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At least 865 records · Page 48Linked to original sources
PubMed1978

[Neurologic disorders in acute dichloroethane poisoning].

The paper deals with a study of the nervous system in 121 patients with acute poisening with dichlorethane. Among the studied contingent there were 110 males and 11 females. According to the severity of the intoxication the patients were divided into 3 groups: mild--23 cases, moderate--11 cases, severe--87 cases. The following 6 neurological syndromes were distinguished: comatose, convulsive, atactic, extrapyramidal, psychotic and asthenic with vegetative-vascular insufficiency. Morphological studies detected the following: congestion plethora, vascular dystonia, microfoci hemorrhages, acute swelling of the nervous cells with signs of chromatolyses, shrunk cells, severe and ischemic change of the nervous cells. The treatment consisted in an accelerated elimination of dichlorethane from the organism and symptomatic therapy. The results of these studies demonstrated that in poisoning with dichlorethane there were diffuse, mainly dystrophic changes in the cells of the brain and spinal cord, which clinically may be expressed by symptoms of a lesion of many systems and may be qualified as toxic encephalomyelopathy.

Adult↗
PubMed1991

[Place disorientation as a clinical feature of a right capsulo-putaminal hematoma. Contribution to the understanding of neuropsychologic symptomatology in subcortical lesions of the right hemisphere].

A 72-year-old right-handed patient with a hereditary coagulation impairment had a sudden disorder of consciousness with left hemiplegia and immediate collapse. CT showed a right capsulo-putaminal hematoma of about 5 cm and important mass effect. When this lesions developed, the patient had just arrived to Barcelona from Alicante . During three weeks, the outstanding and more dramatic symptom was a delirium of geographical localization, in which the patient appeared convinced that every night he was transferred, along with his attending physicians and his partner in the hospital room, from one to another of the many Hospitals de la Sta. Creu i Sant Pau (or within the same hospital) in many different cities between Alicante and Barcelona. He also gave aberrant information about his room. When he was transferred to his home, he was unable to identify it for two weeks or to locate it in any definite place. He also had a nictemeral chronological disorientation. The accompanying syndrome consisted of proportional left hemiplegia, left hemihypoesthesia, hemianopsia, and, in the neuropsychological area, mysoplegia, anosodiaphoria, impairment of visual memory, mild hemineglect, eyelid motor impersistence and constructive apraxia. Emphasis is made on the deep subcortical and to certain extent anterior topography of the causative lesion of this peculiar neuropsychological syndrome, although the possible mechanisms of remote involvement of other cerebral areas are suggested. The crucial role of the right hemisphere lesions, cortical and primarily noncortical, in the development of many variants of spatial disorders is stressed.

Aged↗
PubMed2003

Wernicke's encephalopathy: unusual contrast enhancement revealed by magnetic resonance imaging.

Wernicke's encephalopathy is a serious neurologic disorder caused by vitamin-B1 or thiamine deficiency. The classical triad of clinical symptoms described by Wernicke (gait ataxia, ophthalmoplegia, and confusion) are found in only a third of patients upon initial examination. Typical findings upon MR imaging in patients with Wernicke's encephalopathy are well documented, with signal intensities in the medial thalami and periaqueductal regions of the midbrain. We report a case of Wernicke's encephalopathy revealing an unusual contrast enhancement. It is therefore important to note that the acute stage of Wernicke's encephalopathy may be associated with an intense contrast enhancement upon MR-imaging reflecting the disruption of the blood-brain barrier and inflammatory processes caused by thiamine deficiency. As a consequence from the guideline for managing Wernicke's encephalopathy by the Royal College of Physicians early B-vitamin treatment in suspected is recommended cases.

Acute Disease↗
PubMed2003

Episodic spontaneous hypothermia: a periodic childhood syndrome.

Episodic spontaneous hypothermia is an infrequent disorder, with unknown pathogenic mechanisms. A systemic cause or underlying brain lesion has not been found for the disease. We report four new patients, 3-9 years old, with episodic hypothermia lower than 35 degrees C, marked facial pallor, and absent shivering. The episodes could last a few hours or four days, and recurred once a week or every 2-3 months. Two patients also demonstrated bradycardia, mild hypertension, and somnolence during the events; in one of them, profuse sweating was also a feature, and all four presented with either headache, a periodic childhood syndrome, or both (recurrent abdominal pain, cyclic vomiting, or vertigo). Three patients reported a family history of migraine. Neurologic examination, endocrine function, and imaging studies were normal. Migraine prophylactic therapy was of moderate efficacy. Spontaneous resolution was observed in one patient. The clinical characteristics of the syndrome allow for its inclusion as a childhood periodic syndrome related to migraine.

