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Biomedical subjects

I Reider

Publications and source records attributed to I Reider.

At least 19 recordsLinked to original sources
PubMed1997

Periodic lateralized epileptiform discharges (PLEDs) following stroke are associated with metabolic abnormalities.

PLEDs are an electroencephalographic phenomenon consisting of high voltage stereotyped periodic transients distributed over one hemisphere, associated with acute or subacute structural lesions as well as with metabolic abnormalities. We have evaluated the contribution of metabolic factors in patients with acute hemispheric stroke. Temperature, serum electrolytes, glucose, kidney and liver function tests were examined in two groups of 14 patients each following acute hemispheric stroke differing in regard to the appearance of PLEDs in the EEG. CT features of the infarcts were also compared. Patients with PLEDs had more metabolic derangements as compared to patients with no PLEDs (Mann-Whitney ranking test P = 0.01). Hyperglycemia and fever were significantly associated with PLEDs (logistic regression model, P < 0.05). There was no significant difference regarding radiological findings between the two groups. We conclude that acute stroke as a structural lesion predisposes to PLEDs but the latter may be triggered by metabolic disturbances, mainly hyperglycemia and fever.

Aged↗
PubMed1994

Basal ganglia lacunes and parkinsonism.

'Arteriosclerotic' parkinsonism is still a subject of debate. The aim of this study was to investigate whether parkinsonism associated with basal ganglia lacunes possesses peculiar clinical features and a clinical course which enables its distinction from idiopathic Parkinson's disease (IPD). 106 consecutive ambulatory patients with the clinical diagnosis of parkinsonism were referred for CT examination. Patients in whom isolated basal ganglia lacunes were found were interviewed and examined, and their clinical characteristics were compared to those of patients suffering from IPD without lacunes (controls). In 20 patients, isolated basal ganglia lacunes were detected; all had risk factors for stroke (significantly more than controls) and 7 of them had had clinically diagnosed strokes. The extrapyramidal disability evolved slowly in all. The clinical picture was indistinguishable from IPD in individual patients. However, tremor was significantly less frequent in this group. Lower body parkinsonism was not observed. Extra-pyramidal signs were frequently asymmetrical (55%), with no consistent relationship to the side of the lacune. Asymmetrical pyramidal signs were present in 30% of those with unilateral lacunes, always on the appropriate side. Only 1 patient was an L-dopa nonresponder. Patients with parkinsonism associated with basal ganglia lacunes showed tremor less frequently than other IPD patients; otherwise, clinical features and course of the disease were indistinguishable from IPD. In these cases, parkinsonism and basal ganglia lacunes might have occurred independently of each other and tremor might have been prevented by ischemic events.

Aged↗
PubMed1992

Primary spinal epidural non-Hodgkin's lymphoma. The contribution of nuclear magnetic resonance imaging, therapeutic approach and review of the literature.

Primary spinal epidural lymphoma (Stage I) is diagnosed predominantly late after a long prodromal phase of local back pain resulting in spinal cord compression. The use of CT and NMR images in the early stage of investigation and their analysis may help to diagnose these cases prior to the appearance of neurologic deficit. We report on 2 patients who presented with prolonged localized back pain with sudden symptoms of spinal cord compression. CAT scan and NMR imaging demonstrated the characteristic appearance of lymphoma. Decompressive laminectomy supported the diagnosis. Radiotherapy treatment to the region of the non-Hodgkin's lymphoma resulted in complete resolution. Thereafter, systemic chemotherapy with CHOP achieved a good response.

Adult↗
PubMed1991

Interferon-related leukoencephalopathy in a patient with renal cell carcinoma.

A 75-year-old patient with metastatic renal cell carcinoma was treated with recombinant interferon alpha-C and thereafter developed a neurologic syndrome of dementia, ataxia, confusional state, loss of concentration ability and cortical blindness. CT scan findings were compatible with leukoencephalopathy, which is reported as being a toxic effect of interferon.

Aged↗
PubMed1990

Metastatic disease of the cavernous sinus: contribution of computed tomography and magnetic resonance imaging to diagnosis.

