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Citicoline in the treatment of Parkinson's disease.

The subjects were 20 patients with Parkinson's disease. They were aged 52 to 76 years and the duration of the disease ranged from four to 25 years (mean, 12.5 years). All the patients were receiving levodopa alone or in combination with tricyclic antidepressants, amantadine, bromocriptine, anticholinergic agents, or lisuride. Each patient received 1,000 mg of citicoline intramuscularly daily for 15 days and then 500 mg daily for 15 days. After 30 days of treatment, the scores on the Columbia rating scale improved 7.3%; rigidity was improved 18.8%; times to walk 10 m and turn over were reduced 17.5% and 37.4%; and the handwriting test scores improved 19.7%. No side effects were reported. Four patients with advanced parkinsonian symptoms and psychotic side effects received 2,000 mg of citicoline subcutaneously or intravenously for seven days. No improvements in symptoms or treatment side effects were noted.

Aged↗

PubMed1990

Hospital communication about drugs: the effect of language on accuracy.

OBJECTIVE: To review some of the problems associated with the prescription, supply and administration of drugs in a multicultural environment. METHOD: Staff questionnaire. RESULTS: Most respondents indicated the information received from the pharmacy was satisfactory, that they had read a recent therapeutic bulletin and that they could describe prescription handwriting as 'clear and reasonable'. There was general difficulty in understanding the meaning of Latin abbreviations and a demonstrated failure to absorb recently circulated information.

Culture↗

PubMed1990

Mental efficiency and hypoglycemia.

Cognitive functioning after a mild hypoglycemic episode (MHE) was studied in 24 school-age children with insulin-dependent diabetes mellitus (IDDM). All children were administered a battery of neuropsychological tests which included digit spans, trailmaking tasks, Klove Mathews Maze test, and finger-tapping and handwriting tasks. The experimental group (n = 14) consisted of children who were tested initially after resolution of hypoglycemic symptoms following a documented MHE (Chemstrip bG less than or equal to 60 mg/dl with symptoms). The comparative group (n = 10) consisted of children who were initially evaluated after documentation of euglycemia. Comparison of the comparative group scores with test scores of the experimental group after recovery from the MHE demonstrated statistically significant differences (p less than 0.05 by dependent t-tests) in five of 12 tasks. No differences were noted when second trial scores of both groups were compared when they were retested after documentation of euglycemia. This study suggests that a discrepancy exists between the recovery rate of physical symptoms and cognitive function in children following a MHE.

Achievement↗

PubMed1975

[Rational utilization of the major tranquilizers].

The author examined a group of drug-free patients who during the subsequent period of I month received chlorpromazine. These patients were studied for the chlorpromazine content in the blood, pupilzise, handwriting test, EEG and mental state. The level of chlorpromasine was maximal in the first 2 weeks and then declined. Changes in the peripheral autonomic measures correlated with those in the plasma levels and with an increased liver hydrozylation. Changes in the central measures were inconsistent. A 3-week treatment with phenobarbitone and antiparkinsonic drugs accelerated the metabolism of chlorpromazine. An increased metabolism of chlorpromazine in the intestine and liver may be the cause of the patients' resistanec to chlorpromazine therapy.

Adult↗

PubMed1989

Microcomputer voice-recognition program in a hospital emergency department.

A software program for voice-controlled text creation was used on a microcomputer in the emergency medical department of a large hospital. It was found that automated speech recognition (ASR) permitted doctors to produce their reports faster and more accurately than handwriting or dictation to tape. In addition, ASR reporting is cheaper than dictation to tape. Other advantages include the automatic creation of computer-stored patient files that can be used for statistical purposes. There were a few minor drawbacks, including the need for a procedure for training the system to recognize the user's voice.

Chicago↗

PubMed1989

Visual conversion reaction in children.

Visual conversion reaction (VCR) is a psychosomatic illness that will occasionally be seen by optometrists and ophthalmologists. This paper discusses some of the possible aetiologies and manifestations of the condition. Investigation and management of children with suspected VCR is discussed. Four case histories are presented in which signs of VCR included amblyopia, reduced accommodation and a deterioration in handwriting. The visual field defects presented include a static quantitative anomaly. Such a defect has not previously been reported.

Adolescent↗

PubMed1989

[A psychopathologic conflict in the 18th century in the East Indies Squadron].

