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Biomedical subjects

M L Espir

Publications and source records attributed to M L Espir.

At least 19 recordsLinked to original sources
PubMed1988

Headaches in civil servants: effect on work and leisure.

Headaches in a group of civil servants and their effects on work and leisure activities, the medication taken, and numbers consulting their general practitioners during a year were assessed by a self administered questionnaire sent to 1000 civil servants in sections of a government department in London. The response rate was 74.7%. Altogether 77% of the respondents reported having had headaches in the previous 12 months. There was a higher prevalence in women (88%) than men (70%) and a significant decrease with increasing age. Women also had more frequent and severe headaches than men: 34% reported that headaches had interfered with work, either by impaired performance, making them leave work early, or by stopping them coming into work. About half of those who reported having severe headaches denied that they had affected their work, indicating difficulty in interpreting the term "severe." Nevertheless, 22% said that headaches interfered with their leisure activities as well as work which may be regarded as further evidence that the condition was truly disabling. Eighty per cent of those with headaches took medication, but within the past year only 11% had consulted their general practitioner and only 2.2% had been referred for further specialist opinion. Of the 22% who had not had a headache during the previous 12 months, 5.6% had never had a headache. In this group there was a larger proportion of men, a higher proportion with increasing age, and a higher proportion in non-desk working grades. Differentiation of the causes of headaches was not attempted in this survey but it is concluded that the extent to which they interfere with work and leisure is an important guide to their severity. It is suggested that the occupational health services may have an important role in assessing the causes of headaches and instituting preventive measures that benefit both the worker and industry.

Adolescent↗
PubMed1987

Survey of specialised hospital services for adults with epilepsy in the North East Thames Region of the United Kingdom.

A Government (Department of Health and Social Security) (DHSS) Working Group has recently publish a report concerning the services for epilepsy in the UK, in which a number of recommendations for improvements were made, including the setting up of epilepsy clinics. In view of the lack of information concerning the specialised services currently available on a regional basis, we have undertaken a survey of hospital services for adults in the North East Thames Region. In this paper, we report the findings, noting the developments which have already taken place, the deficiencies that have been identified, and possible improvements in line with the Working Group's report.

Adult↗
PubMed1985

Is there a place for placebo controlled trials of antiepileptic drugs?

In many patients who develop epilepsy the disease is short lived and the overall number of seizures small. The role of anticonvulsant drugs in such patients is uncertain. If treatment is merely suppressive and the disease self limiting then treatment may not be necessary in some patients. If, on the other hand, early treatment prevents the subsequent evolution to chronic epilepsy then it is imperative. To resolve this issue it is essential to undertake placebo controlled trials, in which a group of patients with newly diagnosed epilepsy is given active treatment and compared with a similar group given placebo alone.

Anticonvulsants↗
PubMed1982

Dysarthria.

Explore the source record for details and available documents.

Adult↗
PubMed1981

Long-term treatment of trigeminal neuralgia with carbamazepine.

The results of treating 143 patients with trigeminal neuralgia with carbamazepine (CBZ) over a 16-year period have been reviewed. The drug was effective initially with few mild side effects in 99 patients (69%). Of these, 19 developed resistance later, i.e. between 2 months and 10 years after commencing treatment, and required alternative measures. Of the remaining 80 (56%), the drug was effective in 49 for 1-4 years and in 31 for 5-16 years. Thirty-six patients (25%) failed to respond to CBZ initially and required alternative measures, as did 8 (6%) who were intolerant of the drug. One patient developed CBZ-induced water intoxication with hyponatraemia. Subsequently hyponatraemia was excluded in 17 patients who had been taking CBZ for between 4 months and 7 years. This study has thus confirmed the efficacy of CBZ in the treatment of trigeminal neuralgia and shown that it may continue to be effective for many years.

Aged↗
PubMed1980

Paroxysmal symptoms as the first manifestations of multiple sclerosis.

Paroxysmal symptoms are described in 14 patients with undoubted or suspected multiple sclerosis (MS). In seven of the patients the paroxysms were the first symptom of the disease, although only one has developed definite MS so far. The clinical features have been compared with 153 patients previously reported in the literature which has been reviewed, with special reference to 36 in whom paroxysmal symptoms were the initial manifestations of MS. Attention has been focused on paroxysmal symptoms of brain stem and spinal cord origin of the following types: paroxysmal dysarthria and ataxia, diplopia, tonic seizures, paroxysmal akinesia, paroxysmal sensory disturbances and pains. Examples of each type have been reported as the first symptoms of MS with remissions ranging from less than one to 21 years before other manifestations of MS have developed.

Adult↗
PubMed1979

Remittent painful ophthalmoplegia: the Tolosa-Hunt syndrome? A report of seven cases and review of the literature.

Seven patients with remittent painful ophthalmoplegia for which no specific local cause was found were seen during a period of five years. One had coincidental rheumatoid arthritis, and another had actinomycosis of the ipsilateral middle ear and contralateral parotid gland. The other five had no evidence of generalised autoimmune disease nor any other systemic disorder, two having separate episodes affecting each side. A history of relapsing and remitting painful ophthalmoplegia is suggestive of the Tolosa-Hunt syndrome, but it is rarely possible to confirm that the lesion in the cavernous sinus is the result of non-specific granulomatous infiltration so that the diagnosis remains one of exclusion. Carotid arteriography may show narrowing of the intracavernous part of the internal carotid artery. Orbital venography may also be helpful, particularly when the carotid arteriogram is normal. We believe that the Tolosa-Hunt syndrome is more common in England than is generally realised, but that its clinical features do not necessarily indicate a single pathological entity. Its recognition is important since the response to steroids, although not specific, is rapid in most patients, and the prognosis for complete recovery is relatively good.

Actinomycosis↗
PubMed1978

Familial myoclonic epilepsy with ataxia and neuropathy with additional features of Friedreich's ataxia and peroneal muscular atrophy.

A family is described in which a mother and three of her five children showed myoclonic epilepsy. The mother and one son were also ataxic; one other son had additional features of Friedreich's ataxia, and a daughter had peroneal muscular atrophy as well as myoclonic epilepsy and ataxia. Although some of these disorders have been associated in previously reported families, the occurrence of all three disorders in members of one family seems to be unique. It is concluded that this family shows the manifestations of one, probably dominant, gene. The differences in age of onset and manifestations may be explained by the action of one or more subsidiary genes.

Adult↗