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Biomedical subjects

D K Ziegler

Publications and source records attributed to D K Ziegler.

At least 55 records · Page 3Linked to original sources
PubMed1984

Onset of multiple sclerosis in a 24-month-old child.

A child, aged 24 months, incurred an episode of ataxic gait. Two months later, she had a recurrent episode of ataxic gait and bilateral blindness. Her symptoms were resolved with steroid therapy. A permanent visual deficit of 20/200 remained in the right eye. When she reached 16 years 10 months of age, she incurred the second episode of bilateral blindness. One month later, she had grand mal seizures. Her myelin basic protein level was elevated. Visual evoked responses were abnormal bilaterally. The combination of cerebellar, cortical, and eye symptoms, with a history of well-defined remissions, allowed the diagnosis of multiple sclerosis (MS) to be made. This is the youngest known patient with MS yet described, with the first attack occurring at 24 months of age.

Adolescent↗
PubMed1984

An overview of the classification, causes, and treatment of headache.

Headache has been documented as the reason for approximately 18 million office visits per year in the United States, and may be the most prevalent central nervous system condition for which patients consult doctors. The author presents an overview of the literature on classification, causes, and treatment of headache, including uncertainties about diagnostic criteria for migraine and about differentiation of migraine from muscle contraction headache. He discusses treatment of headache in relation to management of the acute attack, avoidance of trigger factors, and pharmacological and nonpharmacological prophylaxis.

Amitriptyline↗
PubMed1984

Neurologists' knowledge of medication costs.

Using mailed questionnaires, neurologists were asked for (1) estimates of retail prices for 39 common drugs, (2) attitudes about drug costs, and (3) implications for clinical practice. Among these practitioners, (1) more product prices were overestimated than underestimated, (2) old products were as unfamiliar as new products, and (3) community practitioners were more aware of prices than academic neurologists and trainees, but still made errors. Future studies should also consider physician prescribing behavior in terms of adherence to recommended laboratory tests and patient inconvenience factors. Neurologists should be aware of alternative prescription outlets for patients.

Drug Prescriptions↗
PubMed1983

Mercury intoxication simulating amyotrophic lateral sclerosis.

A 54-year-old man had a syndrome resembling amyotrophic lateral sclerosis after a brief but intense exposure to elemental mercury. The syndrome resolved as his urinary mercury levels fell. Mercury toxicity must be considered not only in individuals with recent anterior horn-cell dysfunction but also with otherwise unexplained peripheral neuropathy, tremor, ataxia, and a gamut of psychiatric symptoms including confusion and depression.

Amyotrophic Lateral Sclerosis↗
PubMed1983

Repeated self-induced syncope and subsequent seizures. A case report.

A patient with an unusual "compulsion" to induce syncope over a period of years by bilateral compression of the carotid arteries subsequently had recurrent seizures. The EEG showed patterns typical of cerebral ischemia during the syncope and epileptogenic foci in both temporal lobes after sleep deprivation. It is difficult to distinguish between seizure and syncope associated with involuntary movements when making a differential diagnosis. We hypothesize that the frequent self-induced ischemic insult to the brain caused a cicatrix to develop, which in turn caused the frequent seizure disorder; and that because this ischemia functioned as a stimulus to the reward site in the limbic system, the patient repeatedly induced it.

Adult↗
PubMed1982

Convulsive syncope in blood donors.

Syncope with and without convulsion was studied in unselected blood donors in a community blood center. Convulsive syncope occurred in 0.03% of all blood donors and was more commonly observed when nursing personnel were alerted to its possible occurrence. It was more common in men. Although tonic extensor spasm was the most common convwithout convulsion was studied in unselected blood donors in a community blood center. Convulsive syncope occurred in 0.03% of all blood donors and was more commonly observed when nursing personnel were alerted to its possible occurrence. It was more common in men. Although tonic extensor spasm was the most common convwithout convulsion was studied in unselected blood donors in a community blood center. Convulsive syncope occurred in 0.03% of all blood donors and was more commonly observed when nursing personnel were alerted to its possible occurrence. It was more common in men. Although tonic extensor spasm was the most common convulsive movement, other complex convulsive phenomena occurred, some simulating epileptic seizure. No statistical difference in changes of pulse or blood pressure was found between subjects with convulsive versus nonconvulsive syncope. Similarly, no difference was found between subjects with tonic spasm and those with other convulsive phenomena, nor between those with "early" and those with "delayed" reactions. Marked individual variation may exist in the susceptibility of the central nervous system to ischemia. Some individuals appear to be predisposed to development of seizures in situations of global cerebral ischemia such as occur in hypotension and bradycardia.

Blood Donors↗
PubMed1982

Hemiplegic migraine in childhood: diagnostic and therapeutic aspects.

Focal neurologic deficits, particularly hemiplegia, are occasionally observed in the pediatric migrainous population during the headache attack and are often mistaken for other neurologic or neurosurgical conditions. Clues to the correct diagnosis, illustrated by three patients in this report are: (1) rapid spontaneous recovery from the acute neurologic deficit, (2) striking electroencephalographic abnormalities, frequently consisting of focal slow waves during the acute stage, with rapid resolution, (3) significant past history of recurrent episodes, and (4) positive family history of migraine. Review of previously reported cases indicates that cerebral arteriography in the acute stage should be avoided if the clinical syndrome is typical. Preliminary results of prophylactic treatment with propranolol are encouraging; smaller dosage than those previously recommended sometimes can be effective.

Adolescent↗
PubMed1982

Headache syndromes suggested by statistical analysis of headache symptoms.

Statistical study of the correlation between 49 variables concerning characteristics of headache and of headache patients was carried out on 1,198 sequential patients complaining of severe or disabling headaches and attending a headache clinic. Factor analysis was the statistical method employed, 17 factors accounting for 64% of total variation emerged. The most prominent factor contained descriptors of neurological dysfunction associated with headache. Another factor contained variables of nausea and vomiting, only associated with inability to work. Other factors, contained separately, the following variables: (a) Time of headache, (b) time of week of headache, (c) unilateral nature of headache, (d) visual phenomena associated with headache. Relation of these findings to headache taxonomy is discussed.

Adult↗
PubMed1982

Survey of neurology chairmen in U.S. and Canadian medical schools about neuroepidemiology.

Using a mailed questionnaire, 185 U.S. and Canadian directors of medical school departments and residency programs were surveyed about the role of neuroepidemiology in clinical neurology. Data were obtained about current neuroepidemiologic staff; consultation patterns; current and future needs for neuroepidemiologists, including duties and level of training; funding of neuroepidemiologists; and training of residents and fellows. We recommend more centralized teaching of the epidemilogy of neurologic disease with participation by practicing neurologists, courses in neuroepidemiology in schools without special training programs, and improved training of residents and fellows, with more active participation by medical school epidemiologists.

Canada↗