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Biomedical subjects

M Feucht

Publications and source records attributed to M Feucht.

34 records · Page 2Linked to original sources
PubMed1996

Magnetic resonance imaging for recurrent headache in childhood and adolescence.

We investigated 429 consecutive patients, aged 5 to 18 (mean: 11.0 +/- 3.1) years, diagnosed with migraine or tension-type headache. The patients underwent either MRI or exclusively clinical follow-up examinations. Magnetic resonance imaging revealed normal findings in 82.3% and structural changes in 17.7%. However, the vast majority of these changes had minimal or no pathological relevance, and a causal relationship to the patient's headache could not be proven in any case. In the non-MRI group, clinical follow-up examinations confirmed the initial diagnosis in all patients and MRI was not required in any of these subjects. In conclusion, our study shows a poor relation between recurrent headache fulfilling the criteria of migraine and tension-type headache and structural changes incidentally detected by MRI. In addition, it suggests that clinical follow-up examinations are reliable. Accordingly, MRI is not required for routine examination of recurrent headache in children and adolescents, but it should be performed in patients with abnormal neurological findings, atypical headache pattern, or significant change of preexisting headache.

Adolescent↗
PubMed1995

Slow potential shifts preceding human focal paroxysmal discharges, as represented by spikes of benign rolandic epilepsy of childhood.

We examined the slow potential shifts preceding interictal spikes in the scalp EEGs of the children with benign rolandic epilepsy of childhood (BREC). In contrast to our expectations and the observations reported by Stodieck and Wieser (1987), we were not able to detect focal negative slow shifts preceding interictal discharges. Possible reasons for this result are as follows. The cerebral event to which we triggered might have been too 'weak'. Another problem is that not every single spike generated in the deep reaches the surface. Thus, the moment, a spike occurs in the scalp-recordings does not necessarily represent the moment the brain changes from one state to another. The reference electrode might also play a role in obscuring any slow shift.

Adolescent↗
PubMed1995

Migraine and stroke in childhood and adolescence.

Over 3 years we evaluated two patients, an adolescent and a child, with migraine-like headache and ischemic stroke. Based on our clinical observations and on literature review of migraine and stroke in the pediatric age group, we believe that the criteria of migrainous infarction outlined by the International Headache Society (IHS) could be occasionally too restrictive. Therefore, we suggest subclassifying migrainous infarction into: (i) "definite", referring to the patients whose ischemic stroke fulfills all the IHS criteria, (ii) "possible", referring to ischemic strokes which fulfill some, but not all, criteria. This subclassification of migrainous infarction may be relevant in clinical practice and in human research studies.

Adolescent↗
PubMed1995

The original Gerstmann-Sträussler-Scheinker family of Austria: divergent clinicopathological phenotypes but constant PrP genotype.

We present new data on the original Austrian kindred with Gerstmann-Sträussler-Scheinker disease (GSS) which encompasses currently 221 members in 9 generations. The mode of inheritance is autosomal dominant. Predominant clinical features are slowly progressive ataxia and late impairment of higher cerebral functions. In contrast, a recent case with proven P102L mutation of the PRNP gene had rapidly developing dementia and severe cortical damage indistinguishable from the clinicopathological phenotype of Creutzfeldt-Jakob disease (CJD). PRNP codon 129 was homozygous for methionine in both the historic and recent cases. Neuropathology confirms spongiosis of variable degree and numerous protease resistant/prion protein (PrP) amyloid plaques scattered throughout most of the brain as constant features in this family. Some amyloid deposits are surrounded by dystrophic neurites with accumulation of phosphorylated neurofilaments and abnormal organelles, reminiscent of Alzheimer-type plaques. Severe telencephalic damage and a synaptic-type fine granular immunoreactivity in laminar distribution in the cortex with anti-PrP after hydrated autoclaving of sections were seen only in the recent patient. In conclusion, factors in addition to the PRNP genotype at codons 102 and 129 must play a role in determining clinicopathological characteristics of this inherited brain amyloidosis.

Adult↗
PubMed1994

Use and abuse of analgesics in tension-type headache.

Eighty patients suffering from tension-type headache for an average of 21 years were asked to report on all drugs they had ever taken (type, dosage, duration of intake, efficacy) or were taking currently. The patients had consumed on average 6.3 different drugs. The cumulative doses of derivatives of para-aminophenol, pyrazolone, and salicylic acid in some cases reached a maximum of several kilograms. Most drugs were classified by the patients as "moderately effective". The rating "very effective" was assigned primarily to barbiturates; however, barbiturates are no longer used as components of compound analgesic drugs in Austria. At the time of investigation, patients consumed 2.5 (mean) different drugs, primarily as compound preparations. Seventeen patients (21%) showed signs of possible analgesics- or ergotamine-induced headache and were therefore advised to undergo withdrawal therapy. Our results show that patients with tension-type headache are at considerable risk of becoming drug-dependent and of acquiring analgesics-induced headache.

