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At least 829 records · Page 46Linked to original sources
PubMed1988

Erectile dysfunction in multiple sclerosis.

In a sample of 29 impotent men with multiple sclerosis and erectile problems, penile arterial inflow and venous outflow were within normal limits. In 26 patients, the pudendal evoked potential (PEP) was abnormal, and eight of these also had abnormal bulbocavernous reflex (BCR). Three patients had abnormal PEP and normal BCR, and of these, two had normal and one had abnormal nocturnal erectile activity. The validity of PEP/BCR testing was supported by normal findings in six patients with MS and without erectile problems. Nocturnal erectile activity was normal in 11 patients, of whom nine had abnormal PEP and/or BCR. A high disability score corresponded poorly with both reduced sexual function, insufficient nocturnal erectile activity, and abnormal PEP and/or BCR. Intracavernous injection of papaverine gave erection in 27 patients, the dose needed to create an erection being inversely related to the level of disablement. PEP and BCR testing may be more sensitive in defining neurogenic erectile dysfunction (ED) than nocturnal erectile activity. We considered 26 of the cases to have a neurogenic cause of ED and three to have mainly a psychogenic cause.

Adult↗
PubMed1993

Ataxia and areflexia in SOAA.

Fifteen patients with the classical syndrome of ophthalmoplegia, ataxia, and tendon areflexia (SOAA) were studied in an attempt to clarify the mechanisms of ataxia and myotatic hyporeflexia. All showed features of cerebellar rather than sensory ataxia. Peripheral nerve conduction studies, including F-waves, were normal in a majority of the patients, as was needle EMG. Low-amplitude compound sensory nerve potentials were seen in four patients only, and mild slowing of sensory conduction velocity in two. Three had abnormal blink reflex studies, suggestive of a central lesion in two, and another two showed a transient delay of N5 peak of brainstem auditory evoked potentials. Somatosensory evoked potentials were normal. Despite clinically depressed or absent tendon jerks, T-waves were elicited at normal latencies. These findings do not support the prevailing view that the neurological abnormalities in SOAA are due to involvement of sensory fibres in the peripheral nerves and dorsal roots. We suggest that lesions scattered in the brainstem tegmentum and in the cerebellar peduncles are responsible for the ataxia and the depressed tendon jerks.

Adolescent↗
PubMed1987

Early prediction of outcome following head injury in children.

A retrospective survey of 166 children aged 15 years or less was made in an attempt to identify which clinical features presenting in the first 24 hours after a head injury might be helpful in predicting the eventual outcome as defined by the Glasgow Outcome Scale. In 88% of the children, the trend of Glasgow Coma Scale score over the first 24 hours was useful. This included children admitted with a score of 3 or 4 and those with a score of 5 or more who did not deteriorate within 24 hours of injury. In this group only 2% of the predictions would have been inaccurate and in only 0.7% would the outcome have been worse than the prediction. The presence of both abnormal plantar and pupillary light reflexes predicted death or significant disability in 99% of cases.

Adolescent↗
PubMed1984

Serum vitamin E levels in children with corrected biliary atresia.

In 37 children with long-standing cholestasis who had undergone a Kasai's procedure (double Roux-en-Y hepatic portoenterostomy), serum vitamin E levels were determined. In addition, serum bile acid levels were simultaneously tested as a marker of cholestasis. Eighteen of 37 children had vitamin E levels of less than 0.50 mg/100 ml, and two showed neurological abnormalities including hypoactive deep tendon reflexes and ataxia. Serum vitamin E levels were inversely correlated with serum bile acid levels (p less than 0.01). Older patients have mild cholestasis and high serum vitamin E levels in comparison with younger ones. Improvement in bile excretion into the intestinal tract with age seemed to be responsible for an increase of serum vitamin E levels. Oral supplements of alpha-tocopherol in doses of 5 to 10 mg/kg/day were needed to maintain the normal serum vitamin E levels in postoperative infants.

Ataxia↗
PubMed2002

Novel mechanisms of sympatho-excitation in chronic heart failure.

