Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · May 1988
Case ReportsThe clinical spectrum of ocular bobbing and ocular dipping.
The term "ocular bobbing" defines a distinctive class of abnormal spontaneous vertical eye movements which occur in a variety of clinicopathological settings. Four cardinal forms, which correspond to the predicted permutations of the two characteristic clinical variables, initial vertical excursion and phasic velocity, have now been described. ⋯ The four pathological forms share several basic phenomenological features but exhibit clinical and aetiological diversity and significant differences in prognosis. An analysis of the clinical spectrum of disorders subsumed under the general heading of "ocular bobbing" is presented.
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J. Neurol. Neurosurg. Psychiatr. · Apr 1988
Clinical Trial Controlled Clinical TrialPain intensity measurements in patients with acute pain receiving afferent stimulation.
Six different pain rating scales, including a "pain relief scale", were compared in 80 patients suffering acute orofacial pain. Pain intensity measurements were made before and after a 30 min period of afferent stimulation (TENS/vibration and placebo). ⋯ The verbal rating scale did not perform well. The pain relief scale and the numerical rating scale are interesting alternatives to the established visual analogue scale.
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J. Neurol. Neurosurg. Psychiatr. · Apr 1988
Enlargement of the third ventricle and hyponatraemia in aneurysmal subarachnoid haemorrhage.
Hyponatraemia following aneurysmal subarachnoid haemorrhage is associated with an increased risk of cerebral infarction. Whether the development of hyponatraemia was related to enlargement of the third ventricle on the admission CT scan was investigated in a consecutive series of 133 patients who were seen within 72 hours of aneurysmal haemorrhage. ⋯ The significant relationship between enlargement of the third ventricle and hyponatraemia remained after adjustment for the amount of cisternal blood, but not after adjustment for the amount of intraventricular blood. These results suggest that the size of the third ventricle is an important but not the only factor in the relationship between acute hydrocephalus and hyponatraemia in patients with aneurysmal subarachnoid haemorrhage.
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J. Neurol. Neurosurg. Psychiatr. · Mar 1988
Comparative Study Clinical Trial Controlled Clinical TrialPropranolol and propranolol-LA in essential tremor: a double blind comparative study.
In a double blind, comparative study with 15 patients, a long-acting formulation of propranolol taken once daily (at doses of 160, 240 and 320 mg), was shown to be as effective as conventional propranolol (80 mg three times daily) in reducing the amplitude of essential tremor. The specific protocol employed demonstrated problems inherent in chronic pharmacological trials in essential tremor which have implications for future studies.
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J. Neurol. Neurosurg. Psychiatr. · Mar 1988
Xanthochromia revisited: a re-evaluation of lumbar puncture and CT scanning in the diagnosis of subarachnoid haemorrhage.
The CT and cerebrospinal fluid (CSF) findings of 100 patients with ruptured intracranial aneurysms were reviewed. Forty six percent of the 68 patients who had a lumbar puncture had blood stained CSF but with no xanthochromia. ⋯ It is concluded that it is blood stained CSF that is important in the diagnosis of subarachnoid haemorrhage (SAH), and not xanthochromia, and that a normal CT scan (EMI 1010) and the absence of xanthochromia in the CSF do not exclude a ruptured intracranial aneurysm. To diagnose SAH, it may be necessary to perform both investigations; the CT scan as the primary investigation in those patients in whom lumbar puncture is judged to be hazardous; the lumbar puncture as the secondary investigation in those patients with a normal CT scan.