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Biomedical subjects

G J Howell

Publications and source records attributed to G J Howell.

2 recordsLinked to original sources

Use of tacrine hydrochloride (Cognex) in private practice.

Before administering tacrine hydrochloride (Cognex), an examination is conducted that includes a medical history, neurological examination, laboratory studies, EEG, CT or MRI, and sometimes lumbar puncture. Much consideration by physicians patients, and caregivers goes into the decision to prescribe Cognex. Aside from a diagnosis of mild to moderate Alzheimer's disease, the patient must be in good health. Patient and caregivers must accept the need for weekly ALT measurements for at least the first 18 weeks of treatment, and for periodic office evaluations. Many of our patients who have received Cognex show considerable improvement in overall sense of well-being, affect, and the abilities to converse and participate in daily activities. The most common adverse effects in our patients are nausea, vomiting, and gastrointestinal upset. In our experience, administration of Cognex extends the time that patients with AD can function in a home environment. This approach often represents a cost savings to the patient's family.

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Seizure-induced neglect.

A man with intermittent right parieto-occipital seizures was monitored by electroencephalography while he received 60 trials of being touched on the right, left, or both hands. Half of the trials were given during a focal seizure, and half were given interictally. While the patient was having seizures, he appropriately responded to all 10 stimuli delivered to the right hand, but four of 10 responses were incorrect (allaesthetic) when he was stimulated on the left. With bilateral simultaneous stimulation he neglected the left hand in all 10 trials. His interictal performance was flawless. When given a line-bisection task on two occasions during a seizure, the patient attempted to make a mark to the left of the entire sheet of paper. Immediately postictally he made a mark at the right end of the line. The case illustrates that focal seizures may induce elements of the neglect syndrome and that attention (to contralateral stimuli) and intention to perform (in the contralateral hemispatial field) may be dissociable phenomena.

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