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Biomedical subjects

D Klingler

Publications and source records attributed to D Klingler.

At least 37 records · Page 2Linked to original sources
PubMed1982

[Sleep deprivation as activating procedure in EEG of patients with and without epileptic seizures. II. Focal discharges ].

Of 901 patients investigated 167 showed a focal disturbance in the EEG before and/or after 24-hours sleep deprivation. 459 patients suffered from epileptic seizures, the remainder had non-epileptic attacks or an organic cerebral disease without seizures. Of the 167 focal EEG changes 21.6% were seen only following sleep deprivation. In 9.6% focal changes present before could not be observed anymore following sleep deprivation. There was no significant difference between the three groups of patients mentioned above. The 24-hours sleep deprivation thus represents an activation procedure which may enhance diagnostic information relating to the question of focal EEG disturbances not only in epileptic patients. In the group of patients with epileptic seizures the activation or suppression respectively of the focal disturbance showed some dependence from seizure type and frequency as well as from the type of the focal change (spikes or slow waves). In our material the differences were however not statistically significant. More information could be gained from the waking EEG and from stage 1 than from sleeping stages 2 to 4 according to Rechtschaffen and Kales. Trigger functions could be attributed especially to the transitional phases from wakefulness to sleep and from stage 1 to stage 2 and vice versa particularly associated with arousal reactions. In our short sleep records REM stages could be rarely observed.

Adolescent↗
PubMed1982

[Therapy of idiopathic facial nerve paralysis].

The aim of this study was to determine the influence of the time of onset of therapy with cortisone, antirheumatics and diuretics with respect to successful prevention of secondary lesions by compression of the nerve fibres. Onset of therapy was considered to be "in time" on all cases with incomplete facial paralysis without appearance of electromyographic signs of denervation within the subsequent three days. The results are based on 90 patients with follow-up examination out of a total of 130 patients treated. 94% of the patients thus treated "in time" showed full or almost complete remission. Only 59% of those patients in whom the therapy was not initiated "in time" showed satisfactory results. It may be concluded that the therapy of an idiopathic facial paralysis should commence at the very first clinical signs. The differing therapeutic results reported in the literature are in part due to the problem of the sufficiently early onset of therapy.

Adolescent↗
PubMed1982

Quantification of the effect of epidural spinal electrostimulation (ESES) in central motor disorders.

The importance of film documentation for objective and quantitative assessment of the results of epidural spinal electrical stimulation (ESES) was shown. Our experience is based on 25 patients with central motor disorders, predominantly of spinal origin. 17 were selected for internalization of a receiver system. By means of description and clinical registration of spasticity, reduced mobility, motor strength, dexterity, etc., or by means of electrophysiological tests, complex motor performance such as standing, sitting, dressing and undressing, eating and writing cannot be sufficiently evaluated. Short scenes of these activities when demonstrated by motion picture enable the therapist to compare better the condition of the patient before and with ESES, and thereby facilitate the selection of patients for internalization of receiver systems.

Adult↗
PubMed1982

[Activities in the alpha band in unresponsive patients (author's transl)].

Activities in the alpha band are to be encountered in unresponsive patients. A review is given over the different conditions. Patients suffering from pontine lesions mostly are not comatose but locked-in. Alpha activities with intoxications and with comatose states due to transtentorial herniation can be distinguished by the accompanying neurological signs. In severe metabolic coma alpha activities are to be observed as an epileptic phenomenon. Monorhythmical alpha activities with hypoxic coma are not accompanied by slow waves, succeed a burst suppression pattern and are an ominous prognostic sign.

Adult↗
PubMed1982

[Differentiation of 2 paroxysmal reaction types in the EEG after sleep deprivation].

In the EEG after sleep deprivation paroxysms with spikes and spike wave-complexes as well as paroxysms with slow waves can be seen. The paroxysms occur either spontaneously (it means at any time during the record) or at moments of shifting vigilance. These moments are characterized by sudden changes of the EEG frequency for instance by transition from one sleep stage to another. Paroxysms with spikes or spike wave-complexes occur mainly at the transition from lower to higher levels of vigilance and are accompanied by abnormal K-complexes and abnormal photosensibility. Paroxysms of slow waves occur mainly at the transition from higher to lower levels of vigilance, abnormal K-complexes and abnormal photosensitivity are lacking but in some cases the before diffuse abnormal EEG is improved after sleep deprivation. It assumed that we are dealing with two different types of reaction.

Arousal↗
PubMed1981

[Epidural spinal electrostimulation (ESES) in patients with chronic pain and central motor disturbances (author's transl)].

Epidural spinal electrostimulation (ESES), as method in the treatment of patients with chronic pain or severe central motor disturbances, especially spastic paresis of spinal origin and bladder dysfunction, is indicated when conservative measures prove ineffectual and before surgical intervention is considered. The biochemical and innervation processes which are brought about by ESES are discussed, as well as the literature on the efficacy and possible complications of the method. Twenty cases were subjected to a test stimulation and in twelve of these the stimulation system was implanted. Spinal spasticity and the range of mobility were improved by 20 to 30% in 8 patients with multiple sclerosis and 3 other patients with myelopathy of varied aetiology. In addition, spastic cramps of abrupt onset, with or without pain, disappeared almost completely following ESES in all cases. Three cases with chronic pain, two after a caudal lesion and one with cervical radicular damage, were markedly improved.