The authors first give a psychological evocation of the Bailli de Suffren, a great captain who vastly contributed to improve the image of the French Navy after the appalling seven years war, but whose character showed, nevertheless, originality, authoritarism, violence, sometimes vindictiveness and often negligence. The quarrels he had with most of his subordinates culminated as he was in command of the East Indies Squadron, applying sometimes exaggerated punishments. Chevalier de Tromelin was hierarchically just under him; this Chevalier had a character as chilly and stiff as the Bailli was the opposite; both were ambitious and deserving officers, the Chevalier being as much conformist as his "adversary" was fiery and bold. The shouts and rancours of the Bailli, when confronted to the rigidity and cold technicity of the Chevalier, marked their relationship. More than objective reasons arising from their duties, the fundamental incompatibility of their characters, explain their conflicts. Suffren played a double-game with his immediate subordinate; not lacking verbal smoothness, he nevertheless abused him in such a way in his reports to the authorities, that when Chevalier de Tromelin, being ill, asked to return to France, he learned that he had been dismissed of the Navy without having ever been heard or able to attempt to defend himself. He then spent his time trying to claim for a hearing without ever obtaining it, writing justificatory reports. He was "rehabilitated" in 1793 and died in half-exile in 1815. The authors were struck by the fact that for 200 years, no historian of the Fast Indies has ever taken into account the Squadron's distinctive features and the personality of Suffren. Thanks to their research in family documents, in the National and especially Navy Archives, they are able to show the importance of this psychological, not to say the psychopathological, aspect. One can only be struck by the silence of the various historians who worked on the subject, misjudging this "conditioning" which explains excessive punishments and long-harboured grudges. It is possible that Tromelin was the most affected because he was hierarchically the nearest. As the various documents or testimonies show, no fault or error could ever be retained against him that he could non justify. A detailed study of the handwritings of the two protagonists is presented in the text. Such conflicts are rather common within the Administration, but they seldom are of such duration.(ABSTRACT TRUNCATED AT 400 WORDS)

Conflict, Psychological↗

PubMed1989

[Pure agraphia. Apropos of 2 cases].

Pure agraphia is a disorder of written language without aphasia, alexia or apraxia. Its existence has long been disputed. We report 2 cases due to a left parietal hematoma. In the first patient, with a deep precuneate lesion, agraphia included disorders in handwriting and orthographic problems in copying or writing from dictation with the two hands. The second patient, with a lesion of the postero-inferior part of the left angular gyrus, made errors in choice and combination of letters during dictation, whereas these same letters were well-written and copying was normal. The first cases of pure agraphia were ascribed to frontal lesions and then confusional states. Current opinion tends to implicate parietal lesions of various types: superior or inferior, internal or external. Findings in the present 2 cases and those reported indicate that pure parietal agraphia is heterogeneous.

Aged↗

PubMed1986

[Changes in the health state of schizophrenic patients in neuroleptic therapy].

The state of health of 135 schizophrenic patients was examined during therapy with a nigrostriatal (Haloperidol) and a mesolimbic (Clozapin) neuroplegic drug, and compared with the situation during treatment without neuroplegics. Among the methods used was the state of health scale of von Zerssen; the neuroleptic threshold was tested using Haase's handwriting test. There was evidence that the patient's health was primarily affected, but individual differential treatment with neuroplegics produced a significant improvement in this important respect. Contrary to Haase, we noticed nothing to convince us of a link between the antipsychotic efficacy of the neuroplegics under investigation and the neuroleptic threshold.

Adolescent↗

PubMed1979

Sensory integration in the rehabilitation of blind adults.

Learning difficulties displayed by the blind adult prompted an investigation of a link with sensory integrative dysfunction. A review of the literature provided evidence that tactile and vestibular deficiencies were prevalent within this population. Through observational assessment, sensory integrative dysfunction was identified in a number of clients and individual sensory integrative treatment programs were initiated. In the three case studies presented, improvements were noted in mobility, activities of daily living, handwriting, and behaviour after six months of treatment. A discussion is provided on those deficit areas responding to sensory integrative treatment.

Activities of Daily Living↗

PubMed1988

[Neurologic symptoms in inhalation poisoning with metallic mercury].

