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Biomedical subjects

W Poewe

Publications and source records attributed to W Poewe.

13 recordsLinked to original sources
PubMed1992

Magnetic resonance imaging and angiography in hemifacial spasm.

We used magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) to investigate 14 patients with unilateral hemifacial spasm (HS) and 20 controls. The relationship of the seventh and eighth cranial nerves to adjacent vessels was best visualized on the contiguous flow sensitive 3D-FISP images. Reconstruction of projectional MRA was helpful to assess the complex architecture of the vertebrobasilar system. Neurovascular contact in the facial nerve root exit zone was present in 4 of 20 controls and in 12 of 14 patients, in whom it predicted the affected side. These results support previous findings of surgical and electrophysiological investigations that local irritation of the facial nerve is the most possible explanation for HS. MRI and MRA provide vascular and brain tissue diagnosis in a single non-invasive examination and should be recommended as primary neuroradiological procedure in HS.

Aged↗
PubMed1992

Clinical and polymyographic investigation of spasmodic torticollis.

Polymyographic recordings were used to identify the most dystonic muscles suitable for local injection with botulinum toxin in 100 patients with spasmodic torticollis (TS). Rotating TS (72% of the patients) was due to dystonic activity of the splenius muscle ipsilateral to and/or the sternocleidomastoid muscle contralateral to the side of chin deviation. One-third of these patients had also dystonic activation of the contralateral splenius muscle and, rarely, the contralateral trapezius muscle. Ten patients had laterocollis due to dystonic activation of all recorded muscles on one side of the neck. Nine patients had retrocollis due to activity of both splenius muscles and rarely additional activity in both trapezius muscles. The type of dystonic muscle activity was found to be tonic, phasic or tremulous. Besides the evaluation of spontaneous dystonic EMG activity further examination during the "geste antagoniste" or the muscle activity during rotating head movements can provide additional information. It is concluded that polymyography may provide a rationale for identifying the dystonic muscles underlying the different forms of TS. It may prove to be helpful for the successful therapy with botulinum toxin and may be useful in differentiating tremulous torticollis from other types of head tremor.

Adolescent↗
PubMed1992

Treatment of spasmodic torticollis with local injections of botulinum toxin. One-year follow-up in 37 patients.

Thirty-seven patients with spasmodic torticollis (cervical dystonia) who received repeated local injections of botulinum toxin have been followed up for a mean period of 12.3 (10-29) months, during which time 138 treatment sessions were performed. Mean doses per muscle averaged 320 mouse units (mu; range 160-1000 mu botulinum toxin A prepared by CAMR, Porton Down, UK). Eighty-six per cent of patients experienced significant improvement of posture and 84% of those with pain had relief following the first injection. Muscular patterns of recurrent torticollis were relatively constant and in most patients efficacy was maintained with subsequent injections, while 15% of all follow-up sessions failed. Only 2 of 37 patients were consistent nonresponders; 22% and 10% of all sessions were complicated by transient dysphagia and weakness of neck muscles, respectively. It is concluded that local botulinum toxin injections can be a safe and efficaceous long-term treatment of spasmodic torticollis and that optimal doses should be between 200 and 400 mu/muscle.

Botulinum Toxins↗
PubMed1992

Comparative efficacy of two oral sustained-release preparations of L-dopa in fluctuating Parkinson's disease. Preliminary findings in 20 patients.

20 patients with Parkinson's disease and a fluctuating response to chronic treatment with conventional L-dopa preparations participated in an open randomized trial comparing two sustained-release L-dopa preparations (Madopar HBS, Sinemet CR4). While a majority (15 patients, 7 on Madopar HBS and 8 on Sinemet CR4) showed a favourable response after 2 months of slow-release L-dopa treatment the clinical benefit remained stable in only 2 patients on Madopar HBS and 3 patients on Sinemet CR4 over the entire follow-up period of 12 months. Reasons for treatment failure were increased peak-dose or biphasic dyskinesias or prolonged "off"-periods. This preliminary study failed to demonstrate clinically significant advantages of one slow-release principle over the other.

Benserazide↗
PubMed1992

[The determination of cerebral dopamine (D2) receptor density by using 123I-IBZM-SPECT in Parkinson disease patients].

An alteration of the dopaminergic nigrostriatal system is believed to be the main pathogenetic factor of Parkinson's disease (PD). We report on our initial results on the determination of the post-synaptic dopamine-D2-receptor binding of 123I-IBZM in patients with PD. Drug-native patients showed a significantly higher IBZM binding in the basal ganglia as compared to patients on specific dopaminergic medication. Age, duration of the disease and the severity of the disease do not seem to influence the IBZM-receptor binding. We conclude that 123I-IBZM-SPECT is an extremely useful tool for the evaluation of the functional state of cerebral dopamine-D2-receptors.

