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Biomedical subjects

K Zilstorff

Publications and source records attributed to K Zilstorff.

17 recordsLinked to original sources

Central vestibular involvement in peroneal muscle atrophy: a preliminary report.

A family is presented in which 6 out of 8 members were found to have peroneal muscle atrophy. Neurophysiological and histopathological evidence for the hypertrophic form of this disease was obtained in 3 patients. Three patients with peroneal muscle atrophy and 1 unaffected family member had abnormal differential caloric tests. This is the first report of an apparently hereditary dysfunction of the central vestibular system associated with a hereditary neuropathy.

Caloric Tests

The profile and severity of lithium-induced side effects in mentally healthy subjects.

In a double-blind, placebo-controlled, crossover design various side effects (= unwanted effects) during 6 months of therapeutic serum lithium levels (0.7-1.1 mmol/1) to nonpsychiatric patients were studied. The side effects were measured by self-rating scales and independent observer rating scales administered every 2-4 weeks throughout the study. After months of treatment, lithium induced hand tremor and thirst/polyuria; however, without any relationship to the serum levels of lithium. The frequency of tremor was highest in patients above the age of 60 years. No initial sedative-like lithium effect was found.

Adult

Meniere's disease: a neuropsychological study II.

23 Meniere patients were examined with an extensive battery of neuropsychological tests. In a previous investigation the authors had demonstrated that patients with a long duration of Meniere's disease had psychological disturbances, presumably localized in the nondominant hemisphere. In the present investigation the patients had a short duration of the disease, and we were unable to reproduce the psychological disturbances. It is concluded that the central changes in the nondominant hemisphere function develop over a long period of time. It is hoped for that further neuropsychological investigations of Meniere patients can give more information of what is primary in Meniere's disease: peripheral sensory or central neurological changes.

Adult

Parosmia.

Changes in the sense of smell may be quantitative. The latter are called parosmia. Various forms of central and peripheral parosmia are described. The treatment is mentioned.

Adult

Vestibular function in benign intracranial hypertension.

Investigation of vestibular function in 34 patients with benign intracranial hypertension was performed and a follow-up examination 3-20 years after the primary examination, when the symptoms of intracranial hypertension had disappeared. A primarily affected vestibular function was found in 19 patients (56%), viz. hyporeactivity in 9, preponderance in 9, and hyperreactivity in 2. Except for 2 patients, all had normal vestibular reactions at follow-up. These patients exhibited no evidence of what is called 'congestive inner ear'. An account is given also of the role of vestibular testing in connection with brain death criteria and recent experience of continuous monitoring of intracranial pressure.

Adolescent

Positional nystagmus of the persistent type.

In a 6-year period (1970-1975), a total number of 10,730 patients were examined oto-neurologically by the same physician, all of the patients being referred from the neuromedical and neurosurgical departments. Persistent positional nystagmus is in this material the same as central positional nystagmus, because the lesion in all cases was of central origin. Central positional nystagmus was found to be a rare symptom, since it was only demonstrated in 124 patients (1%). Central positional nystagmus was defined as being with no latency, low and irregular frequency, nonfatiguable with no accompanying dizziness, and the patients examined in the following positions: right and left side, supine and with hanging head. In 52 cases (42%) the nystagmus was only demonstrated with hanging head. The diagnoses were dominated by intracranial tumors (34 infra-tentorial, 19 supratentorial). Among other diagnoses encountered were intracranial vascular disease, encephalopathia, epilepsy and multiple sclerosis. 21 patients were children under 15 years of age, and in this group the intracranial tumors, especially the infratentorial, were even more dominant.

Adolescent

Menière's disease. II. A neuropsychological study.

23 Menière patients were examined with a extensive battery of neuro-psychological tests. In a previous investigation, the authors had demonstrated that patients with long-duration Menière's disease had psychological disturbances, presumably localized in the nondominant hemisphere. In the present investigation, the patients had short-duration Menière's disease, and we were unable to replicate the results of the former investigation. It is concluded that the central changes in nondominant hemisphere function develop over a long period of time. It is hoped for that further neuropsychological investigations of Menière patients will give more information on what is primary in Menière's disease: peripheral, sensory or central neurological changes.

