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Biomedical subjects

H Lauerma

Publications and source records attributed to H Lauerma.

At least 37 records · Page 2Linked to original sources
PubMed1999

Treatment of restless legs syndrome with tramadol: an open study.

BACKGROUND: Tramadol is a central analgesic that seems to have fewer side effects and a lower abuse potential than classical opioids. Since the treatment of restless legs syndrome (RLS) with levodopa or classical opioids is problematic, new treatment possibilities would be valuable. METHOD: We treated 12 patients who fulfilled at least the minimal diagnostic criteria proposed by the International Restless Legs Syndrome Study Group as well as the criteria proposed by Gibb and Lees, some of them treatment resistant or prone to side effects of previous medications, with 50 to 150 mg of tramadol per day in an open study. The follow-up lasted from 15 to 24 months. RESULTS: Ten patients reported clear amelioration and 1 reported slight amelioration of their symptoms, while 1 reported no effect. Tramadol was described to be the most effective treatment and free of side effects when compared with several other treatments. No major tolerance against treatment effect emerged among those who needed only a single evening dose. CONCLUSION: Compared with other treatments for RLS, tramadol seems to be superior in some cases, possibly because of its unique pharmacodynamic profile. Controlled studies are needed. Meanwhile, we believe that tramadol should be considered before other opioids are prescribed. We recommend intermittent treatment and careful monitoring.

Adult↗
PubMed1998

Schizophrenia among patients treated for rheumatoid arthritis and appendicitis.

The widely accepted negative association between schizophrenia and rheumatoid arthritis (RA) is based on the results of investigations which sought RA in large samples of schizophrenic patients. Using a discharge register, we examined the frequency of schizophrenia in a sample of 5626 RA patients. Appendicitis patients (n = 5330) were used as a comparison group. The cumulative incidence of hospital care with the diagnosis of schizophrenia during 8 years was higher in the RA group (0.64%) than in the appendicitis group (0.47%). Schizophrenia was significantly more common in the RA group than in the appendicitis group among the young. The age-adjusted prevalence of schizophrenia was 0.96% in the RA group and 0.51% in the appendicitis group. Because of this unexpected finding, we examined the incidence of RA and appendicitis among a birth cohort born in 1966. The frequencies of RA and appendicitis among schizophrenic cohort members (n = 76), cohort members with psychiatric diagnosis other than schizophrenia (n = 438), and members without psychiatric diagnosis (n = 10503) were similar. These findings do not support the negative association between schizophrenia and RA. Prolonged institutionalization per se may have been the protective factor against RA in the previous studies. The findings also raise the hypothesis that genes that predispose to schizophrenia provide protection from appendicitis, historically a common cause of mortality.

Adolescent↗
PubMed1998

Neurological motor disorders experienced as religious phenomena: role of abnormal movement monitoring.

We describe two cases of neurological motor disorders which were experienced as religious-mystical phenomena by elderly psychotic ladies. One of the patients interpreted a mild hemiparesis as a message from divine forces that changed her left to her right and vice versa. The other patient felt that her perphenazine-induced tardive dyskinesia was the voluntary reading of a silent mantra. Involvement of mystical or religious terms in the interpretation of physical symptoms may lead to the lack of adequate treatment and care. We suggest that a psychosis-related inability to monitor one's own motor behavior is the crucial factor leading to peculiar perception of motor disorders.

Aged↗
PubMed1997

Mianserin and restless legs.

Six cases of restless legs syndrome in association to mianserin are presented. Similarities and differences to previously reported cases are described. Some theoretical and methodological topics on restless legs syndrome in relation to drug-induced akathisia are discussed.

Adult↗
PubMed1996

Fear of suicide during sleepwalking.

It is generally accepted that sleepwalking (SW) is a state of automatism in which an individual is unaware of, and has no control of, his or her behavior. Recently, Broughton et al. (1994) reported a case of a homicide and an attempted homicide during SW in which somnambulism was a legal defense and led to an acquittal. The wide variety in the clinical manifestations of SW and sleep terrors (ST) may sometimes lead to difficulties in diagnosing these treatable entities. The present case illustrates a diagnostic and clinical problem, deciding between histrionic behavior, suicidal acting out, REM-sleep behavioral disorder, and SW; and assessing the risk of suicide during SW.

Adult↗
PubMed1996

Sleep-related disorders in carpal tunnel syndrome.

