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Biomedical subjects

J F Brick

Publications and source records attributed to J F Brick.

At least 19 recordsLinked to original sources
PubMed1991

Musculoskeletal disorders. When are they caused by hormone imbalance?

Often, the source of a musculoskeletal problem can be traced to an endocrine disorder. For example, carpal tunnel syndrome is not uncommon in patients who are pregnant or have diabetes, hypothyroidism, or acromegaly. Joint problems and arthritis are other common findings in diabetes, pregnancy, and hyperparathyroidism. Muscle weakness or stiffness is seen in both hypothyroidism and hyperthyroidism, and muscle wasting is a characteristic of adrenocorticoid insufficiency. Bone disorders are common with glucocorticoid excess, acromegaly, and hyperparathyroidism. Some presentations are a classic picture of a specific endocrine condition and are readily recognized if the index of suspicion is appropriately high.

Carpal Tunnel Syndrome↗
PubMed1991

Paradoxical lid elevation with sustained upgaze: a sign of Lambert-Eaton syndrome.

Myasthenia gravis and Lambert-Eaton myasthenic syndrome are causes of acquired extraocular muscle weakness and ptosis. Exacerbation of ptosis after sustained upgaze is a clinically useful sign in the diagnosis of myasthenia gravis. A 54-year-old woman with established Lambert-Eaton myasthenic syndrome exhibited transient improvement of her ptosis after sustained upgaze. We suggest that paradoxical lid elevation after sustained upgaze may be a clinically useful sign in distinguishing Lambert-Eaton myasthenic syndrome from myasthenia gravis.

Blepharoptosis↗
PubMed1991

Hemorrhagic cardioembolic stroke: is anticoagulation absolutely contraindicated?

Hemorrhagic cerebral embolism should not be considered an absolute contraindication to immediate low-dose systemic anticoagulation. Low levels of anticoagulation may give some protection from recurrent embolism while minimizing the risks of intracranial bleeding. Until further studies are available, these decisions must be made on a case-by-case basis, supported by limited scientific information.

Anticoagulants↗
PubMed1991

Transient appearance of periodic EEG discharges in senile dementia.

We describe an elderly patient with probable Alzheimer's disease whose EEG and clinical status improved rapidly coincident with normalization of temperature. This finding suggests that her transient illness, of fever, pneumonia and confusional state, triggered the production of this periodic EEG pattern. With the increased prevalence of dementia in our aging population, we predict that the appearance of a multifocal periodic triphasic sharp wave pattern in the EEG of chronically demented patients (with superimposed infection) will become more common. Only when this pattern persists over time and the patient is not systemically ill, is this pattern a reliable discriminator for CJD. Serial EEGs in this setting (after treatment of the systemic illness) might reveal the transient nature of the periodic EEG change, thus avoiding the erroneous conclusion that the patient's dementia is a manifestation of CJD.

Aged↗
PubMed1990

EEG and pathologic findings in patients undergoing brain biopsy for suspected encephalitis.

Previous studies have suggested that EEG may be helpful in the diagnosis of herpes encephalitis (HE). To further define the value of EEG in an acutely ill, febrile, encephalopathic patient suspected as having encephalitis, we reviewed initial preoperative EEGs with the results of cerebral biopsies in 24 consecutive patients suspected of having encephalitis. Statistical analysis demonstrated that EEG patterns have only limited association with biopsy results. Since diseases which mimic encephalitis may also generate identical EEG changes, this is not an unexpected finding. EEG is useful in the evaluation and management of patients with encephalitis. However, the absence of specific wave forms or focal EEG abnormalities in the proper clinical setting should not deter consideration of HE or delay treatment.

Adolescent↗
PubMed1990

Cerebral vasoconstriction as a complication of carotid endarterectomy. Case report.

The case is presented of an elderly man with an acute confusional state occurring soon after he had undergone a right carotid endarterectomy. Angiography demonstrated segmental areas of cerebral vasoconstriction and an electroencephalogram revealed periodic lateralized epileptiform discharges, both involving the right hemisphere. Cerebral hyperperfusion has been implicated in the genesis of several transient neurological syndromes following carotid endarterectomy. This case suggests that cerebral vasoconstriction may also be associated with impairment of cerebrovascular autoregulation observed after this procedure.

Brain↗
PubMed1990

Muscle involvement in the scleroderma syndromes.

