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Biomedical subjects

H H Morris

Publications and source records attributed to H H Morris.

At least 109 records · Page 6Linked to original sources

Current treatment of status epilepticus.

Generalized tonic-clonic status epilepticus is a relatively common neurologic emergency. The differential diagnosis of this condition includes decerebrate spasms and hysterical seizures. Initial therapy includes establishing an airway and securing an intravenous line. Blood should be obtained for chemistries and anticonvulsant levels. Administration of anticonvulsants should not be delayed until laboratory results are obtained. Intravenous diazepam will usually stop continuous tonic-clonic seizure activity, but because of a rapid redistribution phase, it necessitates administration of a longer acting anticonvulsant such as phenytoin or phenobarbital. Intravenous phenytoin should be administered slowly at a dose of 15 mg/kg while carefully monitoring vital signs. Intravenous phenobarbital produces sedation and may cause respiratory depression. Occasionally, other anticonvulsants such as paraldehyde, lidocaine, and general anesthesia will be needed to break status epilepticus. Careful follow-up of the patient and monitoring of the anticonvulsant levels may prevent future bouts of status epilepticus.

Adult↗

Neuroleptic malignant syndrome.

The neuroleptic malignant syndrome is an uncommon, severe illness that consists of fever, muscular rigidity, and stupor. Various neuroleptics have been associated with the disease. A detailed neurological, medical, and neuropathological evaluation of this case was performed. Presumably, the syndrome is secondary to biochemical dysfunction of the basal ganglia and possible of the hypothalmus.

Adult↗

Jansky-Bielschowsky form of neuronal ceroid-lipofuscinosis. Ocular pathology of the Batten-Vogt syndrome.

The neuronal ceroid-lipofuscinoses (Batten-Vogt syndrome) are a group of at least four closely related entities that are characterized by the accumulation of autofluorescent lipopigments in neural, visceral, and somatic tissues. The ophthalmic pathology of this syndrome has been investigated less extensively than other tissues and organs. In this report, we present the postmortem ocular findings, including light, fluorescence, and electron microscopy, from a child with the Jansky-Bielschowsky form of this syndrome.

Child, Preschool↗

Problems in family practice: Seizure disorders.

The current seizure classification recognizes two major categories, partial (focal) and generalized. Sublcasses of this system are determined by clinical and electroencephalographic manifestations of the seizures. Neonatal seizures are difficult to recognize and classify but require prompt and appropriate treatment for best results. Infantile spasms are important to recognize because of their grave prognosis and because they respond to steroid medications but not standard anticonvulsants. Febrile convulsions represent a continuing treatment controversy but have a good prognosis. The diagnosis of epilepsy is based on clinical history. Laboratory studies help classify the type of seizure and identify the etiology. The computerized tomography (CT) scan has simplified diagnostic evaluation. The extent of the evaluation must be adjusted to meet individual requirements. The choice of anticonvulsant is dependent on seizure type as well as the side effects and cost of the drug. Anticonvulsants have potential side effects which can be minimized by judicious dosage adjustments utilizing serum anticonvulsant levels when appropriate.

Adolescent↗

Chronic ECHO type 5 virus meningoencephalitis in X-linked hypogammaglobulinemia: treatment with immune plasma.

A patient with X-linked hypogammaglobulinemia developed chronic meningoencephalitis. ECHO virus type 5 was repeatedly cultured from cerebrospinal fluid (CSF). Infusions of high-titer, specific plasma resulted in clinical improvement, but failed to eradicate the virus. After more intensive plasma infusions, the virus could not be cultured from the CSF. The patient died 8 months after institution of intensive therapy. The cause of death was unknown. Autopsy showed persistence of perivascular and meningeal inflammation. Specific anti-ECHO-virus-5 plasma was shown to be more effective in lowering CSF ECHO-virus titers than was plasma without anti-ECHO-virus antibody.

Adolescent↗

Lidocaine: a neglected anticonvulsant?

An elderly man had focal motor status epilepticus secondary to a frontal lobe hematoma. Phenytoin, phenobarbital, and diazepam did not stop the seizures. Intravenous lidocaine by bolus injection and continuous infusion rapidly controlled the seizures.

Aged↗

Tick paralysis: electrophysiologic measurements.

Electrophysiologic measurements in a 9-year-old girl with tick paralysis demonstrated a prolonged distal latency and a decremental response to 30 Hz stimulation. The nerve conduction determinations became normal after clinical recovery. The pathophysiologic process of this disease seems to be within the peripheral nerve although a central site of action of tick toxin cannot be completely excluded. Tick paralysis should be considered in the individual who develops ascending paralysis.

Child↗

Angiographic findings in giant cell arteritis.

A 65-year-old woman had intermittent episodes of blindness. Although severe atherosclerotic changes were documented angiographically, definite radiographic evidence of arteritis also was present. A temporal artery biopsy was diagnostic for giant cell arteritis. Despite high-dose corticosteroid treatment, the patient became blind. A Westergren sedimentation rate of greater than 40 mm/hr in a patient over age 50 with headache, constitutional complaints, or visual symptoms is presumptive evidence of giant cell arteritis and demands further investigation. Prompt treatment with prednisone in high doses may prevent visual loss. At times angiography may be helpful in diagnosis of this illness or in selection of a biopsy site.

Aged↗

Studies in neuronal ceroid-lipofuscinosis: leukocyte peroxidase deficiency in a patient with neuronal ceroid-lipofuscinosis (Jansky-Bielschowsky type).

Leukocyte peroxidase deficiency has been demonstrated in a confirmed case of neuronal ceroid-lipofuscinosis with guaiacol, o-dianisidine, and p-phenylenediamine used as hydrogen donors in the peroxidase assay system. Nitroblue tetrazolium (NBT) reduction values in the leukocytes of the patient were also found to be significantly higher than those of normal controls, indicating the impaired hydrogen peroxide catabolism. When the patient was given a daily dose of vitamin E (400 I.U.), vitamin C (1 gm), and methionine (1 gm.) along with a weekly intramuscular injection of vitamin B12, the leukocyte peroxidase values of the patient returned to normal levels in about 7 weeks. NBT reductions values also decreased to normal levels. The regenerated enzyme in the patient's leukocytes was shown to have similar chromatographic and electrophoretic properties as the leukocyte peroxidase of normal controls. After about 28 weeks of therapy, the peroxidase levels in the leukocytes of the patient returned to original low levels, with concomitant increase in the NBT reduction values. The effect of vitamin therapy on normal control subjects was, at least in some cases, an increase of leukocyte peroxidase. A significant increase in the peroxidase levels of the patient's leukocytes during vitamin therapy remains unexplained, and the possibility of peroxidase deficiency being a secondary manifestation rather than the primary defect in Batten's disease cannot be ruled out.

Ascorbic Acid↗

Pronator syndrome: clinical and electrophysiological features in seven cases.

The clinical and electrophysiological picture of seven patients with the pronator syndrome is contrasted with other causes of median nerve neuropathy. In general, these patients have tenderness over the pronator teres and weakness of flexor pollicis longus as well as abductor pollicis brevis. Conduction velocity of the median nerve in the proximal forearm is usually slow but the distal latency and sensory nerve action potential at the wrist are normal. Injection of corticosteroids into the pronator teres has produced relief of symptoms in a majority of patients.

Adrenal Cortex Hormones↗