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Biomedical subjects

G Schnaberth

Publications and source records attributed to G Schnaberth.

At least 19 recordsLinked to original sources
PubMed1992

Quantification of motor deficit in Parkinson's disease with a motor performance test series.

It was the purpose of the present study to quantify the expected motor deficit in parkinsonian patients with the computer assisted Motor Performance Test Series (MPS), version 05.87 by Schuhfried (1987) and to examine which of the motor test variables found correlate at a significance level of p less than 0.01 with items of "motor examination" recorded at neurological examination and "activities of daily living" of the Unified Parkinson's Disease Rating Scale (UPDRS), version 3.0. 38 patients with idiopathic Parkinson's disease (PD) stages I-IV according to Hoehn and Yahr, aged 41 to 73 years were studied. The study design, i.e. initial rating by the physician followed immediately by testing of motor function with MPS was strictly adhered to in each patient. Physician's rating of rigor and the scores of the semiquantitative tests (finger taps, hand movements and alternating movements) as expression of hypokinesia and the "activities of daily living" correlated with the 3 factors of the Motor Performance Test Series at a highly significant level independent of disease stage. Tremor is only partly and never significantly reflected in the motor data measured. Stages I-II and II-IV (Hoehn and Yahr) differ significantly in the representative data of the Motor Performance Test Series. The results of the study support the assumption that MPS is a valid instrument for quantitative measurement of the motor deficit in parkinsonian patients, but that only some subtests are "pathognomonic".

Activities of Daily Living↗
PubMed1986

[Depression and Parkinson syndrome].

Depressive mood is frequently associated with Parkinson's syndrome, but it may also occur as a precursor of this disease. As regards the subtypes of Parkinson's disease, the frequency of depressive states is significantly higher in the type dominated by akinesia and rigidity than in the type dominated by tremor. On the basis of biochemical changes, certain aspects of the depression can be successfully treated by substitution therapy: L-dopa medication may increase the reduced dopamine values in the striatum, thereby improving drive. Substitution with L-tryptophan raises the lowered serotonin values in the reticular formation, which may influence sleep disturbances. The changes of basic mood, however, which are characteristic of depression, such as cheerlessness and apathy, are the dopamine of antidepressive medication; only these drugs can re-establish the biochemical balance to a large extent.

Antidepressive Agents↗
PubMed1986

Impairment of motor planning in patients with Parkinson's disease: evidence from ideomotor apraxia testing.

Compared with a group of age matched controls, patients with Parkinson's disease scored significantly lower in testing for ideomotor apraxia. Imitation of movement sequences was affected more severely than performance of single movements. The degree of impairment was not related to severity of motor disability, but correlated strongly with the results of tests that measured visuospatial and visuoperceptive abilities. It is suggested that defective encoding and central processing of visuospatial information impairs memory for movement which is necessary for correct imitation of movements. Enhanced vulnerability to interference between successively presented items may cause further deterioration of performance in the copying of movement sequences.

Apraxias↗
PubMed1984

[Contribution of cerebral angiography to the prognosis of juvenile stroke].

46 patients (aged 13 to 40 years) suffering from ischaemic cerebrovascular disease were investigated by means of complete 4-vessel angiography. 40 of these patients were re-examined after a mean follow-up period of 57 months. The aim of the study was to investigate possible connections between the angiographic data and the clinical condition some years later. In the 37 patients who were not subjected to surgical treatment prognosis was not significantly different in cases with, and those without stenoses/occlusions in the craniocervical vessels. However, patients suffering from severe stenoses/occlusions had a significantly worse prognosis than patients with stenoses of a mild degree. The clinical course in patients with stenoses/occlusions localized in the vertebro-basilar system was significantly more favourable than the course of the disease in patients with similar changes in the carotid system. There was a trend towards a worse clinical picture at the end of the follow-up period in cases with degenerative alterations in the small intracranial arteries. The difference in prognostic value of cerebral 4-vessel angiography in cases of stroke in the young, as opposed to the findings in older patients is discussed.

