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Biomedical subjects

R A Bernsen

Publications and source records attributed to R A Bernsen.

7 recordsLinked to original sources

Long-term sensory deficit after Guillain-Barré syndrome.

In order to document the sensory deficit still present several years after onset of Guillain-Barré syndrome (GBS) and to determine if the sensory residua have a disrupting effect on daily life, 122 patients were asked to cooperate in a neurological examination and to complete a questionnaire three to six years after onset. On functional assessment 84 patients had no or only minor neurological symptoms or signs, 24 patients showed moderate recovery and 14 patients were left with severe residual signs. On neurological examination, residual sensory deficit was found in the arms of 38 % of the patients and in the legs of 66 % of the patients. Sensory disturbance was experienced as moderate to severe in the arms of 27 % of the patients and in the legs of 40 % of the patients. Muscle aches and cramps were still present in 48 %. There was a statistically significant relation between muscle aches and cramps and objective residual sensory deficit but not with residual weakness. Furthermore, in the group of patients with a pure motor GBS, significantly fewer people suffered from muscle aches and cramps than in the remaining patients (p=0.04). Twenty-five percent of patients changed jobs after their illness, and 44% gave up some leisure activities. It can be concluded that many patients still suffer from sensory deficit, and a considerable number experience these as moderately to seriously disruptive, especially in the legs. Muscle aches and cramps seems to be related to sensory rather than motor dysfunction.

Activities of Daily Living↗

Residual physical outcome and daily living 3 to 6 years after Guillain-Barré syndrome.

Three to six years after onset of Guillain-Barré syndrome, 63% of 122 patients showed one or more changes in their lifestyle, work, or leisure activities, or in the life of their partners. The changes were influenced by an impaired final functional outcome, along with loss of power and poor condition, although physically recovered patients showed these changes as well.

Activities of Daily Living↗

Residual health status after Guillain-Barré syndrome.

To study the extent to which patients experience residual problems in daily functioning several years after having Guillain-Barré syndrome (GBS) a survey of 123 patients who had had Guillain-Barré syndrome three to six years previously was performed, using the sickness impact profile (SIP) for measuring functional health status and a functional assessment scale (F score) for measuring physical condition. The patients were diagnosed according to the international criteria for Guillain-Barré syndrome and were at the time of diagnosis unable to walk more than 10 metres without support. The physical SIP score correlated positively with final physical recovery (Pearson's r = 0.79). The psychosocial SIP score indicated impairment in all patient groups compared with matched normal control values; they included the group with no, or mild, residual symptoms (P < 0.05). No relation was found between clinical variables related to the severity or duration of Guillain-Barré syndrome and residual psychosocial dysfunctioning, except for a relation with disturbance of sensation in the arms. In conclusion, in many patients with Guillain-Barré syndrome, psychosocial functioning is still seriously affected, even when they have physically recovered, or show only mild residual signs.

Adult↗

A spinal haematoma occurring in the subarachnoid as well as in the subdural space in a patient treated with anticoagulants.

A 75-year-old man on anticoagulant therapy suddenly experienced an excruciating back pain and subsequently developed a paraplegia. At operation a subarachnoid and a subdural haematoma were found, extending between the levels of the vertebrae T3 and L2. This extremely rare combination of haematomas may have been caused either by rupture of a small vessel in the arachnoid membrane or by rupture of the arachnoid membrane itself, secondary to a massive haemorrhage in the subarachnoid space.

Aged↗

Polyglucosan bodies in intramuscular motor nerves.

The presence of polyglucosan bodies was studied in intramuscular motor nerves of 292 muscle biopsies. These biopsies were classified into five diagnostic categories and investigated for the presence of polyglucosan bodies in relation to age and sex. Their presence was nonspecific in patients over 20 years, the only correlation being with ageing. Under 20 years, their presence pointed to the diagnosis of Lafora's disease. In cases in which both a muscle biopsy and a sural nerve biopsy were performed, the former appeared to contain these polyglucosans more frequently.

Adolescent↗