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  • 1
    Electronic Resource
    Electronic Resource
    Influence of transcutaneous nerve stimulation (TNS) on acute pain (1977)
    Springer
    Journal of neurology 217 (1977), S. 1-10 
    Details
    ISSN: 1432-1459
    Keywords: Nerve stimulation, transcutaneous ; Pain suppression by electrical stimuli ; Pain ; Somatosensory evoked cortical potentials ; Peripheral nerve stimulation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Unter transkutaner Nervenstimulation (TNS) sind kleinere operative Eingriffe, wie Zahnextraktionen und Nervenbiopsien ohne weitere Anästhesie durchführbar. Schwellenmessungen und Intensitätsschätzungen überschwelliger elektrischer Schmerzreize zeigen jedoch unter TNS keine signifikante Änderung der Schmerzempfindung. Lediglich nicht schmerzhafte elektrische Reize sind in der Empfindungsschwelle mäßig angehoben. Evozierte somatosensible Hirnrindenpotentiale nach elektrischer Medianusreizung ändern sich unter TNS-Verdeckungsreiz nicht signifikant. Die Latenzen der frühen Komponenten 0, I–III sind unverändert, die Amplituden dieser Komponenten geringgradig reduziert. Die Befunde widersprechen der ‘gate-control’-Theorie des Schmerzes.
    Notes: Summary Using transcutaneous nerve stimulation (TNS) simple surgical procedures such as tooth extractions and nerve biopsies can be performed without the usual anesthetics. Estimation of threshold and suprathreshold intensities of painful electrical stimuli show no significant change during TNS. Only the threshold for non-painful electrical stimuli is slightly increased. Cortical potentials evoked by electrical peripheral nerve stimulation are not significantly modulated by TNS. Latencies of the early components 0, I–III are unchanged, the amplitudes only slightly reduced. These observations are in contradiction to the ‘gate-control’ theory of pain.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00316311
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  • 2
    Electronic Resource
    Electronic Resource
    Influence of dorsal column stimulation (DCS) on spastic movement disorders (1977)
    Springer
    Acta neurochirurgica 39 (1977), S. 233-240 
    Details
    ISSN: 0942-0940
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Dorsal column stimulation in two spastic patients with upper motor neurone disease showed the following effects: 1. The subjective feeling of stiffness decreased. During DCS patients were able to walk longer distances without rest. 2. The ability to perform fast alternating or synchronous “pedal-pressing” foot movements improved by 15%. 3. The threshold of H-reflexes was enhanced up to 12%, and outlasted the end of stimulation by two minutes. 4. The H-reflex amplitude was depressed in relation to intensity and duration of DC-stimulation up to 10 minutes after the end of DCS. 5. A late second facilitatory wave at 300 msec in the curve for H-reflexes conditioned by a short tibial stimulus was inhibited during DCS. Although the hyperexcitability of the H-reflex was dampened significantly during DCS the whole motor disturbance improved only slightly.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01406733
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  • 3
    Electronic Resource
    Electronic Resource
    Alterations of intracranial pressure and cerebral blood flow velocity in healthy neonates and their implication in the origin of perinatal brain damage (1988)
    Springer
    European journal of pediatrics 147 (1988), S. 30-35 
    Details
    ISSN: 1432-1076
    Keywords: Intracranial pressure ; Cerebral blood flow velocity ; Cw-Doppler sonography ; Term, healthy neonate ; Perinatal brain damage
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Intracranial pressure and cerebral blood flow velocity were recorded in term healthy neonates during the first 3 days of life using non-invasive methods (LADD-fontanometry and cw-Doppler sonography). Intracranial pressure increased from 4.0±2.7 cm H2O to 5.8±2.7 cm H2O and maximal cerebral blood flow velocity in the anterior cerebral artery (ACA) increased from 33 cm/s to 58 cm/s as calculated from a Doppler shift of 0.63 to 1.10 kHz and vascular resistance decreased between the 1st and 3rd day of life. These alterations could not be demonstrated in the femoral artery. This is in accordance with other registrations obtained by different methods and under various conditions. They allow an explanation of some well known physiological phenomena like alterations of cranial volume and the structure of the bony skull in the first days of life. Furthermore, these physiological variations may have implications for the origin of cerebral damage during the perinatal period, especially of hypoxic-ischaemic encephalopathies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00442607
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  • 4
    Electronic Resource
    Electronic Resource
    Neurophysiological findings in long-term survivors of acute lymphoblastic leukaemia in childhood treated with the BFM protocol 81 SR-A/B (1997)
    Springer
    European journal of pediatrics 156 (1997), S. 727-733 
    Details
    ISSN: 1432-1076
    Keywords: Key words Acute lymphoblastic leukaemia ; Neurophysiology ; CNS late effects ; Quality of life
