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  • 11
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Zervikalgie ; HWS-Schleudertrauma ; Myofaszialer Schmerz ; Schmerzmessung ; Key words Neck pain ; Pain measurement ; Myofascial pain ; Whiplash injury
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary In patients with an acute cervicocephalic pain syndrome following whiplash injury (n=12), pressure-pain scores for the splenius and the trapezius muscles on both sides, for the fingers on both sides and for the skull were recorded and compared to a control group. A computer-aided pain measurement was applied, which is presented as an improvement of pressure algesimetry. During constant application of pressure stimuli, the patient rated the increasing pain on a visual analogue scale, resulting in a curve of pain intensity against time. Slope and integral of the curve proved to be the most reliable parameters. After whiplash injury, significantly increased pain scores were found for the splenius muscle on both sides, for the left trapezius muscle and for the left finger whereas there was only a tendency of increased pain at the other stimulation sites. The presented method allows quantification of the cervical syndrome with neck and shoulder muscle sprain caused by whiplash injury. This objective and rater-independent method is of great value for diagnostic, therapeutic and medico-legal purposes in the assessment of the disease course and in clinical therapy trials.
    Notes: Zusammenfassung Bei Patienten mit akutem zervikozephalen Schmerzsyndrom nach einem HWS-Schleudertrauma (n=12) wurde die Druckschmerzempfindlichkeit für die Mm. trapezius und splenius beidseits, für die Finger beidseits und am Vertex quantitativ bestimmt und mit einer Kontrollgruppe verglichen. Angewandt wurde eine computerinteraktive Weiterentwicklung der Druckalgesimetrie. Während der konstanten Applikation von Druckstimuli stellten Patienten die zunehmenden Schmerzen kontinuierlich auf einer visuellen Analogskala ein, so daß sich eine Schmerzintensität-Zeit-Funktion bestimmen ließ. Als zuverlässigste Parameter erwiesen sich Steigung und Integral der Kurve. Signifikant erhöhte Werte fanden sich nach Schleudertrauma für den M. splenius beidseits, den linken M. trapezius und den linken Finger, während für die anderen Reizorte lediglich eine Tendenz zu erhöhten Werten bestand. Die vorgestellte Methode eignet sich zur Quantifizierung eines Zervikalsyndroms mit durch Schleudertrauma bedingter Zerrung der Schulter- und Nackenmuskulatur. Diese objektive, untersucherunabhängige Befundquantifizierung ist wertvoll bei diagnostischen, therapeutischen und gutachterlichen Fragestellungen in der Verlaufskontrolle und in klinischen Therapiestudien.
    Type of Medium: Electronic Resource
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  • 12
    Electronic Resource
    Electronic Resource
    Springer
    Der Internist 39 (1998), S. 1080-1097 
    ISSN: 1432-1289
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Koronare Herzerkrankung, Schlaganfall und periphere arterielle Verschlußkrankheit Herz-Kreislauferkrankungen zählen zu den häufigsten Ursachen für eine vollstationäre Behandlung, wobei ischämisch bedingte Herzerkrankungen die größte Behandlungsgruppe darstellen [Statistisches Bundesamt 1998]. Trotz deutlichem zahlenmäßigen Rückgang der kardiovaskulären Mortalität (jährlich etwa –1,5%) in den letzten Jahrzehnten repräsentieren Herzinfarkte, ischämischer Schlaganfall und periphere arterielle Verschlußkrankheit die häufigsten Todesursachen von Erwachsenen in den Industrienationen Europas [Sans et al., 1997] und Nordamerikas [Kannel 1994]. Die Inzidenzen dieser Erkrankungen können durch rationale und rationelle Therapiestrategien reduziert werden. In Abhängigkeit von der ärztlichen Spezialisierung werden jedoch bereits seit vielen Jahren etablierte Therapien häufig aus Angst oder auch Unwissenheit nicht eingesetzt oder nur unzureichend dosiert [Jollis et al., 1996].
