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Biomedical subjects

R S Boyle

Publications and source records attributed to R S Boyle.

11 recordsLinked to original sources
PubMed1992

Severe botulism after eating home-preserved asparagus.

OBJECTIVE: To present a case of adult botulism acquired in Queensland. CLINICAL FEATURES: After eating home-preserved asparagus, a 33-year-old man presented with internal and external ophthalmoplegia, bilateral facial nerve palsies, and descending muscle weakness culminating in a sudden respiratory arrest. Electrophysiological testing demonstrated normal nerve conduction velocities and an incremental response of evoked motor potentials on repetitive stimulation, confirming the clinical diagnosis of botulism. INTERVENTION AND OUTCOME: Treatment with trivalent antitoxin, oral treatment with vancomycin and supportive mechanical ventilation for four weeks resulted in complete clinical recovery. Plasmapheresis was also used but its contribution to the patient's improvement is dubious. CONCLUSIONS: Although botulism is rare in Australia, clinicians should be aware of the clinical presentation and the rapidity of confirmation of the diagnosis by electrophysiological testing. Patients should be nursed in an intensive care setting. Regular testing of vital capacity should be performed to determine the need for mechanical ventilation.

Adult↗
PubMed1991

Status epilepticus.

Status epilepticus, especially the convulsive type, is a medical emergency. Initial treatments include clearing the airway and giving diazepam intravenously (preferably) or rectally. Clonazepam is equally effective. A loading dose of phenytoin should be given to maintain seizure control.

Humans↗
PubMed1990

Onset of dialysis encephalopathy in cyclosporine-treated renal allograft recipients.

Three patients who developed typical features of dialysis encephalopathy following renal transplantation are presented. No patient had evidence of overt neurological dysfunction pretransplantation. All patients were taking cyclosporine at the time of onset of neurological disease. Two patients died as a result of their neurological condition. The third patient made a satisfactory recovery. Factors responsible for the onset of dialysis encephalopathy in the renal posttransplantation period are discussed. We propose that cyclosporine may have been an important precipitating factor of the neurological syndrome of these patients.

Adult↗
PubMed1989

Paroxysmal cerebellar ataxia.

This report describes the clinical features of 13 cases of periodic, paroxysmal cerebellar ataxia. A family history suggestive of an autosomal dominant disorder was present in 10 cases, the first two reported Australian families involved with this disorder. Variation in the age of onset, frequency of attacks and the presence of distinct symptom complexes within one kindred confirm the heterogeneous nature of this disorder. CT head scans were performed on nine cases and were normal in eight. EEG findings were abnormal in six of nine performed. Treatment with acetazolamide resulted in abolition of paroxysms in nine of the 10 treated cases. In addition, two children had dramatic improvement in previously impaired gross and fine motor skills.

Acetazolamide↗
PubMed1989

Posterior cortical atrophy.

Two patients had a steadily progressive disorder of higher cortical function dominated by the early development of cortical visual deficits. In one, a right visual inattention progressed over a period of 2 years to a complete right homonymous hemianopia and relative left inferior quadrantanopia. In the second case, blind in the left eye for unrelated reasons, a temporal field loss was noted at presentation in the right eye, with the subsequent development of field loss in the inferior nasal quadrant on that side. Features of Balint's syndrome developed in both patients, with sticky fixation, ocular dysmetria and simultanagnosia. Prominent associated features were progressive dysmnesia, dyscalculia, ideomotor apraxia and spatial disorientation. Abstract reasoning, speech function and insight were all well preserved. MRI and CT scans revealed no focal abnormalities. These cases are similar to the 5 recently described by Benson et al. The pathological basis is unknown but may be an atypical form of Alzheimer's disease.

Atrophy↗
PubMed1989

Traumatic hypoglossal nerve palsy.

Isolated fracture through the atlanto-occipital region is not common and can easily be missed, clinically and radiologically. The long-term outlook from an isolated twelveth nerve palsy has been good in our experience of two cases.

Adult↗
PubMed1987

Language disorders in dementia of the Alzheimer type.

The language profile of a group of 18 Alzheimer patients is documented and their performance on a standard aphasia test battery compared to a group of institutionalized, nonneurologically impaired control subjects matched for age, sex, and educational level. The Alzheimer patients scored significantly lower than the controls in the areas of verbal expression, auditory comprehension, repetition, reading, and writing. Articulation abilities were the same in each group. A language deficit was evident in all Alzheimer patients. The language disorder exhibited resembled a transcortical sensory aphasia. Syntax and phonology remained relatively intact but semantic abilities were impaired. The results support the inclusion of a language deficit as a diagnostic criterion of Alzheimer's disease.

Aged↗
PubMed1979

Inverted knee jerk: a neglected localising sign in spinal cord disease.

Two cases are described in which inversion of the quadriceps jerk was observed. It is suggested that the finding of an inverted quadriceps jerk is evidence of a spinal cord lesion at 12, 3, 4 segmental level and has for the lumbar cord the same localising value as the inverted supinator jerk for the cervical cord.

Adult↗
PubMed1977

Herpes simplex encephalitis.

In this paper seven cases of severe viral encephalitis seen over a four year period at the Princes Alexandria Hospital, Brisbane, are presented. Four of these cases were proven cases of Herpes simplex encephalitis on the basis of viral culture, and three were probable cases of Herpes simplex encephalitis on the basis of rising serum antibody titres. A summary of the clinical aspects and laboratory investigations of the cases is followed by a brief discussion of the diagnostic and therapeutic problems of this condition.

Adolescent↗