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Biomedical subjects

J U Toglia

Publications and source records attributed to J U Toglia.

At least 19 recordsLinked to original sources

Melatonin: a significant contributor to the pathogenesis of migraine.

It is generally accepted that migraine is caused by a primary biochemical disorder of the central nervous system involving neurotransmitters, specifically serotonin. The pathogenetic mechanism triggered by external and internal stimuli is not well explained or understood. This article points to the possibility that the pineal gland, a primary source of central serotonin and melatonin, contributes significantly to migraine attacks.

Humans↗

Recording eye movements and vestibular tests utilizing EEG equipment.

Abnormalities of spontaneous eye movements occur frequently in patients with neurological diseases, and abnormalities of eye movements induced by vestibular and optokinetic stimulations have great diagnostic value. Their amplitude, frequency, duration, direction, and rhythmicity can be graphically recorded utilizing EEG equipment, and their speed can be easily calculated. The author emphasizes that eye movements can and should be studied in EEG laboratories, since neurologists are well prepared for the interpretation of the electrooculographic (and electronystagmography) data.

Electroencephalography↗

Is migraine due to a deficiency of pineal melatonin?

Recent clinical observations favor the theory that migraine is caused by a primary injury of cerebral neurons with secondary involvement of intracranial and extracranial blood vessels. The primary injury is attributed to disruption of cerebral neurotransmitters and particularly the neuroadrenergic and serotonergic systems. These theories have not explained the importance of environmental factors, which so frequently trigger migraine. The author suggests that the pineal gland, which is outside the CNS unprotected by blood brain barrier and sensitive to external stimuli, could act as the intermediate causative factor of migraine, via a derangement of melatonin.

Animals↗

Functional amaurosis: diagnostic value of electronystagmography.

Hysterical and malingered blindness may be distinguished from organic ocular and cortical blindness by a variety of clinical and electrophysiological tests. This report discusses the limitations of these tests and emphasizes the objective superiority of a new test which utilizes the electronystagmographic technique. This test is based on the principle that visual input blocks nystagmus induced by vestibular stimulations: the presence of nystagmus suppression will indicate that blindness is either hysterical or malingered.

Blindness↗

Treatment of myoclonic dystonia with transcutaneous electrical nerve stimulation.

The use of a transcutaneous nerve stimulator yielded positive results in a condition marked by involuntary movements (tremors and myoclonias) and dystonia. In the absence of clues to the pathophysiology of the myoclonus and dystonia, it is argued that transcutaneous stimulation induces an action on the neurotransmitters that inhibits neuromuscular function.

Dystonia↗

Fatal myoglobinuric renal failure in a patient with tardive dyskinesia.

A patient with severe tardive dyskinesia developed fatal myoglobinuric renal failure. Myoglobinuria has followed other forms of extreme muscular exertion, but has not been previously reported consequent to tardive dyskinesia. Antipsychotic medication should be used to treat severe tardive dyskinesia when alternative forms of therapy are ineffective and discontinuing therapy might otherwise lead to an exacerbation of symptoms with life-threatening complications.

Acute Kidney Injury↗

Study of nystagmus suppression in the Rotatory Tests.

Thirty one healthy subjects ranging in age between 21 and 50, participated voluntarily in the following experiment: they underwent programmed sequential alternating rotations, while their nystagmus was recorded by way of electronystagmography. The direction of rotation was changed every minute, and the total rotation time was 36 minutes. The subjects were rotated under external conditions which were altered every six minutes; these conditions included the following: 1. Rotation in the light with visual fixation and convergence. 2. Rotation in the light with visual fixation without convergence (one eye closed, the other looking at the target). 3. Rotation in the light without visual fixation (both eyes covered by a shade or by Frenzel's glasses). 4. Rotation in the dark without convergence (looking straight ahead). 5. Rotation in the dark with convergence (looking at the thumb, closely placed in front of the nose). The purpose of the experiment was to study the phenomenon of nystagmus suppression observed with visual fixation and often attributed to cortical activity. The conclusion of the study is that nystagmus may be suppressed by light alone as well as by visual stimuli, convergence and proprioceptive stimuli. The inference is that the mechanism involves brain stem reflexes and not necessarily visual cortex activity.

Adult↗

Is there nystagmus habituation to angular acceleration in man?

10 healthy volunteers, ranging in age from 20 to 30 years, were subjected to rotatory stimulation at 1 degree, 2 degrees and 4 degrees/s2 acceleration and deceleration, repeated four times at weekly intervals. Nystagmus was recorded with electronystagmography. Slow-phase velocity and the total numbers of nystagmic spikes were analyzed. There was no evidence for habituation in this experiment, which is in agreement with the majority of previous publications.

Acceleration↗

Medial frontal cortex infarction and the alien hand sign.

Two right-handed patients with infarction involving the left medial frontal cortex are described. Both patients exhibited a form of transcortical motor aphasia and a psychomotor disturbance involving the right arm characterized by forced grasping, motor perseveration, and the presence of apparently purposeful movements that appeared to be dissociated from conscious volition. The latter feature is noted to be identical to the alien hand sign as described in the left arm of commissurotomized patients and patients with callosal neoplasm or infarction. It is suggested that the observed dissociation of conscious intention from purposeful movement may be related to dysfunction of the medial frontal cortex contralateral to the impaired extremity as much as to hemispheric disconnection.

Aged↗

Galvanic vestibular tests in the assessment of coma and brain death.

Galvanic stimulation over the mastoid process elicits oculovestibular responses that provide a measure of brainstem function. The equipment is simple and is available in most neurodiagnostic laboratories. This type of test provides an advantage over caloric testing in the presence of external and middle ear disease and basal skull fracture and can be a useful adjunct in the evaluation of coma and brain death.

Adult↗

The excessively small ventricle on cranial computed tomography: clinical correlation in 75 patients.

Excessively small ventricle (ESV) was demonstrated in 75 (8.3%) of 9,000 patients over 15 years of age examined by cranial computed tomography (CT). The patients had no other CT abnormality except for ESV. Detailed retrospective analysis of clinical records of these 75 patients revealed four major groups of patients: 1) those with seizures (24%); 2) those with headaches (24%); 3) those with acute non-penetrating head trauma (21.5%); and 4) those with benign increased intracranial pressure (8%). The remaining patients (22.5%) had a variety of cerebral derangements.

Adolescent↗

Electronystagmography in neurological diagnosis.

Electronystagmography (ENG) is a technique for recording nystagmus and other eye movements; our technique, based on the utilization of a bioelectrical potential which exists between the retina and the cornea, has been reported in detail elsewhere in a monograph [29]. ENG has been used particularly by otologists to record caloric nystagmus and study labyrinthine function [2, 4, 16, 19]. This technique should have even greater applications in the diagnosis of neurological disease, since nystagmus and abnormalities of ocular and vestibular functions are symptoms frequently encountered by the neurologist. This paper illustrates this point with three case reports.

Adult↗