Adult↗
PubMed1994

[Huntington chorea: (CAG)n repeats on gene IT 15 in Austria].

In March 1993 the gene IT 15 was identified on chromosome 4p and it was demonstrated that it contained an unstable (CAG)n trinucleotide repeat that is elongated in patients with Huntington's chorea (HC). Persons with more than 37 (CAG)n repeats tend to have a higher risk of developing the disease. Testing the (CAG)n repeats in Austrian HC patients with PCR techniques shows correspondence between the clinical diagnosis of HC and genotypes [more than 42 (CAG)n repeats]. There was a weak correlation between the number of (CAG)n repeats and age of onset, however, this finding is without diagnostic value due to the scatter of the values.

Adolescent↗
PubMed1993

[Tension headache--new evaluation of symptomatology based on International Headache Society diagnostic criteria].

This study presents the history and clinical findings in 80 patients suffering from tension-type headache diagnosed according to the criteria (group 2) proposed in 1988 by the Headache Classification Committee of the International Headache Society (IHS). The aim of this investigation was to evaluate the extent to which the symptomatology in our cases still corresponds with the clinical picture of tension headache described in the older literature. A positive family history of headache was obtained in 59% of the patients; mothers of headache patients were affected five times more often than fathers; a history of migraine was reported as frequently as tension-type headache in the families of the investigated patients. The first manifestation of headaches arose almost exclusively in the first four decades of life, whereby two peaks (15-20 and 35-40 years) were observed in patients with the episodic form. Headache in younger patients showed no distinct diurnal pattern; headache in older patients, however, predominantly occurred immediately after awakening from sleep or in the morning. Changes of weather and psychosocial stress were the most frequent precipitating factors; additionally, the premenstrual period, occupational stress, and sleep deprivation were precipitating factors in female patients. Bilateral pain was most often located in the occipital/nuchal, in the frontal, and the periorbital regions. Headache was usually described as pressing/tightening in quality. Difficulties in concentration and the need of rest were the most important associated symptoms. Photophobia, phonophobia and autonomic symptoms were less frequent and are probably partially drug-related and may also be due to the fact that the selected group of patients suffered from severe forms of headache. 33 of our 80 patients belonged to the subgroup "with disorders of pericranial muscles" (IHS criteria: groups 2.1.1., 2.2.1). A remarkable low percentage of patients, especially of the male sufferers, reported regular smoking and/or drinking habits. Oral contraceptives influenced neither frequency nor intensity of headache attacks. Signs of depressive disorders were present in 28% of the female patients. The differences in symptomatology of tension-type headache between patients with episodic and chronic forms, between female and male patients, and also between younger and elderly patients are documented and have to be taken into account in the diagnostik evaluation of this condition.

Adult↗
PubMed1993

[Mefloquine and sulfadoxine/pyrimethamine overdose in malaria tropica].

A 39 year-old man with malaria due to Plasmodium falciparum received 3500 mg mefloquine over 3 days, in addition to 3250 mg chloroquine and 175/3500 mg sulfadoxine/pyrimethamine. He developed severe neuropsychiatric symptoms and had to be hospitalized. Treatment with diazepam, haloperidol and thioridazine achieved relief of the severe symptoms after 4 days. The patient was still suffering from discrete neuropsychiatric symptoms 8 months after treatment.

Adult↗
PubMed1990

[Computerized tomography in epilepsy in children].

We present a retrospective study of 160 children attending our epilepsy out-patient department. Computed tomography (CT) was performed on 123 (77%) patients, namely all children with the exception of those with febrile seizures, typical absence seizures, and benign Rolandic epilepsy. Incidence of CT abnormalities and their correlation with clinical features were evaluated. The CT scan was normal in 84 and abnormal in 39 patients. Although in general, the detection of abnormality on CT will not alter the management of the child, in a small percentage (2%) of our cases a lesion treatable by surgery was discovered. The indications for CT are summarized.

Anticonvulsants↗
PubMed1989

[Differential diagnosis of epilepsies in early childhood].

The last twenty years have seen substantial advances in knowledge concerning the diagnosis as well as the long-term evolution of epilepsies in infants and children. There is, however, no general agreement among epileptologists on the framework of epileptic syndroms in infancy and childhood. The main problems are the lack of a uniform terminology and the fact that there is little unanimity concerning definitions and what may be included under individual syndromic rubrics. In consequence the nosological limits between the various syndromes described are not distinct and they very often represent a heterogenous group of disorders and not a single entity. The present paper reviews the literature recently published and discusses diagnostic difficulties and nosological problems. In addition the attempt has been made to elaborate a "multi-dimensional" classification of syndromes, based on clinical (using the terminology of the international classification) and electroencephalographic criteria, but also taking into consideration aetiological and evolution data. Results show that it was possible to differentiate within a cohort of 77 infants aged 0-24 months (suffering from various types of epileptic disorders) several distinct and homogenous nosological entities and syndromes. As it is well known today, that the type of epilepsy which occurs in a child as well as the prognosis of the disease represent a confluence of age, heredity and structural brain abnormality, it seems apparent that adequate classification systems have to take into consideration the complexity of various factors "triggering" the onset and influencing the course of the disease, even when a number of cases remains outside resp. "borderline" such a syndromic classification.

