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Biomedical subjects

C W Olanow

Publications and source records attributed to C W Olanow.

At least 145 records · Page 8Linked to original sources
PubMed1982

Thymectomy in late-onset myasthenia gravis.

Between 1977 and 1979, 12 consecutive patients with myasthenia gravis who were over the age of 55 years were treated by thymectomy. In all, their conditions improved clinically; 11 of the 12 became free of the generalized features of myasthenia gravis. Nine patients required no further medication. Acetylcholine-receptor antibody titers did not change significantly. Although five patients had atrophic thymus glands, their conditions also improved. We conclude that (1) thymectomy is a safe and effective therapy for patients with myasthenia gravis who are over the age of 55 years; (2) steroids and anticholinesterase agents are not essential in the management of late-onset myasthenia gravis; and (3) reduction in acetylcholine-receptor antibody titer is not essential for beneficial clinical response.

Aged↗
PubMed1982

Treatment of the "on-off" phenomenon in Parkinsonism with lithium carbonate.

Six patients with severe parkinsonism complicated by the "on-off" phenomenon were treated with lithium carbonate in addition to regular antiparkinson medications. A randomized double-blind crossover trial of lithium versus placebo was conducted, followed by an open trial of lithium therapy. Five patients had markedly reductions in akinesia (mean, 70%) and improved by one grade in Parkinson staging. This result was more striking in male than in female patients, and in all responders benefit has been maintained during the open phase of lithium treatment (mean follow-up of 36 weeks). In no patient was a reduction in akinesia observed during placebo treatment. Lithium carbonate appears to offer a new and potentially effective approach to treatment of the on-off phenomenon.

Adult↗
PubMed1982

Familial benign intracranial hypertension and depression.

Two sisters developed benign intracranial hypertension (BIH) two weeks following the resolution of a major depressive episode. The association of BIH and a major affective disorder in genetically related individuals has not been previously reported to our knowledge. Both conditions are associated with disturbances in the hypothalamic-pituitary-adrenal axis. Falling corticosteroid levels in a resolving depression may result in impaired cerebrospinal fluid absorption and subsequent BIH.

Adult↗
PubMed1982

Neonatal myasthenia gravis in the infant of an asymptomatic thymectomized mother.

A case of neonatal myasthenia gravis is reported in the infant of an asymptomatic thymectomized mother with comparably elevated acetylcholine receptor (AChR) antibody titers. The mother remained asymptomatic despite elevated antibody titers while the infant became asymptomatic in association with the disappearance of the AChR antibody. It is suggested that the AChR antibody plays an essential role in the development of neonatal myasthenia gravis. It is also suggested that a thymic factor is necessary for the development of clinical symptomatology accounting for the lack of correlation between the clinical state of the mother and infant.

Adult↗
PubMed1982

A prospective study of thymectomy and serum acetylcholine receptor antibodies in myasthenia gravis.

Forty-seven consecutively presenting myasthenia gravis (MG) patients with generalized weakness were treated according to a standardized prospective protocol. All patients underwent a sternal splitting "total" thymectomy. Medical status before surgery was optimized by plasmapheresis without immunosuppression. Medications were avoided or discontinued whenever possible. All patients were improved. At the time of latest follow-up 83% were free of generalized weakness and 61% were on no medications. There was no significant change in Acetylcholine Receptor Antibody (AChR-AB) titer. The following conclusions were made: (1) thymectomy is an effective therapy for MG, (2) additional medications are not necessary in the majority of patients, and (3) a reduction in the AChR-AB titer is not essential for clinical benefit.

Acetylcholine↗
PubMed1982

[Neurologic manifestations of hyperparathyroidism. Study of 120 cases].

The neurologic findings in 120 patients with possible diagnosis of hyperparathyroidism are reported and the world literature on this matter is reviewed. The neurologic signs and symptoms were divided in 3 categories: central, peripheral and miscellaneous. Headache, cramps weakness and depression where the most frequent complaints but with a so wide list of symptoms we expect mainly to salient the importance of calcium and phosphorus blood levels on neurologic patients as well as the value of neurologic evaluation on hyperparathyroid patients.