    Type of Medium: Electronic Resource
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  • 13
    Electronic Resource
    Electronic Resource
    Springer
    European archives of psychiatry and clinical neuroscience 234 (1984), S. 74-77 
    ISSN: 1433-8491
    Keywords: Carotid endarterectomy ; Neuropsychological changes ; Endarterektomie ; Carotisstenose ; Neuropsychologische Veränderungen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Wir führten bei 23 Patienten mit uni- oder bilateralen hämodynamisch relevanten Carotisstenosen vor und zehn Monate nach einer Endarterektomie testpsychologische Untersuchungen durch. Präoperativ hatten die meisten Patienten TIA (15), fünf hatten einen leichten Schlaganfall erlitten, drei waren asymptomatisch. Die Nachuntersuchung zeigte leicht verbesserte intellektuelle Funktionen, während die mnestischen Funktionen eher schlechter waren als vor der Operation. Die psychomotorischen Funktionen zeigten — ebenso wie die persönlichkeitsbezogenen Tests — keine wesentlichen Unterschiede. Die prophylaktische Wirkung der Endarterektomie zur Vorbeugung von Schlaganfällen ist unumstritten; eine wesentliche Verbesserung der neuropsychologischen Veränderung ist aber in der Regel nicht zu erwarten
    Notes: Summary Psychological testing was performed on 23 patients (mean age 60.7 years) with unilateral or bilateral stenoses of the carotid arteries prior to and 10 months after carotid endarterectomy. Intellectual functions were slightly improved, mnemic functions impaired, psychomotor functions and dimension of personality remained unchanged. Carotid endarterectomy, although improving neuropsychological functions in a few cases, on average does not cause a significant improvement. This underscores the preventive character of the surgical intervention.
    Type of Medium: Electronic Resource
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  • 14
    Electronic Resource
    Electronic Resource
    Springer
    Journal of neurology 235 (1987), S. 122-124 
    ISSN: 1432-1459
    Keywords: Paraneoplastic cerebellar degeneration ; Hodgkin's disease ; MRI ; Anti-Purkinje-cell antibodies
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A case of paraneoplastic cerebellar degeneration (PCD) associated with Hodgkin's disease is presented. The features that make this case particularly interesting are the simultaneous occurrence of PCD with a relapse of Hodgkin's disease, which has been present for 17 years, and the arrested progression of cerebellar dysfunction after a subacute onset. Cerebellar atrophy was revealed by computed tomography and magnetic resonance imaging. In contrast to two previously reported cases, anti-Purkinje-cell antibodies were not detected.
    Type of Medium: Electronic Resource
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  • 15
    ISSN: 1432-1459
    Keywords: Alcoholic neuropathy ; Alcoholic cerebellar degeneration ; Posturography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A total of 78 chronic alcoholics were examined neurologically as well as by electroneurography, myography and posturography. Clinical signs of peripheral neuropathy were detected in 45% of these patients, with electromyographic and neurographic abnormality in 67% and 55% respectively. Clinical signs of cerebellar ataxia were found in 33% of our patients, whereas posturographic measurements of increased sway were recorded in 69%. The posturographic characteristics of cerebellar anterior lobe atrophy were observed in two-thirds of the latter patients. The severity of cerebellar-ataxia did not correlate with the degree of neuropathy. This lack of correlation is interpreted as an indication of different pathogenetic mechanisms acting on peripheral nerves and cerebellum.
    Type of Medium: Electronic Resource
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  • 16
    ISSN: 1432-1459
    Keywords: Chronic headache ; Analgesics ; Withdrawal therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Headache characteristics are described in 139 patients with chronic daily or almost daily headaches due to regular intake of analgesics and the short- and long-term results of drug withdrawal. Drug-induced headache was described as dull, diffuse, and band-like, and usually started in the early morning. The mean duration of the original headache (migraine or tension headache) was 25 years; regular intake of drugs and chronic daily headache had started 10 and 6 years prior to withdrawal therapy, respectively. Patients took an average of 34.6 tablets or analgesic suppositories or antimigraine drugs per week containing 5.8 different substances. The drugs most often used were caffeine (95%), ergotalkaloids (89%), barbiturates (64%), and spasmolytics, paracetamol, and pyrazolone derivates (45%–46%). A total of 103 patients (68 migraine, 35 tension or combination headache) were available for interviews at a mean time interval of 2.9 years after an inpatient drug withdrawal programme. Chronic headache had disappeared or was reduced by more than 50% in two-thirds of the patients. Positive predictors for successful treatment were migraine as primary headache, chronic headache lasting less than 10 years, and regular intake of ergotamine. Drug intake was significantly reduced and patients used single substances more often. Patients who originally suffered from migraine, superimposed on the daily headache, also experienced a significant improvement in the frequency of the migraines and their intensity. Migraine prophylaxis through beta-blocking agents and calcium channel antagonists was more efficient after drug-withdrawal therapy.
    Type of Medium: Electronic Resource
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  • 17
    ISSN: 1432-1459
    Keywords: Computed tomography ; Cerebellar atrophy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The severity of cerebellar signs and the degree of cerebellar atrophy depicted by computed tomography (CT) were independently graded in 108 patients with cerebellar disorders. The overall agreement between these independently scaled measures was only 28%. In patients with involvement of the cerebellar hemispheres and anterior lobe, clinical signs tended to be more pronounced than the cerebellar atrophy revealed by CT. The opposite was true for patients with lesions of the caudal vermis. Patients with Friedreich's ataxia had no or only minor CT abnormalities. Close correlation between the degree of infra- and supratentorial atrophy was found only in chronic alcoholics. The poor correlation between changes in cerebellar structure detected by CT and clinical disability suggests the need for caution in CT interpretation.
