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Biomedical subjects

F R Freemon

Publications and source records attributed to F R Freemon.

At least 37 records · Page 2Linked to original sources

Progressive optic neuropathy and sensorineural hearing loss due to chronic glue sniffing.

A 27-year-old male developed cerebral and cerebellar atrophy over a period of five years of extensive glue sniffing. He also developed bilateral optic atrophy with blindness and severe sensorineural hearing loss. Investigation failed to show any other cause for the visual or hearing loss. Peripheral polyneuropathy and central nervous system damage may follow chronic toluene toxicity, but these auditory and visual complications have not previously been described.

Adult↗

The effect of chronically administered delta-9-tetrahydrocannabinol upon the polygraphically monitored sleep of normal volunteers.

This study describes the effect of two weeks of delta-9-tetrahydrocannabinol (THC) administration upon normal sleep. The two subjects, two brothers in their 20s, slept in the laboratory for 27 consecutive nights and then, after four nights at home, for four additional nights. One subject, after an adaption night, received placebo for four baseline nights, 30 mg of THC for the next 14 nights, and placebo during four withdrawal nights. The other subject received placebo during this entire period. One year later the subjects alternated these conditions. The subjects had difficulty falling and staying asleep during the first two nights of placebo after 14 consecutive drug nights. This mild drug withdrawal insomnia was not accompanied by the increase of REM sleep which frequently accompanies withdrawal of other drugs. Starting after about a week of THC administration, and continuing for a week after drug discontinuance, there was a marked decrease in the type of sleep associated with slow waves in the electroencephalogram, nonREM sleep stages 3 and 4. The fact that prolonged, but not acute use, suppresses slow wave sleep indicates that this commonly used drug produces a poorly understood change in brain physiology.

Adult↗

A new familial disorder of combined lower motor neuron degeneration and skeletal disorganization.

A new familial disorder, inherited as an autosomal dominant trait and characterized by dual features of neurologic degeneration and skeletal disorganization, is reported. The neurologic disease is a degenerative process of lower motor neurons and develops in middle age with progressive muscle weakness and ends in respiratory failure and premature death. Clinical examination, electromyography, and muscle biopsy with histochemical stains are diagnostic. The skeletal disorganization resembles Paget's disease of bone. It is characterized by polyostotic radiographic abnormalities, elevated serum alkaline phosphatase of bone origin, abnormal radioisotopic bone scan, elevated hydroxyprolinuria, and bone histology.

Age Factors↗

Pokeweed poisoning.

A 68-year-old man who ingested an improperly prepared extract of pokeweed had sweating, confusion, tremor, weakness, incontinence, and syncope. Analysis of the symptoms from this and similar patients previously reported suggests that the pokeweed plant contains an agent that produces peripheral and central cholinergic stimulation.

Aged↗

Agenesis of the corpus callosum.

A father and son with agenesis of the corpus callosum are described. An 11-year-old boy underwent clinical examination because of poor school performance. On physical and mental examinations he was normal, except for an enlarged head. Computerized tomographic (CT) scan showed agenesis of the corpus callosum. The patient's father also had an enlarged head. Although he had never had any symptoms, he underwent CT scanning, which revealed agenesis of the corpus callosum. Psychological tests showed good communication between the two cerebral hemispheres. All-night sleep EEGs showed asynchronous sleep spindles.

Adult↗

Physostigmine reversal of diazepam-induced hypnosis. A study in human volunteers.

Under randomized double-blind conditions, 1.00 to 1.67 mg of intravenous physostigmine (Antilirium) reversed sleep induced by administration of 0.102 to 0.238 mg/kg body weight of intravenous diazepam in eight healthy human volunteers. Awakening occurred 330 to 740s after initiation of the physostigmine infusion at a rate of 0.5 mg/min every 4 min. Diazepam plasma levels were not significantly different at the start of either the physostigmine or placebo infusion. Physostigmine did not effect plasma binding of diazepam. Six subjects experienced nausea, and one subject developed an arrhythmia. Physostigmine reverses diazepam-induced hypnosis but causes side-effects requiring cautious administration.

