摘要:

d‐propranolol is almost devoid of beta‐blocking effect but has the same membrane stabilizing properties as the dl‐form. In order to study the importance of membrane stabilizing activity versus beta blockade in the therapeutical effect of propranolol on essential tremor, we compared d‐propranolol with dl‐propranolol in 24 patients in a placebo‐controlled double‐blind cross‐over study. dl‐propranolol reduced tremor intensity better than d‐propranolol. The d‐form did not significantly differ from placebo in its effects on tremor, although it did reduce the heart rate slightly. It is concluded that the membrane effect is not important in the therapeutic effect of propranolo

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1982.tb06847.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

The incidence of stroke in the young is reported to be high in India. The role of the mitral valve prolapse (MVP) syndrome in these patients is not clear. A prospective study over a period of 1 year was carried out in order to evaluate the role of MVP in cases of stroke occurring in patients below the age of 40 years. Of the 38 cases of stroke in the young seen during this period, well‐recognised risk factors of stroke could be detected in 17. MVP confirmed by M‐mode echocardiography was seen in 13% of all stroke patients and in 23.8% of those in which there were no other risk factors. The incidence of MVP was much higher if only the clinical criteria for diagnosis were used. We believe that MVP is a significant risk factor in younger stroke patients, and, in such cases, merits investigation. The probable pathogenic mechanisms and therapeutic implications are discus

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1982.tb06848.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

45 cases of partial seizures of temporal lobe origin undergoing sequential EEG investigation first with routine and then methohexitone activated EEG, 31 supplemented by sphenoidal electrodes, are reported.Methohexitone activated foci from temporal lobes which had previously not displayed temporal spike or sharp wave discharges in 15 (33.3%) cases. In 11 (24.4%) this was the first evidence of a focus in 15 (33.3%) cases. In 11 (24.8%) this was the first evidence of a focus in either temporal lobe and in 4 (8.9%) the focus was contralateral to one already seen in routine EEG. In 3 (6.7%) cases the sphenoidal electrodes were essential for demonstrating the focus. Methohexitone evoked temporal spikes or sharp waves irrespective of the nature of the initial routine EEG which was either normal, had non “epileptic” temporal abnormalities or abnormalities outside the temporal region.2 × 2 χ2tests, comparing the frequency with which a particular symptom was accompanied by an EEG in a sequence with temporal discharges, showed that only in the case of evolution to generalised tonic/clonic seizures (secondary generalization) was the association statistically significant: χ24.28,P<0.025. Similar testing of length of history and frequency of attacks against the frequency with which temporal discharges occurred failed to establish a statistically significant assoc

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1982.tb06849.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Computerised tomography of the brain was used to demonstrate basal ganglia calcification which may be of an insufficient degree to be seen on skull X‐ray.Cases referred for CT scan from hospitals in Singapore for various reasons over a period of 12 months were studied for basal ganglia calcification. There was a startlingly high incidence of 1.5%, as 47 cases (all except 2 were Chinese) showed such calcification. In 42 cases there was no evidence of basal ganglia calcification on skull X‐ray. 16 cases showed neurological affection, fits being the commonest manifestation.An unexpected finding was that no case had abnormality of calcium metabolism or evidence of hypoparathyroidism or pseudohypopara‐thyroidism.The CT scan is very sensitive in demonstrating minimal basal ganglia calcification and our impression is that such calcification is c

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1982.tb06850.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

60 consecutive patients (age 15‐77 years) with the Guillain‐Barré syndrome were studied. 37 subjects had an antecedent infection. Onset occurred with motor and/or sensory limb symptoms in 56 cases; 4 subjects experienced onsets with pain, diplopia or bladder disturbances. The motor symptoms reached a maximum within 42 days in all cases, 87% within<20 days. All patients had limb‐muscle weakness at the symptomatic maximum; 50% exhibited cranial‐nerve affections and 10 subjects had respiratory insufficiency. Signs of a remission appeared within 60 days after onset in all cases surviving the maximal phase, 81% within<40 days. The CSF protein concentration was elevated (0.6‐7.8 g/l) in 95% of the patients; an increased mononuclear cell count (6‐60 × 106/l) occurred in 27% of cases. Electrophysiological abnormalities were detected in 42 out of 43 examined cases.Totally there were 4 deaths, all caused by cardiac or thrombo‐embolic events. Surviving patients had restitutions without functionally significant sequelae within less than 6 months after onset in 73% of cases; all but 2 of the remaining patients recovered within 18 months. The degree of muscle weakness at maximum was the predominant pr

