Relief of common migraine by exercise.
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Adult↗
Biomedical subjects
J Van Gijn
Publications and source records attributed to J Van Gijn.
The diagnosis of Horner's syndrome. Use and limitations of the cocaine test.
We prospectively studied the value of the cocaine test in the diagnosis of Horner's syndrome, by performing the test in 20 control subjects and in 20 patients with a provisional diagnosis of Horner's syndrome. Photographic testing of the darkness reflex of the pupil was used as an independent criterion of oculosympathetic dysfunction, and confirmed the diagnosis in 12 of the 20 patients. A mydriatic response to cocaine that was at least 1.0 mm less than in the unaffected eye occurred only with Horner's syndrome (7 patients). On the other hand, if the difference is smaller than 1.0 mm the chance that the patient does not have Horner's syndrome is only around 60%. There was no relationship between the magnitude of the response to cocaine and the site of the lesion in the sympathetic system.
Adolescent↗
Delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage: clinicoanatomic correlations.
Fifty-seven of 176 prospectively studied patients with aneurysmal subarachnoid hemorrhage (SAH) developed delayed cerebral ischemia. Clinical features included hemispheric focal signs (13), decrease in level of consciousness (14), or both (30), and mutism (15). Forty-seven patients showed hypodense lesions on CT in one (19) or multiple vascular territories (22), or diffusely in one or both hemispheres (6). Twenty-eight had symmetric decrease in ventricular size. Of 18 autopsied patients, only 1 had a purely univascular lesion. The clinical, CT, and pathologic features suggest that delayed cerebral ischemia after SAH is a multivascular or diffuse process in most patients.
Adult↗
Localization of Horner's syndrome. Use and limitations of the hydroxyamphetamine test.
The pupillary response to hydroxyamphetamine eye-drops has been advocated as a test for sub-dividing patients with Horner's syndrome into those with lesions of the 1st or 2nd sympathetic neurone (normal dilatation) and those with lesions of the 3rd neurone (no or minimal dilatation). We compared the response of the right and the left eye in 40 control subjects and also in 25 consecutive patients with Horner's syndrome from a known lesion. In the controls, 1 eye might dilate up to 1.0 mm less than the other. In the patients, abnormally weak dilatation (difference with the other eye more than 1.0 mm) occurred only with lesions of the 3rd neurone, but in only 4 of 10 such cases. Of the other 6 patients with a lesion of the 3rd neurone, 2 had a minimal response of the normal eye, and 4 showed subsequent recovery of oculosympathetic function (which suggests that denervation had not occurred). In conclusion, an abnormal hydroxyamphetamine test reliably indicates a lesion of the 3rd neurone, but a normal test provides little diagnostic aid.
Abducens Nerve↗
The Babinski sign and the pyramidal syndrome.
The presence or absence of a Babinski sign can be puzzling, but in the light of existing pathological studies it is more fruitful to consider which pyramidal tract fibres release it than whether they release it. This was investigated clinically, by looking for correlations with other reflex changes and with motor deficits in the leg. A survey of 50 patients with a unilateral Babinski sign and six patients who lacked it in spite of other pyramidal tract signs was supplemented with follow-up of the patients who had acute lesions. Appearance of the Bibinski sign proved to depend on the interaction of two factors: (1) activity (not necessarily hyperactivity) in the segmental pathways of the flexion synergy; (2) a motor deficit of the foot, in some cases consisting only in an impairment of rapid foot movements, and probably representing a disturbance of direct pyramidal tract projections to distal motoneurones.
Female↗
Interpretation of plantar reflexes: biasing effect of other signs and symptoms.
Twenty neurologists were asked to judge a number of plantar responses on film. Each film was preceded by a slide with a fictitious abstract of history and examination (minus the plantar reflex). The main part of the presentation only served to disguise the fact that two films, both showing equivocal toe movements, were presented twice at the same sitting, but with opposing information as to the probability of a Babinski sign. Interpretation of these identical pictures differed significantly (P less than 0.01), conforming to the information given. Thirty other neurologists who rated the films without previous data showed no such change of opinion.
Diagnostic Errors↗
Scientific meeting of the 'Amsterdamsche neurologenvereeniging' held in Amsterdam on May 11, 1978 [proceedings].
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Humans↗