Abdominal Pain↗
PubMed1976

[Comparison of altered states of consciousness induced by the hallucinogens (--)-delta9-trans-tetrahydrocannabinol (delta9-THC) and N,N-dimethyltryptamine (DMT) (author's transl)].

The study compares altered states of consciousness induced by the hallucinogens (--)delta9-trans-Tetrahydrocannabinol (delta9-THC) and N,N-Dimethyltryptamine (DMT) using two placebo control groups. A total of 24 subjects received 250 mug delta9-THC p.o./kg body weight and 26 subjects were treated with 250 mug DMT i.m./kg. Placebo was given to 24 subjects. The effects were assessed by a questionnaire administered following the experimental conditions. Questionnaire items were combined into the following eight scales according to their content and several cirteria of the theory of mental testing: visual hallucinations (illusions), auditory hallucinations (illusions), impairment of memory and attention, depersonalization syndrome, deprealization syndrome, changes of body image, euphoric state and anxious-depressive state. The two hallucinogen groups differed significantly from placebo on all eight scales. No difference, however, between delta9-THC and DMT was significant. On the scale "optical hallucinations (illusions)" a tendency that DMT might have stronger effects than delta9-THC was found. Methodological problems of comparing different hallucinogens are discussed.

Cognition Disorders↗
PubMed2001

Effects of antimuscarinic drugs on both urinary frequency and cognitive impairment in conscious, nonrestrained rats.

Recent studies indicate a risk of learning and memory impairments when patients with senile dementia are treated with antimuscarinic drugs. In this study, we compared the effectiveness of propiverine hydrochloride (propiverine) and oxybutynin chloride (oxybutynin) on the increased urinary frequency and cognitive impairment induced by nucleus basalis magnocellularis (nBM) lesioning in conscious and nonrestrained rats. For examination of bladder function, nBM-lesioned rats were given total parenteral nutrition regimens for 8 days. Propiverine administered orally at 0.3, 3 and 30 mg/kg on the postoperative day 7 significantly lessened the increase in the frequency of voiding caused by the nBM lesion, whereas oxybutynin administration did not show any improvement at 0.1 or 1 mg/kg but did so at 10 mg/kg. To examine the memory impairment, we trained nBM-lesioned rats in an 8-arm radial maze task for 20 days and then evaluated the effectiveness of oral drug administration on 19th and 20th radial maze performance. The higher rate of errors caused by nBM lesioning was significantly aggravated by oxybutynin at 30 and 100 mg/kg. Propiverine showed slight aggravation of errors, but with no statistical significance at any dose, 30, 100 or 300 mg/kg. These results suggest that propiverine has comparatively less effect on the cognitive impairment than oxybutynin.

Administration, Oral↗
PubMed1976

Clinical, biological and pathogenic features of the syndrome of inappropriate secretion of antidiuretic hormone. A review of 26 cases with marked hyponatraemia.

Twenty-six patients with the syndrome of inappropriate secretion of antidiuretic hormone were reviewed. The underlying diseases were bronchogenic carcinoma (12 cases); myxoedema (five cases); diseases of the nervous system (five cases); bronchopneumonia, carcinoma of the oesophagus, acute intermittent porphria and chlorpropamide therapy (each one case). Serum sodium levels ranged between 104 and 125 mEq per litre. Eighteen patients presented neurological manifestations, which in 14 were considered to be due to hyponatraemia. Neurological signs included disorders of consciousness (stage I and II coma), extrapyramidal signs, asterixis and epileptic seizures. An hyponatraemic coma was the first manifestation of the syndrome in five cases. In all cases where the EEG was recorded it showed non-specific signs of metabolic coma. The fundi never showed signs of intracranial hypertension. Blood urea and creatinine levels were invariably low in the euthyroid patients; these values were normal or elevated in patients with myxoedema and hyponatraemia. Hypokalaemia was frequent, and hypocalcaemia constant. In eleven cases an excess of water intake revealed the clinical syndrome: six patients were excessive beer drinkers and five had received extensive intravenous infusions. In one case the deleterious effect of diuretics was evident, and in another, the syndrome became evident during radiotherapy of an oesophageal tumour. Treatment of the syndrome was successful in all cases. A review of the literature concerning the various pathogenic mechanisms corresponding to the different underlying diseases is presented. The concept of aberrant hormonal production by a tumour is illustrated by an electron microscopic study.

Adult↗
PubMed1994

[Limited reserve of corticotropic hormone (ACTH)].

Chronic deterioration of the glucocorticoid function may result from a primary disorder of the suprarenal glands; from a deficit of the corticotropic hormone (ACTH) due in most cases to an extended hypophyseal affection with reduced secretion of other hypophyseal hormones and from the lack of corticotropin releasing hormone (CRH) at the hypothalamic level. Isolated ACTH deficiency is a rare clinical entity. A subgroup within this pathology is the limited reserve of ACTH which would constitute a mild form of dysfunction in the corticotropic cells, with enough secretion of ACTH to maintain a normal adrenal function in the absence of stress-inducing situations, but unable to show an appropriate reaction in such situations. The difference between these two entities lies in the normal levels of 17-OH-corticosteroids in the limited reserve of ACTH. We describe the case of a patient with acute severe hyponatremia in whom this rare affection was diagnosed and we make some considerations regarding this entity.