INTRODUCTION: Patients with carpal tunnel syndrome (CTS) often wake up at night due to pain and numbness of affected fingers and hand. We studied the sleep disorder caused by CTS. SUBJECTS AND METHODS: 34 consecutive patients referred for operative treatment of CTS answered to a sleep questionnaire and the results were compared to a stratified random sample of 1600 Finns aged 36-50 year, whose response rate to the mailed questionnaires was 75.2% (n = 1186). Six CTS patients underwent a polygraphic sleep study before and after operative treatment of CTS. RESULTS: CTS patients reported suffering from poor sleep quality, fragmentary sleep and daytime sleepiness more often than controls. Before operative treatment of CTS there were more nocturnal body movements (p < 0.01) and awakenings lasted longer (p < 0.05) than after operation. During preoperative sleep studies no drop in median nerve conduction was detected during awakenings. CONCLUSIONS: Patients with CTS suffer from fragmentary sleep. Although patients reported waking up for the pain or numbness of hands no impairment in median and ulnar nerve conduction could be observed during these awakenings. Operative treatment of hand entrapment significantly reduced the number of nocturnal movements.

Adult↗
PubMed1996

Successful treatment of citalopram-induced anorgasmia by cyproheptadine.

This is the first report of the use of cyproheptadine to treat anorgasmia induced by citalopram, a highly selective serotonine reuptake inhibitor (SSRI). Total anorgasmia of a 47 year-old man who suffered from severe unipolar major depression was successfully treated without adverse effects. This case strengthens the impression that anorgasmia associated with SSRIs is related primarily to the serotonine reuptake inhibition and not to various receptor bindings of different compounds.

Antidepressive Agents↗
PubMed1995

The need for excessive dietary sodium chloride following tympanoplasty.

Loss of a single nerve function in the peripheral network responsible for taste perception is traditionally considered clinically insignificant. However, we report the case of a 27-year-old woman who experienced significant selective taste loss for salt after manipulation of the chorda tympani during tympanoplasty. This effect may be explained by disorder of the functional neuroanatomy of salty taste perception together with strong lateralization of mastication to the affected side in this patient. Recently described inhibition of cranial nerve IX by cranial nerve VII is hypothesized as contributing to the contradiction between this case and the commonly accepted role of the chorda tympani in taste perception.

Adult↗
PubMed1995

A case of moclobemide-induced hyperorgasmia.

Moclobemide-induced sexual hyperarousal of a female patient is presented. Remarkable similarities with a previously reported case and implications of the phenomenon are discussed.

Adult↗
PubMed1994

Abnormal lateralization of motor activity during sleep in schizophrenia.

In previous studies it has been demonstrated that during sleep healthy subjects with consistent left- or right-handedness perform about two thirds of their movements with the non-dominant hand. We examined the motor activity during waking and sleep of 13 medicated hallucinating schizophrenic patients without motor side effects and 17 control subjects using bilateral wrist actometry during two nights. Five of the patients were also monitored by continuous infrared video recording and by the Static Charge Sensitive Bed method during the movement recording nights. Lateralization to the non-dominant side during nocturnal low activity period or sleep was absent in the schizophrenic group, in which the dominant hand remained more active. This was not due to movement excess. The difference in lateralization between the controls and the patients should be considered a preliminary finding until replicated. It suggests abnormal laterality of arousal, attention or movement system during sleep in schizophrenia. It may imply abnormality in the sleep dependent modification of attentive behavior, or it may be explained by the lateralized effects of neuroleptic medication.

Adult↗
PubMed1994

Asymmetry of instructed motor response to auditory stimuli during sleep.

Previous studies have demonstrated that motor activity during sleep is lateralized to the nondominant hand. There are two basic theories concerning this phenomenon: 1) The nondominant hemisphere is nonspecifically more alert or responsive than the dominant one, and 2) the lateralization to the nondominant side is task specific, reflecting the spatially oriented mode of information processing that is responsible for movements during sleep. We examined the motor responses to auditory stimuli during waking and sleep of 10 right-handed healthy subjects, who were instructed to switch off a tone stimulus by pressing a transducer that was attached to each hand. Sleep stage scoring was performed according to Rechtschaffen and Kales's criteria. During wakefulness and in all stages of sleep, with and without alpha activity occurring after stimulus onset, the dominant hand was used more, but during nonrapid eye movement S1 sleep the difference was not statistically significant. When alpha activity was present in the electroencephalogram after stimulus onset, the responses were significantly more lateralized to the right hand than when there was no alpha activity. During an actimetric home recording of both wrists of the subjects, there was an excess of left-sided movements during sleep as compared to waking. The results do not support the idea that the right hemisphere is generally more responsive than the left during sleep. They are, however, in accordance with the hypothesis that spatial information processing is a crucial factor in the nondominant lateralization of spontaneous sleep movements.(ABSTRACT TRUNCATED AT 250 WORDS)

Acoustic Stimulation↗