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Biomedical subjects

L Cleeves

Publications and source records attributed to L Cleeves.

At least 19 recordsLinked to original sources
PubMed1989

Tremors.

In this article, normal tremor and common types of pathologic tremors seen in the elderly are defined and described along with a review of current treatments. Problems of differential diagnosis are emphasized.

Adrenergic beta-Antagonists↗
PubMed1989

Post-traumatic tremor.

We present seven cases of tremor caused by mild head injury without loss of consciousness. The interval between head trauma to onset of symptoms was 1 to 4 weeks. A posture and kinetic tremor of the hands and head occurred unassociated with other neurologic signs. Myoclonic-like jerking was frequently present. Neuroimaging studies were normal. Clonazepam administration resulted in tremor reduction in three patients and propranolol decreased tremor in one patient. A tremor, similar to essential tremor, can be a rare complication of head trauma.

Adult↗
PubMed1989

Psychogenic tremors.

We diagnosed 24 patients, 9 men and 15 women ranging in age from 15 to 78 years, with clinically established or documented psychogenic tremors. Clinical presentations were unique, with complex tremors (often resting, postural, and kinetic), unusual temporal profiles (abrupt onset with a variable course), absence of other neurologic signs, inconsistent and incongruous symptomatology, selective disability with ability to perform some functions despite severe tremors, distractibility that lessens or abolishes tremor, atypical tremorgraphic recordings with changing amplitude and frequency, unusual handwriting and drawing specimens, presence of multiple undiagnosed somatizations, unresponsiveness to all treatments, absence of documented disease by laboratory or radiographic tests, presence of psychiatric disease, spontaneous remissions, or recovery with psychotherapy. We present criteria for the diagnosis of psychogenic tremor.

Adolescent↗
PubMed1988

Lack of association between essential tremor and Parkinson's disease.

Four aspects of a possible association between essential tremor (ET) and Parkinson's disease (PD) were investigated: (1) the frequency of extrapyramidal signs in ET; (2) the frequency of concurrent ET and PD (i.e., monosymptomatic postural tremor for 5 or more years prior to onset of PD); (3) the frequency of ET in the families of PD patients; and (4) the frequency of PD in families of ET patients. Two hundred and thirty-seven ET patients (137 in London and 100 in Chicago) were evaluated. One hundred patients with PD and 100 normal control subjects were also investigated. Mild extrapyramidal signs occurred in only 4.5% of ET patients and were consistent with those found in normal aging. Only 3% of PD patients gave a history of uncomplicated ET. There was no difference in the frequency of a family history of PD between ET patients, a group of PD patients, and control subjects. Frequency of a family history of ET was higher among PD patients than control subjects, although the difference was not statistically significant. These data indicate that there is no association or genetic link between ET and PD.

Adolescent↗
PubMed1988

Propranolol and propranolol-LA in essential tremor: a double blind comparative study.

In a double blind, comparative study with 15 patients, a long-acting formulation of propranolol taken once daily (at doses of 160, 240 and 320 mg), was shown to be as effective as conventional propranolol (80 mg three times daily) in reducing the amplitude of essential tremor. The specific protocol employed demonstrated problems inherent in chronic pharmacological trials in essential tremor which have implications for future studies.

Adolescent↗
PubMed1987

Variability in amplitude of untreated essential tremor.

Tremor amplitude was monitored in untreated patients with essential tremor by a procedure designed to minimise fluctuations due to factors known to influence tremor. Tremor was measured hourly for 6 hours in 14 patients and on five to seven occasions (separated by at least a week) in 22 patients. A wide range of within-patient variability was found, with some patients showing little and others showing considerable fluctuations in amplitude over the series of recordings. There was no simple relationship between variability and mean amplitude, frequency, age, duration of tremor or response to a single oral dose of propranolol. Variability did not differ between males and females or between patients with and without a family history of tremor. Diurnal fluctuations showed no consistent pattern. Long-term assessment revealed a significant trend towards lower amplitudes on successive occasions. To overcome systematic bias in data collection, clinical trials in essential tremor should employ large numbers of patients and rigorous randomisation of treatments in cross-over designs.

Adolescent↗
PubMed1986

PET before and after surgery for tumor-induced parkinsonism.

We studied a patient with left frontal meningioma and right-sided parkinsonism that resolved completely after operation. PET scans were performed before and after operation to measure regional cerebral blood flow, oxygen extraction ratio, oxygen utilization, and blood volume. A specific pattern of severe functional changes returned to normal postoperatively. The data suggest increased local tissue pressure due to edema, causing a functional disorder in the left basal ganglia that gave rise to reversible contralateral parkinsonism.

Blood Volume↗
PubMed1985

Primidone in essential tremor of the hands and head: a double blind controlled clinical study.

Uncontrolled clinical studies have suggested that primidone may be effective in reducing essential tremor thus providing a valuable alternative to beta-adrenoreceptor antagonists which are currently the drugs of first choice. A double blind, placebo controlled trial of primidone in essential tremor of the hands and head was carried out using both clinical and objective methods of assessment. Primidone was significantly superior to placebo in reducing the magnitude of hand tremor, its efficacy being comparable to that of propranolol. In two patients tremor was reduced to non-symptomatic levels, an effect rarely seen with propranolol. No consistent attenuation of head tremor was found. There was no correlation between serum primidone or derived phenobarbitone concentrations and the reduction of hand tremor. An acute toxic reaction to an initial small dose (62.5 mg) of primidone was seen in six of 22 patients.

Adolescent↗
PubMed1985

Phenobarbitone in essential tremor.

We conducted a double-blind, placebo-controlled trial of phenobarbitone on a fixed-dose regimen in 12 patients with essential tremor. The drug was better than placebo on accelerometric measurement and clinical assessment, but not according to patient self-assessment or measures of manual performance. Phenobarbitone may be an alternative to beta-adrenoreceptor antagonists in treating essential tremor.

Adult↗