Electroconvulsive therapy for the physical signs of Parkinson's disease without depressive disorder.
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Biomedical subjects
Publications and source records attributed to P T Yeo.
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The relationship between the visual evoked response (VER) and chiasmal lesions remains unclear, although a few published studies have reported waveform distortions as the major abnormality. In this study of 10 female and 2 male patients we carried out a retrospective analysis of the latencies and waveforms of their full field and half field VERs to pattern reversal stimulus. CT scanning showed minimal suprasellar involvement in 3 patients. The VER in 2 of these 3 patients showed slight prolongation in latency and waveform distortions. In 4 of the remaining 9 patients with no suprasellar involvement, the VER showed waveform distortions but normal latencies. We conclude that waveform distortion of the VER is an early finding in patients with pituitary tumours, even in the absence of suprasellar extension.
In view of the conflicting evidence concerning prolongation of the VERs in diabetes, pattern reversal VERs were performed on 60 diabetic inpatients. Only in one patient was the VER unequivocally delayed without some other explanation and in 2 other patients it was prolonged in association with proliferative retinopathy. In the latter instance the latency may have been increased by involvement of the maculo-papillary fibres of the optic nerve which may occur during their passage through the retina. Otherwise the study does not strongly support the concept of optic neuropathy or central encephalopathy of the visual system in diabetes, at least as far as can be demonstrated by visual evoked cortical responses to pattern reversal stimuli.
A 43 year old woman presented with a 10 month history of pain, progressive weakness and wasting of the left calf. Electromyography demonstrated denervation at the level of the lumbosacral plexus, particularly of its sciatic component. CT and ultrasound examination revealed intrapelvic cysts which were confirmed on surgical exploration to be fallopian and ovarian cysts.
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Two known epileptics presented with abnormal behaviour. One was inattentive, aggressive and ataxic. The other carried out quite complex, though purposeless activity. EEG's revealed that the patients' behavioural abnormalities were due to uncontrolled seizures. Absence Status is an uncommon condition and its various manifestations can lead to delays in its recognition and treatment. It should be considered as a possible diagnosis in any patient who presents with recurring episodes of confusion.
Latencies of the F response and the H reflex discharge have been measured in 16 patients with clinical signs of lesions affecting the lumbosacral nerve roots. Responses were recorded from relevant muscles with stimulation of the posterior tibial or lateral popliteal nerves. In seven of the 12 patients with electrophysiological abnormalities, one or more late responses were absent. Radiographic examination in the same group confirmed disc lesions at L4-L5 or L5-S1 levels in nine patients and at T12-L1 in one and showed diffuse degenerative spine disease in two. Three of the four patients with normal electrophysiological results had mild lumbosacral disc disease. It is concluded that measurement of late response latencies is a useful investigation in lumbosacral nerve root disease.
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