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Biomedical subjects

J C Morgenlander

Publications and source records attributed to J C Morgenlander.

At least 37 records · Page 2Linked to original sources
PubMed1996

A syndrome of concurrent central and peripheral nervous system involvement due to Epstein-Barr virus infection.

Epstein-Barr virus infection can affect both the central and peripheral nervous system. In some patients this occurs concurrently. Two patients are presented with encephalopathy and acute quadriparesis with diminished reflexes. Positive serology for Epstein-Barr virus was found in both patients. Both patients had a cerebrospinal fluid pleocytosis in the setting of progressive weakness. Electrophysiologic studies early in the course of their illness demonstrated abnormal F-wave latencies with normal distal conduction. Electromyographic studies demonstrated prominent spontaneous activity in affected limbs. As both the encephalopathy and weakness improved, the electrophysiologic abnormalities improved. This presentation is characteristic of acute Epstein-Barr virus infection. Pathologic studies in other patients have documented both anterior horn cell degeneration and edema as well as cellular infiltration of nerve roots which are responsible for the paralysis with diminished reflexes and electrophysiologic findings. The prognosis for these patients is generally good.

Adult↗
PubMed1996

Transcranial doppler sonography to monitor cerebral vasculitis.

We describe a patient with cerebral vasculitis treated with prednisone and cyclophosphamide and followed by serial transcranial Doppler sonography and arteriography. Proximal cerebral angiographic abnormalities correlated with transcranial Doppler abnormalities. The abnormalities gradually normalized with treatment and correlated with the findings of followup arteriography, which also showed improvement in the vascular morphology. Transcranial Doppler sonography is useful in following proximal cerebral vascular abnormalities in some cases of cerebral vasculitis.

Angiography↗
PubMed1995

Neuro-Behçet's disease: factors hampering proper diagnosis.

We reviewed the clinical course of nine patients with neuro-Behçet's disease to assess difficulties in making this diagnosis. Factors delaying proper diagnosis included lack of accurate history and physical examination, lack of recognition of an underlying systemic syndrome and its relationship to the neurologic symptoms, presence of intermittently normal CSF studies, and use of noncontrasted neuroimaging techniques.

Adolescent↗
PubMed1994

Lumbar puncture and CSF examination. Answers to three commonly asked questions.

The incidence of post-lumbar puncture headache has been shown to be reduced by using a higher-gauge (smaller-bore) needle and orienting the needle bevel parallel to the dural fibers. Incidence of headache is the same in patients given bed rest as in patients who are mobilized immediately. Cerebrospinal fluid (CSF) examination of patients with seizures of unclear cause is indicated. However, pleocytosis can be a result of the seizure alone. Other causes of pleocytosis must be ruled out by clinical evaluation and CSF studies. Although lumbar puncture is often advocated for patients presenting with dementia, it usually is not helpful in finding a specific cause if the dementia is long-standing.

Cerebrospinal Fluid↗
PubMed1992

Posey palsy.

Explore the source record for details and available documents.

Axillary Vein↗
PubMed1991

Myotonic dystrophy.

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Cognition Disorders↗
PubMed1991

Recurrent transient ischemic attacks and stroke in association with an internal carotid artery web.

Fibromuscular dysplasia is a nonatherosclerotic vascular disease that most commonly affects cervical carotid arteries at the C1-C2 level when cephalic arteries are involved. Several histopathologic and angiographic subtypes of fibromuscular dysplasia exist; most have a benign natural history. We describe the third reported case of a pathologically proven, symptomatic proximal internal carotid artery web and suggest that patients with this lesion are at a higher risk for stroke.

Adult↗
PubMed1990

Bell's palsy. Ensuring the best possible outcome.

Bell's palsy is thought to be an idiopathic polyneuritis and must be distinguished from other disorders that cause facial weakness. In most cases, differentiation can be accomplished on the basis of the history, physical examination, and clinical course. Routine follow-up care ensures that recovery is occurring. Electrodiagnostic testing often helps to assess prognosis. Eye care and corticosteroid therapy are recommended.

Adult↗
PubMed1990

Surgical treatment of cluster headache.

Cluster headache is ordinarily managed medically, but may become refractory to such medical management. In this setting, surgical treatment has occasionally been performed, based on evidence that pertinent pain pathways and parasympathetic pathways may be interrupted at the main sensory root of the trigeminal nerve and at the nervus intermedius. Between 1976 and 1987, 13 patients underwent surgery for treatment of cluster headache that was refractory to medical therapy (15 procedures). Partial sectioning of the main sensory root and sectioning of the nervus intermedius were performed in nine patients; only partial sectioning of the main sensory root in one; only sectioning of the nervus intermedius in one; and nervus intermedius sectioning plus microvascular decompression of the trigeminal nerve in two. The average postoperative period for the 13 patients was 37 months (range 2 to 135 months). All patients had return of their headaches postoperatively except for one patient who obtained relief after a repeat procedure. Headache began to return between 2 days and 2 years postoperatively. Three patients are currently free of headache, including both patients who had nervus intermedius sectioning plus microvascular decompression of the trigeminal nerve. Together with recurrence of headache, cluster-associated autonomic disturbances recurred after 14 of the 15 operations but are currently absent in the three headache-free patients. Partial sectioning of the main sensory root and sectioning of the nervus intermedius, as performed in these patients, seem to have limited value in the treatment of cluster headache.

