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Biomedical subjects

M Keidel

Publications and source records attributed to M Keidel.

At least 19 recordsLinked to original sources
PubMed1998

[Pain quantification after whiplash trauma using computer-interactive pressure-pain measurement].

In patients with an acute cervicocephalic pain syndrome following whiplash injury (n = 12), pressure-pain scores for the splenius and the trapezius muscles on both sides, for the fingers on both sides and for the skull were recorded and compared to a control group. A computer-aided pain measurement was applied, which is presented as an improvement of pressure algesimetry. During constant application of pressure stimuli, the patient rated the increasing pain on a visual analogue scale, resulting in a curve of pain intensity against time. Slope and integral of the curve proved to be the most reliable parameters. After whiplash injury, significantly increased pain scores were found for the splenius muscle on both sides, for the left trapezius muscle and for the left finger whereas there was only a tendency of increased pain at the other stimulation sites. The presented method allows quantification of the cervical syndrome with neck and shoulder muscle sprain caused by whiplash injury. This objective and rater-independent method is of great value for diagnostic, therapeutic and medico-legal purposes in the assessment of the disease course and in clinical therapy trials.

Adolescent↗
PubMed1997

[Post-traumatic headache].

Head trauma (HT) and whiplash injury (WI) is followed by a posttraumatic headache (PH) in approx. 90% of patients. The PH due to common WI is located occipitally (67%), is of dull-pressing or dragging character (77%) and lasts on average 3 weeks. Tension headache is the most frequent type of PH (85%). Besides posttraumatic cervicogenic headache or symptomatic, secondary headache due to SDH, SAB, ICB or increased ICP, migraine- or cluster-like headache can be observed in rare cases. Prolonged application of analgetics (> 4 weeks) can cause a drug induced headache. In 80% of patients PH following HT shows remission within 6 months. Chronic PH lasting at least 4 years occurs in 20%. Unfavorouble prognostic factors include an age higher than 40 yrs, a low intellectual, educational and socio-economic level, previous HT or a history of alcohol abuse. A prolonged PH due to WI can be expected in patients with initially severe headache, with an extensive decrease of mobility of the cervical spine, with subjective impediment, with depressive mood, with somatic-vegetative complaints, with a history of pretraumatic headache and with increased age. Acute PH is treated with analgesics, antiphlogistics and/or muscle relaxants; chronic PH with thymoleptics (e.g. Amitryptiline or Amitryptiline oxide). Additional physical therapy (e.g. wearing a cervical collar for a short time, hydrocollator pack), physiotherapy incl. muscle relaxation techniques (Jacobson) and psychotherapy can be performed. Medico-legal issues should be solved as soon as possible.

Analgesics↗
PubMed1997

Headache and the cervical spine: a critical review.

Headache related to the cervical spine is often misdiagnosed and treated inadequately because of confusing and varying terminology. Primary headaches such as tension-type headache and migraine are incorrectly categorized as "cervicogenic" merely because of their occipital localization. Cervicogenic headache as described by Sjaastad presents as a unilateral headache of fluctuating intensity increased by movement of the head and typically radiates from occipital to frontal regions. Definition, pathophysiology; differential diagnoses and therapy of cervicogenic headache are demonstrated. Ipsilateral blockades of the C2 root and/or greater occipital nerve allow a differentiation between cervicogenic headache and primary headache syndromes such as migraine or tension-type headache. Neither pharmacological nor surgical or chiropractic procedures lead to a significant improvement or remission of cervicogenic headache. Pains of various anatomical regions possibly join into a common anatomical pathway, then present as cervicogenic headache, which should therefore be understood as a homogeneous but also unspecific pattern of reaction.

Combined Modality Therapy↗
PubMed1996

[Headache and the cervical spine. A critical review].

