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At least 541 records · Page 30Linked to original sources
PubMed2005

[The role of evoked potentials in neurological clinical practice].

The author provides an overview on the value of evoked potential (EP) methods (VEP, SEP, BAEP, MEP) in the diagnosis and follow-up of various neurological diseases (multiple sclerosis, cerebrovascular disorders, degenerative diseases, coma, epilepsy, migraine) by reviewing the literature supported by his own clinical experience. While in the past EP was mainly used for establishing the diagnosis, recently, with the expansion of neuroradiology, it has gained a wider use in the assessment of the severity and extent of the pathologic process and especially in longitudinal follow-up. Its role in the diagnostic phase has diminished. In patients with multiple sclerosis the abnormality of the evoked potentials correlate better with the clinical state than with the MRI results. The method is also suitable to monitor the response to therapy. The importance of the EP tests is illustrated by several case demonstrations.

Brain Death↗
PubMedDate not supplied

[A comparison of the data from otoneurological and computed tomographic examinations performed in the acute period of severe craniocerebral trauma].

Comparison of the otoneurological symptoms and the results of computed tomography (CT) showed that these methods of examination often differed in the information concerning the degree of local and stem manifestations. Otoneurological examination detects very clearly the stem vestibular signs (primary and secondary), while it fails to detect the focal hemispheric disorders due to impaired consciousness of the patients and predominance of stem symptoms. In contrast, CT determines very distinctly focal affections in the cerebral hemispheres (hematomas, contusion) but sometimes does not reveal a pathological condition in the stem parts of the brain. Comparison of the CT and the otoneurological findings made it possible to explain the pathogenesis of some vestibular symptoms, deficit of the caloric nystagmus rapid phase in particular. Diffuse brain edema, which was detected by CT, was attended otoneurologically by deficit of the rapid phase of the caloric nystagmus or by vestibular areflexia. Diffuse edema of one of the cerebral hemispheres is marked with deficit of the rapid phase of the caloric nystagmus only in one direction, in the other direction this nystagmus is of a phase character but tonic. Comparison of the results of CT with the otoneurological symptoms allows the different role and significance of each method in the acute period of craniocerebral trauma to be ascertained. These methods of examination supplement one another because they reflect different aspects of the complex processes taking place in craniocerebral trauma.

Acute Disease↗
PubMed1989

[Clinical examination of the comatose patient].

The clinical examination of a comatose patient may be divided into neurological ang general. The neurological examination aims at determining all that is proper to the state of coma, its complication, whatever they origin (mostly cerebral oedema and herniation) and its focal signs. As for the coma itself, one may distinguish between disorders of consciousness or perceptivity and disorders of wakefulness. Specific reactivity and reactivity to pain. This must be combined with a study of muscle tone (reactions in flexion and extension, reflexes). Reflexes of the brain stem, nowadays better known, provide for a better assessment of severity and a better evaluation of tiered suffering. Vegetative symptoms, including respiration, cardiovascular system, temperature, trophicity, sphincteral function, must be studies in all comas. The classification of comas into stages of severety and the relevant scores (Glasgow, Liège) must be known with their advantages and limitations. The general clinical evaluation, including past history and associated signs, may suggest an aetiological diagnosis and point to the necessary paraclinical explorations.

Coma↗
PubMed1989

[Surgical treatment of patients with cranio-cerebral trauma and the role of neurological symptoms in the prognosis of its outcomes].

Under examination there were 411 patients with cranio-cerebral traumas. A unified method was used at different medical institutions in order to study questions of prognosis of the outcomes. Surgical treatment was used in 117 of them. The investigations have shown that the state of trance-coma both before operation and in the postoperative period is absolutely unfavourable prognostically. The state of trance-coma and the value of 15 scores and less should be taken into consideration as a contraindication for the solution of the question of operation in patients with cranio-cerebral traumas.

Adult↗
PubMed1997

The treatment of stupor associated with MRI evidence of cerebrovascular disease.

