Clinical and experimental neurology最新文献_第10页

Familial spastic paraplegia: an electrophysiological study of central sensory conduction pathways. 家族性痉挛性截瘫:中央感觉传导通路的电生理研究。

Clinical and experimental neurology Pub Date : 1991-01-01

P K Panegyres, G H Purdie, M A Hamilton-Bruce, R H Rischbieth

引用次数: 0

Lithium neurotoxicity. 锂神经毒性。

Clinical and experimental neurology Pub Date : 1991-01-01

G L Sheean

{"title":"Lithium neurotoxicity.","authors":"G L Sheean","doi":"","DOIUrl":"","url":null,"abstract":"Lithium is potentially toxic to many parts of the central and peripheral nervous systems. Clinical lithium neurotoxicity may appear at any time during therapy and probably often goes unrecognised, at least for a time. Acute lithium toxicity has a mortality of 15%, and 10% of survivors suffer permanent neurological sequelae that are largely unpredictable though persons with the longest and most clinically severe intoxication are probably at highest risk. Even rapidly effective treatment with haemodialysis will not always protect against permanent residual neurological deficits. Lithium may also produce neurotoxic syndromes which develop chronically. There is a large variation among patients in relation to what constitutes a toxic serum lithium level. Both acute and chronic toxicity can occur with therapeutic range serum lithium levels. Failure to appreciate this fact may lead to delays in diagnosis and treatment, placing the patient at risk of permanent neurological damage or death. The diagnosis of lithium intoxication is largely clinical though the EEG may help if typical though non-specific EEG changes are present. If available, the red cell:plasma lithium ratio may be a sensitive indicator of intoxication. Prompt and effective treatment is indicated once the diagnosis of lithium intoxication is made. Prevention of intoxication, which requires the active involvement of both the doctor and patient, is crucial.","PeriodicalId":75709,"journal":{"name":"Clinical and experimental neurology","volume":"28 ","pages":"112-27"},"PeriodicalIF":0.0,"publicationDate":"1991-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12983702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Palmar cold threshold test and median nerve electrophysiology in carpal tunnel compression neuropathy. 掌冷阈试验和正中神经电生理在腕管压迫神经病中的应用。

Clinical and experimental neurology Pub Date : 1991-01-01

R A Westerman, C A Delaney

{"title":"Palmar cold threshold test and median nerve electrophysiology in carpal tunnel compression neuropathy.","authors":"R A Westerman, C A Delaney","doi":"","DOIUrl":"","url":null,"abstract":"The diagnosis of median nerve compression neuropathy at the carpal tunnel is usually confirmed by clinical electrophysiology. The classical findings of a significantly slowed median nerve conduction velocity for both sensory and motor fibres, with a prolonged distal motor latency and a reduced amplitude compared to age-related norms are unambiguous, but these criteria are often present only in part. In such cases another quantitative indicator of compression neuropathy would be extremely helpful. The present study aimed to test whether measurement of warm and cold sensory acuity in cases of putative median nerve carpal tunnel compression would aid diagnostic certainty. Warm sensation is mediated by unmyelinated C-afferents, while cold sensation is conveyed by thinly myelinated A delta afferents. Because compression usually blocks larger diameter fibres first, cold perception on the skin of the palm distal to the compression should be more impaired than is warm perception. Standard electrophysiological measurements (median and ulnar motor and sensory nerve conduction velocities) were made, then perceptual thresholds for both warm and cold stimuli were measured on the skin of the wrist above the carpal tunnel and on the palm of the affected hand in 59 subjects. There was a significantly reduced median motor nerve conduction velocity and prolonged distal motor latency compared to normals. Further, although both thermal thresholds at the wrist were normal, those on the palm were elevated, cold being significantly raised (P less than 0.02) compared both to warm and to age-matched controls. Correlation of the nerve conduction velocity findings and thermal sensory acuity did not yield significant covariance of the positive and negative findings. Overall the results suggest that detection of preferentially elevated cold perceptual threshold (ie reduced cold sensory acuity) on the skin of the palm may aid in the diagnosis of putative carpal tunnel compression in patients with minimal or ambiguous electrophysiological data and provide a functional index of recovery after decompression.","PeriodicalId":75709,"journal":{"name":"Clinical and experimental neurology","volume":"28 ","pages":"154-67"},"PeriodicalIF":0.0,"publicationDate":"1991-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12982927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Botulinum toxin treatment of spasmodic torticollis. 肉毒杆菌毒素治疗痉挛性斜颈。

Clinical and experimental neurology Pub Date : 1991-01-01

L Davies, I T Lorentz

引用次数: 0

Preliminary experience with 99mTc-HMPAO SPECT in cerebral ischaemia. 99mTc-HMPAO SPECT在脑缺血诊断中的初步体会。

