A mild chronic encephalopathy may be the most common neurologic symptom in patients with late stage Lyme disease. The symptoms tend to be diffuse and nonspecific, and patients typically report memory loss, sleep disturbance, fatigue, and depression. Among patients with these symptoms, it is generally felt that those with abnormal ...

The aim of the study was to evaluate the frequency and the kind of multiorgan damage in acute oral carbamates poisonings. Under analysis there were 36 carbamates orally poisoned patients treated at the Department of Clinical Toxicology in the years 1987-1997. Patients with the liver or biliary tract diseases, chronic ...

BACKGROUND: Neurologic and radiologic disorders have been reported in patients receiving long-term parenteral nutrition (PN). On the basis of elevated serum manganese levels, some of these abnormalities have been attributed to manganese intoxication. Alterations of the basal ganglia signal intensity on T1-weighted magnetic resonance images (MRIs) have been previously reported, ...

Cranial irradiation has been widely used in order to prevent central nervous system (CNS) relapse of acute lymphoblastic leukemia (ALL) in childhood. Owing to the risk of late side effects, the Nordic Society for Pediatric Hematology and Oncology (NOPHO) replaced CNS irradiation with systemic high-dose methotrexate (HDMTX) in 1992. A ...

Young homocystinuria patients suffering from lens dislocation frequently have to undergo eye surgery. We describe a 16-year-old girl with mild mental retardation who became psychotic-delirant immediately after the last of three lentectomia operations performed under general thiopental anaesthesia. Because methionine, homocysteine, its oxidation product homocysteate and cysteine are potent glutamate ...

Forty-four patients with cervical spondylotic myelopathy who underwent a ventral surgical approach were evaluated with respect to the results of surgery. The neurological status of the patients was categorized according to the modified Japanese Orthopedic Association scale (0-18). Three patients had a functional score of 8, one patient 9, five ...

Fourteen patients presenting with neuropsychiatric manifestations of Wilson's disease were treated with oral tetrathiomolybdate (TM) for 8 weeks followed by oral zinc (Zn) maintenance therapy. The patients were evaluated prospectively at baseline and at yearly intervals for up to 5 years by slit-lamp biomicroscopy and photography, quantitative neurologic and speech ...

To determine the prevalence of cerebrospinal fluid abnormalities in Southeast Asian refugees with reactive serologic tests for syphilis, we evaluated 65 patients, 36 prospectively and 29 retrospectively, in a primary care clinic. Information was collected on history of treponemal infections, neurologic symptoms and signs, and total protein concentration, leukocyte count, ...

With the push to get patients through the system in five days, most patients undergoing nonemergency coronary artery bypass grafting (CABG) are being "fast-tracked'. Using this anaesthetic regimen appears to keep patients less anaesthetized (light) during cardiopulmonary bypass (CPB) than when using our previous regimen. This is manifested by higher ...

This hospital based study was carried out on 185 adult patients of cerebral malaria. Out of 185 patients, 62 (33.5%) died and 123 (66.5%) survived. Neurological sequelae were present in 13 (10.5%) of 123 survivors at the time of discharge (i.e. 10-15 days after recovery from coma) from the hospital. ...

OBJECTIVE: To test the efficacy and toxic effects of ammonium tetrathiomolybdate in the initial treatment of a relatively large series of patients with neurologic symptoms and signs caused by Wilson disease. Two key aspects of efficacy are to preserve the neurologic function present at the onset of therapy and to ...

We retrospectively studied a consecutive series of 100 patients with acute leukemia and aspergillosis to evaluate the clinical findings and risk factors for colonization of the central nervous system (CNS) by Aspergillus species. The diagnosis of CNS aspergillosis was made in 14 patients on the basis of the following criteria: ...

Recent studies suggest the occurrence of a neurological dysfunction in Obsessive-Compulsive Disorder (OCD). The purpose of the present study was to verify the clinical value of a neurological evaluation in patients with the disease. We submitted 15 patients with OCD (five of whom were under clomipramine) and 15 controls in ...

Intravenous immune globulin (IVIg) is advocated as a safe treatment for immune-mediated neurologic disease. We reviewed the medical records of 88 patients who were given IVIg for a neurologic illness. Major complications in four patients (4.5%) included congestive heart failure in a patient with polymyositis, hypotension after a recent myocardial ...

Unstable fractures of the pelvic ring are an increasingly frequent outcome of motor vehicle trauma. Neurologic injury after such injuries can be a cause of significant morbidity. The available literature on neurologic injuries was reviewed and compared with a clinical review of 90 unstable pelvic injuries treated during a 3-year ...

Seven patients with hemolytic-uremic syndrome who had major neurological symptoms during the acute illness were neurologically and cognitively evaluated prospectively several years after recovery from the illness. Four patients showed evidence of subtle neurological sequelae, including posturing, clumsiness, poor fine-motor coordination, hyperactivity, and distractibility. Psychoeducational evaluation of all seven subjects ...

BACKGROUND: Neuroblastoma is the most common malignant cause of spinal compression in the pediatric population. More than 30% of patients who are impaired prior to treatment remain impaired after the completion of therapy. Those who do not improve after decompressive laminectomy may go on to develop severe delayed spinal deformities. ...

