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T Domzał

Publications and source records attributed to T Domzał.

At least 19 recordsLinked to original sources
PubMed1992

[Migraine--considerations on the achievements in medicine].

Migraine is among the most mysterious diseases. It has been known for centuries but as yet it has resisted the advances in medicine and has not revealed its aetiology, mechanism of headache and possibilities of treatment. Various theories on the pathogenesis of migraine and arguments for and against them are reviewed here. The most convincing hypothesis seems to be that which covers all the achievements in this field, that is the neuronal-vascular theory in which serotonin is given the role of the main biochemical factor. The diagnosis of migraine is easy if its history is known, but the first attack, especially if very severe, may be difficult to diagnose and should be differentiated from meningitis or intracranial haemorrhage. The modern imaging techniques confirm the development of transient ischaemia in the brain which can explain the aura and the post-attack manifestations. The treatment includes interruption of attack and prevention of further attacks. As long as the aetiology and pathogenesis of migraine remain not fully understood, the interruption of attacks seems to be the most adequate management and here new possibilities have been demonstrated connected with the discovery of serotonin receptors. Prophylactic treatment may be justified only in severe and frequent attacks and its effectiveness is temporary. In summary it may be stated that as yet only several unshakeable facts have been established in the aetiology and pathogenesis of migraine: heritability, serotonin, vascular system of the head, trigeminal nerve, cerebral centres of inexact location and factors provoking attacks. They all are forming a chain of relationships which remains in the realm of hypotheses.

Humans↗
PubMed1992

[The so-called stroke headache].

Sudden violent headache occurring for the first time in life suggests subarachnoid haemorrhage and requires diagnostic management. In 20 cases the authors failed to find blood in cerebrospinal fluid, but in 8 cases the protein level was raised. The patients were examined again after 2-10 years, and had control neurological examination and CT of the brain. In half the cases similar headaches returned after various time periods, and haemorrhage was again ruled out. In all patient chronic headaches of lower intensity developed. Control CT examination showed in 7 cases scars or atrophy of brain tissue. It is difficult to qualify such headaches as migraine and other known types of headache. Recently in the literature a new name has been coined for them--thunderclap headaches, and some authors regard them as a sign of minor intracranial haemorrhage. CT changes, raised protein level in cerebrospinal fluid, and the type of pain may suggest haemorrhage. The usefulness of cerebral arteriography in such patients should be considered. We propose the name of stoke headache for suggesting the cause and special management.

Brain↗
PubMed1989

[Clinical, CT and electrophysiologic studies of alcoholics with special reference to the cerebellum].

Comprehensive clinical examinations and laboratory investigations were carried out in 20 alcoholics (Group III according to Jellinek's classification) with particular reference to the cerebellum. Clinical cerebellar signs were found in 4 cases, and in 3 of them atrophic changes of the cerebellum and cerebrum were demonstrated in CT examinations, and in 3 electrophysiological changes compatible with neuropathy were found. Evoked auditory potential from the brainstem was changed in 12 cases, which might be explained as impairment of the cerebellar function. In 12 cases signs of polyneuropathy were disclosed, in 5 of them they were evident clinically and electrophysiologically, and in 7 they were found only in EMG. Changes in somatosensory and visual evoked potentials were less evident, but in connection with abnormalities in other investigations they suggested presence of diffuse or disseminated nervous system damage. These investigations suggest that cerebellar signs in alcoholics are not isolated and are a manifestation of a more generalized damage to the nervous system.

Adult↗
PubMed1982

[Plasmapheresis in the treatment of Guillain-Barre syndrome].

Plasmapheresis was used in the treatment of a 55-year-old man with serious Guillain-Barré polyneuropathy increasing in intensity despite treatment with steroids and azathioprine. The treatment was started in view of reports in the world literature suggesting that the method is effective in autoimmune diseases. A very good effect was obtained, the patient who had had quadriplegia and respiratory failure began to move about unaided. No complications were observed during this treatment. In severe Guillain-Barré syndrome plasmapheresis should be used after exhaustion of other therapeutic methods since it gives a probability of improvement.

Humans↗
PubMedDate not supplied

[Apomorphine in treatment of Parkinson's disease with fluctuations].

Apomorphine is a non-specific dopamine agonist, most similar to it, with a strong action on D2, D3, D4 receptors and weaker action on D1 and D5 receptors. It has been known since 100 years, and in Parkinson's disease it was used first in 1970 by Schwab and Cotzias. Apomorphine is used in Parkinson's disease with high-grade fluctuations of symptoms which cannot be controlled by oral drugs, especially in off" periods resistant to levodopa. After subcutaneous administration it changes the "off" to "on" period within 5-10 minutes. Unfortunately, its effect is short-lasting and wears off after 40-90 minutes. Apomorphine is administered in repeated single subcutaneous injections or in continuous subcutaneous infusion, if more than 7-9 single injections are required daily. Before beginning of treatment the optimal dose of apomorphine should be determined. For counteracting its emetic action domperidon (Motilium) is given additionally 20 mg t.d.s. Apomorphine produces no tolerance and is not losing its effectiveness with continued treatment. The most frequent adverse effects during long-term treatment are local cutaneous reactions, increased intensity of dyskinesia during the "on" period, visual hallucinations whose illusory character is clear to the patient, psychoses, orthostatic hypotension. The authors treated 8 patients with marked fluctuations in Parkinson's disease treated with levodopa. In 7 cases the effects was good--6 of them received 2-3 mg s.c. 3-4 times in 24 hours for 7-12 days. One patient has been treated 9 months with good result. In one case the intensity of dyskinesia made impossible treatment continuation.

Aged↗
PubMedDate not supplied

[Long-term steroid therapy in multiple sclerosis].

