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Biomedical subjects

M Z Al-Kawi

Publications and source records attributed to M Z Al-Kawi.

11 recordsLinked to original sources
PubMed2000

Transcranial magnetic stimulation in Behçet's disease: a cross-sectional and longitudinal study with 44 patients comparing clinical, neuroradiological, somatosensory and brain-stem auditory evoked potential findings.

OBJECTIVES: To compare neurological involvement in Behçet's disease as documented by transcranial magnetic stimulation (TMS) with clinical, neuroradiological, somatosensory (SEP) and auditory evoked potential (BAEP) findings. METHODS: Forty-four patients were studied over an 8 year period. Nine patients had follow-up studies done. TMS central motor conduction (CMC) studies to upper and lower limb muscles, brain magnetic resonance imaging (MRI), SEP, and BAEP testing were conducted. RESULTS: Thirty-nine patients had CMC slowing, decreased amplitude or absent motor evoked potentials (MEP); 5 of these patients were neurologically normal. Concordance of TMS results, clinical deficits, and MRI findings occurred in 36 of the 39 patients. SEP and BAEP testing proved non-complementary to MEP. Generally, follow-up studies revealed faster CMC and higher MEP amplitude. However, in two patients the CMC time to one target muscle became prolonged with diminished MEP amplitude over a period of 1.5-3 years. CONCLUSIONS: TMS can be useful in detecting and quantifying motor tract dysfunction in Behçet's disease and provides functional information complementary to imaging studies. TMS is more sensitive than either SEP or BAEP. Our longitudinal studies suggest that TMS studies may be valuable in monitoring disease activity or therapeutic response.

Adolescent↗
PubMed1998

Biotin-responsive basal ganglia disease: a novel entity.

We describe a novel, biotin-responsive basal ganglia disease in 10 patients. At onset, it appears as a subacute encephalopathy, with confusion, dysarthria and dysphagia with occasional supranuclear facial nerve palsy or external ophthalmoplegia, and progresses to severe cogwheel rigidity, dystonia and quadriparesis. These symptoms disappear within a few days if biotin (5-10 mg/kg/day) is administered, and there are no neurological sequelae. They reappear within 1 month if biotin is discontinued. Patients diagnosed late, or who have had repeated episodes, suffer from residual symptoms such as paraparesis, mild mental retardation or dystonia. The numerous biochemical studies of intermediary metabolism, like the autoimmune and toxicological studies, enzyme assays including biotinidase, carboxylase and lysosomal activities, and bacterial and viral studies were all normal. The aetiology may be related to a defect in the transporter of biotin across the blood-brain barrier. The only consistent radiological abnormality was central necrosis of the head of the caudate bilaterally and complete, or partial, involvement of the putamen on brain MRI. This was present during the initial acute encephalopathy and remained unchanged during follow-up of 3-10 years. Although its aetiology is unknown, it is important to recognize this disease, since its symptoms may be reversed and the progression of its clinical course prevented simply by providing biotin.

Adolescent↗
PubMed1989

Case report: idiopathic giant cell granuloma of the hypophysis: an unusual cause of panhypopituitarism.

A 37-year-old man presented with headache and reduced libido. He suffered from panhypopituitarism, and the walls of the pituitary fossa were noted to be thickened, sclerotic, and irregular. Computed tomography scans showed an intrasellar and suprasellar, patchy enhancing tumor. From a biopsy taken at transsphenoidal surgery, a giant cell granuloma was diagnosed, for which there was no obvious cause. Inflammatory disease within the pituitary fossa should be suspected if a reaction is seen in the surrounding bone.

Adult↗
PubMed1987

Cranial manifestations of aspergillosis.

Five patients with differing forms and severity of cranial aspergillosis illustrate the range of neuroradiologic manifestations as evaluated with angiography, computed tomography and magnetic resonance imaging. Together with the physical findings, these subjects illustrate the dire clinical situation requiring immediate recognition in order to attempt to control this devastating, treatment resistant pathologic fungal infection.

Adult↗
PubMed1987

Dynamic computed tomography of cerebral parenchymal tuberculomata.