OBJECTIVE: To describe the treatment and outcome of organic stupor associated with MRI evidence of cerebrovascular disease. DESIGN: A case series of three patients. SETTING: An urban mental health of the elderly service in southeast London. PATIENTS: Aged 69 years, 72 years and 78 years. Two had organic catatonic disorder and the third organic depressive disorder. INTERVENTIONS: Diazepam, carbamazepine, antidepressants or electroconvulsive therapy (ECT). MAIN OUTCOME MEASURES: Resolution of symptoms and discharge from hospital. RESULTS: Symptoms resolved between 1 and 10 days. All patients were able to return home but relapsed over the following 12 months. One relapse occurred when a patient stopped diazepam and moclobemide. CONCLUSIONS: It is proposed that the initial treatment of organic stupor associated with cerebrovascular disease should include a benzodiazepine or carbamazepine. If patients fail to respond then ECT should be considered. The safety of ECT is not known, when treating patients with depressive disorder associated with cerebrovascular disease.

Aged↗
PubMedDate not supplied

[Indications for surgical treatment of hypertensive intracerebral supratentorial hematomas].

The retrospective analysis comprised 26 operatively and 28 conservatively treated patients with hypertensive intracerebral supratentorial hematomas (HISH). According to indications for surgical treatment the patients were divided into three groups. The first group included patients with milder disorders of consciousness, slight neurological deficit and intracerebral hematomas less than 50 ccm. The second group included patients with more severe disorders of consciousness, marked neurological deficit and intracerebral hematomas larger than 50 ccm. The third group included patients with severe disorders of consciousness at the level of coma and decortication or decerebration phenomena. The results of surgical treatment are significantly better compared to conservative treatment (42,3%:14,3%).

Adult↗
PubMed1991

[Wernicke-Korsakoff syndrome at the Rikshospitalet in 1979-1988. A retrospective study].

Wernicke encephalopathy and Korsakoff psychosis are two facets of the same disease with well-determined cerebral lesions caused by thiamine deficiency. The disease occurs mainly in alcoholics, but other conditions (malabsorption or severe malnutrition) also predispose to the risk of Wernicke-Korsakoff syndrome. The incidence in Denmark is unknown. In the period 1.1.1979-31.12.1988, 24 patients (18 men and six women) were discharged from Rigshospitalet with the diagnosis Wernicke encephalopathy or Korsakoff psychosis. This represents about 0.05% of all admissions in the period. Eighteen out of the 24 cases (75%) were admitted in the past three years (1986-88). The mean age was 55 years. Twenty patients admitted alcohol abuse. The presenting symptoms and the patients' complaints showed great variety and were often related to other alcoholic complications, which could mask the disease. The classic symptom combination: eye movement abnormalities- ataxia and disorders of consciousness were found in seven patients (29%). Sixteen patients had disorders of consciousness or orientation. All the patients were treated with thiamine. The eye-movement disorder has recovered in eight out of ten known cases (80%), nystagmus--in six out of seven cases (86%) while ataxia, disorders of orientation and confabulation recovered in about 50% of cases. The average duration of hospitalisation was 50 days. Altogether nine patients died during the observation period. The condition is most probably underdiagnosed and the traditional diagnostic criteria are considered too rigid. The diagnosis should be considered in alcoholics who present even only one of the classical symptoms and in patients with alcohol dementia. Thiamine should be given on wide indications.

Adult↗
PubMed1993

[Depersonalization as a developmental disorder of self-consciousness].

The comparison of psychopathological and age characteristics of depersonalization was made for 114 schizophrenic patients. It has been concluded that depersonalization syndrome may be viewed as a developmental or dysontogenetic disorder of self-consciousness. In the majority of the cases depersonalization arises in adolescence which is the most critical period in the development of self-consciousness. Typical psychopathological features of depersonalization correspond to typical features of puberty identity crisis.

Adolescent↗