Adolescent↗
PubMed1981

The pathogenesis of myasthenia gravis--a hypothesis.

We have suggested that a thymic factor plays a critical role in the pathogenesis of myasthenia gravis. The presence of specific ACh R antibodies in more than 90% of patients with myasthenia gravis has provided us with a marker for this disorder and has greatly increased our understanding of the pathophysiology. These antibodies can induce physiological parameters similar to those seen in myasthenia gravis following passive transfer to experimental animals and can accelerate degradation of ACh R in myotube culture. However, clinical studies suggest that additional factors of thymic origin are necessary for the development of the clinical features of myasthenia gravis. While the nature of the thymic factor(s) is speculative, this hypothesis has a significant clinical implication as it argues for an early, total thymectomy as the treatment of choice for myasthenia gravis.

Antibodies↗
PubMed1981

The effect of plasmapheresis on post-thymectomy ocular dysfunction.

Five myasthenia patients with post-thymectomy residual ocular signs were treated with plasmapheresis. Despite a significant reduction in AChR antibody titer, there was no clinical improvement. Subsequently, there was a dramatic response to prednisone. The AChR antibody titer did not correlate with the clinical state of the individual patient. It is suggested that plasmapheresis may operate by removing a thymic factor and that prednisone acts by a different mechanism.

Adult↗
PubMed1981

Brain stem glioma in childhood: acute hemiplegic onset.

Two children, age seven and 16 years, are described with the abrupt onset of a pure motor hemiplegia as the initial manifestation of a brain stem neoplasm. Subsequent rapid neurological deterioration localized the lesion to the brain stem and glioblastoma multiforme was diagnosed by surgical biopsy. It is suggested that brain stem gliomas with this unusual presentation are likely to be highly malignant and prone to rapid bulbar deterioration.

Acute Disease↗
PubMed1981

"On-off" syndrome treated with lithium carbonate: a case report.

The authors describe a 42-year-old man who developed "on-off" episodes and for whom lithium carbonate proved an effective treatment. They speculate that the predominant effect of lithium in the "on-off" syndrome is to prevent L-dopa desensitization of the dopamine receptor.

Adult↗
PubMed1981

No direct correlation between serum antiacetylcholine receptor antibody levels and clinical state of individual patients with myasthenia gravis.

Serum acetylcholine receptor antibodies were measured serially in myasthenia gravis patients before and after early extended thymectomy; they received no medication postoperatively. Clinical improvement occurred with little or no change in antibody level. After plasmapheresis without immunosuppressive drug therapy, we also found clinical improvement without decrease in serum antibody level.

Acetylcholine↗
PubMed1981

The effects of salicylate on the pharmacokinetics of phenytoin.

The pharmacologic effect of a highly protein-bound drug is a function of the free serum concentration. In vitro studies have demonstrated that phenytoin is displaced from its protein-binding sites by acetylsalicylic acid. This resulted in increased concentrations of free serum phenytoin and raised the possibility of clinical toxicity. We have studied the effects of salicylates on six patients receiving long-term phenytoin therapy. This reduced the total serum phenytoin concentration but did not alter the free serum concentration. There was no loss of seizure control or toxicity. Total phenytoin concentrations in such patients may not accurately reflect pharmacologic activity and may be misleading.

Aspirin↗
PubMed1981

Phenytoin: pharmacokinetics and clinical therapeutics.

Phenytoin is a highly effective anticonvulsant medication that is considered to be the treatment of choice for generalized major motor and focal epileptic seizures. An understanding of the pharmacokinetic properties of phenytoin greatly facilitates the management of seizure patients. The judicious use of serum-monitoring techniques coupled with careful clinical evaluations enable one to obtain the optimal anticonvulsant effect, freedom from dose-related toxicity, and the avoidance of unnecessary polypharmacy.

Abnormalities, Drug-Induced↗