Clinical and experimental neurology Pub Date : 1991-01-01

A E Baird, G A Donnan, M Austin, M R Newton, W J McKay

{"title":"Preliminary experience with 99mTc-HMPAO SPECT in cerebral ischaemia.","authors":"A E Baird, G A Donnan, M Austin, M R Newton, W J McKay","doi":"","DOIUrl":"","url":null,"abstract":"To assess the sequential changes seen in cerebral blood flow using Single Photon Emission Computed Tomography with 99mtechnetium-hexamethylpropylene amine oxime (99mTc-HMPAO SPECT) in acute ischaemic stroke, 35 patients were prospectively studied from June 1990- to March 1991. Scans were performed during the acute phase (1-7 days), sub-acute phase (8-21 days) and chronic phase of stroke (greater than 1 month). Nine patients underwent scans in all 3 phases, 15 patients had 2 scans, and 11 patients had one scan. The majority of infarcts were in the middle cerebral territory (15 patients), while 4 infarcts were in the posterior cerebral territory and two in the anterior cerebral territory. There was a total of 4 lacunar infarcts. Image analysis was by visual inspection and by semiquantitation using homologous regions of interest in opposite hemispheres. SPECT in the acute phase identified the final vascular territory affected in 19 of 27 patients. There were 8 patients in whom early SPECT predicted the vascular territory as seen on late CT scan when the early CT scan was normal. Hyperaemia or reperfusion in the involved vascular territory was identified in 10 patients on scans performed during the sub-acute phase. Late SPECT scans showed perfusion defects greater than the infarct size seen on CT scan in the majority of patients. In all cases, the perfusion defect on the late SPECT scan was equal to or larger than the defect seen on the acute or sub-acute scan. Crossed cerebellar diaschisis was identified in 8 patients, and cortical/subcortical diaschisis in one patient.(ABSTRACT TRUNCATED AT 250 WORDS)","PeriodicalId":75709,"journal":{"name":"Clinical and experimental neurology","volume":"28 ","pages":"43-9"},"PeriodicalIF":0.0,"publicationDate":"1991-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12984862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ataxia telangiectasia presenting as an extrapyramidal movement disorder and ocular motor apraxia without overt telangiectasia. 共济失调毛细血管扩张表现为锥体外系运动障碍和无明显毛细血管扩张的眼运动失用症。

Clinical and experimental neurology Pub Date : 1991-01-01

A Churchyard, R Stell, F L Mastaglia

引用次数: 0

A clinical and pathological study of progressive supranuclear palsy. 进行性核上性麻痹的临床与病理研究。

Clinical and experimental neurology Pub Date : 1991-01-01

J Frasca, P C Blumbergs, P Henschke, R J Burns

引用次数: 0

Vertebrobasilar embolism. 椎基底动脉栓塞。

Clinical and experimental neurology Pub Date : 1991-01-01

L R Caplan

引用次数: 0

Colour duplex flow imaging in carotid arterial disease: correlation with intra-arterial digital angiography. 颈动脉疾病的彩色双工血流成像:与动脉内数字血管造影的相关性。

Clinical and experimental neurology Pub Date : 1991-01-01

D H Todman, D J Hewson, B Seneviratne, P Walsh

引用次数: 0

Superior sagittal sinus thrombosis. 上矢状窦血栓。

Clinical and experimental neurology Pub Date : 1991-01-01

A Mohamed, J G McLeod, J Hallinan

{"title":"Superior sagittal sinus thrombosis.","authors":"A Mohamed, J G McLeod, J Hallinan","doi":"","DOIUrl":"","url":null,"abstract":"Seven cases of superior sagittal sinus thrombosis seen at Royal Prince Alfred Hospital over the 10 year period 1979 to 1989 have been reviewed. Diagnosis was confirmed by angiography, CT scan or autopsy. The average age was 33 years (16 to 47 years). Five of the patients were female and 2 male. On CT scan the 'empty delta' sign, present in 4 cases, was the most specific diagnostic feature. The underlying causes included primary thrombocythaemia, homocystinuria, post-angiographic investigation of an arteriovenous malformation, and oral contraceptives. In 2 cases no cause was found. Headache was the commonest and earliest symptom, being followed in frequency by convulsions and hemiparesis. Hemiparesis was the commonest sign observed, followed by papilloedema, cranial nerve palsies and impaired level of consciousness. Five of the patients developed signs and symptoms of raised intracranial pressure prior to the appearance of focal neurological deficits, mostly likely due to propagation of the thrombosis to cortical veins. There have been no controlled trials of therapy; however it is important to treat raised intracranial pressure rapidly and effectively, and although the role of anticoagulants remains controversial, their early use may be indicated when there is no radiological evidence of haemorrhage.","PeriodicalId":75709,"journal":{"name":"Clinical and experimental neurology","volume":"28 ","pages":"23-36"},"PeriodicalIF":0.0,"publicationDate":"1991-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12982808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0