered from occasional attacks of dysesthesia in the left side of his body without consciousness disorder. He otherwise remained well for the intervening 37 years. Upon admission, he had a vascular nevus remaining with post irradiation skin changes over the right frontoparietal region. General and neurological examination were not remarkable. Right carotid angiogram and CT scan disclosed the presence of a right frontal tumor. A right frontotemporal craniotomy was performed on December 4, 1979 and a hard tumor was found firmly attached to the dura and bone at the right site. All visible tumor and involved bone were completely removed without difficulty. Histological examination of the surgical specimen showed the characteristic features of a transitional meningioma. There was no evidence of malignancy in the sections examined. Since Mann et al reported a malignant meningioma following irradiation therapy for optic nerve glioma, there have been many reports, over seventy cases of so-called radiation-induced meningioma. However, a meningioma following irradiation therapy for vascular nevus of scalp or face is exceedingly rare.(ABSTRACT TRUNCATED AT 250 WORDS)

Carotid Arteries↗
PubMed1980

[Twilight states in epilepsy].

A total of 82 epileptic patients with twilight states were studied. Such conditions were more frequently encountered in epilepsy due to neuroinfections and brain trauma. Twilight states, as a rule, appear after several years from the onset of the disease, when it was not treated or inadequately treated and indicate an unfavorable development of the epileptic process. It is desirable that twilight states be classified as developing rapidly and with a retarded course. In rapidly developing epileptic disorders the epileptic focus on EEG was more frequently seen in the temporal areas, while in protractd disorders it was seen in the subcortical and stem brain structures. Pneumoencephalography revealed pronounced scarry and cystoadhesive lesions. Twilight states should be differentiated with temporal psychomotor attacks by certain clinical signs.

Adult↗
PubMed1978

Iproclozide fulminant hepatitis. Possible role of enzyme induction.

The authors report the cases of 3 patients who died from fulminant hepatitis after receiving iproclozide, a hydrazine-containing monoamine oxidase inhibitor. Fulminant hepatitis in these patients resembled that reported in patients receiving other hydrazine-containing monoamine oxidase inhibitors: (1) the 3 patients were women; (2) the monoamine oxidase inhibitor has been ingested for 1 month or more; (3) the main clinical manifestations were jaundice and disorders of consciousness; (4) hypersensitivity manifestations were absent; (5) the predominant liver lesion was necrosis; (6) all 3 patients died. In our 3 patients, jaundice occurred 7 to 10 days after the adjunction to iproclozide of a microsomal enzyme inducer. These observations suggest that concomitant administration of iproclozide and of microsomal enzyme inducers may produce fulminant hepatitis in man. It is speculated that iproclozide could be, like iproniazid, transformed into a hepatotoxic metabolite, the production of which would be increased by microsomal enzyme induction.

Adult↗
PubMed1982

[The lucid interval in epidural hematoma].

On the basis of 191 patients with epidural haematomas in an observation period of 15 years, an analysis of the patient group with non-classical symptoms was carried out. The opinions and theories regarding the generation of long-lasting lucid intervals found in the literature are mentioned and discussed on the basis of 3 typical examples. Owing to improved examination methods and early recognition, the mortality rate of the patients with epidural haematomas could be reduced from 54 per cent in the years 1961 to 1965 to about 10 per cent in the years 1975 to 1980.

Adolescent↗
PubMed1982

[Use of the scanner in diagnosis and therapeutic surveillance of brain abscess].

Comparison from 102 cases of brain infections has been done between 2 periods: before and after 1978. The use of CT scan in routine since 1978 has not changed the number of patients diagnosed in acute phase (less than 15 days); but diagnosis was done before 2 days in 37% after 1978 and in 27% before 1978. However frequency of consciousness disorders is equal in both groups: 55%. By a semi-statistical analysis on 40 cases, 10 CT scan datas have been tested according to their sensibility and specificity to the diagnosis of brain abscess; 4 datas have a satisfying sensibility and specificity and are more accurate than the others: regularity of the shape, regularity of the enhanced ring; enhancement after injection, surrounding edema. Survey of 40 cases by CT scan has permitted to determine the average delay of disappearance of mass effect (20 days), of disappearance of the abscess (44 days) and the cicatricial aspects according to the treatment: puncture or excision.

Brain Abscess↗