Effect of clomiphene on EEG activity.
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Biomedical subjects
Publications and source records attributed to B Sharf.
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A right-handed man had recurrent episodes of speech arrest that were focal epileptic seizures. A metastatic adenocarcinoma was identified and removed from the left supplementary motor area. The similarity of these rare seizures to transient ischemic attacks may lead to an erroneous and hazardous misdiagnosis.
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Five patients with dialysis encephalopathy were transferred to deionized water; all died after a variable period, 4 of progressive dementia. Six other patients with encephalopathy were started either on deionized or reverse osmosis water as well as desferrioxamine on dialysis. Serial EEG's were performed in this group. In 2 patients the EEG's showed rapid and sustained improvement after the institution of desferrioxamine, whereas there had been no EEG change after 15 and 32 months of reverse osmosis water. In 2 patients there was similar clinical and EEG improvement, related to water change and the institution of desferrioxamine. Two patients died of progressive dementia in spite of both water change and desferrioxamine. Thus, while not a panacea, desferrioxamine has a definitive therapeutic effect on the clinical and EEG manifestations of dialysis encephalopathy, when used in conjunction with deionized or reverse osmosis water.
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REM ocular activity of levodopa treated Parkinsonian patients was compared to REM ocular activity of normal young adults. REM densities were significantly higher in patients than in normal controls. This difference was most prominent after 10 min of REM sleep. Previous findings that levodopa treated patients reported usually vivid and detailed dreams suggest that increase in REM ocular activity is underlying the new dreaming experiences.
An eight-year-old girl with symptoms and signs of myopathy subsequently was found to suffer from coeliac disease. The myopathy disappeared on a gluten-free diet. It is suggested that the acquired myopathy may be related to deficiency in fat-soluble vitamin D or E, as a result of protracted steatorrhea.
A case of narcolepsy with marked cataplexy is described in detail. Clomipramine hydrochloride effectively controlled the cataplexy and partially alleviated the daytime sleep attacks. However, clomipramine treatment resulted in episodes of severe motor hyperactivity during sleep, which were most intense during rapid eye movement sleep.
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Twenty-seven of eighty-eight (30.7%) Parkinsonian patients on chronic levodopa or levodopa/carbidopa therapy developed drug related dream phenomena. The patients reported three separate types of new dreams which we have classified as vivid dreams, night terrors and nightmares. These dreams are correlated to the duration of levodopa therapy although the mechanism of their production is unclear.
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The activation by a short-acting barbiturate, methohexital, of spike and wave discharges in epileptic patients with normal EEG tracings was evaluated. Seventy-five patients and 20 healthy control subjects were studied. Non-specific changes--desynchronization, fast sharp activity and diffuse slowing--appeared in all the tracings. Only eleven patients had positive activation after methohexital administration. The results were not encouraging and indicate that methohexital is not reliable as a diagnostic tool in problematic cases of verified or suspected epilepsy with normal EEG tracings.
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