Arch Neurol Chicago
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Arch Neurol Chicago · Jan 1978
The clinical significance of spontaneous pulsations of the retinal vein.
A search for spontaneous retinal venous pulsations was carried out in 218 subjects. Spontaneous venous pulsations were present in 87.6% of 146 unselected subjects 20 to 90 years of age and absent in 100% of 33 patients with raised intracranial pressure without papilledema and ten patients with papilledema. ⋯ Some normal subjects with absent pulsations showed definite pulsations on subsequent examinations. These findings confirm that the presence of spontaneous venous pulsations is a reliable indicator of an intracranial pressure below 180 to 190 mm H2O, while the absence of pulsations may be found with normal intracranial pressure and is therefore not a reliable guide to raised intracranial pressure.
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Arch Neurol Chicago · Oct 1977
Case ReportsAlternating proptosis. A case report of acute orbital myositis defined by the computerized tomographic scan.
A 27-year-old woman had a two-week course of acute painful right proptosis with ptosis, medial conjunctival injection, and restriction of eye movements--particularly abduction. One month later, a similar remitting painful left proptosis with complete limitation of abduction developed. Computerized tomographic x-ray scanning showed marked contrast enhancement of both medial rectus muscles, documenting the presumptive diagnosis of acute orbital myositis without recourse to invasive diagnostic techniques. Myositis is a common component of idiopathic orbital inflammatory disease (orbital pseudotumor), but awareness of the rare patient with acute inflammation clinically localized to the extraocular muscles will decrease confusion with cranial nerve and cavernous sinus disease.
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Arch Neurol Chicago · Feb 1977
Case ReportsNeurologic aspects of hereditary hemorrhagic telangiectasia. Report of two cases.
The several neurologic manifestations of hereditary hemorrhagic telangiectasia (HHT) may be caused by complications of pulmonary arteriovenous fistulae or associated central nervous system vascular malformations. The presence of skin and mucosal telangiectases should alert the clinician to the possibility of the disorder and in turn of its potential for associated neurologic disease, including cerebral hemorrhage and abscess. This report describes two cases and demonstrates that the clinical spectrum of HHT should be enlarged to include its admittedly rare, but serious, neurologic aspects.
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Arch Neurol Chicago · Dec 1975
Dorsal column stimulation. Its effect on the somatosensory evoked response.
Several authors have shown that dorsal column stimulation (DCS) modifies appreciation of pain. We studied the effects of DCS on the somatosensory evoked response (SER) in six subjects. ⋯ Stimulus intensities greater than necessary to relieve pain suppressed all SER components. Our findings suggest that the minimal effective DCS variables to relieve pain are those that produce selective suppression of late SER components.
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In 7 of 14 patients with clinically restricted ocular myasthenia gravis, the regional curare test showed latent peripheral involvement. The test consisted of the intravenous administration of 0.2 mg d-tubocurarine into an ischemic arm followed by repetitive supramaximal percutaneous electrical stimulation of the median or ulnar nerves. ⋯ Evaluation of all patients with ocular myasthenia gravis should include regional curare testing of clinically uninvolved peripheral nerves. Thymectomy should be considered for patients with abnormal results.