Headache in association with the cervical spine is often misdiagnosed and treated inadequately due to confusing and varying terminology. Primary headaches such as tension-type headache and migraine are incorrectly categorized as "cervicogenic" merely because of their occipital localization. Cervicogenic headache described by Sjastaad presents as a unilateral headache of fluctuating intensity increased by movement of the head and typically radiating from occipital to frontal regions. Definition, pathophysiology, differential diagnosis and therapy of cervicogenic headache shall be demonstrated. Ipsilateral blockades of the C2/ C3 root and/or the major occipital nerve allow a differentiation between migraine and other primary headache syndromes. Neither pharmacological nor surgical or chiropractic procedures lead to an improvement or remission of cervicogenic headache. Pain of various anatomical regions possibly join into a common anatomical pathway then presenting as cervicogenic headache, which should therefore be understood as a homogeneous but also unspecific pattern of reaction.

Cervical Vertebrae↗
PubMed1994

[Pathological jaw opening reflex after whiplash injury].

The brainstem mediated inhibitory reflex of the m. temporalis was investigated on average 3 days after the accident in 61 patients (f = 36; m = 25; mean age = 28 years +/- 9 SD) who presented an acute cervico-cephalic syndrome with posttraumatic headache and neck pain following acute whiplash injury but without neurological deficits, bone injury of the cervical spine or combined direct head trauma. We postulated a disturbed reflexive temporalis muscle inhibition in patients with 'whiplash cephalalgia', as has previously been reported for classical muscle tension headache. Latencies and durations of the early and late exteroceptive EMG suppression (ES1 and ES2) and the interposed EMG activity (IE) of the voluntarily contracted right temporalis muscle following ipsilateral stimulation of V/2 + 3 afferents were recorded. The reflex data were compared to a cohort of 69 age and sex matched normal subjects (f = 37; m = 32; mean age = 28 years +/- 7 SD). The following significant reflex changes were found in patients: a shortened duration of ES2 with delayed onset and premature ending, a slight prolongation of ES1 and IE, a delayed onset of IE and a diminished ratio of ES2:ES1 and ES2:IE. We conclude that the abnormality of the antinociceptive reflex is based on a transient dysfunction of the brainstem mediated reflex circuit following the acceleration trauma, which can be considered a neurophysiological correlate of the posttraumatic cervico-cephalic pain syndrome and may be useful as a 'biological marker' in monitoring the time course of recovery from pain.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

[Cerebral angiitis or central side effects after lumbar myelography (with intracerebral vascular spasm)].

This is a case report of severe neurological complications following lumbar radiculography with the non-ionic x-ray contrast agent Iopamidol. The complication, which consisted of serious mnestic disturbances and various neurological deficits including hemiparesis, was due to intracerebral vascular spasms, demonstrated by cerebral angiography, and TCD followed by multiple cerebral infarctions, demonstrated by MRI. A possible causal relationship between the cerebral vascular spasm and intrathecal administration of Iopamidol is discussed.

Cerebral Angiography↗
PubMed1993

["Paralysis cruciata"--a rare brain stem lesion syndrome after cervical vertebrae trauma].

Bell's cruciate paralysis with severe paresis or paralysis of the upper extremities and no or minimal paresis of the lower extremities represents a rare lesion of the pyramidal decussation of the lower brain-stem. MRI may show a hypointense lesion on T1-weighted imaging. Prognosis in this syndrome is dependent on the extent of involvement of surrounding brain-stem-structures, as described in three different cases.

Adult↗
PubMed1992

[Prospective follow-up of neuropsychological deficits after cervicocephalic acceleration trauma].

30 patients with acute cervico-cephalic syndrome following whiplash injury (neck and head pain, vegetative symptoms and subjective complaints of impaired mental functions) without neurological deficits were investigated in a prospective follow-up of 3 months with neuropsychological examination in the acute phase (x = 5.7 days) and again 6 and 12 weeks after the accident. Attention, concentration, cognition and verbal and visual memory functions were quantified by neuropsychological tests, and changes over the observation period were analysed. In the acute phase all neuropsychological functions were below the individual's normal level. Deficits in attention and concentration recovered within the first 6 weeks. Further recovery within the following 6 weeks were observed in visual memory, imagination and analytic capacity. The capability of verbal memory and abstraction, cognitive selectivity and information processing speed was impaired for a longer time and first recovered after 12 weeks. In conclusion, intraindividual neuropsychological deficits following whiplash injury can be quantified and monitored to show the time course of recovery. Thus in clinical and forensic practice the diagnosis of a pseudoneurasthenic or even "neurotic" syndrome in acute whiplash injury should be made with caution.

