Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Aug 1998
Randomized Controlled Trial Clinical TrialRoutine follow up after head injury: a second randomised controlled trial.
To confirm that patients admitted to hospital with a head injury benefit from a routinely offered early intervention service. ⋯ The early interventions offered by a specialist service significantly reduced social morbidity and severity of post-concussion symptoms in trial group patients at six months after head injury. Recommendations about how specialist services should be targeted are made both in the light of these results and those from a previous randomised controlled trial.
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J. Neurol. Neurosurg. Psychiatr. · Aug 1998
Case Reports Multicenter Study Comparative StudyGuillain-Barré syndrome variants in Emilia-Romagna, Italy, 1992-3: incidence, clinical features, and prognosis. Emilia-Romagna Study Group on Clinical and Epidemiological Problems in Neurology.
To estimate the incidence rate of Guillain-Barré syndrome variants in an unselected population and to describe their clinical features and prognosis. ⋯ Guillain-Barré syndrome variants other than Miller Fisher syndrome, as obtained through a population based study, account for about 10% of total cases of Guillain-Barré syndrome and, as a whole, have a good prognosis. Their clinical features are heterogeneous; bifacial weakness (associated with other signs, mainly sensory disturbances) represents the most frequent finding.
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J. Neurol. Neurosurg. Psychiatr. · Aug 1998
Sleep and neuromuscular disease: bilevel positive airway pressure by nasal mask as a treatment for sleep disordered breathing in patients with neuromuscular disease.
Investigation of the therapeutic effects of bilevel positive airway pressure delivered by nasal mask in patients with neuromuscular disease. ⋯ Bilevel positive airway pressure delivered by nasal mask may be used successfully to treat sleep disordered breathing associated with neuromuscular disease. This device can be employed to assist nocturnal ventilation by either the spontaneous or timed mode. In the United States it is less expensive and easier to institute than volume controlled NIPPV and may be as efficacious as this mode if close surveillance and regular reevaluation of the patient's status is maintained.
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J. Neurol. Neurosurg. Psychiatr. · Aug 1998
Clinical TrialReversal of hypoaesthesia by nerve block, or placebo: a psychologically mediated sign in chronic pseudoneuropathic pain patients.
To gain understanding of the mechanism and meaning of improvement of hypoaesthesia after a diagnostic intervention, and of the nature of the population that displays such a sign. ⋯ Such reversal of hypoaesthesia is due to a placebo effect, acting on a psychogenic symptom because: (a) 27 of 27 patients in which the sign occurred had absence of nerve disease behind the "neuropathic" symptoms, (b) In 26 of 27 patients the area of hypoaesthesia was non-anatomical, (c) 16 of 27 patients had other sensory-motor signs that could not be explained as a result of organic pathology (give way weakness and punctual denial of hypoaesthesia), and (d) the phenomenon was not found in patients with organic neuropathy.
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J. Neurol. Neurosurg. Psychiatr. · Aug 1998
Case ReportsCarbon monoxide poisoning and treatment with hyperbaric oxygen in the subacute phase.
The use of normobaric versus hyperbaric (>2 atm) oxygen in the treatment of carbon monoxide intoxication continues to be a matter of debate despite reports of increased efficacy with hyperbaric oxygen. When hyperbaric oxygen is used, immediate treatment is preferred for best results. The therapeutic window of time, however, is unknown. ⋯ He was initially treated with normobaric oxygen and failed to show appreciable improvement. One month after carbon monoxide exposure the patient underwent treatment with hyperbaric oxygen and showed appreciable symptom relief confirmed by clinical findings and neuropsychological testing. This case shows that hyperbaric oxygen may be efficacious in the recovery of neuropsychiatric function up to 1 month after carbon monoxide induced brain injury.