ISSN:0014-3022    

DOI:10.1159/000203262

出版商:S. Karger AG    

年代:1912

数据来源: Karger

摘要:

The interim results of the nationwide collaborative study on the long-term effects of bromocriptine in patients with Parkinson’s disease are reported. Four years ago, two prospective clinical studies were started to evaluate the long-term effects of bromocriptine in Parkinson’s disease. The first was to investigate the long-term effects of bromocriptine monotherapy and the second to see the long-term effects of a combination therapy of bromocriptine with levodopa. Patients who had never been treated with levodopa were placed on bromocriptine monotherapy, and those who had been treated with levodopa for not more than 5 years were allocated randomly to either the combination or the levodopa group. Two hundred and eighty-six patients were enrolled in the former study and 416 in the latter. Among the 286 patients, 164 continued for further observation at the end of the fourth year, and 74 of them were still being treated with bromocriptine monotherapy. However, in 78, levodopa had to be added. Among the 416 patients in the second study, 216 were allocated to the combination group and 200 to the levodopa control group. At the end of the fourth year, 130 in the former and 140 in the latter group remained for further observation. In all three groups, a gradual loss of efficacy was noted. The rate of efficacy loss appeared largest in the monotherapy group and smallest in the combination group. Effects on tremor and rigidity are still maintained, but effects on akinesia and gait were lost by the end of the fourth year in all groups. Wearing-off and dyskinesias seem to be better managed by the combination therapy. The incidence of wearing-off was very small in the monotherapy group. No serious side effects were encountered except for 1 patient who died of pulmonary fibrosis in the combination gr

ISSN:0014-3022    

DOI:10.1159/000116716

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

Trace element levels were measured by neutron activation analysis in spinal cord, liver and bone of 7 control patients dying of non-neurological disease and 15 patients dying of motor neurone disease (MND). The concentration of selenium was significantly elevated in the cervical cord, liver and bone in the MND group. Although spinal cord manganese levels were increased at both the cervical and thoracic levels, the hepatic concentration was reduced in the MND patients. These findings are discussed in relation to current understanding of the pathogenesis of MND.

ISSN:0014-3022    

DOI:10.1159/000116626

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

Nocturnal polygraphic recordings (electroencephalography, electro-oculography, submental and intercostal muscle electromyography, electrocardiography, respiration by thoracic strain gauges and oronasal thermistors) with continuous monitoring of arterial oxyhemoglobin saturation by pulse oximeter were performed in 8 patients with ophthalmoplegia plus. All patients except 1 had normal blood gas values and normal lung volumes associated with a diminished ventilatory response to inhaled CO2 during wakefulness. Four patients showed pathological sleep-related breathing patterns consisting of sleep apneic polygraphic tracings mainly of the central type or of REM-related hypoventilation episodes. It is suggested that these disorders in patients with ophthalmoplegia plus may have a central origin and be related to the underlying metabolic disturbance.

ISSN:0014-3022    

DOI:10.1159/000116627

出版商:S. Karger AG    

年代:1991

数据来源: Karger

ISSN:0014-3022    

DOI:10.1159/000203218

出版商:S. Karger AG    

年代:1912

数据来源: Karger

摘要:

The objectives of this review are, first, to summarize results from clinical trials on patients with Parkinson’s disease using grafts of either adrenal medulla or fetal substantia nigra and, second, to discuss some of the scientific issues that need to be clarified in more detail before transplantation can become a real therapeutic alternative in Parkinson’s disease. Adrenal medulla autotransplantation using open microsurgery has been shown to effect a modest reduction of the duration and severity of off periods in about 30–50% of operated patients and to have a high morbidity and mortality rate. The mechanisms of improvement are unknown. It is concluded that adrenal medulla autotransplantation is an experimental approach and not a treatment for Parkinson’s disease. Animal experimental data clearly favour the use of fetal dopamine (DA) neurons in patients, and clinical trials using such grafts are now going on in several countries. We have implanted human fetal mesencephalic tissue into the striatum in 6 patients. The findings indicate that fetal DA neurons can survive in the human parkinsonian brain and produce therapeutically valuable functional effects. Together with the solid animal experimental data the clinical observations support the idea that neural transplantation can be developed into an effective therapy in Parkinson’s disease. However, it should be emphasized that such a treatment is presently not available and that further work is necessary to optimize the transplantation procedure, e.g. with respect to the yield of surviving DA neurons and the location and number of implantation sites to achieve the largest possible symptomatic im

ISSN:0014-3022    

DOI:10.1159/000116717

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

We report the case of a patient with Brown-Sequard syndrome resulting from Borrelia burgdorferi infection. Antibiotic treatment led to complete recovery.

ISSN:0014-3022    

DOI:10.1159/000116628

出版商:S. Karger AG    

年代:1991

数据来源: Karger

ISSN:0014-3022    

DOI:10.1159/000203263

出版商:S. Karger AG    

年代:1912

数据来源: Karger

摘要:

Two patients with simple partial epileptic seizures were able to abate their attacks by vigorous somatosensory stimulation of the body part initially involved by the seizure. In both patients, the seizure symptoms progressed in a marching fashion which suggests a gradual spread of the epileptic discharge from its initial locus to adjacent areas.

ISSN:0014-3022    

DOI:10.1159/000116629

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

An electrophysiological follow-up was performed in a rare case of subacute sclerosing panencephalitis (SSPE) that from the vegetative stage had an extremely favourable course, lasting 4 years, in which clinical conditions passed, according to the Risk and Haddad scale, from stage 3 to stage 1. In this period of time, 5 CT scans and a series of EEGs, visual evoked potentials (VEPs) and brainstem auditory evoked potentials (BAEPs) were performed to investigate the correlation between clinical course and electrophysiological diagnostic data. The results showed a significant improvement in diagnostic results, directly correlated with the remission of clinical symptoms. Electrophysiological signs of improvement in VEPs were obtained before observable improvement was seen on CT scans. These results indicate that an accurate electrophysiological study (through cerebral evoked potentials) has an important role in investigating suspected cases of SSPE, in following the clinical evolution of this disease and providing prognostic data.

ISSN:0014-3022    

DOI:10.1159/000116630

出版商:S. Karger AG    

年代:1991

数据来源: Karger