PubMed Health⌕ Search

Biomedical subjects

R D Thijs

Publications and source records attributed to R D Thijs.

7 recordsLinked to original sources
PubMed2006

Syncope in migraine: the population-based CAMERA study.

OBJECTIVE: To examine the association between migraine and syncope-related autonomic nervous system (ANS) symptoms. METHODS: A population-based study among migraineurs with and without aura (n = 323) and control subjects (n = 153) was conducted. A systematic questionnaire and cardiovascular measurements during rest, while standing, and after venipuncture addressed the prevalence of syncope, orthostatic intolerance, orthostatic hypotension (OH), and the postural tachycardia syndrome (POTS) in migraineurs and control subjects. RESULTS: The lifetime prevalence of syncope in all participants was 41%, more often in women (45 vs 32%; p = 0.02). Compared with control subjects, migraineurs had a higher lifetime prevalence of syncope (46 vs 31%; p = 0.001), frequent syncope (five or more attacks) (13 vs 5%; p = 0.02), and orthostatic intolerance (32 vs 12%; p < 0.001). There was no association between ANS symptoms and the severity of migraine or migraine subtype. Cardiovascular measurements and the prevalence of POTS and OH did not differ significantly between migraineurs and control subjects. CONCLUSION: This population-based study demonstrated an elevated prevalence of syncope and orthostatic intolerance in migraineurs without clear interictal signs of autonomic nervous system dysfunction.

Blood Pressure↗
PubMed2005

Stress induced hypotension in pure autonomic failure.

A 47 year old woman with pure autonomic failure complained of dizziness during emotional stress. Emotional stimuli have not previously been reported to cause hypotension in patients with autonomic failure. In the patient, ambulatory blood pressure recording revealed severe hypotension (50/30 mm Hg) after a stressful event. During a tilt table test, hyperventilation was shown to cause a significant fall of blood pressure. This suggests that emotional stress can induce hypotension, probably through hyperventilation, in subjects with autonomic failure.

Autonomic Nervous System Diseases↗
PubMed2005

[Terms in use for transient loss of consciousness in the emergency ward; an inventory].

OBJECTIVE: To investigate the terminology for transient loss of consciousness in use in a Dutch emergency ward and to compare it with European definitions. DESIGN: Descriptive. METHOD: The records of all consecutive patients seen during an eight-week period in the Emergency Clinic of Leiden University Medical Centre, the Netherlands, were reviewed. Patients were enrolled in one of the following Dutch terms was encountered, expressing either a specific form or a general description of non-traumatic transient loss of consciousness (TLOC): 'collaps' (collapse), 'syncope' (syncope), 'flauwvallen' (fainting), 'wegraking' (TLOC) and 'insult' (seizure). The use of these terms was compared with the definitions of the European Society of Cardiology (ESC). RESULTS: The prevalence of a non-traumatic TLOC diagnosis in the Emergency Clinic was 2.9% (123/4300). 'Collaps' was the most frequently used term (53%), followed by 'insult' (31%), 'wegraking' (11%), 'flauwvallen' (3%) and 'syncope' (2%). The term 'collaps' was found to have been used in the context of the ESC category 'syncope' (n=47), TLOC (n=5), 'no TLOC' (n=9) or for situations that could not be classified (n=4). The term 'insult' was used exclusively in the context of epilepsy and the term 'syncope' exclusively in the context of the ESC category 'syncope'. The term 'wegraking' proved to have been used in the context of the ESC category 'TLOC' (n=11), 'epilepsy' (n=1) or for situations that could not be classified (n=1). 'Flauwvallen' was used in the context of the ESC category 'syncope' (n=3) or the category 'no TLOC' (n=1). CONCLUSION: It would be advisable to give the terms mentioned above a specific meaning: reserve 'collaps' for a fall without an obvious external cause, 'wegraking' for transient loss of consciousness without a clear cause, and 'syncope' for loss of consciousness due to temporary low cerebral blood flow.

Diagnosis, Differential↗
PubMed2005

An unexpected cause of a recurrent cerebral hemorrhage.

A 4-year-old previously healthy boy presented with a non-traumatic right parietal hemorrhage. A second life-threatening left cerebral hemorrhage occurred three weeks later and was decompressed with a craniotomy. Transthoracic echocardiography revealed a hypermobile elongated tumor of the mitral valve. The cardiac tumor was successfully resected three weeks after the craniotomy. Histological examination of the cardiac tumor revealed a papillary lesion of spindle cells with smooth muscle cell differentiation. In view of the histological findings and the clinical symptoms, a cellular myofibroblastic tumor was considered the most likely diagnosis in our patient. Although a cardiac tumor is a rare cause of a cerebral hemorrhage, a cardiac evaluation is recommended in pediatric patients with a cerebral hemorrhage of unknown etiology.

Cerebral Hemorrhage↗
PubMed1998

The outcome of prescribing novel anticonvulsants in an outpatient setting: factors affecting response to medication.

A survey of the prescription of the novel anticonvulsants lamotrigine, vigabatrin, gabapentin and topiramate was carried out in an outpatient setting to investigate the outcome of prescription and factors affecting response. One hundred and fifty randomly selected patient notes were analysed retrospectively. Drug continuation and seizure freedom were used as measures of response. Twenty-nine percent of patients had a brain lesion, 14% a psychiatric disorder, 7% neonatal seizures, 21% a family history of epilepsy and 15% a learning disability. On average at the moment of initiation of the novel anticonvulsant the patients had had a diagnosis of epilepsy for 18 years, were 33 years old, had 19 seizures per month and had previously used two drugs which failed to control their epilepsy. The first novel anticonvulsant was in 55% of cases lamotrigine, in 43% vigabatrin and in 1 % gabapentin. The overall percentage of patients who stayed on their first novel anticonvulsant was 55%, and 17% became seizure-free. No factors were found to influence the response in terms of drug continuation. For seizure freedom, the presence of a psychiatric disorder and partial seizures predicted a significantly poorer response. Length of seizure disorder, seizure frequency at initiation, the number of previously used failed drugs and the total number of drugs previously used were all significantly lower in the seizure-free group.

Acetates↗
PubMed1998

Distribution of muscle weakness of central and peripheral origin.

According to the established clinical tradition about the distribution of weakness, the ratios of flexor/extensor strength of patients with upper motor neuron lesions are expected to be relatively high for the elbow and wrist and low for the knee. To assess the diagnostic value of these patterns of weakness, muscle strength of 70 patients with limb weakness of central or peripheral origin was measured with a hand held dynamometer. The ratios of flexor/extensor strength at the knee, elbow, and wrist did not differ significantly between patients with central or peripheral origin of muscle weakness. The examination of tendon jerks proved to be of more value as a localising feature. The traditional notion about the distribution of weakness in upper motor neuron lesions may be explained by an intrinsically greater strength in antigravity muscles, together with the effects of hypertonia.

Adult↗