Adult

Cerebellopontine pantopaque cisternography and tomography of the internal acoustic meatus in the diagnosis of angle tumors.

The results of 106 consecutive Pantopaque cisternographies performed at the neuro-radiological department, Rigshospitalet, are presented. 41 positive and 65 negative examinations were found. Good accordance between radiological tumor size estimation and size of actual, surgically verified tumor was noted. A comparison between tomography of the internal auditory canal and pantopaque cisternography of the posterior fossa has been made, and we found 6 cases with normal tomography and positive cisternography. Furthermore 17 cases (26%) with pathological tomographic examination of internal auditory canal as well as a negative finding at Pantopaque cisternography, were encountered. Therefore we conclude that asymmetry of the radiological appearance of the internal auditory canal at tomography is not of decisive importance in the indication for cisternography, but the examination should be included in the test battery in search for cerebellopontine angle pathology. We agree with other authors that Pantopaque cisternography is without any doubt the final and most conclusive examination available for the diagnosis of cerebellopontine angle tumors. A system of grading the different objective findings giving indication for Pantopaque cisternography has been made.

Auditory Pathways

Multiple sclerosis. The value of clinical vestibular examination.

A clinical vestibular examination was carried out on 82 patients with multiple sclerosis (MS) selected on McAlpine's criteria. Spontaneous nystagmus, positional nystagmus or pathological caloric test were found in 49 (60%) patients. Pathological horizontal optokinetic nystagmus occurred in 47 (57%) patients. In 36 cases horizontal optokinetic nystagmus was pathological to both sides, in 28 cases combined with a pathological vertical optokinetic nystagmus, indicative of diffuse intracerebral lesions. Lesions in the central vestibular system and in the optokinetic pathways were frequently discovered in early or atypical cases of MS.

Adult

Intermedius nerve involvement and testing in acoustic neuromas.

The clinical findings in 125 patients with surgically confirmed acoustic neuromas are presented, with special regard to the involvement of the intermedius nerve in the diagnosis. In assessing the function of the intermedius nerve the examination of the nasolacrimal reflex and the sensation of taste on the anterior two-thirds of the tongue are used. The methods of investigation are described in detail. The material consisted of 20 medium-sized and 105 large tumours; no intracanalicular tumor was found. Hearing loss was the initial symptom in 85% of the patients, 10% had tinitus and 4% vertigo as the first symptom. Apart from the VIII cranial nerve symptoms, a defective nasolacrimal reflex was the most significant evidence of cerebellopontine angle pathology. The test was positive in 65% of the medium-sized tumours, in the entire material, 85%. The figures are higher than the incidence of trigeminal nerve symptoms. This in contrast to the reports of most authors. The tests described are simple and quick to perform, and it is emphasized that they should be applied to all patients with unilateral hearing loss of unknown origin.

Adult

Lithium treatment of meniere's disease. Results of a double-blind cross-over trial.

21 patients with Meniere's disease participated in a double-blind, cross-over trial, with 6 months' lithium treatment and 6 months' placebo treatment. Even if the results were not completely unequivocal, no difference was found between lithium and placebo treatment. The results might imply that both other medical as well as surgical treatment of Meniere's disease exert a pure placebo effect; so far no controlled investigation has been published, establishing the value of surgical treatment of Meniere's disease.

Clinical Trials as Topic

Meniere's disease. A neuropsychological study.

A neuro-psychological study is described comprising 19 patients with Meniere's Disease who were participating in an experimental lithium therapy programme. The patients evidenced an organic dysfunction which is not entirely periphearl. The interpretation of the results are not incompatible with an attempt to reconcile neuro-psychological and psycho-somatic viewpoints regarding etiological aspects of Meniere's Disease. An evaluation of the lithium effect was performed.

Adult