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Monitoring of therapy-related late effects after acute lymphoblastic leukaemia (ALL) therapy in childhood has become an increasingly important field in posttherapeutic patient surveillance. The usefulness of neurophysiological investigations (e.g. EEG, evoked potentials (EP)) as part of these attempts is controversial. The present report focuses on this problem and the question whether and to what extent routinely performed EEG recordings and visual evoked potentials (VEP) were correlated with further measures of CNS integrity. EEGs and VEPs were recorded in 163 asymptomatic long-term survivors of ALL in childhood during a large retrospective multicentre study evaluating CNS late sequelae following antileukaemic therapy. Fifty-two ALL long-term survivors (4.5–10.6 years after end of therapy, median: 8.8 years), who had been treated according to BFM-81 SR-A (n=30) or SR-B (n=22) were selected for this analysis focusing on therapy-related CNS late effects. Therapy protocols differed with regard to the mode for CNS prophylaxis: SR-A, cranial irradiation with intrathecal methotrexate; SR-B, intrathecal and iv methotrexate. Neurophysiological findings were correlated with illness- and treatment-related parameters, as well as with data on the morphological, neurological and psychological status of the CNS. At the time of follow-up neurophysiological measures were abnormal in 28/52 cases (53.8%). Neither illness- nor therapy-specific differences in CNS prophylaxis showed any relationship to EEG/VEP outcome any relationship to EEG/VEP outcome in this reduced group of the whole study population. Children with EEG/VEP abnormalities showed a significantly higher incidence of structural CNS disturbances compared to those with inconspicuous neurophysiological recordings (60.9% vs 31.8%). However, in this special subject group there was no specific neurophysiological finding for a specific morphological substrate, neurological or psychological deficiency and vice versa. Conclusion Routinely performed EEG/VEP investi gations are not very helpful measures to predict the presence or degree of behavioural deficiencies, neuro‐logical disturbances, or morphological CNS abnor‐malities. Patients who received cranial irradiation or systemic methotrexate applications showed the same incidence of neurophysiological disturbances without evidence for specific neurotoxic correlates.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004310050700
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  • 5
    Electronic Resource
    Electronic Resource
    Ultrasonographic diagnosis of brain tumors in infancy (1984)
    Springer
    Pediatric radiology 14 (1984), S. 284-287 
    Details
    ISSN: 1432-1998
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Fourteen intracranial tumors were diagnosed by means of mechanical sector scanning through the infant's open fontanelle in a series consisting of 1150 examinations. In addition, integrated pulsed Doppler-sonography (duplex-scan technique) was used to diagnose malformations of intracranial vessels. We established five diagnostic criteria: (1) high echogenic structures are mostly seen in solid tumors of the periventricular region; (2) low echogenic structures are seen in infiltrating tumors of the cerebral tissue and they are difficult to recognize; (3) echo-free structures correspond with a cystic process, a necrosis or malformation of vessels; (4) indirect sonographic signs of a cerebral tumor are all changes in shape and size of the normal anatomic structures; and (5) abnormal blood-perfusion of a marked region, e.g. caused by dilatations of vessels, can be proved by integrated pulsed Doppler-sonography.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01601876
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  • 6
    Electronic Resource
    Electronic Resource
    The late facilitation in H-reflex recovery cycles in different pyramidal lesions (1980)
    Springer
    European archives of psychiatry and clinical neuroscience 228 (1980), S. 197-204 
    Details
    ISSN: 1433-8491
    Keywords: H-reflex recovery curves ; Postinhibitory facilitation ; Pyramidal spasticity ; H-Reflex ; Konditionierungskurven ; Postinhibitorische Bahnung ; Pyramidenbahnspastik
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung An 18 Normalpersonen und 26 Patienten mit pyramidaler Spastik (8 spastische Spinalparalysen, 6 spastische Hemiparesen, 12 spastische Spinalläsionen) wurden die H-Reflex-Amplituden des M. triceps surae nach N. tibialis-Reiz und verschiedenen elektrischen Vorreizen registriert. Der H-Reflex wird bei pyramidaler Spastik durch motorisch eben unterschwellige Tibialis-Vorreize nach 300 ms leicht gebahnt (bis 113%), nachdem die erste starke Bahnungsphase (10 ms) und die folgende Depression (20–200 ms) abgeklungen sind. Ähnliche postinhibitorische Bahnungen finden sich bei Spastikern nach ipsilateraler plantarer Hautreizung und direkter Hinterstrangsreizung. Nach kontralateraler Vorreizung des N. tibialis posterior haben Gesunde und Spastiker eine mäßige H-Reflex-Bahnung zwischen 50–300 ms. Diese späte Bahnung korreliert nicht mit dem Schweregrad der Spastik, doch ist sie bei cerebralen Pyramidenläsionen deutlicher als bei spinalen Läsionen. Es wird angenommen, daß die postinhibitorische Bahnung nicht durch supraspinale long-loop-Reflexe, sondern ähnlich wie der Klonus durch einen intraspinalen Rhythmus entsteht, der von supraspinal gebahnt und moduliert wird.
