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Biomedical subjects

F Schon

Publications and source records attributed to F Schon.

At least 19 recordsLinked to original sources
PubMed2000

Isolated finger flexion: a novel form of focal neuromyotonia.

Two almost identical elderly women are described who presented with gradually progressive painless involuntary flexion of the ring and middle fingers over 12 months, leading eventually to contractures. The flexion deformity persisted during sleep and was the sole neurological abnormality. Both patients had advanced chronic obstructive pulmonary disease and were on long term salbutamol and oxygen. Neurophysiological studies indicated that this was due to neuromyotonia mainly involving flexor digitorum superficialis muscles without evidence of underlying peripheral neuropathy, proximal conduction block, or generalised neuromyotonia. Voltage gated potassium channel antibodies were negative. The clinical and neurophysiological picture remained static over a 2 year follow up period. It is suggested that this is a novel form of acquired focal neuromyotonia and speculate both on its cause and distribution.

Aged↗
PubMed1999

Long term use of desmopressin for urinary symptoms in multiple sclerosis.

The benefit of desmopressin (DDAVP) in the treatment of the urinary symptoms of multiple sclerosis has until now only been shown in short crossover studies of up to 6 weeks. We report 19 patients who have used the drug for an average of 2 years and 4 months, 18 of whom confirmed continued dramatic benefit without any obvious change in dosage used or efficacy and with few side effects. Ten of the 19 patients had also used DDAVP during daytime for special occasions with notable success. This is the first study to suggest that DDAVP is safe and effective in long term use in MS.

Adult↗
PubMed1997

Median nerve injury: an underrecognised complication of brachial artery cardiac catheterisation?

OBJECTIVE: To describe the local neurological complications associated with cardiac catheterisation via the right brachial artery. METHODS: A follow up study to determine the mechanism of injury and outcome of patients who sustained a high median nerve palsy after this procedure. Five right handed patients were identified in a 24 month period. Each was assessed clinically and electrophysiologically at presentation. All were followed up initially (range six to 22 months) clinically, electrophysiologically, and using components from the Chessington occupational therapy neurological assessment battery (COTNAB) functional hand assessment. RESULTS: The incidence of this complication was between 0.2 and 1.4%. Three mechanisms of injury were identified. These included direct nerve compression due to formation of antecubital fossa haematoma, direct nerve trauma, and ischaemia secondary to brachial artery occlusion. The initial neurological and nerve conduction deficits improved with time. However, all cases had persistent disability in hand function as documented clinically and on the dexterity and stereognosis subcomponent of the COTNAB test. CONCLUSION: This is an uncommon, but probably underrecognised complication. Those performing cardiac catheterisation via the right brachial artery should be aware of the potential risks of damage to the median nerve. They should evaluate hand function after the procedure and take prompt action if median nerve dysfunction is noted. Damage to the median nerve results in appreciable long term disability, which may have medicolegal relevance.

Aged↗
PubMed1996

Myasthenia gravis and elderly people.

Myasthenia gravis is probably commoner than previously suspected, the annual incidence being nearer 9-10/million than earlier figures of 2-4/million. The current study found an annual incidence in Croyden of 9.1 per million (95% confidence limits 5.7-13.8 per million). Of the 22 patients (59%) seen in Croyden with newly diagnosed myasthenia gravis during the past 7 years, 13 were aged over 60. In a separate study of the age distribution of positive acetylcholine receptor antibody assays, 51% were 60 years or above in 1991, and 64% in 1994. The peak age in both sexes was 70-80, and numbers were greatest in men aged 60-80.

Adolescent↗
PubMed1994

Tetanus: delay in diagnosis in England and Wales.

A 7 day delay occurred in the diagnosis of cephalic tetanus in a 69 year old woman who developed an ipsilateral facial palsy 5 days after a facial laceration. Cranial nerve palsies often precede trismus in this form of tetanus.

Aged↗
PubMed1994

The use of acyclovir in suspected encephalitis.

The early use of intravenous acyclovir in herpes simplex encephalitis (HSE) is essential. However, rapid diagnostic tests are not freely available. Hence, all patients with suspected encephalitis may need to be commenced on acyclovir. In our study, of 34 patients with suspected encephalitis, only two eventually had HSE confirmed, 19 had encephalitis not due to herpes simplex and in 13 a non-encephalitis illness was finally diagnosed. Guidelines for the use of acyclovir in suspected encephalitis are given aimed at minimizing the drug cost whilst still protecting all cases of presumed HSE.