Accidents, Traffic↗
PubMed1991

Relationship between electrical and vibratory output of muscle during voluntary contraction and fatigue.

Measurements were done on the biceps muscles of 6 healthy volunteers to record simultaneously the surface electromyogram (EMG) and vibromyogram (VMG) by means of a piezoelectric device (accelerometer). The VMG is generated by mechanical waves due to the contraction mechanism and often measured as sound. The frequency spectrum and integrated value (IEMG and IVMG) of both signals were calculated. Both IEMG and IVMG showed a clear linear correlation with force, although at high forces, the variability of the VMG became rather high. Two series of experiments were performed to study the EMG and VMG changes in relation to changes induced by fatigue: (1) during constant force at 50% of the maximal voluntary contraction (MVC) and recovery; (2) for one 1 minute during declining force at MVC. The main finding was that the IVMG was related to the absolute force, irrespective of the fatigue state of the muscle. In contrast, the IEMG showed the well-known changes during fatigue, such as an increase during endurance. The spectral changes of the two measurements also showed a divergence. The spectra of the EMG shifted to lower frequencies in both fatigue protocols. In contrast, the spectra of the vibratory signal did not shift, except for several measurements at MVC. However, the shape did change to a somewhat flatter spectrum with less pronounced peaks. Possible explanations for this different behavior are discussed. It is concluded that the vibratory energy generated by the contraction mechanism is linearly related to force. Changes induced by fatigue do not alter this relationship: this contrasts with the behavior of the EMG.(ABSTRACT TRUNCATED AT 250 WORDS)

Electromyography↗
PubMed1989

The computer-vibromyography as a biometric progress in studying muscle function.

Muscular vibrations were recorded from different relaxed and contracted skeletal muscles in human subjects, with the use of a piezo-electric device. Simultaneous wire-EMG recordings were performed. Spectral analysis of the acceleration curves (vibromyograms) disclosed muscle and function dependent compound frequency patterns. We suggest that the activity of motor units including the action of central reflex loops and oscillatory driving is mainly responsible for the muscular vibrations. Other sources are discussed. Computer-Vibromyography as a mechanical ensemble measurement supplements bioelectric EMG techniques and classical tremor analysis and provides further insights into the function of muscle and motor-system.

Adult↗
PubMed1989

[Frequency analytic EEG study on the topic of temporal function disorders in transsexuality].

A high rate of (temporal) EEG abnormalities within the group of transsexual patients has been previously described. These reports however were based on visual EEG analyses, which were not sufficiently statistically supported. It therefore seemed necessary to test this observations by utilizing quantitative frequency EEG analysis by using a larger group of transsexuals (n = 33). Fourier transformed data were recordings from T3-A1, T3-P3, T5-Cz, 01-Cz. The power of the delta-, theta-, alpha, and beta-bands were calculated as the percent of the total power (1,00-30,00 Hz). Different ratios of the absolute power values were computed. No significant differences of frequency-band related power, global power or power ratios between patients and normal subjects were found. There was also no separation on the basis of the genotypic sex of the subjects (Mann-Whitney-test). However 7 EEG's (21%) of the transsexual patients showed according to our interpretation temporo-parietal abnormalities.

Adult↗
PubMed1986

Somatosensory evoked potentials in the ventrolateral thalamus.

