Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Oct 2003
Clinical TrialPlacing nasogastric tubes in stroke patients with dysphagia: efficiency and tolerability of the reflex placement.
Temporary dysphagia affects up to 50% of stroke patients in the acute stage of their illness and often necessitates tube feeding. In these patients, the placing of nasogastric tubes is often difficult or impossible. ⋯ A comparison of the cardiovascular responses to both methods in another 12 patients revealed significantly smaller increases in heart rate and systolic blood pressure during application of the new method. We therefore suggest the use of reflex placement in patients who have suffered a stroke and need tube feeding due to dysphagia.
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J. Neurol. Neurosurg. Psychiatr. · Oct 2003
Spinal dural arteriovenous fistulas: clinical features in 80 patients.
The aim of this study was to describe the clinical spectrum of spinal dural arteriovenous fistulas (SDAF) in a large group of patients. We studied the records of 80 patients who were diagnosed with an SDAF in six hospitals over a 15 year period (1985-2001). We extracted data on demographic variables, initial symptoms, symptoms at the time of diagnosis, level of SDAF, and medical history. ⋯ Fifteen patients (19%) had become wheelchair bound. SDAF is difficult to diagnose, and the delay between first symptoms and treatment is often long. In middle aged men who present with disturbances of gait with ascending motor and sensory deficits, and who subsequently report impaired voiding or other sphincter disturbance, SDAF is one of the first diagnoses that should spring to mind.
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Several lines of evidence suggest that the cerebellum may play a role in higher-order olfactory processing. In this study, we administered the University of Pennsylvania Smell Identification Test (UPSIT), a standardised test of olfactory function, to patients with ataxias primarily due to cerebellar pathology (spinocerebellar ataxias and related disorders) and to patients with Friedreich ataxia, an ataxia associated mainly with loss of afferent cerebellar pathways. ⋯ UPSIT scores did not correlate with disease duration, although they correlated marginally with ambulatory status in the patients with cerebellar pathology. This study suggests that olfactory dysfunction may be a subtle clinical component of degenerative ataxias, in concordance with the hypothesis that the cerebellum or its afferents plays some role in central olfactory processing.
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J. Neurol. Neurosurg. Psychiatr. · Oct 2003
Case ReportsBrain lesions in the course of generalised tetanus.
A 47-year-old woman developed left hemiparesis primarily affecting the lower limbs during the course of severe generalised tetanus. MRI on the 82nd hospital day revealed cortical and subcortical lesions predominantly in the right frontal and parietal lobes in addition to marked brain atrophy. Three months later, the enhancing lesions were still present on follow up MRI. We postulate that structures above brainstem may be involved in severe generalised tetanus.
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J. Neurol. Neurosurg. Psychiatr. · Oct 2003
A study of stereotypic behaviours in Alzheimer's disease and frontal and temporal variant frontotemporal dementia.
To document the prevalence and pattern of stereotypic behaviour in patients with Alzheimer's dementia and frontal and temporal variants of frontotemporal dementia. Secondly, to examine the relationship between stereotypic and other neuropsychiatric behaviours. ⋯ Complex stereotypic behaviours are a core feature of the dementing syndrome in FTD and may reflect early and specific deficits in orbitofrontal circuitry and basal ganglia involvement.