Acyclovir↗
PubMed1993

[Multi-plane transesophageal echocardiography--the next step to 3 dimensional imaging of the heart].

The multiplane transesophageal echocardiography (MTEE) is a new method making the precise imaging of the heart and great vessels possible. That technique allows to obtain the images of cardiovascular structures in two perpendicular investigation planes ("biplane" operation): transverse (examination angle is equal to 90 degrees--in relation to long axis of esophagus) and longitudinal = sagittal (examination angle is equal to 0 degree--in relation to long axis of esophagus) and, as well, in all medial planes enclosed from 0 degree to 90 degrees examination angle. During the investigation planes were being rotated mechanically or manually by rotation wheel. Passing from one plane to another is fluent, due to that the heart and main vessels can be observed continuously. Sector angle variability is 180 degrees (from minus 90 degrees to plus 90 degrees). The investigation planes from 0 degrees to plus 90 degrees from so called "normal" visualization field, and planes from 90 degrees to 0 degree make a "mirror" reflection of the "normal" field (mirror field). In our investigations the Vingmed-Sonotron echocardiograph connected with 5 MHz annular phased--array transducer, placed at the end of flexible endoscope was used. The multiplanar transducers have a full Doppler option (pulsed and continuous waves) with the possibility of colour flow imaging. The initial experience with the new method is presented in this report. The MTEE enables precise assessment of atrial septal defects. The multiplane imaging allows complete evaluation of heart muscle thickness and left ventricular contractility. This technique gives a better visualization of coronary artery. MTEE permits for planimetric assessment of aortic valve.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Histoplasmosis of the central nervous system.

Histoplasma capsulatum infection of the central nervous system is extremely rare in the United Kingdom partly because the organism is not endemic. However, because the organism can remain quiescent in the lungs or the adrenal glands for over 40 years before dissemination, it increasingly needs to be considered in unexplained neurological disease particularly in people who lived in endemic areas as children. In this paper a rapidly progressive fatal myelopathy in an English man brought up in India was shown at necropsy to be due to histoplasmosis. The neurological features of this infection are reviewed.

Adrenal Glands↗
PubMed1992

Cerebral arteriovenous malformation in Noonan's syndrome.

Noonan's syndrome involves the association of multiple congenital abnormalities including neck webbing, pectus excavatum, facial anomalies with a variety of cardiac defects. In this paper the association of Noonan's syndrome with a large cerebral arteriovenous malformation is reported. Congenital cerebrovascular abnormalities are not a recognized feature of the syndrome. The paper also reviews previous reports of neurological associations with Noonan's syndrome, the commonest being mild intellectual impairment and ptosis.

Adult↗
PubMed1991

Epilepsy: disappearing lesions appearing in the United Kingdom.

OBJECTIVE: Investigation of spontaneously resolving lesions associated with epilepsy. DESIGN: Observational study during one year. SETTING: One neurology department. PATIENTS: 4 cases in patients (one of Indian parents, one African, one white English, and one Afro-Caribbean) resident in the United Kingdom, who presented with transient epilepsy. MAIN OUTCOME MEASURES: Findings on computed tomography and on screening for infections. RESULTS: In all four cases a small mass lesion in one cerebral hemisphere was observed on computed tomography, which resolved after 9, 4, 3 and 1.5 months respectively without surgery. CONCLUSIONS: The number of cases seen in one year suggests that the lesions may be more common in the United Kingdom than previously recognised and that research into their cause is warranted.

Adolescent↗
PubMed1991

Neurosarcoidosis--demonstration of meningeal disease by gadolinium enhanced magnetic resonance imaging.

Arriving at a firm diagnosis of neurosarcoidosis continues to pose serious problems, particularly when evidence of granulomatous disease outside the nervous system is lacking. The commonest mode of presentation of neurosarcoidosis is with cranial nerve palsies. Two cases of presumed neurosarcoidosis with cranial nerve palsies showed clear evidence of focal meningeal disease on gadolinium-DTPA enhanced MRI brain scans. Although not specific for sarcoidosis, this technique may be very useful in aiding the diagnosis in suspected cases.

Aged↗