Acute Disease↗
PubMed1998

[Value of cranial MRI in the follow-up of dural sinus thrombosis].

INTRODUCTION: At the present time it is well established that cranial magnetic resonance (MR) is the imaging technique of choice for diagnosis of thrombosis of the dural sinuses. However, few studies have been done to evaluate its role in follow-up in this cerebrovascular disorder. OBJECTIVE: To assess the alterations in resonance signal in follow-up of patients with thrombosis of the dural sinuses and the clinical correlation of this. MATERIAL AND METHODS: We reviewed the clinical histories of 12 patients diagnosed on cranial MR as having thrombosis of the dural sinuses; 8 cases were also seen again six months later. The cranial MR study was done using a 1.5 or 1.0 T superconductive apparatus to do measured spin-echo sequences (SE) in T1 and T2 in sagittal, transverse and coronal planes. The time elapsed between diagnosis on MR and clinical diagnosis was between 24 hours and 6 months. RESULTS: All patients had stronger resonance signals in T1 and T2 indicating a subacute phase of the thrombosis (oxidative conversion of deoxyhaemoglobin to methoxyhaemoglobin) and complete absence of blood flow in the sinuses. The eight patients seen again after six months were found to be normal on neurological. On cranial MR partial recanalization was seen in 5 of these (62%). CONCLUSION: Changes in the resonance signal persist for a long time both with and without signs of recanalization. This finding does not affect the medium term clinical course.

Adult↗
PubMed2001

Gender differences in the subjective effects of MDMA.

RATIONALE: 3.4-Methylenedioxymethamphetamine (MDMA) mainly releases serotonin (5-HT) and is contained in the recreational drug Ecstasy. 5-HT is known to play an important role in mood and anxiety disorders, for which there is a female preponderance. To date, there are no systematic data on gender differences in the subjective effects of MDMA. OBJECTIVES: The present work analyzed the pooled data from three controlled studies on the psychological and physiological effects of MDMA in healthy volunteers with no or minimal MDMA experience. A particular focus of the analyses were possible gender differences. METHODS: A total of 74 subjects (54 male, 20 female) participated in all three studies. MDMA in oral doses ranging from 70-150 mg (1.35-1.8 mg/kg) was administered under double-blind placebo-controlled conditions. Subjective peak changes were assessed by standardized psychometric rating scales. Physiological measures were blood pressure, heart rate, and peripheral body temperature. Adverse drug effects were assessed during the experimental session and after 24 h. RESULTS: Psychoactive effects of MDMA were more intense in women than in men. Women especially had higher scores for MDMA-induced perceptual changes, thought disturbances, and fear of loss of body control. The dose of MDMA positively correlated with the intensity of perceptual changes in women. Acute adverse effects and sequelae were also more frequent in female than in male subjects. In contrast, men showed higher increases in blood pressure than woman. CONCLUSIONS: The fact that equal doses of MDMA per kilogram body weight produce stronger responses in women compared to men is consistent with an increased susceptibility of women to the 5-HT-releasing effects of MDMA. Our results also indicate that increasing doses of MDMA produce more hallucinogen-like perceptual alterations, particularly in women.

Adult↗
PubMedDate not supplied

Order and disorder in the brain function.

The interest in studying the brain electrical activity as a function of the development of intelligence has been spurred by the need to understand how the brain responds to environmental information. The description of sleep in mentally retarded children reveals deviant patterns of the EEG-spindles and of the eye movement activity (REM sleep) when compared to normal children. The patterns may be considered as a valuable index of mental function. According to experimental evidence, the distribution of the eye movements of sleep appears either as random or ordered. The latter are altered in the mentally handicapped in whom the appearance out of chaos, of the order which is needed for intelligence and memory to function, is altered. The sleep signs are redundant as from birth. Their pattern is also related to the psychomotor development of the infant. If their distribution remains random, or appears in long uninterrupted sequences of waves as in epilepsy, intelligence does not develop. A similar strategy appears to function in the foetus when nature organizes the structures that will lead to the development of intelligence. The eye movement patterns of sleep change in the pregnant women as a function of term and resemble those of premature babies of a similar gestational age. They also change as a function of the menstrual cycle and more generally as a function of age. The hypothesis that attention is the diurnal equivalent of REM sleep is discussed. Attempts at modelling the eye movement patterns of REM sleep as a function of near zero gravity environments have been made. 1) By means of a Montecarlo simulation using the semi Markov model during the Spacelab 1 flight. 2) With the method of the single and multiple g-phase transition analysis of the strange attractor dimension (d) during parabolic flights. The implication of the latter for the neural processes involved in learning is that the central nervous system can preserve intact, from input to output, over a period of several days, all the information it receives 3) The relation between spindles and eye movements has also been viewed by a quantum approach which is another medium between the information and the way of describing it.

