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Biomedical subjects

G Selby

Publications and source records attributed to G Selby.

At least 19 recordsLinked to original sources
PubMed2003

Gunshot injuries to the temporal bone.

The current incidence of missile injury to the temporal bone (MITB) is very low in the United Kingdom. However, the increasing frequency of firearm violence in Britain suggests a greater risk of occurrence. This, along with the devastating potential sequelae of MITB (facial palsy, dead ear, intracranial damage, major vascular injury and cosmetic disfigurement), requires otolaryngologists to be conversant with all aspects of their management. The risk of major complications is much higher with MITB than with temporal bone injury following blunt trauma, and surgical management is, therefore, much more common. We present one such case, and review the literature outlining the pathogenesis, clinical features, and recommended management.

Adult↗
PubMed1989

Infarction of the conus medullaris--clinical and radiographic features.

A 53-year-old woman experienced an acute onset of flaccid weakness of the legs associated with severe abdominal and lower limb pain. Sensory loss extended from L3 to S5. Constipation, recurrent abdominal pain and urinary retention were problems during the course of her illness. Six months after the onset the patient could walk with assistance. A myelogram and CT scan of the lower dorsal and lumbar spine showed no abnormality. Magnetic resonance imaging confirmed the diagnosis of infarct of the conus medullaris. This case highlights the clinical features of spontaneous infarction of the conus medullaris and emphasises the value of magnetic resonance scanning for the diagnosis of lesions of the spinal cord.

Female↗
PubMed1989

Hereditary motor and sensory neuropathy type II followed in the next two generations by a clinically distal motor neuropathy.

Four members in 3 generations of a family are reported, who suffered from dominantly inherited hereditary motor and sensory neuropathy Type II. The diagnosis was not made in the first patient, seen at the age of 11 years, because she had no sensory symptoms. The presence of partial denervation in the EMG led to a mistaken diagnosis of distal chronic spinal muscular atrophy. Examination of her mother 11 years later and of her uncle after a further 6 years clearly established the correct diagnosis. Electrophysiological findings in all patients supported the diagnosis of hereditary motor and sensory neuropathy Type II.

Child↗
PubMed1989

The addition of bromocriptine to long-term dopa therapy in Parkinson's disease.

This open trial is a study of the effect of adding bromocriptine (BC) to the treatment of patients who had taken a dopa-containing preparation (LD) for many years. Sixty-five patients entered the trial at an average age of 66.6 years. The mean duration of Parkinson's disease was 12.74 years and LD had been taken by one-half of them for more than 10 years and by an additional 27% for longer than 5 years. The duration of treatment with BC exceeded 2 years in 45% of cases and the average dose of BC was 19.27 mg/day. On the Hoehn and Yahr scale 70.8% of patients were classified as between stages II and IV, 24.6% were in stage I and 4.6% were in stage V. Dopa-induced involuntary movements were observed in 60% of patients at the beginning of the trial but were present in only 25% at the completion, due to the dopa-sparing effect of BC allowing a reduction of the dose of LD by an average of 34%. End-of-dose failure was reduced only slightly and on-off oscillations were not influenced by the addition of BC to LD. Tremor, rigidity, akinesia and dysarthria improved in 22% of all patients but BC offered no beneficial effect on the various gait disorders of Parkinson's disease. The conclusion of the study is that 47.7% of patients felt that the addition of BC to LD had reduced their involuntary movements and the disabilities of their disease.

Adult↗
PubMed1987

Hereditary motor neuron disease.

Nine cases of motor neuron disease (amyotrophic lateral sclerosis) in one family over 3 generations are presented. In 2 instances the disease was transmitted from parent to child. Several of the patients were first cousins. There was no skipping of a generation. The positive family history had been overlooked by several neurologists, although they had enquired for it. Familial motor neuron disease accounts for at least 10% of cases of this disorder.

Adult↗
PubMed1987

Neoplastic angioendotheliosis.

Neoplastic angioendotheliosis is a rare disease in which malignant cells are found within numerous blood vessels throughout the body in the absence of any detectable extravascular primary malignancy. The disorder has a propensity for clinical neurological involvement despite pathological evidence of systemic spread. To date 23 patients with neurological involvement have been described. This report adds a further 3 cases. There was no definite evidence to support the theory that the malignancy arises in endothelial cells; no primary extravascular tumour was found. At present a definite conclusion about the cause of the disease cannot be made.

Aged↗
PubMed1986

Facial neuralgia.

Explore the source record for details and available documents.

Cluster Headache↗
PubMed1985

Intramedullary spinal cord glioma with intracranial seeding.

