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At least 703 records · Page 39Linked to original sources
PubMed1996

[Forensic psychiatric expertise in brain tumors].

The patients with brain tumors are quite rare in forensic-psychiatric practice. The authors observed only 21 cases during 25 years (that is 0.05% from all the persons subjected to the forensic-psychiatric examination). The tumors were revealed in 11 patients during examination; 10 patients underwent forensic-psychiatric examination after operation for brain tumor. There were different mental disturbances of various degree in such patients: disorders of memory, emotional instability, impulsivity, disorders of consciousness, phenomena typical for epileptiform syndrome, and other disorders. 16 patients were characterised as irresponsible ones. The supervision of neurologist and psychiatrist was recommended in all cases.

Adult↗
PubMed1998

[Swallowing changes in cerebrovascular accidents: incidence, natural history, and repercussions on the nutritional status, morbidity, and mortality].

OBJECTIVE: To determine the frequency of dysphagia in CVA, its natural history and value as a risk factor of respiratory infection, malnutrition and death. PATIENTS AND METHODS: A prospective study was made of 187 consecutive patients with cerebrovascular accidents (CVA). A standardized test for dysphagia was done during the first two days of the illness and repeated three days a week. The levels of urea, total proteins and albumin were determined on admission and on discharge. The patients were questioned by phone after 6 months. RESULTS: There was dysphagia of liquids in 36.4% of the patients. The incidence of dysphagia for semisolids was of the same frequency but more severe. Coma was the cause of inability to swallow in 25.7% of the patients. During their stay in hospital one third of the patients with dysphagia died, one third became normal and one third still had dysphagia when they were discharged. After one week, one, three and six months respectively, the cure rate for dysphagia was 29.4%, 4.1%, 55.9% and 55.9%, and survival 83.8%, 67.6%, 61.8% and 60.3%. Thus after 6 months only 3 patients (4.4%) were alive and dysphagic. Half of the 'cures' occurred in the first week, and none occurred after more than 77 days. As compared to the non-dysphagic patients, the dysphagic patients had 10 times more risk of respiratory infection, 18 times higher risk of death, greater loss of albumin and less loss of urea. CONCLUSIONS: There is a high prevalence of dysphagia in CVA and although functional prognosis is not unfavorable, respiratory infections, malnutrition and death are frequent.

Adult↗
PubMed2004

Mania as a dysfunction of reentry: application of Edelman's and Tononi's hypothesis for consciousness in relation to a psychiatric disorder.

The concept of reentry as the most important element in a hypothesis for consciousness proposed by Edelman and Tononi is reviewed. Reentry, is a process of ongoing parallel and recursive signalling between separate neuronal groups along parallel reciprocally fibers that link these groups anatomically. Reentry alters the activity of the target areas it interconnects until a synchronous activity across these areas is created, this may be the direct biological mechanism of consciousness. The repetitive process of reentry may explain how the millisecond time scale of neural signalling is turned into the time scale of seconds characterizing our impression of the duration of a given content of consciousness. It is suggested that reentry may be faster in mania, and specifically that the repetitive recursive signalling is faster in mania, hereby allowing reentry to produce a conscious state, faster than usual. Faster reentry may on a molecular level be caused by faster propagation of nerve impulses, which may be in accordance with a number of hypotheses where mania is seen as a disorder of ionic conductance, nerve cell excitability, action potential firing, membrane abnormalities, and cortical instability. Also the antiepileptic drugs used to treat mania may point to reentry as a factor in this disorder. On a more integrated level faster reentry processes may explain several of the core symptoms of the manic state. Also the drug induced switch from depression to mania in bipolar patients may be explained by the concept of reentry.

Bipolar Disorder↗
PubMed1984

[Various principles for evaluating the prognosis in epilepsy].

The principles of the prognostic evaluation in epilepsy are suggested. Since the concept of prognosis is complex and multifacet it is advisable to differentiate its clinical aspect (including the prognosis of paroxysmal, psychic, neurologic and other manifestations of the disease) and the social one (occupational, familial, and social). The correlation of these factors considered from the viewpoint of a dynamic approach determines the course and the prognosis of epilepsy as a whole. The degree of the patient's clinical and occupational compensation serves as one of the major criteria of the assessment of the disease course and prognosis. Clinical and social criteria taken as a whole permit a comprehensive qualification of the prognosis of epilepsy. The above principles may be applied to other mental disorders as well.

Consciousness Disorders↗
PubMedDate not supplied

[Capsulo-thalamic hemorrhage (author's transl)].

The authors report clinical and scanographic findings in 26 cases of capsulo-thalamic hemorrhage. They stress the frequency of arterial hypertension as a pre-disposing factor. The clinical picture is represented by the association of disorders of consciousness (usually obnubilation), contralateral flaccid hemiplegia with hemianesthesia, oculomotor disorders (disturbance of vertical gaze, miosis) and disorders of linguistic and motor behaviour. The paraclinical examination of choice is scanography which enables the site, volume and extent of the hemorrhage to be estimated, together with the mass effect and intraventricular rupture. Clinical and scanographic follow-up indicates a favourable prognosis for capsulo-thalamic hemorrhage (77% survival). Follow-up findings point to several unfavourable prognostic factors: immediate coma, persistent and massive flaccid hemiplegia, hemorrhage size exceeding 3 cm, and severe intraventricular rupture. In the light of the data in the literature, the authors discuss the clinical and scanographic signs of capsulo-thalamic hemorrhage.

Aged↗