Corticosteroids have a firm place in the treatment of ms, but as yet no generally accepted regimen of this therapy exists. It is not known either, how to achieve the greatest effectiveness of these drugs and avoid side effects. Many clinicians advocate high intravenous doses of methylprednisolone in a short time of 5-7 days. This method is more effective and leads to less adverse effects. The studied patients received prednisone (Encorton Polfa) in short course of 3 days every month. The dose of Encorton in each course depended on the clinical condition but never exceeded 200 mg. The regimen was used in 18 patients who were followed up at least one year. Evident improvement or stabilization was obtained in 11 cases. No adverse effects were noted. These results are comparable to those achieved with methylprednisolone. It may be supposed that every regimen of corticoid treatment in ms is usefull if it causes no adverse effects. The treatment by method of long-term pulse therapy with corticoids is applicable in outpatients.

Adult↗
PubMedDate not supplied

[Botulin in the treatment of local dystonia].

Botulin A has been introduced for the treatment of local dystonia especially blepharospasm and torticollis. Three cases of blepharospasm and 5 cases of torticollis were treated with botulin injections directly into the muscles by a method presented in detail. Good effects were obtained in blepharospasm but very poor in torticollis, which may have been due to too low doses of the toxin and inadequate choice of injection points. The method is safe and in only 1 case transient weakness of the masseters was noted.

Adult↗
PubMedDate not supplied

[Cholinergizing treatment in hyperkinesis].

Hyperkineses are a clinical and pathogenetic counter-part of parkinsonism (MP). Their underlying cause is increased activity of the dopaminergic system or insufficiency of the cholinergic system. Treatment inhibiting the dopaminergic system, similarly as anticholinergic treatment is of little effectiveness in MP. A trial of substitutive treatment was undertaken activating the cholinergic system with a precursor of acetylcholine (dimethyl-amino-ethanol-deanol--Bimanol) with simultaneous inhibition of cholinesterase with prostigmin. The results of this treatment were compared with previously applied antidopaminergic treatment (Haloperidol) and with the effects of L-dopa. This treatment was given to 11 patients with Huntington's chorea (ChH), 4 with faciolingual dyskinesis (DFL), 3 with torticollis spasmodicus (TS), 3 with maladie des tics (MT) and 8 with dyskinesia following treatment with L-dopa (MP). Cholinergizing treatment gave better results than antidopaminergic treatment in TS and ChH, and worse in MT. In dyskinesia following L-dopa cholinergizing treatment gave also no effects reported by others. Differences in the results of cholinergizing and antidopaminergic treatment may indicate non-homogenous pathological mechanism of these hyperkineses. Cholinergizing treatment in hyperkineses is based on a similar principle as L-dopa treatment in MP and this approach seems to be proper but more effective preparations should be sought for.

Adult↗
PubMedDate not supplied

[Sleep disturbances in multi-infarction dementia and trials of treatment with caffeine].

Atherosclerotic cerebrovascular lesions leading to repeated ischaemic strokes produce a wealth of clinical symptoms and signs with dementia. Sleep disturbances are frequent and take the form of difficult falling asleep and shifting of the sleep/waking rhythm to late night and morning hours. Hypnotic drugs produce often a paradoxical effect with complete reversal of the circadian sleep rhythm. These observations gave the inspiration to a trial of reversed treatment: with administration of analeptics in the evening and sedative drugs during the day. Sixteen patients with this dementia and pronounced disability were treated by this method. Before the treatment they spent most time in bed, their age was 51-81 years, 9 were males and 7 females. In 10 cases a significant improvement was obtained with shifting of the sleep rhythm by 4 hours on average towards normal rhythm. Further studies would be necessary for explaining this effect.

Aged↗
PubMedDate not supplied

[Vertebrobasilar ischemia--clinico-radiologic correlations].

This term is used for describing disturbances of blood flow in the vertebral and basilar arteries due to atherosclerotic lesions causing stenosis or occlusion of these arteries. Clinical patterns of the resulting disturbances include transient symptoms, mainly vertigo, and stabilized syndromes with evidence of brain damage in this blood supply area. The purpose of the study was assessment of the blood flow in this vascular bed by means of dynamic computerized tomography (DCT) in relation to clinical signs, and a comparison of the results with those of similar DCT examinations in cases of circulatory disturbances in the carotid arteries. The study was carried out on 40 patients (20 with stabilized syndromes, 10 with transient disturbances and 10 with ischaemic episodes in the carotid artery supply. DCT abnormalities were found in 90% of patients with stabilized syndromes and in 40% of those with transient ischaemia. DCT may be an auxiliary diagnostic methods and may confirm the presence of vertebrobasilar circulatory failure. Normal result is not ruling out presence of changes in this arterial system.

Adult↗
PubMedDate not supplied

[Morphine epidural block in lumbosacral pain].

In 60 patients treated in hospital for discopathy the effectiveness of morphine epidural blockade was studied in the control of very strong pain. The patients were divided into 3 groups with 20 cases in each group. Group I received morphine 5 mg with 5 ml of 1% xylocaine. In group II and III the blockade was repeated giving by the double blind method either morphine with normal saline 5 ml followed by xylocaine as the second blockade (in 20 cases) or normal saline injected epidurally in 20 cases. The analgesic effect was assessed measuring the duration of analgesia. After morphine blockades the mean duration of analgesia was 20 hours, and the addition of xylocaine had no effect on it. Following xylocaine blockade the mean time of analgesia was 9.8 hours, and after normal saline injection it was 8.0 hours. The sensory phenomena experienced after morphine by most patients suggest that morphine exerts not only a local but also a central effect, while the similarity of the effects of xylocaine and normal saline suggests an analgesic effect independent of conduction block after epidural injection of these substances.

Adult↗