Aging↗
PubMed1992

Risk factors for the neurologic complications associated with aortic aneurysms.

We reviewed the incidence of neurologic complications in 200 consecutive patients with aortic aneurysm or aortic dissection. In this 2-year period, neurologic impairment developed in 18.5% of these patients, and in 10 patients neurologic dysfunction heralded aortic rupture or dissection. Those patients with abnormal neurologic examinations at presentation frequently had aneurysm rupture or dissection and a mortality rate of 54%. Patients with thoracic or thoracoabdominal aneurysms were more likely to have neurologic complications than those with abdominal aneurysms. The most common complications were focal central nervous system ischemia, followed by disorders of consciousness and peripheral nerve complications. In patients who had elective aneurysm resection, female sex, aneurysm location, and intraoperative hypotension were risk factors for focal central nervous system ischemia. We conclude that neurologic complications depend on aneurysmal location, occur at various levels of the nervous system, and frequently develop when the intraoperative mean arterial pressure falls below 55 mm Hg.

Aged↗
PubMed2005

The syndrome of combined polar and paramedian thalamic infarction.

BACKGROUND: Occlusion of the polar or the paramedian arteries of the thalamus usually leads to distinct infarcts with specific clinical and imaging correlates. However, vascular variation is such that in up to one third of humans, the polar artery is missing and its territory taken over by the paramedian arteries. OBJECTIVE: To provide attention to the corresponding stroke syndrome of combined polar and paramedian thalamic infarction. METHODS: We studied combined polar-paramedian thalamic infarction in 12 patients (6 right-sided lesions, 3 left-sided lesions, and 3 bilateral lesions) who were selected from 208 consecutively registered patients with thalamic strokes in the Lausanne Stroke Registry. RESULTS: The clinical manifestation included executive dysfunction, apathy, and memory impairment in all patients, with eye movement disturbances in 10 patients (5 with right-sided lesions, 2 with left-sided lesions, 3 with bilateral lesions); acutely impaired consciousness in 11 patients (5 with right-sided lesions, 3 with left-sided lesions, 3 with bilateral lesions); aphasic disturbances in 8 patients (2 with right-sided lesions, 3 with left-sided lesions, 3 with bilateral lesions), including nonfluent aphasia in 1 patient (with left-sided lesions); dysarthria in 5 patients (4 with right-sided lesions, 1 with bilateral lesions); constructional apraxia in 5 patients (with right-sided lesions); mild hemiparesis in 4 patients (2 with right-sided lesions, 2 with left-sided lesions); dyscalculia in 3 patients (1 with left-sided lesions,1 with right-sided lesions, 1 with bilateral lesions); limb dystonia or asterixis in 2 patients (1 with right-sided lesions, 1 with bilateral lesions); mild hemisensory loss in 2 patients (1 with right-sided lesions, 1 with left-sided lesions); hemiataxia in 1 patient (with right-sided lesions); and ideomotor apraxia in 1 patient (with left-sided lesions). Follow-up showed severely disabling, persistent amnesia in 7 patients (4 with right-sided lesions, 3 with bilateral lesions) and persistent eye movement dysfunction in 5 patients (2 with right-sided lesions, 1 with left-sided lesions, 2 with bilateral lesions). The most common etiology appeared to be cardioembolism, followed by artery-to-artery embolism and presumed small-artery disease. CONCLUSIONS: Key features of this syndrome included amnesia preceded by a period of altered consciousness, and vertical eye movement disturbances. The severe and persistent amnesia may be due to coexisting damage to the anterior and dorsomedial nuclei.

Adult↗
PubMed1980

CNS manifestations of the hemolytic-uremic syndrome. Relationship to metabolic alterations and prognosis.

To define the CNS manifestations of the hemolytic-uremic syndrome (HUS), the records of 61 consecutive episodes of HUS in 60 patients were reviewed. Major CNS signs (seizures and/or coma) occurred in 30 of the 61 episodes. Twenty-four children had seizures. Analysis of blood pressure and metabolic parameters or admission to the hospital did not predict which child would exhibit CNS signs. However, during the subsequent course of the illness, children with CNS dysfunction had lower minimum serum sodium concentrations and more severe azotemia and were more likely to require dialysis than children without CNS signs. Of the 61 episodes, there were three deaths, and three children suffered major CNS sequelae. Coma at the time of admission and elevated CSF protein levels were features associated with poor outcome.

Adolescent↗