Nineteen caisson workers had been exposed to metallic mercury vapours while digging tubes underneath the first district of Vienna (exposure between 470 and 2440 min; mean 1621 min). The blood mercury values on admission were between 29 and 166 micrograms/l (mean 75 +/- 34 micrograms/l). The main findings reported are clinical neurologic symptoms, psychic complaints, neurographic results and autonomic parameters (cardiovascular reflexes): 47% complained of headache and tiredness, 37% showed tremor and suffered from sleep disturbances, 26% showed hypersalivation, 16% changes in handwriting, and 11% slight dysarthria. The cardiovascular reflexes (autonomic parameters) were abnormal in 7 of 12 patients. On neurography the distal latency (median nerve) was pathologic in 47%, the distal latency (peroneal nerve) was pathologic in 26%, the antidromic sensory nerve conduction velocity (median nerve) was abnormal in 10%, the motor nerve conduction velocity, compound amplitude and vibratory threshold were normal.

Adult↗

PubMed1987

Mutism, malingering, and competency to stand trial.

Mutism and mental illness have had a long-standing historical relationship with regard to the issue of competence to stand trial. This article reports a defendant who remained mute for 10 months and describes his use of the symptom of mutism in his malingering. Although mutism is frequently used by defendants for malingering, clinicians must have a high index of suspicion for the possibility. We recommend a comprehensive evaluation including neurologic workup, repeat interviews, observation of the defendant at unsuspected times for communicative speech with other inmates, study of handwriting sample, collateral nursing documentation, and, if necessary, Pentothal interviews to establish authenticity of mutism. The authors review the historical background and legal considerations of the relationship between mutism and malingering.

Forensic Psychiatry↗

PubMed1978

[Extrapyamidal side-effects with 1-day dosage of haloperidol (author's transl)].

In a double blind study, 30 in-patients (14 females, 16 males, ranging in the age from 18 to 55) suffering from an acute paranoid-hallucinatory syndrome, were treated with haloperidol for 30 days. 13 patients (3-day group) received 3 times a day 3 mg haloperidol (at 8 a.m., 12 a.m,, 5 p.m.) and 17 patients received 9 mg haloperidol only in the evening (9 p.m., 1-day group). Placebo instead of medication was given at the same time to the control group. Every 5 days the following assessments were performed: AMP 3 and 4, Webster and Simpson rating scales, handwriting tests according to Haase and psychometric tests according to Schoppe. In the 1-day dosage group the amount of anticholinergics were significantly reduced (2.4 mg biperiden/day compared to 4.6 mg/day in the 3-day group). The 1 daily application of neuroleptics is useful in treating acute psychosis. This treatment schedule has the advantages of sedation during the night, reduction of side-effects during the day, simpler and cheaper application form and induction of social activity.

Adolescent↗

PubMed1984

[A case of spongiform encephalopathy with ataxia and amyloid plaques].

CASE: A 63-year-old man was admitted to our hospital because of gait disturbance. His daughter died of the same disorder at age 29. In 1974, at age 59, the patient noticed mild recent memory disturbance and clumsiness in handwriting. In 1976, his gait was markedly unstable, but he could walk without assistance, and his speech became dysarthric. In spring, 1977, he was unable to walk without assistance. From Jan. 9, 1978, through Feb. 14, 1978, he was hospitalized in our hospital. Neurological examination revealed an ataxic gait and scanning speech. Deep tendon reflexes of the upper extremities and ankle jerks were normal, but knee jerks were absent. Pathological reflexes were not elicited. Both superficial and deep sensations were normal. He was alert and showed no overt dementia. Laboratory data including CSF, EEG and brain CT were normal except positive TPHA in serum. Thereafter, he was followed up with the diagnosis of spinocerebellar degeneration. In 1979, he developed a limb ataxia. In spring, 1980, he became very irritable and was easily excited. He gradually developed dementia and urinary incontinence. In 1981, his illness progressed to an akinetic mutism and died of pneumonia on July 19, 1981. Myoclonus and periodic synchronous discharges in EEG were not observed until his death. The brain was 1,075 g in weight after formalin fixation and the cerebrum was generally soft. The gyri showed no evidence of abnormalities or atrophy, while the cerebellum and brain stem, especially the pons, were atrophic. The arterial and venous systems showed no remarkable changes. The spinal cord was externally unremarkable. The ventricles were dilated.(ABSTRACT TRUNCATED AT 250 WORDS)

Akinetic Mutism↗

PubMed1982

Learning disabilities in children with sex chromosome anomalies.

