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Biomedical subjects

T J Murray

Publications and source records attributed to T J Murray.

17 recordsLinked to original sources
PubMed1992

A Canadian population survey on the clinical, epidemiologic and societal impact of migraine and tension-type headache.

Trained telephone interviewers contacted 1,573 adults across Canada about the nature and frequency of headaches suffered by them or by others in their households. Using a table of pain symptoms and other characteristics abstracted from the International Headache Society (IHS) classification, the headaches were assigned to migraine headache, tension-type headache or other diagnostic groups. Of the households sampled, 59% had at least one headache sufferer in residence. The proportion of headache sufferers with migraine was 14%; with tension-type, 36%; and with both, 14%. Migraine headache caused more disability than tension-type headache, with nearly 20% of migraine sufferers taking time off work and disability lasting for a mean of 1 day. It is concluded that the current prevalences of migraine and tension-type headache in Canada fall around the mean of previous studies, that the IHS criteria can form a basis for diagnostic classification and that the functional impact of migraine has been seriously underestimated in the past.

Adolescent↗
PubMed1979

Dr Samuel Johnson's movement disorder.

Dr Samuel Johnson was noted by his friends to have almost constant tics and gesticulations, which startled those who met him for the first time. He also made noises and whistling sounds; he made repeated sounds and words and irregular or blowing respiratory noises. Further, he often carried out pronounced compulsive acts, such as touching posts, measuring his footsteps on leaving a room, and performing peculiar complex gestures and steps before crossing a threshold. His symptoms of (a) involuntary muscle jerking movements and complex motor acts, (b) involuntary vocalisation, and (c) compulsive actions constitute the symptom complex of Gilles de la Tourette syndrome (Tourette's syndrome), from which Johnson suffered most of his life. This syndrome is of increasing interest recently because it responds to haloperidol, and because there are new insights into a possible biochemical basis for the tics, vocalisations, and compulsions.

Famous Persons↗
PubMed1979

Carotidynia: a cause of neck and face pain.

Carotidynia is a form of vascular neck are face pain in which the vascular change occurs in the carotid artery in the neck. The disorder is not uncommon, and most patients have a prior history of migraine. They present with pain in the neck and face, and are often thought to have a disorder such as chronic sinusitis or trigeminal neuralgia. Diagnosis can be made from the type and location of the pain and the finding of a tender and swollen carotid artery on the same side. Carotidynia responds to the prophylactic medications used for migraine, often disappearing in weeks or months. In some patients the syndrome may become recurrent or chronic, with a variable response to medication.

Carotid Artery Diseases↗
PubMed1978

Tourette's syndrome: a treatable tic.

Tourette's syndrome, or Gilles de la Tourette's disease, is a disorder characterized by involuntary tic-like muscular movements, compulsive behaviour and involuntary vocalization of sounds, words or profanities. It begins in childhood and may persist for life, with a varied pattern and course. Recent studies indicate an organic basis for the disorder, and an abnormality of dopamine or purine metabolism has been suggested. The treatment of choice is haloperidol administration; most patients do well with low or moderate doses for long periods. Because these patients are often mistakenly regarded as anxious, psychoneurotic or hysterical, correct diagnosis is important if they are to be treated appropriately and regarded properly in the home, school and society.

Butyrophenones↗
PubMed1978

Carbon monoxide poisoning from Sterno.

A high school student became ill and later unconscious while working over a heating table set over three cans of burning Sterno. Measurements of 1000 to 3000 parts per million of carbon monoxide were obtained around and above the apparatus. Although the room was well ventilated there was incomplete combustion of the canned heating fuel because the apparatus was surrounded by aluminum foil, which resulted in poor oxygenation of the flame area. This case demonstrates the hazards of carbon monoxide poisoning from incompletely burned Sterno.

Acute Disease↗
PubMed1977

Concepts in undergraduate neurological teaching.

Common neurological problems in family practice were determined to assess what knowledge of neurology is essential to the graduating medical student. The family practitioner's difficulties in managing these problems and needs for referral, were studied. Types of problems seen in a teaching hospital neurology service were also examined. Neurological problems are important if they are common, require therapy, or demand emergency management. However, dealing with these problems family practitioners report considerable difficulties. An approach to medical training is outlined in an effort to assist future physicians in handling the neurological problems of daily practice with competence and confidence.

Canada↗
PubMed1977

Visual acuity and contrast sensitivity in multiple sclerosis--hidden visual loss: an auxiliary diagnostic test.

In 48 patients with multiple sclerosis sine-wave gratings were used to test visual sensitivity for coarse, medium, and fine detail rather than measuring visual acuity for fine detail only, as in conventional clinical tests. In 20/48 patients the test revealed a visual defect of neural origin, qualitatively different from that caused by refractive error. In 11 of these 20 patients, visual sensitivity to detail of medium coarseness was markedly degraded, even though sensitivity to both coarse and fine detail was unimpaired. In 3 of these 20 patients visual sensitivity to coarse detail was selectively degraded. These visual defects could not be detected by the Snellen test, yet the patient might experience visual problems in everyday life and also experience distorted visual perception. Possible neural bases for these visual impairments are discussed. Since 8 of the 14 patients with selective loss showed no clinical evidence of visual involvement, the test can aid the earlier diagnosis of multiple sclerosis.

Adolescent↗
PubMed1977

Temporal arteritis.