Cluster Headache↗
PubMed1990

Disc space infection: a case report with MRI diagnosis.

Vertebral disc space infection is an uncommon cause of back pain. Physical findings may be unimpressive and laboratory evaluation may only disclose an elevated erythrocyte sedimentation rate. Magnetic resonance imaging is particularly useful, since it reveals abnormalities earlier than plain radiographs and is more precise than bone scan.

Back Pain↗
PubMed1989

Aspergillus disc space infection: case report and review of the literature.

Aspergillus disc space infection is an unusual complication of the immunocompromised state. Magnetic resonance imaging may aid the clinician in arriving at a prompt diagnosis of discitis in affected patients. We report a case of systemically acquired Aspergillus discitis at multiple levels diagnosed by plain x-ray films, bone scan, magnetic resonance imaging, and biopsy. We review the literature on this subject and suggest that aggressive diagnosis with early biopsy, treatment with systemic antifungal agents, and surgical debridement of the infected disc space yield the best outcome for these patients.

Anti-Bacterial Agents↗
PubMedDate not supplied

EKG abnormalities in pediatric patients with myotonic dystrophy.

Electrocardiographic (EKG) abnormalities are frequent in patients with myotonic dystrophy; cardiac complications may lead to significant morbidity and mortality. The charts of 17 pediatric patients with myotonic dystrophy were reviewed to ascertain the frequency of EKG abnormalities and cardiovascular symptoms. Fifteen of 17 patients had abnormal EKGs with sinus bradycardia being the most common abnormality. Only 1 of 17 patients had cardiovascular symptoms. Four patients had moderate to severe weakness and 3 of them had a conduction disturbance (i.e., first-degree AV block or intraventricular conduction delay). Two of the remaining 13 patients with mild weakness had conduction disturbances. No pediatric patients had progressive EKG abnormalities during follow-up. Baseline EKG study of pediatric patients with myotonic dystrophy is recommended because abnormalities are frequent and usually asymptomatic. Frequent follow-up EKGs are probably unnecessary unless the patient is symptomatic or has heart block.

Adolescent↗
PubMedDate not supplied

Spontaneous vertebral dissection: clinical, conventional angiographic, CT, and MR findings.

OBJECTIVE: The purpose of this study was to determine if typical clinical and neuroradiologic patterns exist in patients with spontaneous vertebral artery (VA) dissection. MATERIALS AND METHODS: The medical records and neuroradiologic examinations of 14 patients with spontaneous VA dissection were reviewed. The medical records were examined to exclude patients with a history of trauma and to record evidence of a nontraumatic precipitating event ("trivial trauma") and presence of possible risk factors such as hypertension. All patients underwent conventional angiography, 13 either CT or MRI (11 both CT and MRI), and 3 MRA. Conventional arteriograms were evaluated for dissection site, evidence of fibromuscular dysplasia, luminal stenosis or occlusion, and pseudoaneurysm formation. CT examinations for the presence of infarction or subarachnoid hemorrhage. MR examinations for the presence of infarction or arterial signal abnormality, and MR angiograms for abnormality of the arterial signal column. RESULTS: Seven patients had precipitating events within 24 h of onset of symptoms that may have been causative of dissection and five had hypertension. At catheter angiography, two patients had dissections in two arteries (both VAs in one patient, VA and internal carotid artery in one patient), giving a total of 15 VAs with dissection. Dissection sites included V1 in four patients, V2 in one patient, V3 in three patients, V4 in six patients, and both V3 and V4 in one patient. Luminal stenosis was present in 13 VAs, occlusion in 2, pseudoaneurysm in 1, and evidence of fibromuscular dysplasia in 1. Posterior circulation infarcts were found on CT or MR in five patients. Subarachnoid hemorrhage was found on CT in two patients and by lumbar puncture alone in two patients. Abnormal periarterial signal on MRI was seen in three patients. MRA demonstrated absent VA signal in one patient, pseudoaneurysm in one, and a false-negative examination in one. Repeat catheter angiography of nine VAs at an interval ranging from 2 weeks to 1 year showed progression to occlusion in two arteries, unchanged appearance in 4, and angiographic resolution in three, which did not closely correlate with clinical outcome. CONCLUSION: No preferred site of dissection along the course of the VA was found in this study. CT and MR examinations of the head are frequently normal in patients with VA dissections. No correlation between clinical outcome and findings at repeat angiography was demonstrated.

Adult↗