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Biomedical subjects

S Khoshbin

Publications and source records attributed to S Khoshbin.

31 records · Page 2Linked to original sources
PubMed1987

Urodynamic assessment of children with cerebral palsy.

More than a third of the children with cerebral palsy present with dysfunctional voiding symptoms. Clinical evaluation and urodynamic study of cerebral palsy patients were performed to characterize the symptoms, to define the type of neurological deficit and to document its effect on voiding dynamics. We evaluated flow rate, and cystometrographic and external sphincter electromyographic findings in 57 children with cerebral palsy. Upper and lower motor neuron lesions were defined by standard criteria. Of the children 86 per cent had evidence of a pure upper motor neuron injury and 11 per cent manifested electromyographic findings suggestive of incomplete lower motor neuron sphincteric injury. The latter deficit could not be predicted on the basis of clinical neurological findings but it was suggested by a history of neonatal cyanosis. Treatment protocols achieved continence in more than 75 per cent of the children. The voiding dynamics in children with cerebral palsy have not been assessed previously. We have defined the lower urinary tract dysfunction in these patients, and provide a rational and effective plan of management.

Adolescent↗
PubMed1984

Predictive value of urodynamic evaluation in newborns with myelodysplasia.

We examined 36 infants with myelodysplasia, using excretory urography, voiding cystourethrography, and urodynamic assessment in the newborn period and periodically thereafter to determine those at risk for decompensation of the urinary tract. Urodynamic evaluation showed 18 with dyssynergia of the detrusor and external sphincter, nine with synergic activity of the sphincter, and nine with no activity of the sphincter. Thirteen (72%) of the group with dyssynergia had or later were found to have hydroureteronephrosis, while this was the case in only two (22%) with synergy and one (11%) with absent activity. The conditions of these 16 patients improved after decompression by cutaneous vesicostomy or intermittent catheterization. Infants with dyssynergia of the detrusor-external sphincter are at high risk for deterioration of the urinary tract; they should be followed up closely, and intermittent catheterization should be started early.

Child, Preschool↗
PubMed1984

Reflexes of the external urethral sphincter in children.

The electromyographic responses in the external urethral sphincter to electrical stimulation of the pudendal nerve and stretch of the external sphincter were analyzed in a pediatric population; the population included a group with recurrent urinary tract infections and a group with complete or almost complete upper spinal cord lesions. Electrical stimulation produced a response of reflex nature mediated in the sacral spinal cord, frequently beginning with two components that could be individually characterized and that behaved similarly to a flexor reflex. The response produced by stretch appeared to be similar to that produced by electrical stimulation.

Adolescent↗
PubMed1983

Evaluation and management of children with sacral agenesis.

Sacral agenesis is a rare congenital anomaly of the lower vertebral column which usually produces lower urinary tract dysfunction. Sixteen children with varying degrees of sacral agenesis and urinary symptoms were extensively evaluated. The neurologic lesion varied from no denervation to a complete loss of sacral motor and sensory function. The treatment instituted was individualized and based on specific urodynamic and radiologic findings. Overall, 12 of the 16 children (75%) achieved continence. Clues to the diagnosis including symptoms, physical findings, and the relationship to maternal diabetes are discussed.

Abnormalities, Multiple↗
PubMed1981

Multimodality evoked potentials and blink reflex in multiple sclerosis.

Thirty patients with definite multiple sclerosis and 50 patients in whom the diagnosis was suspected but not proved (indefinite multiple sclerosis) were studied with visual evoked potentials from each eye, somatosensory evoked potentials from each limb, brainstem auditory evoked potentials from each ear, and the blink reflex. The purpose was to organize a battery of clinically practical tests. The battery found 100% abnormality in the definite patients and 82% in the indefinite patients. Of the individual tests, somatosensory evoked potentials were most often abnormal: 86% in definite patients, 58% in indefinite patients, and 77% in asymptomatic definite patients. Visual evoked potentials were abnormal in 76%, 55%, and 40% of the same three categories. Brainstem auditory evoked potentials and the blink reflex were abnormal less often but contributed to the efficacy of the battery.

Adult↗
PubMed1980

Urinary undiversion in myelodysplasia: criteria for selection and predictive value of urodynamic evaluation.

Urinary undiversion was done in 15 children with myelodysplasia and ileal conduits. The process of evaluation and the criteria for selection are described. Neurologic and psychologic factors have an important role. Electromyography of the external urethral sphincter is helpful in predicting which children would be continent after undiversion and in managing the neurogenic bladder postoperatively. Over-all, a successful outcome has been achieved in two-thirds of the children chosen for undiversion.

Child↗
PubMed1980

A physiological mechanism of bradykinesia.

Patients with Parkinson's disease were asked to make ballistic elbow flexion movements of 10, 20 and 40 degrees. Normal subjects made all these movements in the same amount of time with a single 'triphasic' EMG pattern of successive bursts in biceps, triceps and biceps. Almost all the patients made some movements requiring additional cycles of alternating biceps and triceps activity. Most of the patients exhibited at least one example of a longer movement taking more cycles than a shorter movement. It is argued that this behaviour explains previous kinematic analyses of movement in patients with Parkinson's disease and represents a physiological mechanism of bradykinesia. In part on the basis of the data presented here, it is suggested that a normal role of the basal ganglia in movement is to energize the appropriate muscles required to make the movement.

Aged↗
PubMed1980

Urethral narrowing in region of external sphincter: radiologic-urodynamic correlations in boys with myelodysplasia.

Narrowing of the urethra in the region of the external sphincter as seen during voiding cystourethrography has routinely been termed sphincter spasm. This diagnosis was found to be incorrect in a significant percentage of boys with myelodysplasia. Thirty boys with myelodysplasia and dysfunction of the lower urinary tract, in whom voiding cystourethrography revealed narrowing in the area of the external sphincter, underwent urodynamic evaluation. Incoordination of the bladder and the sphincter (sphincter spasm) was found in only 16 (52%). In the other 14 (48%), there was either relaxation of the sphincter or absent electrical activity; atrophy and fibrosis of the striated muscle of the external sphincter (documented in six patients) probably resulted from chronic denervation. Thus, voiding cystourethrography only reveals narrowing of the urethra in the region of the external sphincter. However, when it is combined with urodynamic evaluation, the dynamics of the function of the sphincter can be defined and a rational approach to treatment planned.

Child↗
PubMed1980

The unstable bladder in childhood.

A comprehensive study of children with voiding dysfunction, which included careful documentation of voiding habits, thorough radiologic investigation, and urodynamic evaluation was undertaken. Proposed etiologic factors, indications for therapy, and results of treatment are discussed.

Adolescent↗
PubMedDate not supplied

MR imaging of paraneoplastic limbic encephalitis.

Paraneoplastic limbic encephalitis is a rare disorder that has been previously diagnosed on clinical and pathologic grounds without good radiologic correlation. We present the case of a 42-year-old woman who developed gradually progressive limbic dysfunction 4 years after undergoing mastectomy for breast cancer. Although CT scans were normal, magnetic resonance (MR) imaging showed signal abnormalities in the medial portions of both temporal lobes, the amygdaloid nuclei, and the hypothalamus. An MR-guided temporal lobe biopsy confirmed the presence of encephalitis.

Adult↗