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M Luisto

Publications and source records attributed to M Luisto.

8 recordsLinked to original sources

Polyneuropathy caused by chlorprothixene.

Seven chronic psychiatric patients developed signs of polyneuropathy mainly in the lower limbs after receiving chlorprothixene (500-1800 mg/d) from 3 to more than 24 months. The most prominent electroneuromyographic findings were decreased or not measurable motor conduction velocities of the peroneal nerves. Electromyography showed signs of denervation in the leg muscles in all the patients, and also in the upper limbs in 4 of them. The signs of polyneuropathy gradually subsided after withdrawal of chlorprothixene. Thus, chlorprothixene may cause a toxic, dose-dependent, reversible polyneuropathy.

Adult

Tetanus caused by occupational accidents.

The role of occupational accidents as a source of tetanus is poorly known. In Finland, during the period 1969-1985, 28 (26%) of the 106 cases of tetanus were caused by occupational accidents, 16 of which occurred in agriculture and forestry. Twenty-one of the patients were men and seven were women. The mean annual incidence of tetanus was 1 per 100,000 occupational accidents during the study period. The cases were concentrated in summer and autumn. Most of the primary injuries were minor, 61% of the injuries occurring in the hands and fingers. Forty-three percent of the patients had not been immunized against tetanus, and 46% were unaware of their state of immunization. The systematic immunization of the population against tetanus is important because the disease is often caused by slight injuries not requiring treatment by health care personnel. This need is emphasized for work in agriculture, forestry, and other branches in which contact with soil or animals occurs.

Accidents, Occupational

Tetanus in Finland: diagnostic problems and complications.

In a 16-year nationwide study in Finland 106 patients were diagnosed as having tetanus. Tetanus was diagnosed on the first visit to a doctor in half the patients, it was suspected in 28% but not considered in 22%. Diagnosis of tetanus may be delayed if a patient is elderly or has no known primary lesion. Abnormal EEGs and CSF findings with increased protein level were unexpectedly common (76% and 24% respectively). The most significant complications were cardiac arrhythmias (34%), blood pressure lability (32%), an increased haemorrhagic tendency (28%), an increase in thrombosis (8%) and/or of anoxic periods (16%) and death (11%). Intensive care has markedly improved the prognosis of tetanus; the main problems at present are difficulty of early diagnosis and treatment of complications of the most serious cases.

Adolescent

Electroencephalography in tetanus.

To assess the brain involvement caused by tetanus, we examined the EEGs of 39 patients recovered from tetanus and those of 39 sex- and age-matched controls. The patients had significantly more frequent and more severe EEG abnormalities than their controls. The most marked difference was in the occurrence of diffuse EEG abnormalities (P less than 0.05). Twenty patients had normal EEGs. EEGs of 14 patients (5 of whom in this follow-up) during acute tetanus showed abnormalities in 10 patients, marked in degree in 3 of those. EEG abnormalities started to improve after the acute phase of tetanus. It is concluded that EEGs of patients with tetanus are often abnormal and that EEG is helpful in revealing brain involvement in patients after tetanus.

Adult

Outcome and neurological sequelae of patients after tetanus.

From 1969-1985, 106 people contracted tetanus in Finland. The outcome of the disease was good in 78 cases (returned to work), poor in 27 (12 died, 5 institutionalized and 10 retired) and unknown in 1. Poor outcome was the result of a disease requiring respirator treatment. Other clinical factors significantly correlated with poor outcome were blood pressure lability, hyperglycemia, hyperthermia, tachycardia and anticoagulation therapy. Forty people who were representative of the whole series with regard to sex, age and severity of disease attended a follow-up study on average 7 years and 4 months later. Forty age- and sex-matched controls had the same examinations, and compared with them, the 40 patients still had significantly more muscle fatigue and cramps, nervousness, decreased mental capacity and difficulties in balance, speech and memory. They also had more clinical findings, such as peripheral paresis, muscular atrophy, decreased or absent tendon reflexes and decreased mental capacity than the controls.

Adolescent

Epidemiology of tetanus in Finland from 1969 to 1985.

During the period 1969-85, tetanus caused the hospitalization of 106 patients (63 men and 43 women) in Finland. 12 (11.3%) of them died, most of the causes of death being unexpected complications during the intensive care. The majority of the patients were more than 50 years old and had not been fully vaccinated against tetanus. There was a clear seasonal variation, most of the cases occurring during the months when there is no snow on the ground. Half of the primary lesions were minor injuries to hands and fingers. Only half of the primary lesions had needed medical treatment and usually the patients had received antibiotics and tetanus vaccination but not immunoglobulin. To diagnose tetanus is more difficult today than previously, because few doctors nowadays encounter tetanus cases and the diagnosis is based entirely on clinical criteria, and because abortive mild forms of tetanus may occur, especially in patients with partial immunity.

Adolescent

[Tetanus today].

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Humans

Electroneuromyographic sequelae of tetanus, a controlled study of 40 patients.

To assess the peripheral nervous system involvement caused by tetanus 40 patients recovered from tetanus and their sex and age matched referents were submitted to electroneuromyography (ENMG). Clinical symptoms and signs of peripheral neuropathy were found in 6 patients, 3 of whom had other obvious aetiology than tetanus. EMG was examined of the masseters and three muscles in the extremities. Motor conduction velocities (MCVs) were examined of the median, ulnar and peroneal nerves, distal sensory conduction velocity (dSCV) of the median, ulnar and radial nerves and the sensory conduction velocity (SCV) of the median nerve. Repetitive stimulation was done to study the neuromuscular transmission. The patients had significantly longer motor distal latencies (DLs) and slower dSCVs and more frequent ENMG findings compatible with mono- or polyneuropathy than their referents. There was no systematical difference in the MCVs. These findings suggest that tetanus may cause toxic axonal polyneuropathy, sequels of which appear to be slight or subclinical and can be seen at a group level.

Adult