Studies of clinical populations have suggested that genetic factors may be involved in the etiology of learning disabilities. The present study included 44 children (ages 7-16) with sex chromosome anomalies (SCA) who were identified in a 10-year sex chromosome screening of all newborns in 2 large hospitals and thus represents an unbiased sample of children with a genetic etiology. 17 chromosomally normal siblings are included as controls. All subjects were given IQ and achievement tests, and extensive, repeated school histories were taken from parents and school personnel. Results demonstrate that SCA children are at an increased risk for encountering learning problems and receiving special education intervention in school. Furthermore, the nature of the learning disabilities may be karyotype specific, although the results are not invariant within karytypes. 45,X children demonstrate a visuo-spatial deficit as evidenced by lower-performance IQ scores and an increased incidence of handwriting problems, while 47,XXY children experience a verbal language deficit seen in lower verbal IQs and a tendency toward more reading delays. 47,XXX children demonstrate a more global delay crossing most cognitive skill areas, although retardation is rare. Mosaic children are relatively unaffected by their karyotypic variations and hence serve as a second control group which guards against the effects of a negative self-fulfilling prophecy. It is concluded from this evidence that learning disabilities can have a genetic basis, although the specific biological mechanism that affects cognitive development in this population remains elusive.

Child↗

PubMed1980

[Clinico-neurologic criteria for different degrees of alcoholic intoxication].

As a result of a cliniconeurological study of 500 people in a state of alcoholic intoxication of the I--II degrees and 100 sober people, certain clinical indices were elaborated to establish the degree of alcoholic intoxication. These indices are as follows: the existence of alcohol odour, changed speech, inadequate to the situation behaviour pupil dilatation, akrocyanosis, a sharp drop or absence of Achilles (tendon) and abdominal reflexes, a changed gait; the results of the study of "sensitized" Romberg's test, Tachen's test, handwriting test and the use of the Schulte tables. In order to identify the degree of alcoholic intoxication, as the frequency analysis demonstrated, there should be 4--5 signs of the above mentioned symptoms in the examinee.

Adult↗

PubMed1995

[Wilson's disease; diagnosis with the aid of magnetic resonance tomography].

In a 21-year-old woman with a smaller and sloppy handwriting, drooling especially when stooping, sporadic choking, clumsiness, and frequent stumbling, Wilson's disease was diagnosed. The medical history disclosed a short period of haemolytic anaemia with transient hepatic failure, and irregular menstruation periods with infertility. On examination there were no signs of liver or spleen enlargement. She was slow, had an expressionless face and mild dysarthria, and slight impairment of the coordination of the limbs. Magnetic resonance imaging of the brain showed bilateral hyperintensive lesions of the basal ganglia on T2W images. Zinc therapy induced a good biochemical response and there was also some clinical improvement. Linkage analysis within the family identified one other asymptomatic homozygotically affected sister. A diagnostic delay occurs frequently due to relative unfamiliarity with this rare disease and due to its variable clinical expression.

Adult↗

PubMed1996

[Hepatic minimal encephalopathy. The most frequently overlooked, clinically occult "metabolic syndrome" on the cirrhosis patient].

The syndrome of minimal hepatic encephalopathy is used to describe discrete psychomental and neuro-psychological abnormalities in patients with chronic liver disease (cirrhosis) or portosystemic shunt, in whom classical clinical investigations reveal no evidence of mental or cerebro-neurological disorders, and who cannot be assigned to any of the usual stages of hepatic encephalopathy. Disorders of cerebral function, such as lack of concentration, impaired ability to think logically, loss of comprehension, impairment of space perception and the recognition of numbers and letters can be very reliably detected by simple psychometric tests (number-connection test, line-tracing test, handwriting), and are present in as many as 70% of cirrhotics. This may be expressed in everyday life by an impairment of driving ability, and at work by impaired ability to operate a machine. The use of established means of lowering blood ammonia levels (lactulose, ornithine-aspartate) results in a rapid improvement in the symptoms of encephalopathy.

Ammonia↗