Biomedical subjects
Publications and source records attributed to B J Ansink.
The case of a 63-year old man is presented in whom remission of a primary central nervous system lymphoma was achieved by corticosteroids only. After discontinuation of steroid therapy the remission persisted for two and a half years. Recurrences appeared at other sites of the brain, and were steroid resistant.
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One hundred recurrent headache patients, referred for neurologic examination, were randomly invited for a functional examination of their stomatognathic system. The patients were grouped on the basis of headache localization, neurologic diagnosis of the headache, and stomatognathic diagnosis. The relationship between groups was analyzed. Several significant correlations were found between the clinical findings and the localization of headache (P less than 0.05 to P less than 0.001). Patients with or without a definite craniomandibular disorder pain displayed differences in mouth opening capacity (P less than 0.001). The results indicate a close relationship between recurrent headache and craniomandibular disorders, independent of the neurologic diagnosis of the headache.
The stomatognathic system was examined in 100 chronic recurrent headache patients, and the asymmetry in clinical and radiographic findings was studied. A clinically recorded facial asymmetry was found more frequently in patients with a definite CMD pain (P less than 0.001), in patients with mainly a unilateral headache (P less than 0.01), and in patients with a head injury in the history (P less than 0.05). The radiographically determined asymmetry in condylar height in these headache patients was high. More condylar asymmetry was found in migraine patients than in patients with tension headache (P less than 0.05). Asymmetric findings in the hard-tissue condition of the temporomandibular joint were more prevalent in patients with a definite CMD pain and in those with mainly bilateral headaches.
Twenty-three neurologically examined headache patients completed treatment for a concomitantly diagnosed craniomandibular disorder. More than two-thirds of the subjects responded favorably to the treatment and headaches decreased. Differences between patients regarding the response to treatment were studied. Patients with a decreased headache intensity reported more coexisting neck problems before treatment (P less than 0.05). Patients with an alleviation of headaches showed a larger distance between passive and active maximum mouth opening before treatment (P less than 0.05). The probability of headache improvement by craniomandibular disorder treatment was found to be greater in patients with a difference of 5 mm or more between passive and active maximum mouth opening (P less than 0.05).
Fifty-five of 100 chronic headache patients, referred consecutively to a neurologist, exhibited craniomandibular pain during examination of the stomatognathic system. This suggests a possible relationship between the headaches and the condition of the masticatory muscles. The patients were randomly divided into two groups. One group was treated by a neurologist and the other by a dentist. More of the patients treated by the dentist reported a decreased intensity of the headache (P less than 0.025) or a reduction in medication (P less than 0.05). Changes in headache frequency were also reported more often in the craniomandibular disorder treatment group (P less than 0.025).
The Landau-Kleffner syndrome is an acquired condition in children consisting of aphasia and epileptic discharges in the EEG with or without clinical manifestation of epilepsy. We describe a case of a very young child whose neurologic and language development before onset of the illness was uniquely well documented. Apart from her aphasia she showed several other disturbances of higher cortical functions in the acute phase of the illness. No anatomical basis has been discovered for this disease till the present day. We discuss the possibility of an electrical dysregulation in several parts of the cortex as a pathophysiological basis for this syndrome.
Fifty patients with recurrent headache who had been referred to a neurologist were randomly invited for an examination of their stomatognathic system. The prevalence and distribution of the findings in many ways resemble the clinical findings in CMD patients. In 66% of the patients, a myogenous or arthrogenous origin of CMD pain could be detected. Headache occurred more bilaterally, but unilateral findings were more common at the functional examination. The results did not show any statistical differences between the sexes.
Dichotic listening performance was studied in 35 aphasic patients with unilateral brain lesions. Within this group, 30 patients exhibited an abnormal ear discrepancy: 20 patients showed a left-ear advantage (right-ear extinction), and 10 patients showed a right-ear advantage (left-ear extinction). All subjects were given a number of verbal tasks in order to evaluate several aspects of their linguistic abilities. For the left-ear advantage group, verbal scores were positively related to left-ear scores, but not to right-ear scores. For the right-ear advantage group, verbal scores were positively related to both left- and right-ear scores. The present results lend partial support for the prediction that right-ear extinction is associated with damage to the temporal lobe involving the geniculo-temporal system. No support was found for the prediction that left-ear extinction is associated with lesions placed in the deep structures of the parietal or parieto-occipital lobe involving the corpus callosum system. Our data indicate that the initial severity of brain injury is a critical factor in determining the direction of ear extinction, the lesions being larger in the left-ear advantage group. Results are discussed in relationship to other explanations of ipsilateral and contralateral extinction in aphasic patients.
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A questionnaire with 54 relevant questions was studied in 100 ALS patients and 100 age and sex matched control cases. The findings were discussed in relation to 7 questionnaires in the literature. No differences were found between ALS patients and controls. Especially the increase of frequency of gastrointestinal operations, previous poliomyelitis, toxic metal exposure frequency, antecedent fractures and excess milk drinking as described in the literature were not confirmed.
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The clinical radiological and pathological findings in a case of diffuse sclerosis are described with special emphasis on the premortem diagnosis.
The vestibular function was extensively investigated in 75 patients suffering from migraine. Pathological findings were present in 62 patients (82.6%). With the exception of position nystagmus, vestibular abnormalities were not related to migraine characteristics. Fifty-six patients were treated with flunarizine 10 mg daily for three months. A favourable effect on headache was obtained in 44 patients (78.5%). Flunarizine therapy influenced significantly gaze nystagmus and position nystagmus. The latter tended to be related to anti-migraine efficacy. Other electronystagmographic parameters were not substantially influenced. The authors assume that the vestibular abnormalities in migraine are side phenomena, the clinical relevance of which, at least during the headache-free phase, is not yet well understood.
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