Adult↗

Controlled use of cranial computerized tomography.

This study attempts to assess the impact of computerized cranial tomography (CT) on clinical practice in a veterans hospital. A CT scan could be performed only if there existed a reasonable potential for the results to affect the patient's clinical course. We document many instances of how the 163 CT scans obtained during a one-year period aided patients. We quantitated one beneficial aspect by estimating the major neuroradiologic contrast procedures obviated by CT scan. Case-by-case review indicates 70 cerebral arteriograms and 58 pneumoencephalograms would have been performed had CT scanning not been available.

Adolescent↗

Herpes zoster ophthalmicus with contralateral hemiplegia.

A 48-year-old man developed left hemiparesis nine weeks after herpes zoster skin lesions had appeared over the right forehead. Cerebral angiography showed bilateral changes consistent with cerebral arteritis. The patient's condition worsened after the angiographic procedure. Reports from the literature as well as the present case suggest that arteritis and ischemia best explain contralateral neurological symptoms that occur suddenly following herpes zoster ophthalmicus.

Cerebral Angiography↗

The effect of a new benzodiazepine on the polygraphically monitored sleep of normal volunteers.

All-night sleep was polygraphically monitored from ten normal volunteers who took placebo and three dosage levels of a new benzodiazepine hypnotic, SCH 16134, in a double-blind, crossover design. All dosages of the drug decreased the time to fall asleep, and the two highest dosages also decreased interspersed wakefulness. REM sleep was suppressed, but slow-wave sleep was not affected in this experiment. The subjective quality of sleep was improved by the new hypnotic. One subject reported that he felt lethargic the day after the largest dose.

Adolescent↗

The Foster Kennedy sign: a case with papilledema contralateral to a sphenoid wing meningioma but without apparent optic atrophy.

A 28 year old lady with a one year history of mental changes and headaches presented with right fundus normal but with marked papilledema on the left. Subsequent evaluation demonstrated a right sphenoid wing meningioma which was successfully removed as an emergency procedure. The case illustrates the well known clinical dictum that the side of unilateral papilledema offers little information concerning tumor localization.

Adult↗

Evaluation and treatment of patients with dementia.

Dementia is a common problem in middle-aged and elderly adults. Thorough diagnostic evaluation uncovers a significant minority who are suffering from an underlying neuropsychiatric disease amenable to specific medical or surgical therapy. Even in those patients with brain atrophy of unknown cause the physician can offer counseling and environmental manipulation to maximize remaining intellectual capacity.

Aged↗

Evaluation of patients with progressive intellectual deterioration.

Sixty consecutive patients with progressive intellectual deterioration were evaluated by a specific protocol. Eighteen (30%) were found to have an underlying disease potentially reversible by medical or surgical therapy. Sixteen patients had a specific diagnosable but untreatable disease as a cause of dementia. The laboratory and radiologic tests of the protocol that uncovered treatable illnesses were the radioisotope brain scan (two cases of bilateral subdural hematoma), the pneumoencephalogram (seven patients with normal-pressure hydrocephalus), thyroid function screen, and liver function studies (one case each). Unrewarding tests included serum barbiturate, bromide, vitamin B12, and folate levels.

Aged↗

A differential diagnosis of the inspirational spells of Muhammad the Prophet of Islam.

This paper reviews the spells of Muhammad, the Prophet of Islam. During these spells, Muhammad sensed the approach of a figure whom he thought to be the Angel Gabriel. The inspirational message transmitted to Muhammad during these spells helped form the religion of Islam. This is a review of the historical details of these spells and an attempt to reach a medical diagnosis. Although an unequivocal decision is not possible from existing knowledge, psychomotor or complex partial seizures of temporal lobe epilepsy would be the most tenable diagnosis. An examination of Western civilization's views of Muhammad's spells reveals historical and modern misconceptions about epilepsy.

Arabia↗