PubMed Health⌕ Search

Biomedical subjects

R Borgmann

Publications and source records attributed to R Borgmann.

5 recordsLinked to original sources

[Botulinum toxin A--effect on spasticity].

BACKGROUND: Severe spasticity may lead to problems of movement and function, pain and hygiene, and may be difficult to treat. A team of neurologists and physiotherapists evaluated the effect of botulinum toxin A (BTX-A) on spasticity. MATERIAL AND METHODS: Ten patients with central nervous disorders were included in this study. Function, pain and personal hygiene were assessed before and after injections with BTX-A. RESULTS: Nine patients experienced improvement of function and/or pain relief. One patient had improved perception in his hand, and one patient needed only two injections to stop a vicious circle. The effect varied from patient to patient. It seemed that patients with some preserved motor control in the spastic limb could use it to learn more appropriate movement strategies. INTERPRETATION: We recommend that doctors and physiotherapists work together to identify muscle groups that need to be targeted for injection and evaluate consequences of the treatment. Injections with BTX-A should be combined with physiotherapy.

Adult↗

[Treatment of spasmotic torticollis with botulinum toxin A. A 5-year experience].

60 patients have been treated with botulinumtoxin A for cervical dystonia since december 1990. These patients have been seen at 472 visits and received at least two treatments. 55 (92%) patients noted improvement, and marked improvement was noted by 50 out of 60 patients (83%). Further improvement after repeated treatments has been seen up to five years. Only one patient experienced no effect after several treatments with marked improvement. This might have been due to production of antibodies against the toxin. Side effects occurred after 9% of the toxin injections, and dysphagia was the symptom most often reported. The side effects were usually mild and transient, and never gave reason to terminate the treatment.

Adult↗

Sustained-release Madopar HBS compared with standard Madopar in the long-term treatment of de novo parkinsonian patients.

In this Danish-Norwegian randomized double-blind parallel-group multicentre study, we compared the therapeutic response of slow-release Madopar HBS to standard Madopar in 134 de novo patients with idiopathic Parkinson's disease during a 5-year period. The drugs were dosed according to the individual need of the patients. The Webster, NUDS, UPDRS and Hoehn & Yahr scales were used for evaluation of symptoms. Addition of a morning dose of standard Madopar 62.5 mg was allowed after 6 months. Bromocriptine could be administered but not Selegiline. Sixty-five patients got Madopar HBS and 69 standard Madopar. Surprisingly, no differences were found as to the mean daily levodopa dose, the mean number of daily doses or the use of the doses of bromocriptine. Unexpectedly, we found a trend towards a more frequent use of a morning dose of standard Madopar in the group treated with the standard formulation. No differences were observed in the occurrence of motor fluctuations or dyskinesia, the incidence of which was relatively low. Sustained-release Madopar (HBS) thus proved to be as effective as standard Madopar in the long-term treatment of de novo parkinsonian patients, but the drug showed no advantage in postponing or reducing the long-term levodopa treatment problems.

Aged↗

Sequelae one year after meningococcal disease.

Of 99 consecutive patients with meningococcal disease, 6 died during the acute stage. The 93 survivors were examined one year after hospitalization. 21 (40%) of the adults and 6 (15%) of the children had definite sequelae, and an additional 27% and 11% possible sequelae. 6 adults (12%) and 1 child (2%) had definite neurological sequelae. Electroencephalography (EEG) abnormalities were observed in 7 adults (14%) and 2 children (5%). Epileptogenic activity was present in 3 of these, but none had experienced seizures. 8 adults (19%) and 5 children (14%) had sensorineural hearing loss or impaired vestibular function. Cerebral computerized tomography (CT) scan showed definite and possible abnormalities in 1 (3%) and 6 (18%), respectively, of the 34 patients tested. Neuropsychological tests were performed in 9 patients, 2 of these showed definite impairment. The frequency of neurological abnormalities was higher than in many previous studies, probably reflecting the more comprehensive examinations performed in the present study. However, only 3 patients had serious sequelae. The results suggest that the occurrence of sequelae after meningococcal disease is related to the severity of the acute disease. This may explain the higher rate of sequelae in adults, who have a higher proportion of seriously ill patients. The presence of meningitis is not required for the occurrence of neurological sequelae.

Adolescent↗

Natural course of intracranial pressure and drainage of CSF after recovery from subarachnoid hemorrhage.

Twenty-eight patients were followed 12 months or longer after recovery from subarachnoid hemorrhage (SAH). The examination included spinal infusion test (SIT), clinical evaluation and cerebral computertomography (CT). The results indicate that when resting pressure and drainage of CSF are within normal limits 3 months after the hemorrhage there is little if any risk of developing late communicating hydrocephalus. In this study, most patients with a moderate impaired CSF drainage and/or slightly increased resting pressure 3 months after SAH did not show any increase in the ventricular size or clinical deterioration during the follow-up period. None of the 28 patients developed late communicating hydrocephalus or the clinical picture of normal pressure hydrocephalus.

Adult↗