The technique of intravenous dynamic cranial computed tomography has been applied to our patient population in Saudi Arabia in which parenchymal tuberculomata make up approximately 10-15% of all cerebral mass lesions. A spectrum of perfusion patterns was observed in tuberculosis progressing from presentation, through treatment, to resolution. These patterns reflect the microscopic vascular evolution of tuberculomata and parallel at least in part the effects of treatment. The method of dynamic scanning further demonstrates its value in improving the specificity of computed tomography in the evaluation of cerebral masses, thereby enhancing patient-beneficial triage.

Adolescent↗
PubMed1986

Cystic necrosis of the spinal cord in compressive cervical myelopathy: demonstration by iopamidol CT-myelography.

Seven consecutive patients with compressive cervical myelopathy were studied with standard water-soluble contrast myelography and immediate CT followed by delayed CT of the spinal canal at 10 to 12 hr. Every case demonstrated findings suggestive of necrosis and/or cavitation of the central portions of the spinal cord on the delayed CT study. Two types of abnormalities were visualized in the form of delayed collections of contrast media inside the cord: bilateral enhancement, a double-barreled "snake-eyes" appearance at or near the level of compression (consistent with central gray matter necrosis and/or cavitation--local syringomyelia ex-vacuo); and longitudinally oriented, "pencil-shaped" central enhancement of variable length distant from the level of compression (consistent either with an enlarged central canal--hydromyelia ex-vacuo--or with necrosis and/or cavitation extending craniad and caudad from the area of maximal compression and located in or near the anterior portion of the dorsal columns--distant syringomyelia ex-vacuo). These findings, supported by previous reports of autopsy specimens, may explain in part: the frequent discrepancy between the levels of maximal cervical compression and the variable neurologic signs; and the frequent lack of improvement in clinical signs after surgical decompression of the spinal cord at this late stage of the illness. We believe similar intramedullary lesions may be present in other cases of chronic compression of varying etiology at any location within the spinal cord.

Adult↗
PubMed1985

Nervous system brucellosis: diagnosis and treatment.

We treated six patients with nervous system brucellosis causing polyradiculitis (2 patients), myelopathy (2), encephalitis (1), or meningitis (1). Diagnosis was based on Brucella species cultured from one patient, and a twofold or greater rise in antibody titer after therapy was started in the others. Treatment with trimethoprim-sulfamethoxazole with rifampin (5 patients) or tetracycline (1 patient) produced excellent clinical and laboratory response.

Adult↗
PubMed1983

Intracranial tuberculoma: conservative management.

Twenty cases of intracranial tuberculoma were treated by us. A clinical-radiographic syndrome was recognized, consisting of an avascular enhancing mass lesion surrounded by marked edema and associated with relatively less severe clinical manifestations than would have been expected from the size and location of the lesion. This allowed successful medical therapy with three antituberculous drugs for an average of 12 months. Steroids, when used, were beneficial in relieving symptoms of cerebral edema without causing spread of tuberculosis. Medically treated patients had a significantly better functional recovery than those from whom the tuberculoma was excised.

Adolescent↗
PubMedDate not supplied

The parenchymal CT myelogram: in vivo imaging of the gray matter of the spinal cord.

Past attempts to visualize the internal structure of the spinal cord in vivo have been hampered by many factors, including the small size of the cord, the dense bony investiture of the spine, and the similarities of tissue densities from one region to another within the cord. Delayed CT is the imaging technique currently being used at our institution as an adjunct to iopamidol myelography to visualize the deep gray matter of the cord. This visualization is achieved by a poorly understood differential gray/white-matter enhancement, possibly due to either a shielding effect of the white matter as it envelops the gray matter, a differential absorption rate between gray and white matter, or a greater rate of reabsorption of contrast by the more highly vascularized gray matter. This method is not being advocated as a primary diagnostic technique due to the lack of reliability in providing successful results from section to section, from patient to patient, and from one time period of delay to the next. Instead, it is an initial attempt to image the basic, intrinsic structure of the spinal cord in vivo, which may herald a valuable advance in imaging methodology.

Atrophy↗