Mirle Girish | PubMed Health

PubMed2005

Complex nocturnal visual hallucinations.

BACKGROUND AND PURPOSE: To describe the clinical features and associations of complex nocturnal visual hallucinations. PATIENTS AND METHODS: We identified 12 patients seen between 1997 and 2004 with complex nocturnal visual hallucinations. Charts were reviewed and data analyzed. RESULTS: Of the 12 patients, 11 were women. Vivid, silent, often distorted images of people and animals occurred after waking, disappearing with increased light. Idiopathic hypersomnia, beta blocker use, dementia with Lewy bodies, macular degeneration and anxiety were associated factors. The hallucinations appeared to be a primary parasomnia in four patients with anxiety being the only associated feature. CONCLUSIONS: Complex nocturnal visual hallucinations represent a well-defined syndrome with diverse causes which should be differentiated from other parasomnias causing arousals.

Adolescent↗

PubMed2003

Pramipexole in the management of restless legs syndrome: an extended study.

STUDY OBJECTIVES: To determine whether pramipexole used over an extended time for restless legs syndrome (RLS) remains effective; whether the dose of the drug needs to be increased; whether augmentation develops; and whether side effects, especially sleepiness, are prominent. DESIGN: Retrospective review of the records of consecutive patients treated with pramipexole for RLS. SETTING: Sleep disorders center in an academic hospital. PATIENTS: 60 consecutive patients treated with pramipexole for RLS. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: Pramipexole was completely effective in controlling RLS in 67%, partially effective in 27%, and ineffective in 7% of patients. Eleven patients (18%) discontinued pramipexole after less than 4 months; the remainder were followed for a mean of 27.2 months, during which only 4 others stopped the drug. The median daily dose increased from 0.38 mg after stabilization to 0.63 mg at the end of the study. Forty percent experienced mild side effects, most commonly insomnia, nausea or dyspepsia, and dizziness. Only 5% experienced sleepiness, and none experienced sleep attacks while driving. Augmentation developed in 33%, most in the first year and all by 30 months. Augmentation was not predictable by prior augmentation with other dopaminergic agents. Only 1 patient discontinued pramipexole because of augmentation. CONCLUSIONS: Pramipexole was effective for RLS with continued response with time. Modest escalations in dose occurred, partly due to additional doses prescribed for augmentation. Side effects were common, but generally mild and tolerated. Sleepiness while driving was not a problem. Augmentation occurred in 33% of patients but was treatable with increased doses earlier in the day.

Adult↗

PubMed2003

Atypical Pott's disease: localized infection of the thoracic spine due to Mycobacterium avium-intracellulare in a patient without human immunodeficiency virus infection.

Mycobacterium avium-intracellulare (MAI) rarely causes disease of the spine in healthy individuals. We describe an elderly woman who had isolated skeletal involvement with MAI, mimicking Pott's disease. She responded well to surgical excision of the inflamed tissue and antibiotic therapy. Osteomyelitis due to MAI must be differentiated from that due to Mycobacterium tuberculosis because the treatment regimens are different.

Aged↗