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Biomedical subjects

E Dietrichs

Publications and source records attributed to E Dietrichs.

At least 19 recordsLinked to original sources
PubMed2000

[Acute headache--diagnostic considerations].

Acute headache may be the presenting symptom of several conditions. Sometimes, a headache with an abrupt onset and unusual severity may occur, experienced by the patient as the worst headache ever. The diagnostic evaluation primarily aims at ruling out subarachnoid haemorrhage (SAH), as well as other serious causes of acute headache, such as meningitis or stroke. The clinical examination should immediately be followed by cerebral computed tomography (CT). A CT scan will reveal 95% of SAHs, provided that it is performed within the first 24 hours after headache onset. If the CT scan is normal, a lumbar puncture should follow, preferably 12 hours after the onset of headache, unless infectious meningitis is suspected. If infectious meningitis is strongly suspected, lumbar puncture should be performed without delay. The spinal fluid should be investigated by spectrophotometry, in order to obtain optimal diagnostic accuracy for SAH. This article briefly reviews the various conditions that may present with an acute headache.

Acute Disease↗
PubMed1999

Bulbar myoclonus without palatal myoclonus. A hypothesis on pathophysiology.

A 40-year-old woman with myoclonic contractions bilaterally in the infrahyoid neck muscles, especially in the left cricothyroid muscle, was presented and successfully treated with botulinum toxin injections. The patient had a wide, aberrant vessel curving into the left dorsolateral reticular formation of the medulla oblongata. Based on our observations, we propose that symptomatic bulbar and palatal myoclonus is caused by pathology in the dorsolateral reticular formation, and not by inferior olivary dysfunction as is currently thought.

Adult↗
PubMed1998

[History of the reflex hammer].

The knee jerk was first described by Erb and Westphal in 1875. In subsequent years neurologists used direct finger taps and light-weight chest percussion hammers, but these proved to be inadequate for eliciting muscle stretch reflexes. The first hammer specially designed for eliciting such reflexes was the triangular reflex hammer introduced by John Madison Taylor in 1888. Over the next 25 years several popular reflex hammers were designed, some of which are still in use. These include the Babinski hammer with a round head fixed perpendicular to the shaft, and Rabiner's modification where the head can also be attached parallel to the shaft.

History, 19th Century↗
PubMed1997

The cerebellar-hypothalamic axis: basic circuits and clinical observations.

Experimental studies on a variety of mammals, including primates, have revealed direct and reciprocal connections between the hypothalamus and the cerebellum. Although widespread areas of the hypothalamus project to cerebellum, axons arise primarily from cells in the lateral, posterior, and dorsal hypothalamic areas; the supramammillary, tuberomammillary, and lateral mammillary nuclei; the dorsomedial and ventromedial nuclei; and the periventricular zone. Available evidence suggests that hypothalamocerebellar cortical fibers may terminate in relation to neurons in all layers of the cerebellar cortex. Cerebellohypothalamic axons arise from neurons of all four cerebellar nuclei, pass through the superior cerebellar peduncle, cross in its decussation, and enter the hypothalamus. Some axons recross the midline in caudal areas of the hypothalamus. These fibers terminate primarily in lateral, posterior, and dorsal hypothalamic areas and in the dorsomedial and paraventricular nuclei. Evidence of a cerebellar influence on the visceromotor system is presented in two patients with vascular lesions: one with a small defect in the medial cerebellar nucleus and the other with a larger area of damage involving primarily the globose and emboliform nuclei. Both patients exhibited an abnormal visceromotor response. The second, especially, showed abnormal visceromotor activity concurrent with tremor induced by voluntary movement. These experimental and clinical data suggest that the cerebellum is actively involved in the regulation of visceromotor functions.

Aged↗
PubMed1996

[Drug-induced dystonia misinterpreted as hysteria].

Psychic distress is often expressed in the form of physical pain or disease, but the converse also occurs. Illnesses with an organic aetiology are sometimes misdiagnosed as psychogenic. We describe three patients who developed rare forms of acute drug-induced dystonia when treated with antipsychotic drugs. All three cases were initially misdiagnosed as "hysteria" because the patients had psychiatric illnesses and because the symptoms were bizarre and became worse when the patients became very anxious. Furthermore, if the patients were helped to relax the symptoms disappeared for a moment. One of the patients developed dystonia 24 hours after ingestion of 750 mg tetrabenazine in an attempt at suicide. Another patient who had HIV/AIDS developed severe dystonia after receiving only 2 mg haloperidol by mouth. The clinical presentation, treatment, and possible mechanisms of the pathophysiology of acute drug-induced dystonia are briefly reviewed.

Adrenergic Uptake Inhibitors↗
PubMed1995

[Unusual intracranial infections].

The frequency of intracranial infections caused by microorganisms which have been uncommon in Norway is increasing. Contributing factors are travel, immigration and acquired immune deficiency, either as the result of disease or medical treatment. This article presents some of these infections, and also briefly reviews some other unusual infections which should be considered as differential diagnoses in unclear disease of the central nervous system.

Emigration and Immigration↗
PubMed1994

[Tapeworms in the brain--a current problem in Norway?].

