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J L Topel

Publications and source records attributed to J L Topel.

5 recordsLinked to original sources

Dementia in the elderly--a search for treatable illnesses.

Forty patients with senile dementia were evaluated prospectively with laboratory and radiologic investigations, including computerized axial transverse tomography. Five patients were believed to have potentially treatable illnesses causing the dementia. After treatment, the dementia in one patient with hypothyroidism was completely resolved. One patient with pernicious anemia was markedly improved, and a second patient with hypothyroidism was somewhat improved. One patient with a brain tumor was not treated, and a severely demented patient with possible normal pressure hydrocephalus died shortly after shunting without improvement. The discovery of these unsuspected illnesses and the gratifying response to treatment in some suggests the importance of systematic evaluation in all patients with senile dementia.

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Use of computerized tomography in senile dementia.

Computerized tomography was used to evaluate 35 patients with senile dementia and proved to be a simple and practical screening procedure. Those patients with moderate or severe cerebral atrophy had a poorer short-term prognosis than those with questionable or mild atrophy. Two patients with potentially treatable illnesses (hypothyroidism and pernicious anaemia) and only questionable atrophy had reversal of the dementia with treatment. A single patient with moderate atrophy had a potentially treatable illness (hypothyroidism) which only partially resolved. Those patients with dementia but relatively little atrophy by computerized tomography may represent a unique group with a better prognosis who require particularly careful evaluation for potentially treatable illnesses.

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Deanol in the treatment of levodopa-induced dyskinesias.

Levodopa-induced dyskinesias frequently limit the clinical efficacy of levodopa therapy in Parkinson's disease. Deanol recently has been reported to be of value in relieving the dyskinesias by acting through a central cholinergic mechanism. Seventeen outpatients with levodopa-induced dyskinesias were given deanol in dosages of 300 to 900 mg per day. The dyskinesias improved in four of the patients, remained unchanged in five, and worsened in eight. In all four patients who showed improvement after institution of deanol therapy, the improvement continued after the patients were switched to a placebo. One of these patients also demonstrated improvement in his parkinsonism, while two others experienced a worsening in their parkinsonism. Deanol does not appear to be effective in the treatment of levodopa-induced dyskinesias.

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