Biomedical subjects

N Biary

Publications and source records attributed to N Biary.

At least 19 recordsLinked to original sources

PubMed1995

Post-heatstroke parkinsonism and cerebellar dysfunction.

A case is presented of a 45-year-old woman who developed parkinsonism, cerebellar dysfunction, aphasia and flaccid paralysis secondary to heat stroke. Magnetic resonance imaging revealed irregular patchy areas of increased signal intensity in the white matter of both cerebral hemispheres and the left striatum, remaining unchanged over a follow-up period of two years. Cerebellar atrophy, while not seen on initial examination, was present on the follow-up study done one year later and became more marked after two years.

Atrophy↗

PubMed1995

Long-term therapy of essential tremor with flunarizine.

We investigated the effect of long-term treatment of essential tremor (ET) with flunarizine (Fz) (10 mg/day) in 17 subjects who had a favorable response to 1 month of treatment. Side effects (dystonia, parkinsonism, weight gain and depression) occurred in 29.4% (5/17) of patients, leading to drug discontinuation. Fz was still effective at the end of 30 months of treatment in 41% (7/17) of patients. Loss of efficacy was observed in 29.4% (5/17) of patients. It is concluded that Fz is an alternative for long-term treatment of patients with ET; however, loss of efficacy and side effects are common.

Adolescent↗

PubMed1995

The effect of nimodipine on essential tremor.

We investigated the effect of nimodipine (30 mg qid) in 16 de novo patients with essential tremor in a double-blind placebo-controlled study in which we assessed tremor by clinical scorings, tremorgraphic recordings, and patient self-evaluation. Of the 15 patients who completed the study, eight improved. We conclude that nimodipine is effective in some patients with essential tremor.

Adult↗

PubMed1994

Posttraumatic paroxysmal nocturnal hemidystonia.

The term "nocturnal paroxysmal dystonia" has been used to describe patients who display paroxysmal episodes of dystonic-dyskinetic movements arising during nonrapid eye movement sleep, in particular stages 2-3 (Lugaresi E, Cirignotta F. Hypnogenic paroxysmal dystonia: epileptic seizure or a new syndrome. Sleep 1981;4: 129-138). The pathogenesis of these attacks has remained controversial. We describe a patient with posttraumatic paroxysmal nocturnal hemidystonia. Acetazolamide led to improvement.

Acetazolamide↗

PubMed1993

Idiopathic long QT syndrome: asking the right question.

Infants and young children cannot describe symptoms of cardiogenic syncope accurately. If the attention in such cases is focused on the seizure activity that may follow, the patient will be treated inappropriately with anticonvulsants. We report such a presentation in 4 infants and young children (ages 6 to 48 months) with idiopathic long QT syndrome. All patients presented with recurrent seizures. All patients had a corrected QT interval (QTc) > or = 0.44 s and none had deafness. The diagnosis was suspected by careful history-taking which revealed episodes of loss of consciousness before convulsions in all patients. All patients were treated successfully with propranolol and remained free of symptoms during the follow-up period of 1-2 years. Screening the other family members revealed a prolonged QTc in 9 out of 16, and a history of 3 sudden and unexplained deaths in two families.

Child, Preschool↗

PubMed1993

Choroido-cerebral calcification syndrome with retardation.

We present a sibship with a rare syndrome characterized by mental retardation, dense calcification of the lateral ventricular choroid plexus, and increased CSF protein. Neurophysiologic studies yielded nonspecific results, and endocrine studies, including parathormone levels, were normal. Simultaneous measurements of CSF and serum calcium, magnesium, and other electrolytes were normal, but the CSF/serum ratio of phosphate was low, suggesting a possible role in the pathogenesis of this syndrome.

Brain Diseases↗

PubMed1992

Flunarizine in migraine: a double-blind placebo-controlled study (in a Saudi population).

We evaluated the effect of flunarizine (Fz) (10 mg/d) on migraine in a double-blind placebo-controlled design. The attacks' frequency, duration, severity and associated symptoms were compared before and after treatment. Forty-two patients completed a three-month trial period; 21 patients received Fz and 21 placebo. Statistical analysis showed no significant difference between Fz and placebo (p > 0.05). In this study Fz was not more efficient than placebo in migraine.

Adolescent↗

PubMed1991

Intractable hiccup induced by brainstem lesion.

Four patients with brainstem lesions presented with intractable hiccup and mild to moderate neurological signs. Two of the patients had been initially diagnosed as having a psychogenic cause for their hiccup. Magnetic resonance imaging (MRI) demonstrated brainstem infarction in one case, tuberculoma at the junction of the medulla oblongata and the cervical spinal cord in two, and a vermian tuberculoma compressing the brainstem in one. The brainstem infarct and one of the medullary tuberculoma were not detected on high resolution enhanced computed tomography. The 3 patients with CNS tuberculoma were free of hiccup 1-5 months after antituberculous chemotherapy. It is proposed that hiccup is not an abnormal reflex, but a myoclonus generated by repetitive activity of the "inspiratory solitary nucleus" due to release of higher nervous system inhibitory/-regulatory control. The neuroanatomical network and the mechanisms underlying the formation of intractable hiccup are outlined. The value of MRI in the initial diagnosis and follow-up of patients with intractable hiccup due to brainstem lesions is emphasised.