Neurological complications are a recognized but unusual manifestation of celiac disease. We present here our experiences with four current cases. Age of patients at presentation with neurological signs varied from 7 to 67 yr. In one patient, the neurological disability developed before the diagnosis of celiac disease, whereas, in the ...

The intellectual, neurological, and neuropsychological outcome of patients with non-phenylketonuric-hyperphenylalaninaemia (PKU-HPA) (serum phenylalanine levels under free diet < 600 mumol/l) has not been systematically studied so far. We therefore tested 28 patients (mean age = 21.8, SD = 4.2 years) for IQ (WAIS-R/WISC-R), school performance, job career, clinical neurological examination, ...

Cumulative trauma disorders plague industry, yet definite diagnostic criteria and treatment guidelines have not been established. This study is a review of a group of 470 worker's compensation patients with upper-extremity pain. Eighty-four of these patients had neurologic symptoms that were related to repetitive activities, rather than a specific pain-producing ...

PURPOSE: To evaluate the effect of aging and cerebrovascular diseases on T2 shortening in the motor cortex at magnetic resonance (MR) imaging. MATERIALS AND METHODS: High-field-strength (1.5-T) MR images of 298 neurologically normal patients (157 male patients, 141 female patients; age range, 2-86 years) and 107 patients with cerebrovascular diseases ...

STUDY OBJECTIVE: To test the hypothesis that neuropsychologic test results and functional outcome will be abnormal if hyperbaric oxygen (HBO) is not used in patients with severe carbon monoxide (CO) poisoning. METHODS: For a 1-year interval, we retrospectively identified all CO-poisoned patients who were comatose on presentation at a large, ...

Five patients survived acute paraquat ingestion, despite developing restrictive pulmonary dysfunction. Of these, 2 patients with documented long-term follow-up had progressive functional improvement. A literature review revealed 29 other patients surviving restrictive pulmonary dysfunction following acute paraquat poisoning. Some patients who survive an acute paraquat poisoning may develop pulmonary fibrosis, ...

Three hundred forty patients were diagnosed with pertussis infection at the Pediatric Clinic of the University of Catania, Sicily during the period 1979-1994. None of these patients had been previously vaccinated. Fourteen developed neurological complications at some point in their course, which took the form of seizures (both febrile and ...

A 33-year-old male patient was admitted to our hospital because of progressive gait disturbance and involuntary movement of the neck. He showed choroideremia, distal motor neuropathy, and leukoencephalopathy on T2-weighted brain magnetic resonance imaging (MRI). Choroideremia is a rare X-linked, progressive, degenerative disease of retina and choroid. There have been ...

The results of a neurological, neuropsychological and MRI study of the brain in 21 patients (aged 18-59 years) with Sneddon's syndrome are reported. The predominant findings were marked neuropsychological deficits in two-thirds of the patients. While sensorimotor deficits after stroke in these patients had a good prognosis, neuropsychological deficits persisted. ...

We studied the relationship of regional cerebral glucose consumption (rCMRGlc) and striatal dopamine D2 receptor binding as assessed with positron emission tomography (PET) with the structural abnormalities of the brain in magnetic resonance images (MR), and the degree of neurological impairment in 18 patients with Wilson's disease (WD). The rCMRGlc ...

Twenty-four untreated adolescent and adult patients with non-phenylketonuria (PKU) hyperphenylalaninaemia (HPA) (serum phenylalanine levels < 600 mumol l-1) and 24 healthy controls matched for age, sex and IQ were investigated for their neurological outcome, especially for fine motor abilities by the Motor Performance Task. No pathological findings could be revealed ...

Degos' disease, a rare multisystem vasculopathy of unknown etiology, only occasionally involves the nervous system. We report the Mayo Clinic experience of the neurologic features of Degos' disease in a series of 15 patients. All 15 patients had the typical skin lesions of Degos' disease, confirmed by skin biopsy. Ten ...

OBJECTIVE: To determine the clinical presenting signs and symptoms in presumed overdoses of sertraline, a recently approved antidepressant. METHODS: A prospective study involving five western regional poison control centers was performed to evaluate the clinical manifestations of presumed sertraline ingestions (overdoses). Information about calls pertaining to sertraline ingestions was recorded ...

Twenty Behcet's disease (BD) patients with or without neurologic signs and symptoms were studied by means of magnetic transcranial stimulation. The most frequent abnormalities were an increase of motor evoked potential latency and a delay of central motor conduction time (CMCT). In 5 out of 9 BD patients with pyramidal ...

We examined the relationship between length of the trinucleotide (CAG) repeat at IT-15 and clinical progression of Huntington's disease in 46 mildly to moderately affected patients over a 2-year interval. Patients were divided into those with short mutations (37 to 46 repeats; n = 25) and those with long mutations ...

Quail poisoning is known to produce an acute myoglobinuric syndrome. The cause of this syndrome is still unknown. It has been suggested that a toxic effect or a genetic sensitivity plays a major role. Ten patients with a history of quail poisoning were examined to determine their present state and ...