Adrenocorticotropic Hormone↗
PubMed1989

[The variability of the number and daily distribution of spike wave seizures in two 24-hour long-term EEG recordings made one shortly after the other].

30 patients suffering from primary generalized epileptic seizures were investigated twice in intervals of 1-7 days by means of mobile long-term-EEG monitoring. The total number of paroxysms showed a variability from 53% to 187%, the time of maximum paroxysmal activity varied in between 2.76 hours to 5.40 hours for the whole group; the results for adults, children and patients with/without antiepileptic medication did not differ much. Our findings suggest, that the results of one single 24 hours long-term-EEG investigation must be interpreted with great caution.

Adolescent↗
PubMed1987

[Valproic acid monotherapy in epilepsies in childhood and adolescence].

The effectiveness and side effects of a DPA monotherapy were evaluated in 96 children and adolescents over a period of five years. In addition the attempt has been made to find correlations between sex, age of seizure onset, etiology of the disease, types of seizures, and EEG abnormalities on the one hand, and the clinical response to the drug on the other hand. The results are in many respects similar to other observations with DPA: good therapeutic effect in cases with seizure onset between the age of 7-10 years, cryptogenic or genetic etiology, primary generalized seizures, and a generalized pattern in EEG (without focal changes). On the contrary positive effect of DPA in partial epilepsies and secondarily generalized epilepsies was seen only in those patients who had a seizure onset between seven and ten years and a cryptogenic etiology (syndrome of benign rolandic epilepsy in childhood can be suspected in these cases).

Adolescent↗
PubMed1986

[Carbamazepine (Tegretol) monotherapy in epilepsies with partial and/or secondary generalized seizures in childhood and adolescence].

The effectiveness and side effects of a carbamazepine monotherapy were evaluated in 40 children and adolescents (22 boys and 18 girls with an age distribution between 1 and 16 years) over a period of 6 years. In addition the attempt has been made, to find correlations between sex, age of seizure onset, aetiology of the disease, types of seizures, and EEG-abnormalities on the one hand, and the clinical response to the drug on the other. Selection criteria were, that the patients were under continuous follow-up, that they suffered from partial or/and secondarily generalized seizures and that Tegretol was the first and only drug at the beginning of the examination. The treatment with the Carbamazepine-monotherapy was successful in 63% of the patients, 37% remained resistant to the treatment. Carbamazepine proved to be effective against partial seizures as well as secondarily generalized grand-mal-seizures. The therapeutic range of the serum carbamazepine levels during monotherapy varied between 15-35 mu Mol/l. 40 patients entered, 38 completed the study. In two cases the drug had to be stopped owing to allergic skin rash due to the drug. No other serious side effects were observed in any of the remaining 38 patients. The most frequent laboratory changes were an increase of Gamma-GT and leucopenia. All the cases who became seizure-free (Responder) were compared with the remaining cases with unfavourable treatment results (Nonresponder) in order to find out whether there are significant differences between the two groups, as far as sex, age ... etc. (see above) are concerned.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Gamma-vinyl-GABA (vigabatrin) in the therapy of Lennox-Gastaut syndrome: an open study.

The antiepileptic effect of vigabatrin (gamma-vinyl GABA, VGB) in children has been demonstrated in controlled and open studies. According to the literature, results were good to excellent in partial seizures (with and without becoming secondarily generalized) and promising in infantile spasms (IS). In patients with myoclonic epilepsies of early childhood and especially those with Lennox-Gastaut syndrome (LGS), the effect of VGB has been investigated only to a limited extent and the pattern of response was variable. The present open, add-on, dose-ranging study was initiated to assess the long-term effect and safety of VGB in a cohort of 20 children with LGS who were not responding sufficiently to first-line drug monotherapy with valproate (VPA) instead of adding classical second-line antiepileptic drugs [AEDs: benzodiazepines (BZD), phenobarbital (PB), primidone (PRM)], which usually are associated with rapid diminution of their antiepileptic properties and a high frequency of side effects. Eighty-five percent of children experienced a 50-100% reduction in seizure frequency, even after dose reduction of VPA. No serious side effects occurred except in 1 patient who experienced dyskinesia. Mood changes, sedation, ataxia, and hypersalivation, well-known complications of other AEDs, were not observed.

Adolescent↗