Adolescent↗
PubMed1984

[Long-term prognosis of patients with juvenile infarct. Catamnestic results].

Seventy patients suffering from ischemic cerebrovascular disease had had their first attack before the age of 40 years. Of these patients 57 were re-examined 84 months (mean) after the initial event. Within 48 months, 22 of 51 patients (43.1%) without surgical treatment had recurrent ischemic events (78.6% patients with transient ischemic attacks, 33.3% patients with protracted reversible deficits, 28.6% patients with completed stroke). Of all patients 31.5% had their first recurrent attack during the first year, most of them during the first few months after the initial event. In spite of the considerably higher recurrence rate, patients with initial transient ischemic attacks or protracted reversible deficits had a lower degree of social disability at the end of the follow-up period than patients with an initial completed stroke. In 72.2% of the patients with recurrent events the ischemic focus was found in a vascular area different from the one originally concerned. Patients with arterial hypertension during the follow-up period had a somewhat less-favorable long-term prognosis, but nicotine abuse or relative body weight had no influence on the degree of social disability at the end of the follow-up period. In general, long-term prognosis was rather favorable, 78.4% of the patients being fully capable of work at the end of the follow-up period. Nevertheless, results point to the necessity of complete diagnostic evaluation without delay and introduction of individual therapy for patients suffering from "juvenile stroke."

Adolescent↗
PubMed1982

[Cerebral metastases as the first clinical manifestation of cancer].

A review of the case histories over the 10-year period 1969 to 1978 revealed 80 patients with cerebral metastases. Group 1 comprised 41 patients (43.9% carcinoma of the breast, 12.2% malignant melanoma, 9.8% hypernephroma, 9.8% carcinoma of the colon) in whom the primary site had been established before the manifestation of neurological deficit. Group 2 comprised 39 patients (56.4% bronchogenic carcinoma, 10.1% hypernephroma, 20.5% primary malignancy not identifiable) in whom the neurological symptoms due to metastasis had been first manifestation of malignancy. The sex distribution, age distribution, site of metastasis, cerebral symptoms and the time-lag before the diagnosis were analysed and compared with the literature. The patients in group 1 had an average survival time of 9 months, as compared with 7 months in group 2, from the time of the initial symptoms of cerebral metastasis. The survival time was not essentially different whether surgical or radiotherapeutic measures were undertaken.

Adenocarcinoma↗
PubMed1981

[Lactate acidosis in the cerebrospinal fluid as a prognostic parameter of malacic cerebral insult (author's transl)].

The concentrations of lactate and pyruvate were determined in 111 CSF and blood samples. The CSF and blood chemistry of 43 patients with a lateralized ischaemic cerebral insult was compared with that of a control group of 18 patients. The first tests were carried out within 24 to 48 hours and 50 follow-up determinations were undertaken in the cerebral insult group. The patients were classified according to their level of consciousness (lucid-somnolent-soporous-comatose). Covariance analysis revealed a distinct relation between the CSF chemistry and the level of consciousness of the insult patients; accordingly, a continuous increase in the lactate level from 1.54 mmol/l to 3.48 mmol/l and in the pyruvate level from 0.11 mmol/l to 0.21 mmol/l was noted. Spearman's correlation analysis also pointed to a statistically significant correlation between decreasing levels of consciousness and the CSF lactate/pyruvate quotient. The increase in the CSF/blood quotient of lactate from 1.17 to 2.14, corresponding to the decrease in the level of consciousness, also indicates that during the early stages of the disease, cerebral tissue hypoxia is reflected in the CSF rather than in the blood. Further subdivision of the groups according to whether the patients survived or died, showed that the critical maximum concentrations from the prognostic point of view are 2.74 +/- 0.19 mmol/l in the case of CSF lactate, 0.186 +/- 0.017 in the case of CSF pyruvate and 1.92 +/- 0.65 for the CSF/blood quotient of lactate. None of the patients with a CSF lactate level of 3.1 mmol/l or more survived the ischaemic cerebral insult. Thus, the above-mentioned parameters are to be regarded as important indicators of the threat to the patient's life.

