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R Lechtenberg

Publications and source records attributed to R Lechtenberg.

17 recordsLinked to original sources
PubMed1992

Total ethanol consumption as a seizure risk factor in alcoholics.

Population studies suggest that seizures occur in chronic alcoholics as an effect of ethanol withdrawal or ethanol toxicity. Our own studies of individuals undergoing inpatient alcohol detoxification revealed a correlation between the number of detoxifications conducted and the probability that the individual will have a seizure disorder. To establish the basis for this association we studied drinking histories, drug use, and related characteristics of 500 individuals, 83 of whom were women, who enrolled in an inpatient detoxification program. Discriminant analyses revealed a direct correlation between average daily alcohol consumption and the prevalence of seizures in the alcoholic individuals studied. This correlation was significant, but it was not as strong as that between seizure prevalence and the number of times an individual underwent inpatient detoxification. This data supports the hypothesis that seizures occur in alcoholics because of a long-term kindling effect of recurrent detoxifications and a more short-term effect of ethanol exposure.

Adult↗
PubMed1992

Franz Gall.

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Behavior↗
PubMed1991

Relative kindling effect of detoxification and non-detoxification admissions in alcoholics.

We reviewed the histories of 340 men and 60 women who were admitted for alcohol detoxification to determine if hospitalizations unrelated to detoxification increased the prevalence of seizures observed in these patients. Previous investigations on this cohort suggested that recurrent detoxification admissions increased the probability of seizure histories. Detoxification and non-detoxification hospitalizations were calculated from patient reports and chart reviews on patients admitted for alcohol detoxification. Discriminant analysis of each type of hospitalization and total hospitalizations for each sex revealed an increased risk of seizure activity correlating with non-detoxification hospitalizations, but the correlation was weaker than that observed for detoxification admissions and for total admissions. This correlation between hospitalizations and seizure prevalence supports the hypothesis that recurrent alcohol withdrawal may have a kindling effect.

Adult↗
PubMed1991

HTLV-I-associated myelopathy/tropical spastic paraparesis in the United States.

HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is endemic in the Caribbean basin and Japan. Because of the close proximity of the United States to the Caribbean and the presence of HTLV-I-seropositive persons in the United States, we sought reports of patients who were HTLV-I seropositive and had a slowly progressive myelopathy. Over a 2-year period, there were 25 patients reported, 19 of whom were black and 12 of whom had been born in the United States. All patients except two had become symptomatic while living in the United States. Six patients had no apparent risk factor for acquiring HTLV-I. These data demonstrate that HAM/TSP is occurring in the United States and that the diagnosis of HAM/TSP should be considered in patients with a slowly progressive myelopathy regardless of risk factors for acquiring HTLV-I.

Adult↗
PubMed1991

Effect of gender on neurologic findings in alcoholics.

We examined 340 men and 60 women admitted for alcohol detoxification to determine if there was a difference in the neurologic effects of alcohol on men and women with similar alcohol, drug, and medical histories. Focal neurologic deficits, seizure histories, and electroencephalographic abnormalities were assessed. Confounding factors, such as illicit drug use, head trauma, neurosurgery, and repeated detoxifications were monitored in both male and female populations. Our findings reveal no excess focal neurologic deficits in women compared to men. EEG recordings revealed more abnormalities in women than men, but there was no excess seizure activity reported for the women. For men, the prevalence of seizure histories is correlated with the number of inpatient detoxifications to which the patient submitted. For women, the correlation of seizure prevalence with detoxification admissions does not hold.

Adult↗
PubMed1990

Seizure risk with recurrent alcohol detoxification.

To determine if there is an increase in the risk of seizure activity when patients experience recurrent alcohol detoxifications, we reviewed the detoxification and seizure histories of 256 men and 45 women voluntarily admitted to a 5-day in-patient detoxification program. Structural brain damage, focal neurologic deficits, epileptogenic findings on electroencephalograms, and provocative drug use were all considered pertinent variables for seizure risk. Seizures did not occur during alcohol detoxification in any of the study patients, despite a high incidence of antecedent seizures and provocative drug use. Oral chlordiazepoxide use during detoxification was associated with the elimination of withdrawal seizures. Of all 301 patients, 64 had a history of seizures, 42 had significantly abnormal electroencephalograms during detoxification, and 30 had focal slowing on the electroencephalogram. There was no correlation between the duration of alcohol abuse or lifetime consumption of alcohol and seizure activity. There was, however, a significant correlation between the number of inpatient alcohol detoxifications and the prevalence of seizure disorders. This correlation held true even when provocative drug use was taken into consideration.