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1982.tb06851.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

The serum lipid levels of 200 epileptics (aged 20 to 40 years) undergoing long‐term treatment with anticonvulsants were measured and compared with the levels of a normal population of the same age. The epileptics had higher serum lipid levels (especially of apolipoprotein B and HDL‐cholesterol) but no higher incidence of hyperlipemias. A correlation between LDL‐cholesterol and vitamin E has been found in epileptics, but it was not as significant as in normals. In male epileptics, positive correlations between the average daily dose of anticonvulsants (especially of those with a well‐known enzyme‐inducing effect) and triglycerides, cholesterol and LDL‐cholesterol were found; in females there were no significant c

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1982.tb06852.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

The serum concentrations of the vitamin D metabolites 25‐hydroxy‐vitamin D (25OHD), 24,25‐dihydroxyvitamin D (24,25(OH)2D), and 1,25‐dihydroxyvitamin D (1,25(OH)2D) were measured in 18 epileptic patients and 10 controls. The patients were divided according to the anti‐convulsant treatment they had been receiving for at least 1 year: 9 patients had received phenytoin and 9 patients carbamazepine, as the sole anti‐convulsant therapy.The serum 25OHD was decreased in the patients on phenytoin (P<0.01). whereas the other serum vitamin D metabolites were normal. Moreover, serum alkaline phosphatase was increased (P<0.001) and serum calcium was decreased (P<0.001) in this patient group.In the patient group treated with carbamazepine (a negligible liver inductor), changes in serum 25OHD and serum alkaline phosphatase were less pronounced (P<0.05), but the same degree of hypocalcaemia (P<0.001) was present.Our data suggest that liver induction in epileptic patients on anti‐convulsant drugs cannot explain the pathophysiology behind anti‐convulsa

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1982.tb06853.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

A correlation has been reported between the development of MS and sibling birth order. We have re‐examined the question in 2 groups of MS families. The first group consisted of 175 MS patients from single affected families. The second consisted of 36 families in which 2 or more sibs in the family had MS. Our results show no association between birth order and MS in single‐affected sibships. In multiplex sibships, affected individuals appear to be randomly orde

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1982.tb06854.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

51 sequential determinations of cerebrospinal fluid (CSF) lactate dehydrogenase (LDH) isoenzyme in 5.5% polyacrylamide gel were performed in 26 samples from patients with brain tumors. The assay was made prior to and after treatment. 26 untreated patients demonstrated elevated total LDH activity. 17 of 26 patients showed altered isoenzyme pattern. Disappearance of LDH5, decrease of LDH4and relative increase of LDH2were accompanied by improvement in clinical status in 15 of 26 patients. This suggests the utility of the CSF LDH isoenzyme pattern to monitor the clinical status of treatment in brain tumors.

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1982.tb06855.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Analysis of the initial symptomatology, age at onset and course as factors influencing the prognosis of multiple sclerosis (MS) revealed that the rate of deterioration in a sample of 1,571 patients ‐ registered during a neurological examination in a standardized way ‐ was slower for patients with optic neuritis as the initial sign, for patients with an age at onset of under 39 years and for patients with a remissive course of disease.The progression index, obtained by dividing the present disability by the duration of the disease was used as a measure for the rate of progression.The course of the disease was responsible for 13% and age at onset for 1.6% of the total variation in the progression index.Endogenous or exogenous factors may modify the appearance and dynamics of MS which might be a syndrome rather than a disease ent

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1982.tb06856.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY