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S Sergay

Publications and source records attributed to S Sergay.

4 recordsLinked to original sources

Open-label dose-titration safety and efficacy study of tizanidine hydrochloride in the treatment of spasticity associated with chronic stroke.

BACKGROUND AND PURPOSE: Spasticity is a frequently observed motor impairment that develops after stroke; it can cause pain and disability in those affected. The objective of the present study was to evaluate the safety and efficacy of tizanidine, a centrally acting alpha(2)-adrenergic agonist, in the treatment of stroke-related spasticity. METHODS: Forty-seven patients, who were a minimum of 6 months poststroke and had significant spasticity, were studied at 4 centers. Tizanidine was administered in an open-label manner for 16 weeks, beginning at 2 mg/d and slowly titrated to a maximum of 36 mg/d. The Modified Ashworth Scale, muscle strength testing, functional assessments, and Pain and Functional Spasticity Questionnaires were administered at baseline and at 4, 8, 16, and 18 weeks (after 1 week off tizanidine). RESULTS: Spasticity was significantly improved between baseline and week 16, with a decrease in total upper extremity Modified Ashworth Scale score of 2.80+/-0.47 (P<0.0001). No decline in strength was noted. Treatment with tizanidine resulted in a significant improvement in pain intensity (P=0.0375), quality of life (P=0.0001), and physician assessment of disability (P=0.0001). The most frequent side effects were somnolence (62%) and dizziness (32%). No serious adverse events were considered to be drug related. Ten of 47 patients (21%) were able to reach the maximum daily dosage of 36 mg. CONCLUSIONS: Overall, the data suggest that tizanidine is safe and efficacious in the treatment of stroke-related spasticity, preserving muscle strength while reducing muscle tone and painful spasms in affected patients.

Clonidine↗

Somatosensory evoked potential monitoring in the surgical management of acute acetabular fractures.

Fifty patients undergoing acute acetabular fracture surgery had intraoperative somatosensory evoked potential (SSEP) monitoring. Group II, the final 38 patients, in addition had independent neurological evaluation preoperatively and postoperatively. Thirteen of 50 patients (26%) had preoperative sciatic nerve involvement. Fourteen of 50 patients (28%) developed significant intraoperative SSEP changes (decreased amplitude, increased latency). When the nerve was involved preoperatively (high-risk group), changes in SSEP occurred in 60% of patients. Iatrogenic sciatic/peroneal neuropraxia occurred in only one patient in the series (2%), and this resolved within 4 months. These results compare favorably to the incidence of 5-18% reported in the literature. We conclude SSEP is feasible and should be used in the operative treatment of acetabular fractures, especially the posterior fracture patterns and for those in the high-risk group.

Acetabulum↗

Positional cerebral ischaemia.

Four patients are described in whom recurrent, dramatic transient clinical worsening accompanied elevation from the supine toward the sitting position, though postural hypotension was not present. In each patient occlusive cerebrovascular disease was documented angiographically. During an acute stroke syndrome, some patients' compensatory capacity may be so tenuous that postural changes may produce clinical worsening. Possible mechanisms are discussed.

Aged↗