Transient global amnesia-like episode in a patient with severe hyperhomocysteinemia     

A. Semmler  A. Klein  S. Moskau  M. Linnebank 《European journal of neurology》2007,14(9):e5-e6

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Lithium for irritability in Post-Traumatic stress disorder     

Peter L. Forster  Frank B. Schoenfeld  Charles R. Marmar  Ariel Janna Lang 《Journal of traumatic stress》1995,8(1):143-149

Irritability is often a problem for patients with Post-Traumatic Stress Disorder (PTSD). We describe two cases that illustrate the use of lithium in the treatment of veterans with PTSD who complained of serious problems with irritability or angry outbursts. These cases are discussed in the context of evidence that lithium may be useful in other patients with disorders of impulse control. The evidence linking disorders of anger and impulse control to a dysregulation in neurotransmitter regulation, particularly in serotonergic pathways, supports a psychopharmacologic approach to treatment. These findings should lead to further study of the role of lithium in the treatment of this symptom complex in patients with PTSD.  相似文献   

Familial Sneddon's syndrome   总被引：4，自引：0，他引：4  

Alexander Lossos  Tamir Ben-Hur  Ziva Ben-Nariah  Claes Enk  Moshe Gomori  Dov Soffer 《Journal of neurology》1995,242(3):164-168

We report the familial occurrence and apparent autosomal dominant inheritance of Sneddon's syndrome with variable clinical expression. The proband, a 40-year-old woman, presented with livedo reticularis and progressive neurological deterioration following a stroke. The diagnosis was confirmed by cerebral angiogram and skin biopsy, both showing the characteristic findings. Two of the patient's sisters were reported to have been similarly affected in the past. Her mother, two additional siblings and five of her seven children exhibited various vasospastic skin phenomena. Familial aggregation of this disorder may be common and a genetic basis may be involved in its pathogenesis.  相似文献   

Effect of chronic oral domperidone therapy on gastrointestinal symptoms and gastric emptying in patients with parkinson's disease     

Irfan Soykan  Irene Sarosiek  Jeannie Shifflett  George F. Wooten  Dr. Richard W. McCallum 《Movement disorders》1997,12(6):952-957

This study investigated whether domperidone could improve gastrointestinal symptoms in patients with Parkinson's disease who were receiving levodopa therapy. A total of 11 patients were studied. Following a baseline gastric emptying test, patients were treated with a starting dose of domperidone 20 mg p.o. q.i.d. A follow-up gastric emptying test was repeated at least 4 months after starting domperidone therapy. At the beginning and at each 3-month follow-up visit, symptoms of nausea, vomiting, anorexia, abdominal bloating, heartburn, regurgitation, dysphagia, and constipation were evaluated and scored on a scale of 0–3. The overall mean follow-up period was 3 years. Compared with their baseline evaluation, patients experienced a significant improvement in all symptoms (p < 0.05) except dysphagia and constipation. Gastric emptying of an isotope-labeled solid meal was significantly faster, with a baseline result of 60.2 ± 6.4% retention of isotope 2 h after the meal compared with 37.0 ± 2.2% retention during domperidone therapy (p < 0.05). Patients' global assessment of Parkinson's disease remained stable or improved. Serum prolactin was elevated in all patients after domperidone therapy (p < 0.05). Domperidone therapy significantly reduces upper gastrointestinal symptoms and accelerates gastric emptying of a solid meal, but does not interfere with response to antiparkinsonism treatment.  相似文献   

The biomechanics of vibration and low back pain     

David G. Wilder 《American journal of industrial medicine》1993,23(4):577-588

This work is a review of the mechanical factors related to low back pain production in a vibration environment. The sitting posture is an extreme orientation for the lumbar intervertebral disc that 1) increases its internal pressure, 2) increases its anteroposterior shear flexibility, while: 3) decreasing its resistance to buckling instability and 4) stressing the posterior region of the disc. Vibration is an additional mechanical stressor. Several studies suggest that the following preventive measures be taken to reduce the risk of low back pain due to driving: 1) minimize the vibration reaching the driver, 2) avoid lifting or bending immediately following driving, and 3) walk around for a few minutes following driving. © 1993 Wiley-Liss, Inc.  相似文献   

The desipramine-induced growth hormone response and the dexamethasone suppression test in obsessive-compulsive disorder.     