Cestode infections of the human central nervous system are reviewed. These conditions represent a major health problem in many countries, and neurocysticercosis is one of the major causes of epilepsy worldwide. Neither cysticercosis nor echinococcosis are endemic to Norway. Therefore, little attention has been paid to these conditions. However, owing to increased travelling and immigration, occasional cases are found. Five cases of neurocysticercosis and one case of presumable brain echinococcosis have recently been diagnosed in our department.

Adult↗
PubMed1994

Transient reinnervation of antagonistic muscles by the same motoneuron.

When reinnervation is allowed after a sciatic nerve cut in the adult rat, motoneuron axons may branch to innervate antagonistic muscles. This multiple innervation is widespread, but transient. Fourteen weeks after denervation isometric muscle contraction experiments and studies with anterograde transport of the fluorescent tracer Fast Blue showed that branches from the same motoneurons reached the distal part of the tibial nerve and either the soleus or the extensor digitorum longus muscles or both muscles. Retrogradely double-labeled motoneurons were found after injections of different fluorescent tracers into these muscles. Sixty-four to 88 weeks after the nerve cut, similar experiments showed that selective innervation was reestablished. The findings suggest a selective mechanism for axon withdrawal in an adult mammal.

Amidines↗
PubMed1994

Meningeal irritation: possible manifestation of cerebral Echinococcus infestation.

A patient with meningeal irritation and a small occipital cystic lesion is presented. Based on serological tests, the condition was diagnosed as presumably echinococcosis. To our knowledge, meningeal irritation has previously not been reported as an early symptom of cerebral Echinococcus infestation. Cysticercosis is discussed as a possible differential diagnosis.

Adult↗
PubMed1994

Hypothalamocerebellar and cerebellohypothalamic projections--circuits for regulating nonsomatic cerebellar activity?

Cerebellar involvement in visceral and affective responses is known from physiological and behavioral studies, but the pathways involved in these responses have remained enigmatic. Over the last ten years neuroanatomical studies have shown that the cerebellum and hypothalamus are interconnected by direct hypothalamocerebellar and cerebellohypothalamic projections and by a multitude of indirect pathways. The hypothalamocerebellar projection terminates in the cerebellar nuclei and in all layers of the cerebellar cortex as multilayered fibres. This projection is, at least in part, histaminergic. New immunocytochemical experiments indicate that small numbers of hypothalamocerebellar neurones may contain GABA- or glycine-like immunoreactivity. GABA may function as a transmitter in hypothalamocerebellar fibres, probably in conjunction with histamine, but it is not clear whether glycine may also function as a transmitter or only serve metabolic functions. The bidirectional pathways between the cerebellum and hypothalamus may be part of the circuits through which the cerebellum participates in the modulation of a variety of nonsomatic events. In addition, new observations on patients with well localized cerebellar lesions reveal simultaneous somatic and visceral dysfunction. Recent research on direct hypothalamocerebellar pathways and on other connections between hypothalamus and cerebellum is reviewed. It is hypothesized that the cerebellum may act as a general modulator and coordinator of a wide range of central nervous activities, somatic as well as nonsomatic.

Aged↗
PubMed1994

The hypothalamocerebellar projection in the cat: branching and nuclear termination.

The hypothalamic projection to the cerebellar nuclei and cortex in the cat was studied by means of retrograde transport of wheat germ agglutinin-horseradish peroxidase complex and various fluorescent tracers. The hypothalamocerebellar nuclear projection originates from various parts of the posterior hypothalamus and reaches mainly the ipsilateral fastigial and interposed nuclei, but all nuclei receive some hypothalamocerebellar fibres. It appears from our double labelling experiments that at least one half of the hypothalamocerebellar nuclear neurones by means of axon collaterals also projects to the cerebellar cortex. Experiments with depositions of fluorescent tracers in both cerebellar hemispheres show that some hypothalamocerebellar fibres branch to reach different parts of the cerebellar cortex. Previous studies have shown that hypothalamocerebellar axons may be branches of hypothalamic efferents to other sites. However, experiments with combined fluorescent tracer depositions in the cerebellum and hippocampus gave no evidence for hypothalamic neurones with axon collaterals to both these regions.

Animals↗
PubMed1993

Cerebral cysticercosis in Norway.

Neurocysticercosis has been rare in Scandinavia. Due to immigration from and travels to endemic areas, we expect the number of such patients to increase. We here report the first four patients from Norway with diagnosed neurocysticercosis. Three are immigrants; one is of Norwegian heritage and was probably infested during short trips to other European countries.

Adult↗
PubMed1992

[Drug therapy of Parkinson disease].

The author reviews the various strategies for treatment of Parkinson's disease by modern drugs. Either levodopa or a levodopa agonist is recommended for treatment of early Parkinson's disease. For long-term treatment, a combination of levodopa and levodopa agonist is preferable, since combined treatment appears to cause fewer side effects and motor fluctuations than does high dose monotherapy. Selegeline may be added, both in initial and long-term treatment. However, it is still uncertain whether selegeline acts only as a dopamine agonist, or also has a neuroprotective effect.

Antiparkinson Agents↗