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Biomedical subjects

A A Burt

Publications and source records attributed to A A Burt.

13 recordsLinked to original sources

Prognostic value of cortical magnetic stimulation in spinal cord injury.

Cortical magnetic stimulation was performed in a consecutive series of 10 patients presenting within 15 days of traumatic spinal cord injury. In those patients with complete paraplegia or quadriplegia, motor evoked potentials at presentation were absent below the level of the lesion. Six months after the injury, potentials had returned in the biceps brachii and abductor pollicis brevis muscles in some quadriplegic cases, but remained absent from the tibialis anterior in all of this group. None of those with a complete lesion made a significant functional recovery. Of the three patients with incomplete quadriplegia, two showed a significant recovery after 6 months. Motor evoked potentials were recordable below the level of the lesion at presentation in these cases, although the latencies were prolonged. In the remaining patient who failed to improve, potentials were unrecordable throughout the study. This small pilot study suggests that cortical magnetic stimulation may be useful in refining the prognosis in patients with an incomplete spinal cord injury.

Adolescent↗

Prophylactic low dose heparin anticoagulant therapy in patients with spinal cord injuries: a retrospective study.

A retrospective study was performed of 100 consecutive acute traumatic spinal injury patients with neurological deficit admitted to the Yorkshire regional spinal injuries centre prior to May 1990. Ninety-seven of these patients received prophylactic low dose subcutaneous heparin and 3 patients were excluded because of noted complications. Twenty-six patients developed thromboembolic complications. Apart from the fact that acute spinal cord injury patients are considered to be in an hypercoaguable state, the occurrence of deep vein thrombosis/pulmonary embolism (DVT/PE) in our study, even though these patients were on prophylactic low dose subcutaneous heparin, was related to delay in transfers, operative intervention, level of spinal cord injury and was possibly due to loss of some amount of heparin solution from the prefilled syringe during removal of air bubbles prior to the subcutaneous heparin injection.

Acute Disease↗

Myotonic dystrophy and traumatic quadriplegia: case report.

A thirty-year-old man with traumatic quadriplegia, was also found to have weakness above the level of the injury. He had facial weakness, difficulty in swallowing, and recurrent respiratory problems. A diagnosis of myotonic dystrophy was supported by examination of his sister. The problems of diagnosis, and the implications of the diagnosis on the management of the patient with myotonic dystrophy and a spinal injury are discussed.

Adult↗

Status epilepticus complicating migraine.

We describe 2 patients who developed status epilepticus in association with migraine attacks. One patient died and at the autopsy had ischaemic changes confined to the occipital lobes. The second patient made an uneventful recovery.

Adult↗

Successful rehabilitation in conversion paralysis.

A rehabilitation programme for patients with conversion paralysis has been introduced in which they are offered physical rehabilitation. During an eight month period between October 1984 and May 1985 six patients who had been diagnosed as dependent on wheelchairs owing to conversion paralysis for a mean of 3 years (range 1-6 years) were entered into the inpatient neurorehabilitation programme. All six patients were able to walk within a mean of 41 days (range 10-70 days), and then relinquished a variety of aids and allowances as a result of their regained mobility. They continued to be independent at outpatient review for a mean of 10 months (range 8-15 months). Successful rehabilitation from wheelchair dependency can be achieved by a cost effective, prolonged, inpatient neurorehabilitation programme.

Adolescent↗

Brain stem signs in acute cervical cord trauma.

Four cases are reported which illustrate mechanisms by which patients with cervical cord trauma may develop signs of acute brain stem damage. Two patients suffered vertebro-basilar ischaemia as a result of trauma to the vertebral arteries. The remaining two patients developed cavitating lesions within the cervical cord which later dissected rostrally into the brain stem.

Brain Stem↗

Suprapubic catheterisation after spinal cord injury: a follow-up report.

The spinal injury patients who were initially treated by suprapubic catheterisation and reported from this unit in 1976 have been reviewed. Fifteen had died by early 1982; only in two cases from renal causes. All but one of the 23 survivors seen has a normal blood urea, and 15 have normal intravenous pyelograms. Eight patients have abnormal IVPs; the abnormalities were insignificant in four, and have been treated in two. Two patients have unilateral nonfunctioning kidneys. These results suggest that no long term ill effects result from the technique. In view of its considerable administrative advantages suprapubic urinary drainage should become more widely used.

Adult↗

Some extrapyramidal motor signs in cases of undifferentiated amentia.

A group of 50 mentally handicapped patients who were without gross motor deficit and had never been on anti-psychotic drugs were examined for signs of Parkinsonism and compared with a matched control group of non-handicapped people who were also examined. There was a very significant increase in masking, positive glabella tap, absence of arm swing, rigidity and hypokinesis.

Adult↗

Acute spinal epidural abscess.

A case of acute spinal epidural abscess is reported demonstrating many of the important features in the natural history of the disorder. The pathological changes in the cord at the level of the lesion are described. A series of 12 patients is reviewed. The average interval between the initial consultation and the onset of complete paralysis is 5 days and it is essential that the diagnosis is made during this period. Two indicators of prognosis are discussed--the duration of complete paralysis and the extent of sensory disturbance.

Abscess↗

Percutaneous cystostomy in paraplegia--a follow-up of 41 patients.

Percutaneous cystostomy using a fine calibre (9 Charriere) plastic trocar and cannula has been used in 51 male patients in the early weeks following spinal cord injury. The results are satisfactory. Of the last ten patients none has been catheterised per urethram; eight of these patients are now passing urine satisfactorily using a condom urinal.

Adolescent↗

Peripheral motor nerve function in diabetic autonomic neuropathy.

Motor conduction velocity was measured in the median, ulnar and common peroneal nerves of 32 diabetics with clinical features of autonomic neuropathy. The responses to the Valsalva manoeuvre and sustained handgrip, and the postural fall in blood pressure were used to assess the integrity of the autonomic nervous system. Abnormalities in the three autonomic function tests were significantly correlated with the forearm conduction velocity of the ulnar nerve, the conduction velocity and motor latency of the common peroneal nerve, and the H reflex. These results show that, in diabetics with autonomic neuropathy, abnormalities in the autonomic nervous system parallel changes in the peripheral nerves. Any diabetic with peripheral neuropathy should be examined for evidence of autonomic nervous system involvement.

Adult↗