Chronic heart failure (CHF) is associated with an increase in the production and secretion of various regulatory hormones that are initially beneficial, but become deleterious when elevated for prolonged periods. The neurohumoral excitation that occurs in the CHF state is mediated, in part, by abnormal inhibitory cardiovascular reflexes, such as the arterial baroreflex and the cardiopulmonary reflex. In addition, two sympatho-excitatory reflexes have been shown to be enhanced in CHF: the arterial chemoreflex and the cardiac sympathetic afferent reflex. While these reflexes may play a role in the sympatho-excitation of the CHF state, there is an important central modulation of sympathetic outflow by a variety of hormones that are elevated in CHF and have been shown to have neural effects. These include angiotensin II (Ang II), nitric oxide (NO), and endothelin-1. In fact, experimental animal data suggest that a central reciprocal relationship exists between Ang II and NO in their ability to modulate sympathetic outflow. These substances may also participate in the beneficial effects of exercise training in the CHF state. Exercise training lowers sympathetic nerve activity and plasma Ang II, and enhances arterial baroreflex function. This review emphasizes the neurohormonal and reflex regulation of sympathetic outflow in heart failure. While abnormal reflex regulation may predict a poor outcome, new treatment options may emerge from a better understanding of reflex regulation in CHF.

Angiotensin II↗
PubMed1990

Trigeminal sensory neuropathy associated with decreased oral sensation and impairment of the masseter inhibitory reflex.

We describe 4 patients with severe trigeminal sensory neuropathy whose main disability resulted from impaired intraoral sensation associated with disturbances of mastication and swallowing. Each patient had an abnormal blink reflex and jaw jerk. In addition, the masseter inhibitory reflex was absent in 3 patients and abnormal in the 4th. This reflex plays a role in the reflex control of mastication and can easily be elicited in normal subjects by stimulation of the skin and mucous membrane in the distribution of the 2nd and 3rd divisions of the trigeminal nerve while the jaw-closing muscles are contracting. Disturbed intraoral sensation combined with impaired trigeminal reflexes (particularly the masseter inhibitory reflex) interferes with neural mechanisms that regulate chewing and can be a source of severe disability in patients with trigeminal sensory neuropathy.

Aged↗
PubMed1994

Electrodiagnostic and histologic changes of graded caudal compression on cauda equina in dog.

STUDY DESIGN: An animal model of lumbar spinal stenosis, in which the pathophysiology of this condition could be examined, was retrieved according to Delamarter's method. OBJECTIVES: The purpose of this study was to develop a reproducible animal model of lumbar spinal stenosis to further understanding of the long-term electrophysiologic changes, and to detect prognostic indices of the long-term anatomic and physiologic status of chronic compression of the cauda equina. SUMMARY OF BACKGROUND DATA: Somatosensory-evoked potentials and bulbocavernosus reflexes revealed abnormalities before neurologic signs and symptoms appeared. If delayed somatosensory-evoked potentials and bulbocavernosus reflexes were recovered with the lapse of time, neurologic findings showed gradual recovery. The loss of somatosensory-evoked potentials, bulbocavernosus reflexes, and neurologic, histological abnormalities occurred at 50% constriction of the cauda equina; at the same time, that was the critical point of possible recovery. METHODS: Four experimental groups, each containing six dogs, were studied. One group had a laminectomy of the sixth and seventh lumbar vertebrae only; these animals served as controls. In the three other groups, a laminectomy was performed, and the cauda equina was constricted by 25%, 50%, or 75% to produce chronic compression according to Delamarter's method. RESULTS: Somatosensory-evoked potentials and bulbocavernosus reflexes revealed neurologic abnormalities before the appearance of neurological signs and symptoms. Constriction of more than 50% was the critical point; it resulted in loss of evoked potentials, reflexes, neurologic deficits, and histological abnormalities. CONCLUSION: To accurately forecast prognosis of chronic cauda equina compression, the combined diagnostic study of somatosensory-evoked potential with bulbocavernosus reflex is recommended.

Animals↗