Acid-Base Equilibrium↗
PubMed1981

[The Steel Richardson Olszewski-syndrome. A report on 3 further cases (author's transl)].

In this report we are describing 3 further cases of progressive supranuclear palsy, all displaying the typical clinical features (first described by Steele, Richardson and Olszewski, 1964): Ophthalmoplegia (affecting chiefly vertical gaze), pseudobulbar palsy, dysarthria, dystonic rigidity of the neck and upper trunk and dementia. Clinical symptoms started between 49 and 51 years of age with slow progression during 2 to 4 years. One patient died 2 years after the first clinical symptoms began. The purpose of this paper is, to describe a further group of 3 cases of progressive supranuclear palsy and to point out in detail the clinical symptoms, that all correspond to supranuclear localisation of this disease and to report about some differences in the development of the disease and the fully developed disorder. The use of treatment with Adamantin and Akineton was not (very) satisfying.

Amantadine↗
PubMed1980

[Arteritis in cerebral inflammatory diseases. Diagnostic value of angiography (author's transl)].

Cerebral angiography may sometimes show up inflammatory changes in the brain arteries in cases of tuberculous and acute purulent bacterial meningitis. The arteries at the base of the brain are predominantly affected, in some cases together with peripheral branches. Normal angiograms or non-specific alterations may be expected in patients suffering from non-purulent meningitis and encephalitis. Patients with luetic diseases show circumscribed or diffuse vessel wall lesions which cannot be differentiated from alterations caused by arteriosclerosis. The results are presented of 15 patients suffering from inflammatory diseases of the central nervous system of different aetiology. The morphology and the distribution of the arterial changes in the cerebral angiogram are discussed.

Adult↗
PubMed1979

[Cerebral angiography in collagen disease and arteritis of different aetiology (author's transl)].

The cerebral angiograms of 11 patients suffering from collagen disease are presented. Panarteriitis nodosa was diagnosed in 4 cases, Lupus erythematodes in 2 cases. With 5 patients immunovasculitis with cerebral affection was found, which was, however, not to be classified in detail. More or less characteristic features are to be expected in the angiogram; they might harden the suspicion of collagen disease, although they are not likely to prove its diagnosis. An interpretation of the radiological findings should--in addition to the morphology--primarily take into account the distribution type of the vessel wall lesions. Clinically as well as by means of angiography it is difficult to differentiate between collagen disease and cerebral arteriitis of different aetiology; this applies particularly to the alterations in cases of embolic circumscribed encephalitis in sepsis lenta. The diagnostic value of angiography in cases of collagen disease with cerebral affection is discussed, the criteria of cerebral arteriitis of different aetiology are dealth with.

Adolescent↗
PubMed1978

[Acid-base equilibrium in the cerebrospinal fluid in diseases of the central nervous parenchyma].

A number of case studies reveal and dynamic changes of the acid-base balance in the blood and cerebrospinal fluid, such as the increasing decompensation of the metabolic lactate acidosis in the cerebrospinal fluid in lethal cases or the gradual regression in patients who were cured. Individual metabolic cerebrospinal parameters are correlated with the disturbance of consciousness. The cerebrospinal fluid parameters of patients with clouded consiciousness constitute prognostically critical values: lactate 3.6 mmol/l, pyruvate 0.19 mmol/l, pH 7.249 and bicarbonate 18.1 mmol/l. Affections of the central nervous parenchyma are better reflected in the cerebrospinal fluid than in the blood. The determination of the CSF/blood relationship of individual parameters shows a significant increase of the lactate quotient as well as a decrease of the pH quotient and of bicarbonate quotient. Respiratory parameters do not show any statistically significant changes. Statistically significant correlations show that, in the case of primary central nervous diseases, the increased hydrogen ion supply in the cerebrospinal fluid is quickly intercepted by the bicarbonate buffer and that, with a corresponding pH decrease, there is a rapid decompensation of the acid-base balance.

Acid-Base Equilibrium↗