    Type of Medium: Electronic Resource
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  • 18
    Electronic Resource
    Electronic Resource
    Springer
    Journal of neurology 235 (1988), S. 475-484 
    ISSN: 1432-1459
    Keywords: Tremor recording ; Parkinson's disease ; Resting tremor ; Diurnal variations ; Treatment effects
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A new method of prolonged recording of EMG provides a good estimate of spontaneous and induced diurnal variations in resting tremor in Parkinson's disease. It provides a record and a measure of the effects of treatment. Tremor intensity shows considerable variations even over short periods of time. Therefore short-term measurements of tremor are unhelpful. Long-term recordings agree better with the patient's assessment than with the clinical rating score. Repeated recordings over a similar 10-h period on 3 consecutive days in one patient showed fairly constant measures of occurrence and intensity of tremor. In contrast to accelerometer measurements of tremor, artefacts caused by movements and general activity of the patient do not materially interfere with tremor evaluation using surface EMG.
    Type of Medium: Electronic Resource
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  • 19
    ISSN: 1432-1459
    Keywords: Hemiparesis ; Posture ; Voluntary movement
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Postural adjustments associated with the task of raising oneself on tiptoes were investigated in a reaction time paradigm in six normal subjects and six patients with hemiparesis due to stroke. Body and ankle position in space were measured by means of a movement analysis system (ELITE). The findings indicate that the task of going up on tiptoes is performed in two steps. First, the centre of gravity is shifted forward to a position per pendicular to the forefoot. This movement is initiated by a phasic burst of EMG activity in the tibialis anterior (TA). The activity of the quadriceps femoris (QUA) aids the forward shift and together with the biceps femoris (BF) stabilizes the knee. Following these postural adjustments, the action of going up on tip-toes is performed mainly by the gastrocnemius medialis (MG). The basic pattern of preparatory (TA, QUA, BF) and focal (MG) activity was disturbed in its temporal sequence in patients with hemiparesis. The analysis of the biomechanical data showed smaller movement velocities for leaning forward and going up on tiptoes in patients, with increased duration of going up on tiptoes and decreased movement amplitude on the paretic side. In addition, the correlation between the start of horizontal (leaning forward) and vertical (going up on tiptoes) hip movement was lost in patients. The preserved correlation between the latency of MG activity and the onset of the vertical hip movement on the paretic side in patients and the loss of correlation on the non-paretic side indicates that the EMG activity on the healthy side is adapted to the functional requirements of the affected side. The findings demonstrate that preparatory and executional activity are not programmed as a unit, but are more likely to be generated by a hierachically organized structure using proprioceptive and exteroceptive feedback.
    Type of Medium: Electronic Resource
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  • 20
    Electronic Resource
    Electronic Resource
    Springer
    Journal of neurology 234 (1987), S. 396-400 
    ISSN: 1432-1459
    Keywords: Subclavian steal syndrome ; Vertebrobasilar insufficiency ; Doppler sonography ; Atherosclerosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Continuous-wave (CW) Doppler sonography has proved to be a reliable tool both to detect subclavian stenosis or occulusion and to detect reversal of blood flow in the vertebral artery. This method is entirely atraumatic and in contrast to angiography allows investigation of asymptomatic patients and provides more representative data for epidemiological studies. The incidence of subclavian stenosis or occlusion was 1.15% among the 23,500 patients examined in our department between 1978 and 1985. Of the 272 patients with unilateral or bilateral subclavian stenosis or occlusion, 54% were asymptomatic with no subjective complaints and were normal upon neurological examination; 29% reported vertebrobasilar transient ischaemic attacks (TIAs), with or without concomitant TIAs or infarction in the vascular territory of the carotid arteries; and 17% complained of symptoms exclusively referring to the region of carotid blood supply. Reversal of blood flow in the ipsilateral vertebral artery was detected in 152 patients (56%). The incidence of neurological symptoms within this group was double that found in patients without steal. None of the patients suffered from permanent vertebrobasilar damage. In most cases, subclavian artery disease was due to atherosclerosis. For 13 patients an inflammatory, iatrogenic, traumatic, or congenital aetiology could be assumed. The marked preponderance of left-sided subclavian stenosis or occlusion, reported by others, could be confirmed among our patients, but was less pronounced for tight stenoses than for occlusions. Mild-to-moderate subclavian stenoses were about equally distributed on each side.
    Type of Medium: Electronic Resource
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