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Biomedical subjects

A J Larner

Publications and source records attributed to A J Larner.

At least 19 recordsLinked to original sources
PubMed2007

Transient global amnesia in the district general hospital.

Cases of transient global amnesia (TGA) seen by one consultant neurologist over a 4-year period (2002-2005 inclusive) were identified. Of 10 possible cases, eight fulfilled suggested diagnostic criteria. Five cases were seen as ward consultations, three in outpatient clinics; seven were seen in district general hospitals. Six of the eight cases had already been seen by hospital physicians, whose working diagnoses included stroke/TIA and epilepsy. In some cases, this had resulted in inappropriate investigation, treatment and advice. Although rare, TGA is a diagnosis both hospital physicians and general practitioners need to be aware of in order to avoid potential pitfalls. The critical importance of collateral history in reaching the diagnosis is emphasised.

Aged↗
PubMed2006

The R269H mutation in presenilin-1 presenting as late-onset autosomal dominant Alzheimer's disease.

Two siblings fulfilling clinical diagnostic criteria for late-onset Alzheimer's disease (AD) are reported. The family history suggested a total of nine individuals affected with AD in three generations with autosomal dominant disease transmission. Neurogenetic testing of the proband revealed a mutation, R269H, in the presenilin-1 (PS1) gene. Late-onset AD may be associated with deterministic PS1 mutations; these should be sought when the family history suggests autosomal dominant disease transmission.

Age of Onset↗
PubMed2006

The diagnosis of dementia: diagnostic accuracy of an instrument measuring activities of daily living in a clinic-based population.

BACKGROUND/AIMS: Since widely accepted definitions of dementia encompass impairments in social and occupational, as well as cognitive, function, we investigated the diagnostic accuracy of Lawton and Brody's Instrumental Activities of Daily Living (IADL) Scale as an independent test for the diagnosis of dementia. METHODS: The IADL Scale was administered to consecutive referrals to 2 memory clinics over a 2-year period, independent of other tests (interview, neuropsychology, imaging) which were used to establish diagnoses according to standard diagnostic criteria, and the results were compared. RESULTS: In a cohort of 296 patients, 52% adjudged to have dementia, IADL Scale scores and subscores showed low sensitivity, specificity, and positive and negative predictive values for the diagnosis of dementia. The likelihood ratios, a measure of diagnostic gain, were generally small to unimportant, and diagnostic accuracy as measured by area under the receiver operating characteristic curve was no better than 0.75. CONCLUSION: IADL Scale scores are not very helpful in making a diagnosis of dementia. More sensitive scales may be required to detect dementia-related functional decline, although it is also possible that dementia syndromes may be present in the absence of functional decline, challenging accepted definitions of dementia.

Activities of Daily Living↗
PubMed2006

Prevalence and causes of seizures at the time of diagnosis of probable Alzheimer's disease.

BACKGROUND/AIMS: To investigate the frequency of epilepsy at the time of diagnosis of Alzheimer's disease (AD). METHODS: Observational study, Cognitive Function Clinic population, over a 6-year period (2000-2005 inclusive). RESULTS: In a cohort of 177 patients with newly diagnosed clinically probable AD, 12 (6.8%) had a history of seizure disorder and/or were using anti-epileptic medications at the time of diagnosis. In 6 of these cases (3.4%), seizure onset was approximately concurrent with the onset of cognitive decline, and no symptomatic or provoking factor for seizures other than AD was identified. CONCLUSION: Although epileptic seizures are more common later in the course of AD, nonetheless they may accompany the onset of, and be symptomatic of, the disease, perhaps reflecting a shared pathogenesis.

Aged↗
PubMed2006

A possible account of synaesthesia dating from the seventeenth century.

An account of a blind man able to detect colors by touch, dating from the mid-seventeenth century, is presented. The details come to us through the physician John Finch, the scientist Robert Boyle, and the author Jonathan Swift. The details in the account suggest the possibility that this may be an early report of colored-touch synaesthesia.

Color↗
PubMed2006

Headache induced by dopamine agonists prescribed for prolactinoma: think SUNCT!

Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) syndrome may be associated with pituitary prolactinoma and may be induced by treatment of prolactinoma with dopamine agonists. Endocrinologists treating patients with prolactinoma need to be aware of this syndrome as its pathophysiology and treatment differ from that of other headache syndromes.

Adult↗
PubMed2006

Antisocial behaviour orders: the need to consider underlying neuropsychiatric disease.

Antisocial behaviour orders are legally constituted civil orders which aim to stop undesirable behaviour as part of United Kingdom government plans for crime reduction. They have been increasingly used since their introduction in 1999 and have attracted much media attention. The need to consider neurological illness as a possible cause of behaviour deemed anti-social is illustrated by a patient eventually diagnosed with neuroacanthocytosis.

Adult↗
PubMed2006

Primary headache disorder in the emergency department: perspective from a general neurology outpatient clinic.

Over a six month period, 22% of patients with headache seen in general neurology outpatient clinics reported prior attendance at an emergency department because of their headache; 9% of the headache cohort had been admitted to hospital. All had primary headache disorders according to International Headache Society diagnostic criteria. Improved primary care services for headache patients are required to reduce the burden of primary headache disorders seen in emergency departments.

Adolescent↗
PubMed2006

Searching the Internet for medical information: frequency over time and by age and gender in an outpatient population in the UK.

The frequency of home Internet access and use to search for medical information was measured by questioning consecutive new patients referred to the neurology outpatient department for three-month periods in five consecutive years (2001-05). In a cohort of over 1000 patients, 40% reported home access to the Internet, and 11% had undertaken searches for medical information prior to clinic attendance. The frequency of Internet searches was consistent over time and by patient gender, but varied by patient age, being higher in the younger age groups. Of the 114 patients undertaking Internet searches, 45 (39%) were judged to have accessed information or reached conclusions inappropriate to the final neurological diagnosis. However, no patient was judged to have come to physical harm as a result of accessing information inappropriate to the final neurological diagnosis. Data on health-information-seeking behaviour through Internet searching are relevant not only to clinical consultation, but also to the possibilities of targeting health-related information and to email consultation.

Adult↗
PubMed2006

David Livingstone's uvulectomy.

In April 1852 in Cape Town, South Africa, Dr David Livingstone, then 39 years of age and yet to commence the explorations of Africa which would bring him to public attention, underwent the surgical procedure of uvulectomy. This article reviews the history of Livingstone's uvulectomy and its indications and outcome, as documented by his own writings. The practice of uvulectomy in indigenous African societies and some contemporary ideas about uvulectomy are also considered in order to try to ascertain why Livingstone elected to undergo this procedure.

Attitude to Health↗
PubMed2006

Neuroinhibitory molecules in Alzheimer's disease.

Aberrant neurite growth is one of the neuropathological signatures of the Alzheimer's disease brain, both around amyloid plaques and in the cortical neuropil. Disruption of neuroinhibitory or repulsive growth and guidance signals, as well as of neurotrophic or permissive signals, may contribute to this dystrophic growth. Hence, therapeutic efforts directed exclusively at restoring neurotrophic activity are unlikely to meet with success. The molecular species responsible for neuroinhibitory effects in the Alzheimer's disease brain are beginning to be elucidated.

Alzheimer Disease↗