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Biomedical subjects

C Willert

Publications and source records attributed to C Willert.

11 recordsLinked to original sources
PubMed2005

[Neuropsychological dysfunction after cerebellar stroke].

Secondary to an ischemic cerebellar lesion in the territory of the right posterior inferior cerebellar artery (PICA), a 62-year-old man suffered relevant neuropsychological dysfunction. This included disturbances of executive functions, impaired visuospatial memory, blunting of affect, inappropriate behaviour, and linguistic difficulties. In this case report, we discuss the clinical presentation of so-called cerebellar cognitive affective syndrome.

Cerebellar Diseases↗
PubMed2004

Serum neuron-specific enolase, prolactin, and creatine kinase after epileptic and psychogenic non-epileptic seizures.

PURPOSE: To evaluate the discriminative power of serial, simultaneous determinations of serum neuron-specific enolase (NSE), prolactin (PRL) and creatine kinase (CK) in differentiating psychogenic non-epileptic seizures (PNES) from epileptic seizures (ES). METHODS: Prospective measurement of the three markers after 44 single seizures (32 ES and 12 PNES) during continuous video-EEG monitoring at seven different sampling points. RESULTS: Patients with ES had a significantly greater increase in PRL at 10, 20, 30 min, 1 and 6 h. The sensitivity for elevated NSE and CK was low. PRL showed a higher sensitivity. However, the corresponding positive predictive value was lower than in CK and NSE. Additionally, PRL had the lowest specificity of all parameters. CONCLUSIONS: The limited discriminative power of PRL, CK, and NSE calls into question if these markers are helpful in differentiating PNES and ES.

Adolescent↗
PubMed2001

[Pseudomigraine with pleocytosis].

We report two cases of male patients aged 32 and 34 presenting with headache, neurological deficits, and fever. Neither the patients nor their families had a history of migraine. Analysis of the CSF revealed lymphocytic pleocytosis, but no causative infectious agent could be identified. During the attacks, EEG showed focal slowing and was normal afterwards. Computed tomography, MRI, Doppler sonography, and routine blood parameters were normal. In both patients, the focal deficits and the headache vanished within a few hours. We diagnosed a pseudomigraine with pleocytosis (PMP), recently described as an entity. This disorder is characterized by brief relapsing attacks with headache, nausea, vomiting, focal neurological deficits, and a lymphocytic pleocytosis in the CSF. The differentiation from vascular disorders is important because angiography should be avoided due to a high rate of complications in patients with PMP.

Adult↗
PubMed2000

[Early manifestation of fronto-temporal dementia].

The term frontotemporal dementia is used to describe a primary degenerative form of dementia, which is characterized by typical clinical, neuropsychological, radiological and neuropathological features. Its onset is usually before the age of 65 years; manifestations before the age of 30 years have rarely been described. We report the case of a 22-year old man, who showed symptoms of behavioural disorder such as social retreat, lack of initiative, mental rigidity, progressive reduction of speech, and stereotyped behaviour. The neuropsychological examination revealed disorders of the executive functions. The cerebral MRI investigations showed bifrontal atrophies corresponding with hypoperfusion areas on the SPECT. Other investigations including EEG, evoked potentials, duplex ultrasonography, cerebral angiography, laboratory tests and cerebrospinal fluid were normal. In the present case report we discuss the clinical presentation of frontotemporal dementia with early onset.

Adult↗
PubMed1996

[Prognostic factors and clinical outcome in symptomatic focal epilepsies].