The objective of this study was to evaluate whether mild neurological symptoms suggestive of neuropsychiatric involvement may be associated with cerebral perfusion defects as detected by functional brain imaging with 99m-Tc-HMPAO-SPECT (single photon emission computed tomography). SPECT analysis for the early detection of central nervous system (CNS) involvement was evaluated ...

Forty-eight previously untreated, ambulatory patients with advanced or unresectable renal carcinoma were treated with either amonafide (17 patients), caracemide (17 patients), or homoharringtonine (14 patients). No objective responses were observed in any of the treatment cohorts. Amonafide and caracemide were well tolerated with no unexpected toxicities. One patient each died ...

Distilled spirits are the major source of ethanol consumption in Poland. Such concentrated alcohol is drunk quickly, especially in teenager groups who consider consumption of 250 or 500 ml of vodka during one hour or one hour and half as quite normal. For two years the New Years Eve party ...

Undiagnosed and untreated odontoid fractures are relatively common in developing countries where treatment for minor injuries is not considered. As a result, patients frequently present with neurological deterioration secondary to delayed odontoid dislocation. Fifty-one consecutive patients with this problem were entered into a management protocol and reviewed for this report. ...

STUDY DESIGN: This was a retrospective prevalence study. OBJECTIVE: A review of structural cervical spine injuries (fracture or dislocation) treated at a regional spine injury referral center from 1987 to 1992 was undertaken to identify and analyze patients who had secondary neurologic deterioration after they had arrived and had primary ...

We reviewed the results of 68 consecutive Fontan procedures from 1978 to 1993 to determine the frequency of late central neurologic complications of the Fontan procedure in patients living at a mean altitude of 4500 feet. Two surviving patients had transient neurologic symptoms or signs with no corresponding evidence of ...

We describe two patients who developed neurological side effects as part of the spectrum of nitritoid reactions. Both reactions occurred late in the course of treatment. The first patient developed mild nitritoid symptoms and pain in a band-like distribution, corresponding to T10-T12 dermatomes, shortly after gold sodium thiomalate (GSTM) injection. ...

In this case-series analysis, of 34 patients originally identified with eosinophilia-myalgia syndrome (EMS), 31 survivors were followed-up by yearly telephone interviews. We ascertained type, duration, and severity of symptoms and whether certain patient characteristics were associated with illness improvement. At a median of 3.6 years after onset, 3 patients (8.8%) ...

Neuropsychiatric syndromes occur in about 40% of Cbl-deficient patients and are characterized by progressive and variable damage to the spinal cord, peripheral nerves and cerebrum. The first abnormality is usually sensory impairment, most often presenting as distal and symmetrical paraesthesiae of the lower limbs and frequently associated with ataxia. Almost ...

Over the past ten years, we have cared for 13 patients who suffered serious neurologic complications after being struck by lightning. The spectrum of neurologic lesions includes the entire neuraxis from the cerebral hemispheres to the peripheral nerves. We describe these various neurologic disorders with regard to the site of ...

Gadodiamide injection, a new nonionic, MRI contrast medium, was compared with the ionic agent gadolinium (Gd)-DTPA at 0.1 mmol/kg body weight in a double-blind, randomised trial in 60 patients, 30 receiving each substance, with known or suspected lesions of the central nervous system. The patients were closely questioned about adverse ...

An anxious patient may experience an uncontrollable increase in ventilatory effort, far in excess of the body's metabolic needs, to such a degree that profound changes are induced in the cardiovascular and neurological systems. This abnormal drive to breathe rapidly leads to a reduction in the tension of carbon dioxide ...

Five cases of transcobalamin II deficiency presenting to our institution were reviewed. A delay in diagnosis often led to acute deterioration. Two patients have long term neurological sequelae. Minimal treatment in these patients may be dangerous. While haematological normality may be maintained, the adequate therapeutic dose of vitamin B-12 to ...

A rare case of suicidal strychnine poisoning that resolved naturally without treatment is presented. The patient first complained of chest pain, which was originally thought to be caused by a dissecting aneurysm; however, nystagmus, dysesthesia, spastic paraplesia, and hyperreactivity to stimuli shortly developed. Diagnosis was difficult because the patient did ...

In this retrospective study, we determined the clinical value of screening for paracetamol in 294 Chinese patients with acute poisoning presenting to the general medical wards at the Prince of Wales Hospital between January 1992 and June 1993. Of the 86 patients suspected of having ingested paracetamol, eight had levels ...

Eight-hundred eleven case records of patients with hemorrhagic fever with renal syndrome (HFRS) caused by Puumala virus were reviewed, and particular attention was given to data regarding severe neurological manifestations. The most common symptoms were headache (97%), blurred vision (40%), and vomiting (31%); 27% of the patients had all three. ...

Between March 1989 and December 1993, 101 patients with inoperable arteriovenous malformations (AVMs) and seven patients with inoperable angiographically occult malformations (AOVMs) have been treated with stereotactic multiple arc radiotherapy (SMART). All patients (excluding one patient with a brain stem AOVM) were treated with a uniform dose of 1750 cGy ...