Within the target area (VL) used for the stereotactic treatment of parkinsonian tremor and spasmodic torticollis, electrical stimulation as well as recording of somatosensory evoked potential (SEP) was performed. The effects of stimulation in the target area are facilitation of muscle tone showing some degree of somatotopic distribution. The recorded SEPs indicate a projection of an afferent system (probably of muscle afferents) to the target area. We assume that the target area is a relay station involved in the control of muscle tone. The interruption of muscle afferents in combination with the correct somatotopic localization of the lesion is important for the therapeutic efficacy in parkinsonian tremor and spasmodic torticollis.

Afferent Pathways↗
PubMed1984

[Malignant cerebellar infarct].

Three patients with cerebellar infarcts and secondary obstructive hydrocephalus (hydrocephalus occlusus) are described, the condition being due to the space-occupying action of the ischaemia and oedema zone with compression and displacement of the fourth ventricle and/or obstruction of the aqueduct. Possible brain stem compression and danger of cerebellar tonsillar herniation were present. From the acute deterioration of the clinical picture, particularly of the state of consciousness, as well as from the findings obtained via computed tomography showing a widening of the inner ventricular space, it was imperative to perform emergency pressure-relieving drainage surgery with ventriculo-atrial shunts in all the cases described. The first two patients could be discharged postoperatively with successful treatment, only slight neurological disturbances remaining. This leads to the conclusion that a (malignant) cerebral infarct should be treated as an emergency case, in a somewhat similar way as in cases of cerebellar haemorrhage or other space-occupying lesions in the posterior fossa of the skull. To recognize the life-threatening exacerbation, sufficient observation and supervision will be necessary. Rapid deterioration in consciousness should be considered a sign of increasing intracranial pressure progressing with the development of hydrocephalus internus occlusus. After neuroradiological diagnosis, especially after verification via computed tomography, this should be interpreted as an indication for immediate neurosurgical intervention. This is the only way to keep the mortality rate satisfactorily low. Dichotomy of cerebellar infarcts into a benign type with spontaneous decrease of symptoms and signs, and a malignant type with development of hydrocephalus internus and increased intracranial pressure, such as in the cases described here, is suggested.

Cerebellum↗
PubMed1983

[Motor intention potential. Electrophysiologic objectization of a single intended movement].

Autocorrelation of the EEG was used to registrate a potential from the intact human scalp during intended, but not executed movements (dorsalflexion of the right hallux, imaginated in equal time intervals). This "Motor Intention Potential" (MIP) is a possible electrophysiological sign of the otherwise purely introspectively experienced intention of a voluntary movement and the cortex of the frontal lobes is suspected to be its origin. The average maximum amplitude height is 6 microV, and the potential shows a continuous decrease from the frontal to occipital region. The duration of MIP is in the range of seconds. Methodological questions are discussed, and the MIP is differentiated from other event-, movement- and imagination-related potentials. An attempt is made to place the motor intention potential in the context of existing movement theories.

Action Potentials↗
PubMed1983

Frontal hemispheric differences in the Bereitschaftspotential associated with writing and drawing.

Twenty right-handed subjects participated in a study investigating the cerebral potentials related to three complex actions: (1) writing one's own signature, (2) drawing a pentagram, and (3) fast meaningless scribbling. The Bereitschaftspotential (BP, readiness potential) started as early as 3 s prior to writing, 2.5 s prior to drawing, but only 1.5 s prior to scribbling. In all three tasks, the BP had its earliest onset over the supplementary motor area (SMA). BP topography was shifted towards the frontal lobes when compared to encephalographic activity reflecting simple finger movements, and was very weak in retro-rolandic leads. The side of the performing hand, as assessed from scribbling, was reflected in a contralateral preponderance of the precentral BP. The maximum BP (about 6 microV) was, in all three tasks, located in FCz (mid fronto-central) overlying the SMA. This location is different from that for simple finger movements, when the maximum is at the vertex. Hemispheric differences were found over the frontal cortex and were characteristic for the verbal and spatial tasks involved: for writing, the BP was significantly larger left frontally than right (even after considering the effect of the performing hand from scribbling), and the difference was largest prior to the onset of movement; for drawing, the BP was larger over the right than over the left frontal lobe, and the difference was largest during the movement.

Action Potentials↗