Successful drug therapy for symptomatic focal epilepsy is often difficult to achieve. The aim of our study was to determine predictors of seizure-free versus therapy-resistant courses of epilepsy. To accomplish this, we evaluated clinical data obtained early in the course of focal symptomatic epilepsy to determine which factors best determine the probability of therapeutic success. This retrospective study included 70 patients who were treated at the Neurology Clinic, University of Greifswald, between 1984 and 1992. Inclusion criteria were: Clear clinical diagnosis, a minimum of 3 years follow up in our epilepsy outpatient clinic, therapy with standard anticonvulsant drugs, and good compliance. We distinguished between patients who were seizure-free for at least two years and those who were not. 22 patients (31.4%) were seizure-free, whereas 48 patients (68.6%) remained resistant to pharmacotherapy. Prognostic factors for seizure-free outcome were: Focal grand mal seizures as the only seizure type ever experienced by the patient, the occurrence of only one type of seizures during the course of the illness, the occurrence of only nocturnal seizures, few grand mal seizures before starting an effective anticonvulsant therapy, no previous status epilepticus, and the remission of focal epileptic EEG patterns during effective drug therapy.

Adolescent↗
PubMed1985

Penicillin plus rifampin eradicates pharyngeal carriage of group A streptococci.

We evaluated the efficacy of rifampin in eradicating chronic pharyngeal carriage of group A streptococci. Carriers were defined as healthy children whose throat cultures showed persistence of group A streptococci 3 weeks after receiving benzathine penicillin G intramuscularly. Subsequent M and T typing of group A streptococcal isolates and limited serologic studies confirmed that enrolled patients were carriers. Thirty-eight carriers (37 completed the study) were randomly assigned to three groups: group 1 (13 patients) received no treatment; group 2 (10) received benzathine penicillin intramuscularly; group 3 (14) received benzathine penicillin intramuscularly plus rifampin orally (10 mg/kg twice a day for eight doses). Throat cultures were obtained every 3 weeks for at least 9 weeks. Group 2 and 3 patients who still had positive cultures 3 weeks after treatment were crossed to the opposite group. Cultures became negative in 93% (13 of 14) of patients in group 3, compared with 23% in group 1 and 30% in group 2 (P less than 0.001 and P less than 0.01, respectively). Including patients crossed over, the penicillin plus rifampin regimen was effective in 17 (89%) of 19 treatment courses and was significantly superior to no therapy or to penicillin alone (P less than 0.0005 and P less than 0.005, respectively). We conclude that rifampin plus benzathine penicillin intramuscularly is an effective regimen for those selected patients in whom eradication of group A streptococcal carriage is judged to be desirable.

Administration, Oral↗
PubMed1985

Short-term holding room treatment of asthmatic children.

We undertook a randomized trial to compare holding room treatment vs hospitalization of patients with childhood status asthmaticus. Two thirds of 51 patients were discharged from a holding room within 24 hours (mean 11.8 +/- 4.61 hours); the others required hospitalization. One third of 52 hospitalized patients received less than or equal to 1 day of intravenously administered therapy, and two thirds received less than 2 days of therapy (mean 45.6 +/- 12 hours). There were no statistically significant differences in recurrence rates between the two groups in the 28 days following status asthmaticus. For patients receiving less than or equal to 1 day of therapy, the holding room cost was $526 +/- $226 vs $1439 +/- $339 for hospitalized patients (P less than 0.001). Thus, holding room therapy for childhood status asthmaticus is both medically and economically effective.

Aminophylline↗
PubMedDate not supplied

Wound infection following dog bite despite prophylactic penicillin.

Dog bite wounds of 39 children (ages one to 16 years) were cultured and irrigated. Cultures showed various organisms but were of no predictive value for development of infection. By using a table of random numbers, patients were assigned to either oral penicillin V-K (100,000 U/kg/day every 6 h) or placebo for two days. All patients were seen in follow-up in three to four days and again at seven to 10 days or earlier if signs of inflammation occurred. The mean patient age, location and type of wound, and initial wound care were similar in the two treatment groups. Three of 39 (7.7%) children enrolled in the study developed infection at the bite site, including two of 19 in the penicillin group and one of 20 in the placebo group. In our study, prophylactic penicillin failed to prevent infection in dog bite wounds. Good local care on presentation seems to be the most important factor in determining future infection.

Adolescent↗