Aged↗
PubMed1992

Dystonia--a clinical, neuropathological and therapeutic review.

Dystonia is a syndrome characterized by sustained muscle contractions frequently causing twisting and repetitive movements or abnormal posture. For diagnosis, prognosis and therapy, it is useful to classify dystonia with regard to types of abnormal movements present, their mode of activation and topographical distribution taking into account age of onset, and etiology. The majority of cases are idiopathic, or primary dystonias, while in a minority environmental, structural, or metabolic causes can be identified. Primary dystonias can be familial or sporadic. The most important neurophysiological phenomenon in dystonia is pathological cocontraction of antagonistic muscles, while there is no consistent neuropathological abnormality in idiopathic dystonia. Causal therapies for dystonia are only possible in a few symptomatic forms (M. Wilson, Segawa-syndrome). As a rule, treatment has to be symptomatic but results of systemic pharmacotherapies remain disappointing. For adult onset focal dystonias, a breakthrough in symptomatic therapy has been achieved with local "chemical" denervation by means of botulinum toxin type A injections.

Adolescent↗
PubMed1991

High-speed memory scanning in Parkinson's disease: adverse effects of levodopa.

High-speed memory scanning as assessed by the Sternberg paradigm was studied in 12 nondemented patients with fluctuating Parkinson's disease and 13 age-matched healthy controls. Patients were first assessed before taking their morning dose of levodopa ("off") and again after that dose had produced full clinical effect ("on") after that dose had produced full clinical effect ("on"). Although motor components of the measured choice reaction time were slower in patients when off than in control subjects, memory scanning speed was not different. After levodopa (on), patients' motor time normalized, but cognitive processing speed became significantly slower when compared with previous performance in the off condition and with controls. Contrary to previous concepts of bradyphrenia in patients with Parkinson's disease, these results indicate that dopaminergic stimulation can reduce cognitive processing speed.

Frontal Lobe↗
PubMed1991

Memory dysfunction in Parkinson patients: an analysis of verbal learning processes.

The German version of the California verbal learning test (Münchner Gedächtnis-Test) was administered to compare memory functions of 45 Parkinson patients and 32 healthy controls. Although the Parkinson patients were within their age norm in their performance on standard intelligence and memory tests, a significant pattern of impaired learning was observed with the MGT. While learning capacity showed a linear increase, it was altogether lower than that of healthy normals. Parkinson patients have difficulty organizing new material and applying useful strategies. When offered useful cues, they can apply these for a while, but soon loose these strategies again. They are more irritated by distractors than healthy people. Once material is learned and stored, it hampers the learning of new material. Also, new information disturbs the reproduction of formerly acquired information.

Female↗
PubMed1990

Slowing of high-speed memory scanning in Parkinson's disease is related to the severity of parkinsonian motor symptoms.

High-speed memory scanning (Sternberg paradigm) was tested in a collective of 20 parkinsonian patients (10 newly diagnosed, untreated patients, duration of the disease 0.5-3.8, mean 1.5 years; 10 levodopa-treated patients, duration of the disease 4.2 to 11, mean 7.6 years). The levodopa-treated patients stopped taking levodopa before the test. There was a tendency towards retarded memory scanning in the patients' collective compared with 20 healthy controls with similar ages and verbal IQs (p = 0.076, Mann-Whitney U test). The mental slowing correlated significantly with bradykinesia and the sum-score of the Columbia University Parkinson Rating Scale (p = 0.021 and 0.019; Spearman rank correlation). Kruskal-Wallis ANOVA revealed a significant mental slowing in the subgroup of patients with Parkinson's disease for greater than 4 years compared with the newly diagnosed patients and the controls (H = 8.54; p = 0.019 and 0.006, Mann-Whitney U test). The findings suggest a mental slowing in Parkinson's disease, which is associated with the progression of parkinsonian motor symptoms and not with depression.

Aged↗
PubMed1978

Myotonic myopathy with painful muscle contractions and decrease of symptoms by cold.

Myotonic reaction and paresis accompanied by painful muscle contractions limited to the upper limbs, which decrease remarkably in the cold, were observed in a 29 year old man. The histological investigation revealed minimal non-specific signs of myopathy. The biochemical studies of muscular tissue contained a normal amount of myophosphorylase, acid maltase and glycogen. Ischemic work induced normal elevation of venous lactate. The activities of CPK, LDH and SGOT in the blood serum were occasionally increased. The EMG showed typical myotonic bursts and electrical silence during painful muscle contractions. Repetitive high frequency stimulation demonstrated a clear initial increase of the amplitude of action potentials followed by a decrease in the contracted muscle. The father of the patient suffered from dystrophia myotonica. This coincidnece suggests that this myotonic myopathy is a variant of dystrophia myotonica.

Cold Temperature↗