    Notes: Summary H-reflex amplitudes were recorded after stimulation of the tibial nerve and different electrical stimuli in 18 normal persons and 26 patients showing pyramidal spasticity (8 spastic spinal paralysis, 6 spastic hemiparesis, 12 spinal lesions). A just subthreshold stimulus of the tibial nerve facilitated the H-reflex in spastic patients slightly after about 300 ms (up to 113%), following an early strong facilitation (10 ms) and a longer lasting depression (20–200 ms). Similar postinhibitory facilitation was obtained in spastic patients after ipsilateral stimulation of the plantar surface and after direct stimulation of the dorsal columns. Conditioning by contralateral stimuli of the posterior tibial nerve caused a slight late facilitation in both normal and spastic patients. This late facilitation did not correlate significantly with the severity of spasticity, but it was more pronounced in cerebral pyramidal lesions than in spinal ones. It is assumed that this postinhibitory facilitation is probably generated as a spinal rhythm, similar to the clonus, and that it is modulated from supraspinal structures.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00342345
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  • 7
    Electronic Resource
    Electronic Resource
    Aktuelle Diagnostik bei Muskeldystrophien Neue Entwicklungen, Untersuchungs- methoden und Fallbeispiele (1999)
    Springer
    Der Nervenarzt 70 (1999), S. 89-100 
    Details
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Gliedergürteldystrophie ; Dystrophin ; Sarkoglykan ; Adhalin ; Emery-Dreifuss-Dystrophie ; Emerin ; Merosin ; Calpain-3 ; Muskeldystrophie Duchenne ; Muskeldystrophie Becker ; Key words Limb-girdle dystrophy ; Dystrophin ; Sarcoglycan ; Adhalin ; Emery-Dreifuss muscular dystrophy ; Emerin ; Merosin ; Calpain-3 ; Becker muscular dystrophy ; Duchenne muscular dystrophy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Recent progress in the field of molecular genetics revealed a broader spectrum of dystrophin-related disorders than previously assumed. In addition, the pathogenetic basis of other types of muscular dystrophies could be identified: some autosomal-recessive limb girdle dystrophies are caused by mutations of sarcoglycan genes, others are caused by deficiency of the sarcoplasmatic enzyme calpain-3. Emery-Dreifuss muscular dystrophy is due to the deficiency of the nuclear membrane protein emerin. About 50% of congenital muscular dystrophies are related to mutations of a extracellular matrix protein merosin (α-laminin). A series of monoclonal antibodies for immunohistochemistry is now available recognizing many cytoskeletal muscle proteins. In combination with molecular genetics a diagnostic flow chart can be developed which allows a definite diagnosis in most cases. In this review disease entities are illustrated by case reports. We discuss the significance of immunohistochemical and molecular methods for diagnosis.
    Notes: Zusammenfassung Neue Ergebnisse der molekularen Genetik haben in den vergangenen Jahren zu der Einsicht geführt, daß das klinische Spektrum der Erkrankungen, die auf Defekte des Muskelmembranproteins Dystrophin zurückgeführt werden können, erheblich breiter ist, als bisher angenommen wurde. Außerdem konnten die molekularen Ursachen anderer Unterformen der progressiven Muskeldystrophien identifiziert werden: ein Teil der autosomal-rezessiv vererbten Muskeldystrophien vom Gliedergürteltyp beruht auf Mutationen der Sarkoglykangene, andere auf Defekten der sarkoplasmatischen Protease Calpain-3; als Ursache der Emery-Dreifuss-Muskeldystrophie konnte ein Membran-Protein der Kernhülle identifiziert werden; etwa die Hälfte der kongenitalen Muskeldystrophien beruht auf Störungen des Merosins (=α2-Laminin), einer Komponente der extrazellulären Matrix. Es steht heute ein Repertoire an spezifischen Antikörpern gegen fast alle der o.g. Muskelproteine für die Immunhistologie zur Verfügung. Zusammen mit den Methoden der molekularen Genetik kann somit ein differenziertes diagnostisches Schema entwickelt werden, das in vielen Fällen zu einer definitiven Diagnose führt. Anhand eigener Fallberichte werden diese Krankheitsentitäten referiert und auf die differentialdiagnostische Bedeutung einer erweiterten immunhistochemischen und molekularen Diagnostik eingegangen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001150050408
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  • 8
    Electronic Resource
    Electronic Resource
    Cerebral infarction in term neonates: diagnosis by cerebral ultrasound (1986)
    Springer
    Child's nervous system 2 (1986), S. 195-199 
    Details
    ISSN: 1433-0350
    Keywords: Neonates ; Infarction ; Hypoxic-ischemic encephalopathy ; Ultrasound
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Cranial ultrasound (US) through the newborn's open fontanelle can diagnose not only intracerebral hemorrhages but also diffuse and localized hypoxic-ischemic encephalopathies. Sonographically, it was possible to distinguish between different courses of cerebral ischemia in seven neonates: (1) ischemic infarction, usually in the area of the middle cerebral artery; (2) borderline infarction; (3) transient ischemia. The patients showed lateralized seizures during the first days of life with a corresponding focus in the electroencephalogram (EEG). Computed tomography showed areas of partially reduced density corresponding to the regions of increased echogenicity in ultrasound. The course was various; prognosis was good except in one patient. Etiologically, embolism, thromboses or hypoxemia were responsible for cerebral infarction. In some cases secondary bleeding ensued. The prognostic value of cerebral lesions was dependent on the involved area, gestational age, and any concurrent hypoxic cerebral damage.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00706810
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