Muscle involvement was identified in 14 patients with scleroderma or a connective tissue disease overlap syndrome with predominant features of scleroderma. Patients presented with symmetrical proximal weakness indistinguishable from other inflammatory myopathies. Creatine kinase and electromyography were useful to demonstrate muscle involvement. Muscle histopathology demonstrated primarily the vasculopathy of scleroderma or polymyositis in similar numbers of patients. Scleroderma vasculopathy and polymyositis generally occur without specificity to diffuse scleroderma, the calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, telangiectasia syndrome, or an overlap syndrome with arthritis. Polymyositis also occurs when the vasculopathy of scleroderma involves other organ systems.

Adult↗
PubMed1989

Reflex epilepsy and nonketotic hyperglycemia in the elderly: a specific neuroendocrine syndrome.

We present five elderly patients with focal reflex or posture-induced seizures and nonketotic hyperglycemia (NKH). Each patient exhibited interictal focal findings, such as hemiparesis or hemisensory or aphasic deficits. With control of the hyperglycemia, the seizures stopped, and the neurologic deficits resolved. The syndrome of focal reflex epilepsy and neurologic deficits in the elderly is transient and almost invariably related to NKH, thus representing a specific neuroendocrine syndrome.

Aged↗
PubMed1989

Neurologic manifestations of rheumatologic disease.

Patients with pain, dysethesias, or dysfunction of an extremity may present to a neurologist or rheumatologist for the same complaints. A careful history, physical examination, and a simple investigation will usually, but not always, allow for assignment to the proper clinic. This article addresses the ground shared by these two specialties with particular emphasis on common diseases.

Arthritis, Rheumatoid↗
PubMed1989

Ischemic cerebrovascular disease in the young adult. Emergence of oral contraceptive use and pregnancy as the major risk factors in the 1980s.

Although oral contraceptives and pregnancy are recognized risk factors for stroke, epidemiological studies in young adults have not demonstrated these as the major risk factor of ischemic stroke in this age group. Our experience suggests that pregnancy and oral contraceptives have emerged as the major current risk factors for ischemic stroke in young adults.

Adolescent↗
PubMed1988

Ultrastructural pathology in emetine-induced myopathy.

Progressive myopathy developed in two women who consumed ipecac syrup containing emetine hydrochloride to induce vomiting as part of their anorexia nervosa. Muscle biopsy specimens were characterized by severe disruption of the sarcomeres. The ultrastructural spectrum extended from "Z-band streaming" to the formation of cytoplasmic bodies and also comprised abnormalities of the sarcotubular system, thus suggesting that muscle weakness may be related to both sarcomeric and sarcotubular lesions in this self-inflicted myopathy. It is tempting to suggest that muscle weakness may be correlated with or based on the pathology in sarcomeres and the sarcotubular system. As the myopathy is clinically reversible upon discontinuation of ipecac consumption the morphological findings should also be potentially reversible. Experimentally induced emetine myopathy may, thus, serve as a useful model to study morphological dynamics of sarcomeric lesions, which may be observed separately or simultaneously in a variety of spontaneously occurring human neuromuscular disorders.

Adult↗
PubMed1988

Hot flash epilepsy.

A woman had episodes of bilateral thermal sensation, initially thought to be hot flashes related to menopause. EEG telemetry documented the epileptic nature of the attacks with an electrographic seizure emanating from the right temporal area coincident with the hot flashes.

Adult↗
PubMed1988

Vanishing cerebrovascular disease of pregnancy.

A woman developed TIAs in the last days of her pregnancy. Angiography revealed partial obstruction of the left middle cerebral artery. Following delivery and anticoagulation her symptoms abated. Angiography 11 weeks later revealed resolution of the obstruction. We propose that this intrinsic vascular lesion was secondary to reversible intimal hyperplasia brought on by reproductive steroids.

Adult↗
PubMed1988

Reversible coma with prolonged absence of pupillary and brainstem reflexes: an unusual response to a hypoxic-ischemic event in MS.

A quadriparetic man with multiple sclerosis became comatose with absent pupillary and brainstem reflexes for 48 hours following a respiratory arrest. A periodic electroencephalographic pattern was recorded 12 hours after arrest suggesting a poor prognosis. Despite the poor prognostic signs, clinical recovery to baseline occurred within 2 weeks. Reversible coma with absent pupillary and brainstem reflexes may occur in MS patients for prolonged periods and lead to potential errors in prognosis if not recognized.

Brain Ischemia↗