[Do most of the persons with whiplash injury suffer of profit neurosis?].
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Biomedical subjects
Publications and source records attributed to I A Sulg.
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Among 51 patients referred for investigation of possible organic solvent encephalopathy 20 (39%) had pathological sleep apnoea [apnoea index (AI) greater than 5], compared with 5 of 16 house painters exposed to solvents (31%) who were screened for the disorder, and 1 of 18 (6%) age-matched controls. Twelve of the patients with AI greater than 5 were retested after 2 or more weeks without exposure to solvents, and showed a significant drop in AI. Likewise, significantly lower AI was seen in patients who were no longer exposed to solvents, compared with recently exposed patients. The implications of these findings for diagnostic evaluation of solvent encephalopathy and sleep apnoea are discussed.
Severe accidental hypothermia is often associated with global ischaemia due to cardiac arrest. The purpose of the present study was to evaluate whether rewarming on cardiopulmonary bypass (CPB) should be slow or as fast as possible. Pigs were cooled to 23 degrees C (rectum), subsequently followed by 1 h period of circulatory arrest, whereupon rewarming was started. Pigs were randomly allocated to 3 groups: slowly rewarmed (2 h), rapidly rewarmed (0.5 h) and a control group on CPB maintaining normothermia. EEG was continuously analyzed by means of Anesthesia-Brain-Monitor (ABM-system), which allows simultaneous monitoring of EEG, blood- and intracranial pressures, heart rate and capnogram as trend graphs. The ABM-system thus delivers a continuous on-line printout of all measured variables. Cooling resulted after about 30 min in electrocerebral inactivity (ECI) in all pigs. EEG reappeared in all animals regardless of the considerable long cardiocirculatory arrest, followed by nearly 3 hours of ECI! It would appear tempting to rewarm an accidentally cooled organism as fast as possible. The present study, however, indicate that the brain during rewarming seems to have its own speed for regeneration of the EEG. This speed showed to be slower than the steeply rising temperature during rapid rewarming. Furthermore, a too vigorous rewarming may jeopardize cerebral metabolism; 90 min after the start of rewarming the EEG had reappeared in 5 out of 8 pigs in slow group, but only in 2 out of 7 in rapidly rewarmed animals. In controls the EEG was continuously present throughout the experiments.
In 100 MS patients, BAEP and tibial SEP abnormality rates increased significantly with disease duration and clinical disability. VEP correlated non-linearly with disease duration, and median nerve SEP correlated with disability. In multifactorial analysis, however, BAEP correlated significantly only with clinical brainstem and cerebellar signs. These results suggest that evoked potentials correlate more strongly with neurological status of the functional subsystems than either overall disability or disease duration. These findings indirectly suggest that evoked potentials may be useful monitors during large therapeutical trials in MS patients.
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Fifteen patients referred for the evaluation of possible organic solvent encephalopathy were studied by clinical polysomnography. Seven had more than 30 apnoeas per night and an apnoea index of higher than 5, thus fulfilling the commonly used criteria of the sleep apnoea syndrome. Another group of eight workers exposed to trichlorethane, examined without prior knowledge of their individual symptoms, showed a significantly elevated number of sleep apnoeas compared with nine controls. The results indicate that organic solvent exposure can cause sleep apnoea.
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The quantitative EEG (QEEG), regional cerebral blood flow (rCBF) and circulation time of 17 patients were examined semisimultaneously thrice during the first 3 months after a cerebral supratentorial infarction. The EEG was quantified according to normalized slope descriptor technique in nine patients and by means of a combined period and amplitude analysis in eight patients. Intravenously injected isotopes 133Xenon and 99TcmO4 were used for blood flow and circulation time measurements. The QEEG-values improved during the whole follow-up period. Cerebral blood flow stayed low for all 3 months and did not alter during this period, while initially prolonged circulation time to some extent improved within 2 weeks remaining, however, prolonged even thereafter. A tendency for a positive correlation between QEEG and rCBF values in the infarcted hemisphere could be seen.
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