Adult↗
PubMed1981

[Neurological signs in diphenylhydantoin intoxication (case reports and review) (author's transl)].

Five patients who were treated with long-term diphenylhydantoin for epilepsy developed neurological signs of poisoning. In 4 cases the symptoms appeared following treatment of status epilepticus with additional phenytoin medication. All patients had an acute symptomatic psychosis and a diffuse slowing of the curves in the EEG. All 5 patients showed cerebellar signs and two of them complained additionally of objective polyneuropathy, a third case complaining of itching only. An axonal polyneuropathy with minimal reduction in motor nerve conduction and a considerable extension of distal latency and diminution of compound action potential was found. In one case the biopsy showed concentric lamellar bodies coming from the axon, with intact myelin sheaths. All alterations were reversible. The pathogenesis of toxicity is discussed. Cumulation of toxic products in the plasma arising from delayed elimination of DPH metabolites is pointed out. However, one case with cerebellar signs had normal DPH levels.

Adult↗
PubMed1981

[Diphenylhydantoin intoxication following the exchange of seemingly equal DPH-preparations (author's transl)].

Following replacement of diphenylhydantoin (DPH) medication by a DPH preparation of different manufacture in a 41 years old woman the patient developed in spite of identical dosage clinical symptoms of overdosage which could be confirmed by EEG and determination of serum levels. In healthy volunteers the serum levels after a single oral dose of 300 mg of Epilan D Gerot and Difhydan respectively were compared. Although both preparations contained the acid of DPH significant differences in serum levels were observed. Therefore it must be concluded that the extent of the resorption differs greatly and that galenics plays a major role with regard to the bio-availability of the drug. From this single dose study no conclusions can be drawn, however, to the serum levels in long term therapy. The early clinical manifestations as well as the value of EEG and plasma level determinations in recognition of an overdosage during DPH therapy are discussed.

Adult↗
PubMed1980

[Hypnosis and modified hypnotherapeutic methods. Indications and results in hospitalized and ambulatory patients].

164 patients were treated hypnotherapeutically. The therapeutical methods used were heterohypnosis and the so-called gestufte Aktivhypnose (graded active hypnosis), a method which is closely related to autogenous training. In most patients independent continuation of the application of guiding principles in autogenous training was envisaged for stabilizing the results of the hypnotherapy and also achieved. The indications include a wide range of psychovegetative syndromes, including addictions. Especially syndromes showing predominantly vegetative symptoms and a relatively insignificant neurotic component responded most positively to this type of treatment. The results were less satisfactory in patients suffering from pronounced personality disorders. Hynotherapy now supplements psychotherapeutical treatment, hitherto mainly orientated to behaviour therapy, in such a way, that psychotherapy in a general hospital can be realized more effectively.

Autogenic Training↗
PubMed1980

Eclampsia--monitoring of intraventricular CSF pressure.

Continuous monitoring of the intraventricular CSF pressure was performed for 48 h in a woman of 23 years who had postpartum eclampsia with unconsciousness for 5 days and decerebrate spasms suggesting compression of the upper brainstem. The intraventricular pressure was normal with minor variations of 10--20 mm Hg.

Adult↗
PubMed1979

[Chronic thallium poisoning (author's transl)].

A rare case of criminal, chronic thallium poisoning is described. In spite of the general prohibition of the cosmetics, drugs and rodent exterminators containing thallium thallium intoxications are still observed occasionally. In the reported case typical symptoms as initial pain, dryness of the skin, constipation and insomnia were missing. The clinical picture was dominated by a polyneuropathy more pronounced in the lower extremities, a lesion of the optic nerve and the psychic symptoms of organic damage. A particular feature was the early loss of sensitivity of the anterior rami of the intercostal nerves.

Adult↗
PubMed1979

[Three years behaviour therapy in a general hospital (author's transl)].

On the basis of 172 cases a report is given on the experience with behaviour therapy in a general hospital. Diagnostic and therapeutic proceedings as well as the fundamentals and methods of practically applied behaviour therapy are discussed. The results indicate that the dilemma of the so-called "healthy" discharged patients following organic thorough examination may be rendered less harmful by this proceeding.

Ambulatory Care↗
PubMed1978

[EEG after sleep deprivation in patients with unequivocal and equivocal epileptic seizures, as well as no epileptic patients (author's transl)].

In 107 patients the EEG after sleep deprivation was performed. The patients have been divided in three groups: 1) with clinically unequivocal, 2) equivocal and 3) no epileptic seizures. All the patients where subdivided in those with and those without anticonvulsive medication. In patients with a previous normal EEG, sleep deprivation had the most activating effect regarding focal or generalized spikes or spike wave complexes in group one. However, patients without medication showed more often activation compared with untreated patients. In the second group the activation was less pronounced, again presenting the same relation between treated and untreated patients. Patients with no seizures as well as a control group of 20 volunteers had no activation at all.

Adolescent↗