Adult↗

PubMed1991

The effect of flunarizine on essential tremor.

We investigated the effect of flunarizine treatment (10 mg/d) in 17 subjects with essential tremor in a double-blind placebo-controlled design. Tremor was assessed by clinical scoring, tremographic recordings, and subjective rating by subjects. Of the 15 subjects who completed the study, 13 showed improvement. We conclude that flunarizine is effective treatment for essential tremor.

Adolescent↗

PubMed1990

Correlation between essential tremor and migraine headache.

The relationship between essential tremor (ET) and migraine was investigated in a prospective study. In a group of 74 ET patients 36.5% had migraine compared with 17.7% of 102 control subjects without tremor. In a group of 58 patients with migraine 17.2% had ET compared with 1.2% of 85 controls without migraine. The prevalence of ET in migraine controls was greater than controls without migraine (22% compared with 1%; p = 0.002). It is concluded that there is an association between essential tremor and migraine.

Adolescent↗

PubMed1989

Post-traumatic tremor.

We present seven cases of tremor caused by mild head injury without loss of consciousness. The interval between head trauma to onset of symptoms was 1 to 4 weeks. A posture and kinetic tremor of the hands and head occurred unassociated with other neurologic signs. Myoclonic-like jerking was frequently present. Neuroimaging studies were normal. Clonazepam administration resulted in tremor reduction in three patients and propranolol decreased tremor in one patient. A tremor, similar to essential tremor, can be a rare complication of head trauma.

Adult↗

PubMed1988

A double-blind trial of clonazepam in the treatment of parkinsonian dysarthria.

We studied the effect of clonazepam in a double-blind trial on 12 parkinsonian patients with hypokinetic dysarthria. Speech samples were judged on 14 of the dimensions used in the Mayo Clinic dysarthria study. Of the 11 patients who completed the study, 10 showed improvement. The effective dosage of clonazepam was 0.25 to 0.5 mg/d with higher dosage than that less effective. Clonazepam has a definite role in the management of parkinsonian dysarthria.

Aged↗

PubMed1987

Essential tongue tremor.

Twenty patients with tongue tremor associated with essential tremor are reported. Patients were unaware of the tongue tremor, and voice disturbance was a complaint in only one patient. Three patients had an isolated tongue tremor. Hand tremor was present in 16 patients. Dystonia, myoclonus, and tremor of other body parts were present in some patients. Three patients had a mild-to-moderate dysarthria. The frequency of tongue tremor (4-8 Hz) was identical to hand tremor. The intravenous infusion of ethanol suppressed tongue tremor. Therapy with propranolol, primidone, or clonazepam also reduced tongue tremor amplitude. Tongue tremor is a common finding in some essential tremor patients but often there are no symptoms.

Adolescent↗

PubMed1987

Essential tremor variants: effect of treatment.

Essential tremor may not represent a single condition. Subclassifications include kinetic predominant tremor; combined resting-postural tremor; primary writing tremor; isolated voice, chin, or tongue tremor; and orthostatic truncal tremor. We report patients with these disorders. An association of these conditions with essential tremor is suggested by a high occurrence of a family history of essential tremor, frequent presence of a mild postural tremor, and tremor reduction with alcohol ingestion. Pharmacologic responsiveness is different for these disorders. Propranolol and primidone often have beneficial effects but clonazepam was the only drug effective in some cases of kinetic predominant tremor and in orthostatic truncal tremor. Combined resting-postural tremor and voice tremor were often unresponsive to treatment.

Adult↗

PubMed1987

Kinetic predominant essential tremor: successful treatment with clonazepam.

Fourteen patients with marked kinetic tremors of long duration but no other major neurologic signs are described. A positive family history of essential tremor, mild postural tremor, and tremor suppression with alcohol suggest that the condition is a variant of essential tremor. Kinetic tremors had a frequency of 3.5 to 6.0 Hz and an alternating EMG pattern. Propranolol caused improvement in some patients, but clonazepam treatment resulted in tremor suppression in all patients. Kinetic tremor without cerebellar signs is a subtype of essential tremor with pharmacologic responsiveness to clonazepam.

Aged↗

PubMed1986

Disability in essential tremor: effect of treatment.

We studied 18 patients with essential tremor for difficulty with handwriting, drinking, eating, fine manipulations, and embarrassment. Propranolol and primidone reduced the amplitude of both postural and kinetic tremor. Handwriting, drinking, and eating were improved with therapy, but fine manipulations and motor performance on tapping and pegboard tests were unaltered. Embarrassment remained unchanged. Essential tremor is not a benign condition; disability can be only partly reversed with drug therapy.

Aged↗

PubMed1985

Handedness and essential tremor.

In patients with essential tremor, a direct relationship was found between hand dominance and severity of hand tremor. A higher incidence of left-handedness was found in patients with essential tremor than in controls.

Adolescent↗

PubMed1985

Effect of alcohol on dystonia.

An intravenous infusion of a 250-ml, 10% ethanol solution decreased dystonic scores in five of seven patients with spasmodic torticollis, but had no effect in patients with Meige syndrome, tardive dystonia, or generalized torsion dystonia. Alcohol may temporarily decrease some forms of dystonia.

Aged↗