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Biomedical subjects

G W Paulson

Publications and source records attributed to G W Paulson.

At least 19 recordsLinked to original sources
PubMed1992

Reflexes and neurologists.

Neurologists are particularly concerned with elicitation of reflexes, interpret them as indicative of levels of the nervous system and its development or dissolution. This article reviews selected aspects of reflex action. No longer simply reflexology, clinical neurology will still make new observations about reflexes and, more relevant, clinical neurologists will enjoy the process. The breadth of interests of George Bruyn is a permanent reminder to future neurologists of what complexities can be constructed on basic observations such as have been done on "our" reflexes.

Brain↗
PubMed1979

Pheochromocytoma causing exercise-related headache and pulmonary edema.

A 13-year-old hypertensive girl with a history of severe headaches following exercise developed circulatory collapse after "squat jumps." Pulmonary edema was present without evidence of a cerebral mass. The patient died with increased intracranial pressure despite decompressive craniectomy. Neuropathological evaluation revealed diffuse cerebral edema and a pheochromocytoma in the right adrenal gland. Examination of urine revealed elevation of vanillylmandelic acid levels.

Adolescent↗
PubMed1979

Brain hamartomas and tumors associated with tuberous sclerosis.

Ventricular tumors of tuberous sclerosis are almost always hamartomas or benign tumors occurring predominantly in children or young adults. No clear gross or histological distinctions between the ventricular "candle gutterings" and "tumors" have been identified. The clinical presentation may be acute, with the sudden onset of increased intracranial pressure and possible serious morbidity (visual impairment) or death. When these tumors are surgically removed or decompressed, the prognosis for life seems to be quite good. Malignant change in these lesions is very rare.

Adolescent↗
PubMed1979

"Recreational" misuse of nitrous oxide.

With the use of nitrous oxide increasing, overuse and excessive exposure to this gas are also more prevalent. Neuropathy, expressed as amnesia, aphasia or weakness, numbness, and incoordination affecting all extremities, is the common result of frequent overexposure. For optimal dental treatment, it is recommended that both patient and dentist be aware that nitrous oxide can be an exogenous toxin, damaging to neuronal structures, if used in excess.

Adult↗
PubMed1978

Fibromuscular dysplasia.

Fibromuscular dysplasia is an increasingly recognized cause of vascular disease in young or middle-aged persons and may be amenable to medical or surgical management. We report five patients, one of whom died, with emphasis on the beaded and irregular pattern of change in the carotid arteries. Neck pain, bruit, and transient ischemic attacks are the most usual clinical symptoms. The cause of fibromuscular dysplasia remains obscure, but in view of the increased incidence in young women, hormonal factors may be involved. Dilation or resection can be considered, as in two patients reported here, and anticoagulation may benefit other patients.

Adult↗
PubMed1977

Atypical facial pain.

"Atypical facial pain" is the current label for a possibly heterogeneous group of discomforts localized in the lower half of the head and often confused with dental disease. As illustrated in seventeen cases reviewed here, the condition occurs mostly in women, and there are often neurotic problems in addition to the pain. The pain is dull or burning, incessant, and, in contrast to trigeminal neuralgia, relatively poorly relieved by carbamazepine or diphenylhydantoin sodium; antidepressants and psychotropic agents are worth considering. Although local pathology can occasionally be detected, in this condition the entire state of the patient and the emotional concomitants of the illness require particular attention.

Adult↗
PubMed1977

Environmental effects on the central nervous system.

The central nervous system (CNS) is designed to respond to the environment and is peculiarly vulnerable to many of the influences found in the environment. Utilizing an anatomical classification (cortex, cerebellum, peripheral nerves) major toxins and stresses are reviewed with selections from recent references. Selective vulnerability of certain areas to particular toxins is apparent at all levels of the CNS, although the amount of damage produced by any noxious agent depends on the age and genetic substrate of the subject. It is apparent that the effects of certain well known and long respected environmental toxins such as lead, mercury, etc., deserve continued surveillance. In addition, the overwhelming impact on the CNS of social damages such as trauma, alcohol, and tobacco cannot be ignored by environmentalists. The effect of the hospital and therapeutic environment has become apparent in view of increased awareness of iatrogenic disorders. The need for particular laboratory tests, for example, examination of CSF and nerve conduction toxicity studies, is suggested. Epidemics such as the recent solvent neuropathies suggest a need for continued animal studies that are chronic, as well as acute evaluations when predicting the potential toxic effects of industrial compounds.

Auditory Pathways↗
PubMed1977

Huntington disease: early indentification by H reflex testing.

This investigation was undertaken to determine the potential use of the H reflex of Hoffmann as a means of early detection of Huntington disease. Three groups of subjects were tested: 9 having Huntington disease, 8 first-generation offspring "at risk" of Huntington disease, and 30 normal persons as controls. The deep peroneal nerve was stimulated by a monopolar needle electrode, and the muscle potentials of the anterior tibialis and the extensor digitorum brevis were recorded with surface elctrodes. The action potentials were examined for the direct M response and the presence or absence of an H reflex response. The H reflex response was found in the anterior tibialis muscle, at least unilaterally if not bilaterally, in eight of nine subjects with Huntington disease and in five of eight persons at risk. The H reflex was present in 1 of 30 controls unilaterally. This significant difference between the patients with Huntington disease and at risk subjects compared to the control group, indicates that H reflex testing may be useful for the early identification of at risk individuals who will ultimately develop Huntington disease. This would be most helpful in family counseling terms, and also may aid in further understanding of this complex diseases.

Adolescent↗
PubMed1977

The neurological examination in dementia.

The thesis of this chapter is that the neurological phenomena discussed and numerous others omitted or not yet recognized relate primarily to a release of primitive activity when diffuse brain damage erodes cerebral inhibition mechanisms. Anatomical correlations are always difficult when there are multiple lesions, and those that have been made have not completely explained these phenomena. A phylogenetic explanation is not completely adequate either but certainly does not bar further investigations. Indeed such a concept points out the necessity to continue to search for other fetal or developmental responses in dementia, to assess the interrelationships between these reflexes, and to quantify the stimulus as well as the response. The prognostic value of these reflexes is not emphasized, because it is not known. In the evaluation of dementia, one of the last obvious frontiers of neurological science, both specific observations and general principles await discovery.

Aged↗