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Biomedical subjects

A Minagar

Publications and source records attributed to A Minagar.

30 records · Page 2Linked to original sources
PubMed2000

Glossopharyngeal neuralgia and MS.

Glossopharyngeal neuralgia (GPN) is characterized by a severe lancing pain in the posterior pharynx, tonsillar fossa, and base of the tongue. It is induced frequently by swallowing and yawning. GPN has not been described previously in MS patients. The authors report four MS patients with GPN. Three responded to carbamazepine and one resolved during treatment with adrenocorticotrophin hormone (ACTH) and cyclophosphamide. Withdrawal of carbamazepine after 1 week in one patient resulted in recurrence of pain. GPN may be associated with MS and responds to carbamazepine.

Adult↗
PubMed2000

The effect of pregnancy in Parkinson's disease.

Pregnancy in patients with Parkinson's disease (PD) is a rare occurrence. Previous reports based on retrospective analysis suggest that pregnancy may have a deleterious effect on PD. We describe the effects of pregnancy on the symptomatology of a 33-year-old woman with PD using quantitative neurologic and quality-of-life scales prepartum, intrapartum, and postpartum. During her pregnancy, she was only treated with carbidopa/levodopa. The pregnancy resulted in a normal full-term vaginal delivery of a healthy infant. Significant worsening of this patient's motor symptoms occurred during pregnancy without return to baseline at 15 months postpartum. Pregnancy may exacerbate PD and may have a long-term negative impact on the course of the illness. This report may assist physicians in the counseling of patients with young-onset PD who wish to consider pregnancy.

Adult↗
PubMed2000

The use of dopamine agonists in very elderly patients with Parkinson's disease.

BACKGROUND: Controversy exists regarding the use of dopamine receptor agonists in elderly patients with Parkinson's disease because of concern about a high rate of intolerable side effects. METHODS: A retrospective chart review was used to examine our experience with dopamine agonist use in the very elderly by identifying patients in our Parkinson's disease database who were over the age of 80 years and who had received agonists. Sixty-nine patients were identified who had 120 separate trials of agonist therapy. Successful treatment with the agonist was defined as maintenance of the agonist for a minimum of 6 months. RESULTS: The overall success rate among the very elderly for an agonist trial was 46%. Success rates for individual agonists were 15 of 27 (56%) bromocriptine, 18 of 34 (53%) pergolide, 17 of 43 (40%) pramipexole, and 5 of 16 (31%) ropinirole. In successful trials with bromocriptine, the mean daily dose was 12.8 mg, mean duration of treatment was 40 months, and mean age at drug initiation was 82 years; for pergolide it was 1.8 mg, 32 months, and 83 years; for pramipexole 2.7 mg, 14 months, and 83 years, and for ropinirole 10.6 mg, 11 months, and 83 years. CONCLUSION: This study demonstrated that therapeutic dosages of dopamine agonists were well tolerated by 46% of very elderly patients who received a trial of an agonist. These results indicate that dopamine receptor agonist therapeutic trials are warranted in selected very elderly patients.

Aged↗
PubMed2000

Persisting aphasia as the sole manifestation of partial status epilepticus.

OBJECTIVES: Persisting aphasia presenting as an isolated inability to vocalize is an uncommon presentation of simple partial status epilepticus and only eight such cases have been reported over the past 40 years. METHODS: We studied a patient with a 5-year history of recurrent episodes of inability to talk, without any other motor or cognitive impairments. Episodes lasted as long as 24 h, interictal EEGs were normal and she was diagnosed as a conversion disorder. RESULTS: EEG recordings during one of the episodes showed continuous discharges in the right frontal and parasagital areas demonstrating the ictal nature of the deficits. During the episode the patient had no deficits of strength, or in her ability to perform skilled movements to command, imitation or manipulation of objects. Comprehension of complex verbal commands was preserved and she would make attempts to articulate words and correctly answered questions with head nodding or monosyllables, yes or no. She could hum but had no other vocalizations. CONCLUSIONS: This is the first case of aphasic status epilepticus secondary to epileptogenic discharges of the right hemisphere. The case is also unique for the isolated involvement of production of language during the seizure.

Aged↗
PubMed2000

Case report: one-and-a-half-syndrome and tuberculosis of the pons in a patient with AIDS.

A patient with advanced AIDS presented with right conjugate gaze palsy and impaired adduction on left gaze (the one-and-a-half syndrome). The responsible pontine lesion involved the ipsilateral abducens nucleus and the adjacent medial longitudinal fasiculus (MLF), as demonstrated by magnetic resonance imaging (MRI). Tuberculosis (TB) was the etiology of the brainstem lesion. The patient had complete recovery after anti-tuberculosis treatment. The nuclear location of the tuberculoma is unusual and the reversal of this neuro-ophthalmologic syndrome is noteworthy.

AIDS-Related Opportunistic Infections↗
PubMed1999

Amantadine-induced peripheral neuropathy.

We report a 48-year-old woman with a 17-year history of PD who developed a peripheral sensory-motor neuropathy secondary to chronic administration (8 years) of amantadine. Discontinuation of amantadine resulted in resolution of trophic skin ulcers, paresthesias, and distal weakness. Amantadine may be hazardous to patients with severe and chronic livedo reticularis.

Amantadine↗
PubMed1999

Pramipexole in progressive supranuclear palsy.

Progressive supranuclear palsy (PSP) is a progressive neurodegenerative disorder with no effective treatment. Dopaminergic agents occasionally produce transient symptomatic improvement. The authors report the results of pramipexole treatment (4.5 mg daily) in six patients with PSP (average disease duration, 4.4 years). Patients were treated for 2 months. Patients were evaluated with the Unified Parkinson's Disease Rating Scale, Hoehn and Yahr stage, and Schwab and England Activities of Daily Living Scale at baseline and 2 months. Pramipexole was not efficacious for the symptoms of PSP.

Aged↗
PubMed1999

Bilateral infarction in the territory of the anterior cerebral arteries.

An elderly hypertensive man had extensive bilateral infarction in the distribution of the anterior cerebral arteries. The circle of Willis was fully formed, but occlusion of the dominant anterior cerebral artery, aggravated and perhaps caused by postlaparotomy hypotension, produced the dramatic lesions, causing akinetic mutism. This stroke pattern occurs in various settings and does not require an anomalous azygous unilateral supply to both anterior cerebral arteries.

Cerebral Arteries↗
PubMed1999

Skin eruption with gabapentin in a patient with repeated AED-induced Stevens-Johnson's syndrome.

Skin eruptions have been reported with the use of all antiepileptic drugs and there is a significant risk of cross-reactivity between these agents in causing serious eruptions such as Stevens-Johnson's syndrome. Gabepentin is usually considered a safe agent for patients with a previous history of drug allergies and there have been no cases of skin eruption reported to the gabapentin post marketing surveillance. We report a patient who had severe Stevens-Johnson's syndrome induced by phenytoin and later by carbamazepine. Subsequent use of gabapentin also resulted in a skin eruption which was limited to the lower extremities but without systemic or mucosal involvement. This case suggests that patients with a strong history of drug-induced idiosyncratic reactions may experience such reactions to gabapentin as well.

Acetates↗