Temporal arteritis (granulomatous inflammation) usually involves the temporal and ophthalmic arteries, but may be part of a more widespread inflammation of the medium and large vessels. The patient usually presents with an associated group of constitutional symptoms (fever, malaise, anorexia, weight loss, anemia) and rheumatic complaints (polymyalgia rheumatic complaints (polymyalgia rheumatica). The diagnosis should be considered in any patient over 55 years old in whom these symptoms develop or in whom there is evidence of recent onset of headache, visual loss of localized arterial involvement. The diagnosis is also to be considered when the erythrocyte sedimentation rate is over 50 mm/hr, and the presence of arteritis is confirmed by temporalartery biopsy findings. Visual loss may occur in 50 percent of affected patients; other serious complications are less common. A strong clinical suspicion of temporal arteritis will permit diagnosis of the more uncommon and atypical presentations of the syndrome. Although cases of temporal arteritis may be self-limited, treatment is imperative because of the threat of blindness. Patients respond well to steroid (prednisone) therapy, which should be maintained for a prolonged period.

Arteries↗
PubMed1977

Effect of body temperature on visual evoked potential delay and visual perception in multiple sclerosis.

Seven multiple sclerosis patients were cooled and four heated, but evoked potential delay changed in only five out 11 experiments. Control limits were set by cooling eight and heating four control subjects. One patient gave anomalous results in that although heating degraded perceptual delay and visual acuity, and depressed the sine wave grating MTF, double-flash resolution was improved. An explanation is proposed in terms of the pattern of axonal demyelination. The medium frequency flicker evoked potential test seems to be a less reliable means of monitoring the progress of demyelination in multiple sclerosis patients than is double-flash campimetry or perceptual delay campimetry, although in some situations the objectivity of the evoked potential test would be advantageous.

Body Temperature↗
PubMed1977

Haloperiodl in the treatment of stuttering.

Haloperidol treatment for stuttering was examined in a double-blind cross-over study of 26 adult volunteers with long-standing stuttering. Most had had unsuccessful speech and drug therapy. During the three-month study, their speech and stuttering patterns were repeatedly evaluated from videotaped readings of a standard passage and during spontaneous speaking. Of the 18 patients completing the trial 11 were significantly more improved on haloperidol than on placebo, three benefited equally from both, and four were unchanged. Improvement over placebo was indicated by fewer dysfluencies, increased speed of speaking, and reduced secondary "struggle" phenomena. Side effects were common on a dosage of 3 mg haloperidol daily. Poor concentration, akathisia and dystonic movements caused 8 patients to discontinue the trial despite significant improvement in 5 of them. Although "statistically significant" improvement occurred in most patients on haloperidol, the "clinical significance" of this form of therapy will be limited by the partial response, the need for continuous medication, the side effects of haloperidol and the attitude of stutters to this type of therapy.

Adolescent↗
PubMed1977

Relevance in undergraduate neurological teaching.

About 10% of patients consulting a family practitioner have neurological complaints, and about 2% ultimately receive a neurological diagnosis. As it is not possible to train enough neurologists for these patients, graduating medical students must be competent and confident in assessing neurological problems, particularly those that are common, treatable or require emergency management. An evaluation was made of the neurological problems commonly seen in family practice, the difficulties in managing neurological problems by the family practitioner and the criteria for referral to a neurologist. To evaluate the teaching of medical students and house staff, the types of problems seen in a teaching hospital neurology service were examined. As a result of this study an approach to the training of physicians is outlined to assist them to handle confidently and competently the neurological problems they will see in daily practice.

Canada↗
PubMed1976

Long-term therapy of essential tremor with propranolol.

In a double-blind crossover study 12 patients with essential tremor were treated with propranolol and a placebo; 8 improved with propranolol and 3 with the placebo; the degree of improvement with propranolol was greater. In a similar study with diazepam 5 of 12 improved with diazepam and 4 of 12 with the placebo; the degree of improvement was less than that achieved with propranolol. Response in 21 patients to treatment with propranolol for 2 to 4 years was excellent in 4, good in 4 and fair in 10; the condition of 1 was unchanged and that of 2, worse. Excellent response was maintained for as long as 4 years, but response tended to deteriorate with time if initially it was less than excellent. Response decreased with increasing age. No patient 60 years of age or older had an excellent response, and the four with an excellent response were under age 55, three being under age 35; all four had had their tremor less than 12 years. Patients with essential tremor should be given a 3-month trial of propranolol at 120 mg/d; if no significant response is seen the dose should be decreased, then the drug discontinued.

Adult↗
PubMed1976

An unusual occurrence of multiple sclerosis in a small rural community.

Ten patients with multiple sclerosis were found to have lived in close proximity in a Nova Scotia farming community of 150 people. All had drunk unpasteurized milk as children, were teetotallers, ate a high animal fat diet, and were well educated. Of greater interest was the observation that six of the ten cases were related in two family groups. The only time all patients lived in the community at the same time was in 1951 and 1952 during a polio outbreak. The relationship of polio to multiple sclerosis bears further study. The average age of the patients when they had measles was 11.8 years. Evidence suggests a link between risk of multiple sclerosis and both late onset of measles and pubertal age. Late onset of measles may be important in this cluster. Further epidemiological studies are needed to examine the age of onset of measles in M.S. cases.

Age Factors↗