Electroencephalography↗
PubMed1990

AIDS in the brain.

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AIDS Dementia Complex↗
PubMed1984

The neurologic implications of tinnitus.

One hundred twenty-one patients with chronic tinnitus were examined for associated neurologic lesions. A routine otologic evaluation was supplemented by an extensive neurologic evaluation, which usually included computed tomography with special views of the posterior fossa. Twenty-one percent of these patients had neurologic disease that appeared to be responsible for the tinnitus. Twenty-three percent had neurologic problems associated with or evolving in concert with the tinnitus, but the auditory complaint could not be confidently ascribed to the CNS disease. Several patients had neurologic or psychiatric problems uncovered during the evaluation that were clearly unrelated to the auditory complaint. The high incidence of neurologic disease in association with tinnitus indicates that tinnitus is often an early sign of CNS disease. Chronic tinnitus justifies a rigorous neurologic evaluation of the affected person regardless of the character of the tinnitus.

Adult↗
PubMed1984

Psychologic adaptation of children to epilepsy in a parent.

A prospective study of the children in 12 families examined the impact of and adjustments to epilepsy in one of the parents. Young children allowed to see the parent's seizures and the treatment for those seizures adapted to the threat of illness in a parent by becoming involved in the care and supervision of the affected adult. Parents concealing the neurologic disorder from their children faced the most anger and resentment when the children discovered the epilepsy. Uncompromising and consistent disclosure of the problem to the children, regardless of their ages, by the parents allowed the children to adjust to the epilepsy while maintaining trust in and concern for both parents.

Adaptation, Psychological↗
PubMed1979

Listeria monocytogenes: brain abscess or meningoencephalitis?

A brain abscess caused by Listeria monocytogenes developed in an immunosuppressed renal transplant patient. Meningitis and meningoencephalitis from this organism were encountered in three other renal transplant recipients at this medical center during the past 4 years. Focal neurologic deficits occurred in patients with either Listeria abscess or meningoencephalitis. Computerized tomography was a rapid aid to the diagnosis of abscess. Immunosuppression has increased the incidence of central nervous system Listeria infections, but ampicillin still provides effective treatment, even when immunosuppressive therapy is continued. Limited experience with Listeria brain abscess suggests that surgical intervention improves the prognosis.

Adult↗
PubMed1978

Speech disorders in cerebellar disease.

The areas of cerebellar damage most commonly associated with dysarthria were sought by reviewing the clinical, radiographic, surgical, and autopsy findings in patients with nondegenerative cerebellar disease. Case histories on 162 patients with focal cerebellar lesions were reviewed. All but 15 of the patients underwent surgery, and 28 had autopsies. Thirty-one of the 122 patients with adequate descriptions of speech had dysarthria. Twenty-two of these 31 dysarthric patients had exclusively or predominantly left cerebellar hemisphere disease; 7 had right hemisphere disease; and 2 had vermal disease. Only 19 of 41 patients with exclusively or predominantly left hemisphere disease had had normal speech before surgery. Dysarthria developed in isolated cases following cerebellar resections extending into the paravermal segments of the left hemisphere. There was no correlation between the extent of vermal damage and development of abnormal speech. Cerebellar speech function was most commonly affected with damage to the superior portion of the left cerebellar hemisphere.

Adult↗
PubMed1977

Schistosomiasis of the spinal cord.

Four cases of spinal cord schistosomiasis were characterized by paraparesis, sensory loss, and sphincter disturbances progressing over hours to days. One patient showed deterioration over months and remission after laminectomy, followed by the typical, rapidly progressive deficits. Biopsies on two patients showed granulomatous and necrotizing myelitis. Spontaneous improvement and unremitting deterioration, despite chemotherapy, make evaluation of treatment difficult. A survey of all previously reported cases provided no consistent pattern of response to any treatment modalities. Laminectomy for decompression and diagnosis, administration of antischistosomal medications, and high-dose oral prednisone early in the illness are recommended.

Adult↗