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Biomedical subjects

S B Zachariah

Publications and source records attributed to S B Zachariah.

14 recordsLinked to original sources
PubMed1995

Gabapentin treatment of seizures in acute intermittent porphyria.

Most antiepileptic drugs (AEDs) available have demonstrated porphyrogenicity in hepatic porphyrias. Gabapentin is a new AED not appreciably metabolized by the liver in humans. We report two patients with acute intermittent porphyria successfully treated with gabapentin without its inducing porphyric crisis.

Acetates↗
PubMed1995

Carcinomatous meningitis: clinical manifestations and management.

Carcinomatous meningitis (CM) is a cause of significant morbidity and mortality in patients with cancer. During the past 15 years, diffuse leptomeningeal metastases of extracranial malignant tumors have been increasingly reported [Wasserstrom et al. 1982, Theodore and Gendelman 1981, Little et al. 1974, Olson et al. 1974, Yaphey et al. 1978, Sorensen et al. 1984], CM is increasing in frequency because of improved survival of patients with systemic anti neoplastic therapies and increased awareness of this problem among physicians. In this review, we will be discussing the epidemiology, etiology, pathology, pathophysiology, clinical manifestations, diagnosis and management of carcinomatous meningitis, as well as the status of recent basic and clinical investigations.

Carcinoma↗
PubMed1994

Positive response to oral divalproex sodium (Depakote) in patients with spasticity and pain.

Divalproex sodium (DVS; Depakote) is a commonly used antiepileptic agent that increases the levels of gamma aminobutyric acid. Spasticity from different causes may be due to a deficiency of inhibitory transmitters like gamma aminobutyric acid or an excess of excitatory neurotransmitters. Spasticity also may be accompanied by pain. The authors administered DVS orally for pain and spasticity in three patients with a history of spinal cord injury and one patient with a history of head injury. Three patients had marked improvement in spasticity and pain. One patient, who had some symptomatic improvement in spasticity, could not tolerate DVS because of gastric irritation. In contrast to the side effects of sedation and increased motor weakness associated with antispasticity drugs commonly used, no such side effects were detected with DVS. It is suggested that a possible enhancement by DVS of gamma aminobutyric acid-ergic postsynaptic inhibition of motor reflex arc in the spinal cord may represent a new nonsedating, management approach for spasticity as a result of traumatic spinal cord and head injuries.

Adult↗
PubMed1994

Case report: brain metastasis from primary small cell carcinoma of the prostate.

Primary small cell carcinoma of the prostate (SCCP) is rare. Natural history of this tumor is similar to that of bronchogenic small cell carcinoma. A majority of patients with SCCP have distant metastasis at presentation. Because the disease is rapidly fatal, the incidence of brain metastasis from SCCP is not known. A case of primary SCCP with multiple subcutaneous and lymph node metastases is presented. The patient failed to respond to systemic hormone therapy but had a near complete response to multiple agent chemotherapy consisting of cyclophosphamide, adriamycin, and vincristine. Multiple brain metastases subsequently developed, and he responded poorly to cranial irradiation. The clinical behavior of this cancer being similar to that of bronchogenic small cell carcinoma, it supports the recommendation of computerized axial tomography of the brain to be included in the staging workup of patients with SCCP. Prophylactic cranial irradiation might be of value in patients with a complete response to chemotherapy.

Aged↗
PubMed1994

Neuroimaging studies of cerebral "visceral larva migrans" syndrome.

"Visceral larva migrans" syndrome is a zoonotic disease caused by the migration or presence in human tissue of nematode larva from lower-order animals. This syndrome includes generalized illness, eosinophilia, and symptoms arising from larval invasions of different organs including the liver, lungs, eyes, and central nervous system. There has been only one case report of the computed tomographic (CT) and magnetic resonance imaging (MRI) appearances of cerebral toxocaral disease. Described here is a patient with cerebral toxocaral disease with a high eosinophil count and toxocaral titer in the serum and abnormal CT and MRI findings who had spontaneous recovery of the clinical symptoms.

Brain Diseases↗
PubMed1991

Stroke after heavy marijuana smoking.

I examined two young men who developed cerebral infarction associated with heavy marijuana smoking. Both were light tobacco smokers, but they did not drink alcohol or use other street drugs. Diagnostic work-up for nonatherosclerotic causes of stroke was unremarkable. I postulate that marijuana-associated alterations in systemic blood pressure resulted in vasospasm, leading to strokes in these patients.

Adult↗
PubMed1991

Pseudohypoparathyroidism and cerebrovascular disease with dural calcification.

A 53-year-old woman is reported with recurrent cerebrovascular disease, pseudohypoparathyroidism and dural calcification without basal ganglia calcification. She had typical clinical and laboratory features of pseudohypoparathyroidism and a family history of the condition. One case has been reported previously with pseudohypoparathyroidism and Parkinson's disease without basal ganglia calcification. Patients with widespread intracranial calcification should be evaluated for underlying abnormalities in calcium metabolism. Calcium supplementation and administration of vitamin D frequently correct the metabolic abnormality and halt clinical progression.

Brain↗
PubMed1989

Fatal pontine metastasis: clinical, CT, MRI and pathological correlates.

Progressive brainstem and cerebellar signs developed in a previously healthy 70-year-old man over a course of seven days. A pontine mass characterized by CT and MRI suggested an infiltrating primary pontine glioma. Gross postmortem examination showed a medullary-pontine hemorrhage. Microscopic analysis disclosed an undifferentiated large cell carcinoma which was found to originate from the lung. Differential diagnoses in cases of suspected brainstem lesions are given, including metastatic tumors which are rare when presenting as a solitary brainstem mass. Optimal patient management should be formulated on the basis of histopathological diagnosis rather than imprecise imaging data. Exact tissue diagnosis will also avoid an extensive and expensive search for an occult systemic cancer. The roles of radiation, chemotherapy and surgery are also discussed.

Aged↗
PubMed1988

Anabolic androgenic steroids and a stroke in an athlete: case report.

Use of anabolic androgenic steroids among athletes has grown at an alarming rate in recent years, despite the knowledge that their use has resulted in such side effects as severe depression of high-density lipoprotein levels, increased low-density lipoprotein/cholesterol levels, and hepatocellular carcinoma. We report here the case of a 34-year-old man whose hobby was body building, in the course of which he had been taking various anabolic androgenic agents for four years. Seventeen days before a scheduled body physique contest, he developed an acute right hemiparesis and experienced difficulty in speaking. In the emergency room he developed a simple partial seizure activity; an electroencephalogram showed abnormal slowing suggestive of left hemispheric structural lesion. After rehabilitation, he was able to ambulate independently; he had mild motor weakness in the right upper extremity with no sensory changes at discharge. Physicians working with athletes who use anabolic androgenic steroids should warn them of the risk of stroke.

Adult↗