J V Lucey  S Barry  M G Webb  T G Dinan 《Acta psychiatrica Scandinavica》1992,86(5):367-370

Ten patients with DSM-III-R obsessive-compulsive disorder (OCD) underwent the desipramine (DMI) growth hormone (GH) stimulation test as well as the dexamethasone suppression test (DST). The results were compared with the responses in a group of matched healthy controls. The GH response to DMI did not differ between patients and controls and 9 of 10 patients showed cortisol suppression in response to dexamethasone. The data suggest that neither alpha 2 adrenergic dysfunction nor DST non-suppression are features of primary OCD.  相似文献   

Measurement of depression in dementia: Self vs clinician rating     

Brian R. Ott  Barry S. Fogel 《International journal of geriatric psychiatry》1992,7(12):899-904

The presence of depression was evaluated in a cross-section of 50 outpatients with dementia using the self-rated Geriatric Depression Scale and the clinician-rated Cornell Depression Scale. Impaired insight, as manifested by unawareness of dementia, correlated with dementia severity and discriminated a group of patients in whom the self-rated scale failed to show evidence of depression. Discrepancy between the two types of scales occurred among mildly as well as moderately demented patients when insight was impaired. Recognition of this discrepancy suggests that reliance on self-ratings may underestimate the presence and degree of depression among patients with dementia.  相似文献   

REM sleep behavior disorder and vocal cord paralysis in Machado-Joseph disease.     

Alex Iranzo  Esteban Mu?oz  Joan Santamaria  Isabel Vilaseca  Montserrat Milà  Eduardo Tolosa 《Movement disorders》2003,18(10):1179-1183

We evaluated the occurrence of REM sleep behaviour disorder (RBD) and vocal cord abductor paralysis (VCAP) in a group of 9 Machado-Joseph disease (MJD) patients. RBD was diagnosed by clinical history plus audiovisual polysomnography in 4 men and 1 woman (55%). While dreaming, 4 fell out of the bed and the other injured his arms. Laryngoscopy detected bilateral VCAP in 1 patient with stridor who required emergency tracheotomy, and partial vocal cord abductor restriction in 2. RBD and VCAP are two potentially injurious conditions that should be considered part of the clinical spectrum of MJD.  相似文献   

Bright dawn simulation compared with bright morning light in the treatment of winter depression.     

D Avery  M A Bolte  M Millet 《Acta psychiatrica Scandinavica》1992,85(6):430-434

In a randomized cross-over design, 7 patients with winter depression were treated with a week of a bright (1700 lx) dawn simulation (0400 to 0600) and a week of standard bright (1700 lx) morning (0600 to 0800) light therapy. The Hamilton Rating Scale for Depression scores decreased significantly for the standard light therapy (18.9 to 6.6) but not for the bright dawn therapy (18.0 to 11.3). Early morning awakening was a frequent side effect with the bright dawn simulation. Although dawn simulation at a lower illuminance may be an effective treatment, the bright dawn used in this study showed only a nonsignificant trend to lower depression ratings. The illuminance of dawn simulation should be adjusted to minimize side effects.  相似文献   

Depression symptoms in movement disorders: comparing Parkinson's disease, dystonia, and essential tremor.     

Kimberly M Miller  Michael S Okun  Hubert F Fernandez  Charles E Jacobson  Ramon L Rodriguez  Dawn Bowers 《Movement disorders》2007,22(5):666-672

Depression is common in Parkinson's disease (PD) and affects 30 to 50% of all patients. In contrast to the wealth of research on depression in PD, little is known about the occurrence of depression in other movement disorders. The primary objective of the current study was to determine whether the high prevalence of depression symptoms seen in PD is also found in other movement disorders, by directly comparing rates of specific depression symptoms and depression severity across PD, dystonia, and essential tremor (ET). Three hundred and fifty-four patients with PD, 83 patients with dystonia, and 53 patients with ET completed the Beck Depression Inventory (BDI). We found no significant between-groups differences for depression severity, frequency, or endorsement of specific depression symptoms. Forty-eight percent of PD patients, 37.3% of dystonia patients, and 34% of ET patients were found to be at least mildly depressed (BDI score of 10 or higher). The most commonly endorsed symptoms were fatigability, difficulty with work, anhedonia, and sleep disturbance. Clinicians should be aware that depression is a frequent problem in dystonia and ET, in addition to PD, and inquire about depression symptoms in these patients so that they can be appropriately treated.  相似文献