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Biomedical subjects

John W Dunne

Publications and source records attributed to John W Dunne.

5 recordsLinked to original sources
PubMed2006

First seizure presentation: do multiple seizures within 24 hours predict recurrence?

We compared clinical features and prognosis of 72 adults with a first-ever seizure presentation comprising multiple discrete seizures within 24 hours to 425 patients presenting with a single seizure. Those presenting with multiple seizures were no more likely to have seizure recurrence, irrespective of etiology or treatment. Hence, a presentation with multiple seizures within 24 hours should be regarded as a single event, in keeping with the International League Against Epilepsy recommendations.

Adolescent↗
PubMed2004

Diabetic amyotrophy progressing to severe quadriparesis.

Diabetic amyotrophy is a distinctive form of diabetic neuropathy usually characterized by the abrupt onset of pain and asymmetric proximal leg weakness and wasting. Involvement of the upper limbs is unusual, and prognosis is said to be good. We describe two patients, each with type II diabetes mellitus, who presented with diabetic amyotrophy progressing to severe quadriparesis. One patient remains severely disabled. The clinical spectrum of diabetic amyotrophy includes progression to severe quadriparesis.

Diabetes Mellitus, Type 2↗
PubMed2004

Incidence of ankle contracture after moderate to severe acquired brain injury.

OBJECTIVE: To examine an adult population undergoing rehabilitation after brain injury to determine the incidence of ankle contracture and factors contributing to the development of this deformity. DESIGN: Descriptive study SETTING: Specialist inpatient neurosurgical rehabilitation unit in Australia. PARTICIPANTS: Patients (N=105) admitted with a new diagnosis of moderate to severe brain injury over a 12-month period. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Maximal ankle dorsiflexion range and the presence of abnormal muscle tone affecting the lower limb(s) were evaluated at weekly intervals. Ankle contracture was defined as maximal passive range of less than 0 degrees dorsiflexion with the knee in extension. Patients were grouped into 3 muscle tone categories: normal, predominantly spastic, or predominantly dystonic. Age, sex, mechanism and severity of brain injury, time to onset of ankle contracture, total length of hospital stay, and discharge mobility status data were also recorded. RESULTS: Muscle tone was designated as normal in 68 (64.7%), as spastic in 14 (13.3%), and as dystonic in 23 (21.9%) patients. The incidence of ankle contracture was 16.2% (17/105 cases). Ankle deformity correlated closely with muscle tone category. Of 23 cases with dystonic muscle overactivity, 17 developed contracture at some point between 1 and 16 weeks after brain injury, although no subject with normal tone or spasticity developed the deformity. There was a weak association between the severity of brain injury and development of ankle contracture. CONCLUSIONS: The incidence of ankle contracture was much lower than previously reported. Dystonic overactivity of the plantarflexor and invertor muscles is a major predisposing factor to ankle contracture.

Activities of Daily Living↗
PubMed2002

The general practice management of epilepsy in Perth, Western Australia.

Ninety randomly selected general practitioners from the Perth metropolitan area completed a self-administered postal questionnaire aiming to examine the extent of their involvement with epilepsy and how closely their management mirrored best practice guidelines. GPs saw a median of 6 patients with epilepsy, mainly adults. They perceived complementary roles for GPs and neurologists: the GP providing ongoing support and education, monitoring treatment and making dosage adjustments; with the neurologist largely making the formal diagnosis and other management decisions. Only 42% regarded their knowledge of epilepsy as adequate for their practice. About half advised patients on the existence of the Epilepsy Association. Some respondents overestimated the usefulness of EEG. Plasma antiepileptic drug (AED) measurements were overvalued, with 69% of respondents performing plasma levels without regard to symptoms, and 20% would alter AED doses solely on the basis of plasma levels. GPs may tolerate very frequent seizures before referring their patients for more specialised evaluation.

Adolescent↗