Two cases of intracranial dissemination of primary intramedullary spinal cord gliomas are reported, with a review of the literature. One patient had a post mortem confirmation and in the second, cerebral CT scan and CSF examination demonstrated the occurrence of intracranial dissemination. CSF protein was elevated on both patients and malignant cells were found late in only the one patient. Both patients had raised intracranial pressure. The mechanisms of dissemination and of raised intracranial pressure are discussed. Such dissemination may be more common than previously realised.

Adult↗
PubMed1984

The Graeme Robertson memorial lecture, 1983. The long-term prognosis of Parkinson's disease.

Review after more than ten years' treatment shows that Parkinson's disease continues to progress in about 50% of patients. This progression involves mainly gait and equilibrium, but akinesia and speech deteriorate also, though at a slower rate. Organic dementia appears in about 40% of parkinsonian patients, mainly after ten years of treatment. Only 17% of patients enjoy a benign course, mild from the outset and without progression after ten years' treatment.

Adult↗
PubMed1984

Fatal migraine.

A 58-year-old woman, with a past history of classic migraine since youth, suddenly experienced blurred vision and flexor spasms of her left hand, followed by a right hemicrania and photophobia, similar to previous attacks of migraine. Within a few hours a progressive left hemiplegia and paralysis of left conjugate gaze developed. Severe right hemicrania continued. CT brain scans showed a progressing large right parietotemporal infarct. Her level of consciousness declined and she died ten days after admission to hospital. The autopsy showed a large infarct in the area of supply of the right middle cerebral artery, associated with oedema and with a shift of midline structures to the left, with cingulate and right hippocampal herniation. There was secondary midbrain haemorrhage. Recent secondary haemorrhagic infarction was present in the left calcarine cortex. The carotid arteries in the neck showed only minimal atheromatous change and were patent; the cerebral arteries were remarkably free of atheroma, but the right middle cerebral artery contained red thrombus. Histologically the cerebral infarction antedated the middle cerebral artery thrombus by several days, supporting arterial spasm as the cause of infarction. The thrombosis was considered to be a secondary phenomenon.

Brain↗
PubMed1979

Cerebral arteritis in cat-scratch disease.

Acute right hemiplegia and transient expressive aphasia occurred in a 7-year-old girl a few days after nonspecific constitutional symptoms and the appearance of a large right submandibular lymph node. Biopsy of this node and lack of other evident cause suggested a diagnosis of cat-scratch disease. Carotid arteriography showed a localized arteritis of the supraclinoid part of the left internal carotid artery and the left middle cerebral artery, involving also some lenticulostriate vessels. Computerized tomography demonstrated infarction in the left internal capsule. The size of this infarct and the angiographic abnormalities improved 6 weeks after onset, and coincided with clinical recovery. Cat-scratch disease may have caused the localized arteritis.

Arteritis↗
PubMed1978

Relapsing neuropathy due to tetanus toxoid. Report of a case.

A unique case history is presented, of a 42-year-old patient who has suffered three episodes of a demyelinating neuropathy, each of which followed an injection of tetanus toxoid. The clinical features on each occasion were characteristic of acute idiopathic polyneuropathy; a rapid onset of a mainly motor neuropathy with eventual recovery. Nerve conduction studies performed during the second and third episodes demonstrated grossly slowed motor conduction velocities. The sural nerve was biopsied after the third episode, and the features seen on light and electron microscopy included prominent hypertrophic changes, mononuclear cells associated with most "onion bulbs" and macrophage mediated demyelination. Studies of blastogenesis and macrophage migration inhibition, showed T lymphocyte responsiveness to both peripheral nerve myelin and tetanus toxoid. Typing for antigens of the HLA system indicated that the patient was homozygous for HLAB8.

Adult↗
PubMed1977

Syndrome of ophthalmoplegia, ataxia and areflexia.

The clinical details and results of some laboratory investigations are described in 4 patients who initially presented with severe external ophthalmoplegia, ataxia and areflexia. In 3 of these patients paresis of the limbs was restricted and minimal as in the syndrome first described by Fisher (1956). The fourth patient initially presented with similar symptoms but his illness progressed to a more typical form of acute idiopathic polyneuropathy, confirming Fisher's (1956) contention that this syndrome is an unusual variant of acute idiopathic polyneuritis.

Acute Disease↗
PubMed1976

Treatment of parkinsonism.

Although the mortality of Parkinsonism is negligible, it is one of the major causes of progressive and often pitiful disability in the elderly. Treatment of the condition, whether medical or surgical, is still only palliative. The successes and limitations of the various forms of treatment are discussed. Despite the spectacular gains which have been achieved during the past 25 years by sterotactic thalamotomy and treatment with levodopa, the patient's disabilities tend to progress slowly and the fundamental enigma of Parkinson's disease and of its cure still awaits solution.

Amantadine↗