摘要:

Phenytoin (PT) and carbamazepine (CBZ) are the two most prescribed anticonvulsants in Finland. Their effect on the cognitive functions of 43 newly diagnosed epileptic patients was examined. The medication was randomly assigned. The patients were tested before the medication was started, and after half a year's therapy. In order to estimate the practice effect in repeated testing a control group of 21 volunteers was similarly tested and retested. Both anticonvulsants, PT in particular, decrease the normal practice effect observed in neuropsychological testing. Compared to the CBZ group, patients with PT became somewhat slower, and their visual memory decreased. Within the PT group the motor slowing was more marked in female patients, and in patients having higher PT serum levels. In PT and CBZ groups there was an equal decrease in negative mood i.e. tension, depression, bewilderment and irritability.

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1994.tb01640.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The neuro‐ophthalmological manifestations of 20 patients with the syndrome of ophthalmoplegia, ataxia and areflexia are described. The symmetrical nature of the ophthalmoplegia and the associated cerebellar ataxia point to centrally placed lesions. Several supranuclear, nuclear and internuclear ophthalmological signs are identified. Some of these, like partial sparing of the levator palpebrae and normal downgaze in the presence of severe ophthalmoplegia are noted too frequently to be just unusual signs of peripheral oculomotor dysfunction. Other identified features included upper lid retraction on attempted upgaze and preserved Bell's phenomenon in the presence of paralysis of the latter, as well as several other central ophthalmological signs. These findings contrast with those seen in the Guillain‐Barré syndrome and, thus, the syndrome of ophthalmoplegia, ataxia and areflexia is not a mere variant o

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1994.tb01641.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Lymphocyte subpopulations, T cell activation antigens, and serum levels of interleukin 2 (IL‐2) and soluble IL‐2 receptor (sIL2R), were studied in relapsing‐remitting MS (RR‐MS) patients before and after high‐dose steroid therapy. Prior to therapy, a minority of patients showed increased HLA‐DR antigen expression, and an increased number of CD16 + and CD19+ cells. Steroid treatment induced a significant increase in HLA‐DR and CD 19 expression, a significant reduction in CD 16 +, CD57 +, and CD8 + CD57 + cells, and a slight, non‐significant, decrease in IL‐2 and sIL‐2R levels and CD25 expression on

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1994.tb01642.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

To elucidate whether any relationship exists between genetic polymorphic acetylation and the risk for multiple sclerosis (MS), we determined this polymorphism, using sulphamethazine, in 71 patients with definite MS and in 268 age‐matched controls. Thirty‐seven patients (52.1%) and 151 controls (56.3%) were classified as slow acetylators (not significant difference). No relation was found between acetylator polymorphism and age at onset of disease in MS patient's group. Our results do not support the existence of any relationship between acetylator polymorphism and the risk for

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1994.tb01643.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

We studied saccadic and smooth pursuit eye movements in 24 patients suffering from multiple sclerosis during disease worsening, before and after high‐dose 6‐methylprednisolone infusions. Quantitative evaluation of saccades was based on amplitude/duration and amplitude/peak velocity relationships, precision (i.e. the ratio of actual to desired saccade amplitude) and the latency, whereas smooth pursuit eye movements were studied using target velocity/performance index relationship. At basal recordings, 22/24 (91.7%) of the patients showed at lest one abnormality. Eleven of the 24 patients (45.8%) showed modification of one or several parameters: improvement in 6 patients, worsening in 2, coexistence of both trends in 3. Latency improvement was the only significant modification when patients were considered as a group. Neurophysiological modifications did not correspond to clinical chan

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1994.tb01644.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The records of 100 patients with anorexia nervosa were reviewed. Neurologic complications were present in 47 patients. Neuromuscuiar abnormalities were most common and were present in 45% of patients. Generalized muscle weakness was detected in 43% of patients and peripheral neuropathies in 13%. Less common neurologic complications included headaches (6%), seizures (5%), syncope in the absence of orthostatic hypotension (4%), diplopia (4%), and movement disorders (2%). Neurologic problems due to chronic deficiency diseases were rare; only one patient had symptoms directly attributable to a vitamin B12deficiency and none had evidence of Wernicke's encephalopathy. In most patients, the neurologic complications were reversed completely after correction of nutritional deficiencies and fluid and electrolyte imbalances.