The clinical presentation of metastatic disease to the cavernous sinus includes ophthalmoplegia, pain and sensory deficit along the optic or maxillary branches of the trigeminal nerve. The role of a CT scan and magnetic resonance imaging in the diagnosis is discussed. It was found that magnetic resonance imaging is superior to CT scan in demonstrating the cavernous sinus and pontine borders, especially in lymphomatous involvement of these structures.

Adult↗
PubMed1989

Spinal epidural compression in chronic lymphocytic leukemia.

Spinal epidural compression is a rare neurologic complication in patients with lymphoma. It occurs mostly in those with intermediate-grade to high-grade malignancy disease. This type of neurologic involvement has not been described in chronic lymphocytic leukemia (CLL). A patient with a long, stable CLL course developed spinal epidural compression and consequently died. The frequency of spinal epidural compression in lymphoma, according to the histologic subtypes and the considerations in making the right choice of therapy are discussed in light of the presented case.

Aged↗
PubMed1989

Non surgical treatment of subdural hematoma in a hemodialysis patient.

The development of subdural hematoma in the course of hemodialysis treatment has been well documented in the literature. We report a case of a subdural hematoma in a patient on hemodialysis, in whom surgery was contraindicated, due to her concurrent use of anticoagulants. Good recovery was achieved by steroid treatment. Although surgical removal constitutes the essential therapeutic approach for subdural hematoma, we emphasize the importance of medical management in special cases where surgery is contraindicated.

Adrenal Cortex Hormones↗
PubMed1987

Computed tomography brain changes in parkinsonian dementia.

In order to evaluate the relationship between brain atrophy and the motor and cognitive function in Parkinson's disease, we have evaluated CT changes in 132 consecutive patients and compared them to measures of physical and mental decline, using intercorrelations and variance analysis. The result demonstrated age as a most important factor relating to brain atrophy. After correction for this determinant, it became clear that the motor and cognitive parameters were interdependent but they affected similar CT parameters. The effect of motor decline was the stronger of the two and it was the only one which correlated with cortical atrophy. The results support the notion of subcortical changes underlying the dementia of Parkinson's disease.

Aged↗
PubMed1985

Cerebellar astrocytoma presenting as deterioration of handwriting in a child.

Deterioration of handwriting in an 11-year-old boy over a 2 month period was found to be caused by a cerebellar astrocytoma. The clinical picture was characterised by a lack of the classic symptoms of increased intracranial pressure. The only positive neurological findings pointed to an isolated right cerebellar symptomatology expressed by mild intention tremor and decreased tone of the right hand. Progressive deterioration of handwriting can be an ominous sign and it should be known to all professionals, as a lack of awareness can cause delay in expert referral and diagnosis.

Astrocytoma↗
PubMed1985

Epileptic psychosis: an evaluation of PSE profiles.

Data are presented on 24 patients with epilepsy and psychosis whose clinical presentation was rated using the Present State Examination (PSE). Seventeen had complex partial seizures and a diagnosis of temporal lobe epilepsy, seven had generalised epilepsy. An association between a CATEGO category of nuclear schizophrenia (NS) and a lesion of the left side was noted. No clear link between depressive symptoms and a right-sided focus was discovered. Affective disorders were noted in both groups of epileptic patients, although paranoid psychoses were commoner in the temporal lobe group. There was also a tendency for the latter to have more delusions of persecution, ideas of reference, and special features of depression. The group rated as NS appear less likely to show evidence of intellectual deterioration than the other psychotic patients; in addition, the interval between the onset of their epilepsy and the onset of their psychosis is shorter. Radiological assessment by CAT reveals few differences between groups, but the psychotic samples do show higher than expected values on a number of variables, in particular the bilateral septum-caudate distance and the size of the third and fourth ventricle.

Adult↗
PubMed1982

Effects of long-term treatment with bromocriptine on pituitary prolactinoma in a male.

Poor surgical results are obtained when operating on large prolactinomas, especially when an extrasellar growth is demonstrated. Several groups have reported tumor regression following bromocriptine treatment. A case report is presented of a young hyperprolactinemic man with a large pituitary adenoma with suprasellar extension, normal visual fields, decreased libido, impotence, hypogonadism and azoospermia. This man was treated with high doses of bromocriptine for a period of 5 months. A significant improvement of potency libido and sperm concentration associated with radiological evidence of a marked reduction of tumor size was noted following suppressive treatment with this ergot alkaloid.

Adult↗