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Biomedical subjects

R M Trosch

Publications and source records attributed to R M Trosch.

7 recordsLinked to original sources
PubMed1998

Clozapine use in Parkinson's disease: a retrospective analysis of a large multicentered clinical experience.

We conducted a multicentered, retrospective review of clozapine's (CZP) effects on a range of psychiatric, sleep, cognitive, motor, and sensory disorders in Parkinson's disease (PD). Therapeutic outcomes and adverse events were compared with varying prescribing practices at participating sites. The medical records of 172 consecutive PD patients treated with CZP at four movement disorder clinics were reviewed. Low-dose CZP improved psychiatric symptoms of psychosis, anxiety, depression, hypersexuality, sleep disturbance, and akathisia. Tremor, torticollis, limb dystonia, and pain showed modest rates of improvement. Twenty-three percent of patients withdrew as a result of adverse events or treatment failure. Inpatient CZP initiation did not improve therapeutic efficacy, or reduce adverse events or the withdrawal rate. Low-dose CZP in the outpatient setting is generally an effective and well-tolerated treatment for many of the psychiatric, sleep, motor, and sensory disturbances common to late-stage PD.

Aged↗
PubMed1997

Idiosyncratic adverse reactions to intramuscular botulinum toxin type A injection.

Three cases of adverse reactions to repeated intramuscular botulinum toxin A (BTA) injections are described: a persistent rash on the face at the site of injection, a localized anaphylactic reaction following BTA injection into one leg, and bilateral ptosis repeatedly following BTA injection into neck muscles. The mechanisms for these idiosyncratic adverse responses are not known.

Adult↗
PubMed1994

Botulinum toxin A injections for the treatment of hand tremors.

We conducted an open-label study to determine the utility of treating severe hand tremors with intramuscular injections of botulinum toxin (BTX) in forearm and arm muscles in 26 patients, 12 with Parkinson's disease (PD) and 14 with essential tremor (ET). The effect after 6 weeks for each patient was evaluated using two clinical rating scales, subjective evaluations of functional improvement and global disability, measures of weakness, and computer-assisted quantitative assessments of tremor. Although none of the clinical scores averaged > 3/4 point change, statistical significance was found on comparison of pre- and postinjection scores in the Webster Tremor and Global Disability Scales in the ET patients. Similarly, although average tremor amplitudes decreased by no more than 25% by quantitative analysis, amplitude decrease significantly correlated with patient subjective assessment in ET. In only two of 12 PD (17%) and three of 14 ET patients (21%) were major quantitative changes in tremor amplitude (> 50% reduction) found after BTX injections. Nevertheless, 10 patients (38%; five PD and five ET) reported moderate to marked subjective improvement in functional benefit after BTX. These findings suggest that although there were no major changes in clinical ratings or objective measurements, BTX injections may subjectively improve tremor in some patients, particularly those with ET.

Aged↗
PubMed1990

Emotional facial paresis with striatocapsular infarction.

Emotional facial paresis (EFP) refers to hemifacial paresis of emotionally evoked or spontaneous smiling or weeping with preserved volitional movements of the face. The anatomical location for this phenomenon has been controversial. We report a 15-year-old boy with EFP. Follow-up MRI demonstrated infarction limited to the head of the caudate, putamen and anterior limb of the internal capsule on the contralateral side. This case lends support for selective damage at a striatal or capsular site in the production of EFP.

Adolescent↗
PubMed1990

Levodopa-responsive parkinsonism following central herniation due to bilateral subdural hematomas.

A 66-year-old man suffered bilateral subdural hematomas progressing to central herniation, despite repeated surgical evacuations. This eventually resolved, leaving him with a severe parkinsonian syndrome that was responsive to levodopa. MRI and CT showed midbrain compression from central herniation, and a follow-up MRI revealed thinning of the pars compacta. The clinical and radiologic evidence suggested that midbrain compression from central herniation was the probable cause of parkinsonism in this patient.

Aged↗
PubMed1977

[Cryosurgical treatment of malignant tumors in the cerebral hemispheres].

In 35 patients with deep-lying and medial gliomas (25 cases of glioblastoma multiforma, 10 cases of dedifferentiated astrocytoma), stereotactic cryodestructions were performed after preceding biopsies. Diagnosis was made in the usual manner, mainly by means of angiography. Sites of action were the tumour mass proper and the blood supply zones. In some cases, partial removal of the tumour was carried out in the usual way before or after cryodestruction. There are 3 kinds of further development after cryodestruction: regression, slow progression and rapid progression. Progression was found in 14 patients; 9 patients died within 2 weeks after the operation. In their cases, cryodestruction was by far insufficient. Dedifferentiated astrocytomas showed more a regressive behaviour than multiform glioblastomas. The possibility of local chemotherapy was also utilised.

Astrocytoma↗