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1994.tb01645.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Three cases affected by peripheral neuropathy associated to monoclonal gammopathy of undetermined significance (MGUS) were treated by using selective apheretic techniques, chosen on the basis of the serological characteristics of the gammopathy. Double filtration plasmapheresis was used in the first two cases, respectively affected by gammopathy of IgM type, kappa chains, and IgG type, lambda chains; protein A immunoadsorption in Case 3 with IgG type, lambda chains. Apheretic sessions were performed for three‐four months, in association with low‐dose immunosuppressive therapy. Clear and stable improvement of the neuropathy over 12‐month follow‐up period was observed both from a clinical and electrophysiological point of view. It is concluded that in peripheral neuropathy associated with MGUS selective techniques of apheresis can prove useful both in obtaining positive results and in avoiding the collateral effect of the original plasma e

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1994.tb01646.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Eighteen consecutive patients with inclusion body myositis (IBM) were studied. The mean age of onset of symptoms was 60 years. A typical clinical pattern with insidious onset of muscle weakness in knee extensors and finger flexors combined with dysphagia was observed. Serial measurements of the maximal voluntary muscle strength revealed a mean loss of muscle strength of 1.4% per month. Two of the cases had common variable immunodeficiency, and three cases had reduced levels of the IgG3 subclass. Treatment with prednisone resulted in a temporary improvement of muscle function in three patients. No positive effect of azathioprine or cyclosporine A could be documented. The results show that IBM may be associated with immunodeficiency, and that prednisone treatment may temporarily improve the clinical signs. The results from our studies on the progression of the muscle weakness may provide basis for future studies on treatment of IBM.

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1994.tb01647.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

This study aimed to explore verbal and spatial memory spans in Alzheimer's (AD) and multi‐infarct (MID) demented patients. For this purpose, we administered the forward and backward versions of the Digit Span and of the Corsi test to 18 AD, 18 MID and 26 controls. Results revealed a normal forward verbal span but reduced backward verbal and forward and backward spatial spans in both demented groups. These data are discussed in the light of the Working Memory model. It is argued that the normal verbal forward span is sustained by a normally functioning Articulatory Loop. The deficient processing resources of the Central Executive, on the other side, are responsible for the reduced extension of the other memory spans. The possible anatomical substrate of short‐term memory impairment in dementia, as well as alternative interpretations of memory span performance in demented patients are discus

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1994.tb01648.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Of 99 consecutive patients with meningococcal disease, 6 died during the acute stage. The 93 survivors were examined one year after hospitalization. 21 (40%) of the adults and 6 (15%) of the children had definite sequelae, and an additional 27% and 11% possible sequelae. 6 adults (12%) and 1 child (2%) had definite neurological sequelae. Electroencephalography (EEG) abnormalities were observed in 7 adults (14%) and 2 children (5%). Epileptogenic activity was present in 3 of these, but none had experienced seizures. 8 adults (19%) and 5 children (14%) had sensorineural hearing loss or impaired vestibular function. Cerebral computerized tomography (CT) scan showed definite and possible abnormalities in 1 (3%) and 6 (18%), respectively, of the 34 patients tested. Neuropsychological tests were performed in 9 patients, 2 of these showed definite impairment. The frequency of neurological abnormalities was higher than in many previous studies, probably reflecting the more comprehensive examinations performed in the present study. However, only 3 patients had serious sequelae. The results suggest that the occurrence of sequelae after meningococcal disease is related to the severity of the acute disease. This may explain the higher rate of sequelae in adults, who have a higher proportion of seriously ill patients. The presence of meningitis is not required for the occurrence of neurological sequelae.

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1994.tb01649.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY