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  • 11
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Annals of the New York Academy of Sciences 377 (1981), S. 0 
    ISSN: 1749-6632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Natural Sciences in General
    Type of Medium: Electronic Resource
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  • 12
    ISSN: 1749-6632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Natural Sciences in General
    Type of Medium: Electronic Resource
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  • 13
    Electronic Resource
    Electronic Resource
    Springer
    Intensivmedizin und Notfallmedizin 34 (1997), S. 110-123 
    ISSN: 1435-1420
    Keywords: Key words Neuromuscular diseases ; Guillain-Barré syndrome ; chronic inflammatory demyelinating polyneuritis ; myasthenia gravis ; Lambert-Eaton syndrome ; poly-/dermatomyositis ; Schlüsselwörter Neuromuskuläre Krankheiten ; Guillain-Barré-Syndrom ; Chronisch entzündliche demyelinisierende Polyneuritis ; Myasthenia gravis ; Lambert-Eaton-Syndrom ; Poly-/Dermatomyositis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Übersichtsarbeit befaßt sich mit der Differentialdiagnose und Therapie von Erkrankungen des neuromuskulären Systems. Kardinalsymptom ist eine generalisierte Muskelschwäche, die de novo auftritt oder als krisenhafte Dekompensation einer vorbestehenden Erkrankung entsteht. Typische klinische Befundkonstellationen erlauben die rasche diagnostische Eingrenzung, unterstützt durch wenige gezielte technische Zusatzuntersuchungen. Die Abgrenzung seltenerer Erkrankungen als Ursache einer bedrohlichen Muskelschwäche erfordert eingehendere Untersuchung und besonders ausführliche anamnestische und fremdanamnestische Erhebungen. Die Intensivbehandlung neuromuskulärer Krankheiten zeichnet sich durch einige Besonderheiten aus, aus denen sich Konsequenzen für Monitoring, Sedierung, Schmerztherapie und Beatmung ergeben. Im speziellen Teil wird die intensivmedizinisch relevante Stufentherapie neuromuskulärer Erkrankungen detailliert besprochen.
    Notes: Summary This review deals with the differential diagnosis and treatment of critically ill neuromuscular patients. Acute muscular weakness may be a sign of newly acquired neuromuscular disorders or of an exacerbation of a previously existing disease. Typical features of the more common neuromuscular conditions are presented and the problems of neurocritical care delineated. The appropriate ancillary tests are presented. Intensive care management includes adapted strategies for monitoring, sedation, pain treatment, and artificial respiration as applied to the critically ill neuromuscular patient. Specific treatments for disorders including Myasthenia gravis, the Lambert-Eaton myastenic syndrome, Guillain-Barré syndrome, chronic inflammatory neuropathies and myositis are summarized proposing a step-wise escalation of treatment modalities.
    Type of Medium: Electronic Resource
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  • 14
    ISSN: 1432-1459
    Keywords: Adult-onset mixed myopathy ; Nemaline myopathy ; Minicore disease ; Central core disease ; Polymyositis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A woman, aged 75 years, presented with a 15-year history of progressive, generalized, painful muscle weakness and wasting. Clinical and laboratory investigation revealed a sporadic muscle disorder. Muscle biopsy showed a mixed pattern of nemaline myopathy with minicores and central cores and severe atrophy of type-1 and type-2 fibers. A trial of immunosuppressive treatment did not improve her condition, which clinically mimicked chronic progressive polymyositis. Mixed myofibrillar myopathies of this type have so far only been described among the group of congenital myopathies.
    Type of Medium: Electronic Resource
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  • 15
    Electronic Resource
    Electronic Resource
    Springer
    Journal of neurology 236 (1989), S. 170-173 
    ISSN: 1432-1459
    Keywords: Ethylene glycol intoxication ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The case of a young man with sublethal ethylene glycol poisoning is reported. Complete recovery occurred after 12 days of deep coma and a prolonged flaccid tetraplegia. The lesions of gross degree in the CNS, demonstrated by serial CT, resolved and electrophysiological testing as well as neuromuscular signs improved. The recovery, clinically and radiographically, over 35 days was dramatic. Ethylene glycol intoxication should always be considered in the differential diagnosis of acute severe encephalopathy because complete recovery is possible with correct therapy.
    Type of Medium: Electronic Resource
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  • 16
    Electronic Resource
    Electronic Resource
    Springer
    Journal of neurology 241 (1994), S. 475-480 
    ISSN: 1432-1459
    Keywords: Lower motor neuron syndrome ; Multifocal motor neuropathy ; Anti-ganglioside antibodies
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract IgM class antibodies against the ganglioside GM1 have been found in a subgroup of patients with lower motor neuron syndromes and multifocal motor neuropathies (MMN). The pathogenic relevance of these antibodies is still unclear, but some MMN patients with IgM antibodies against GM1 seem to profit from immunosuppressive therapy. A reliable test for IgM antibodies against GMl may be useful for identifying these patients. We have assessed the comparability of the ELISA tests used for the determination of IgM against GM1 by sending coded serum samples to nine laboratories. In three samples high-titre IgM antibodies against GM1 were detected by all laboratories. This result was confirmed by dot blot immunodetection and thin-layer chromatography immuno-overlay. Seven samples were read as negative by nearly all laboratories. Major discrepancies between laboratories were noted in the analysis of one sample with results ranging from negative to “high titre”.
    Type of Medium: Electronic Resource
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  • 17
    ISSN: 1432-1459
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 18
    ISSN: 1432-1459
    Keywords: Key words Multiple sclerosis ; Tumor-necrosis factor ; Genetic polymorphism
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Tumor necrosis factor-α (TNFα) is a pluripotent proinflammatory cytokine and is thought to play an important role in the inflammatory process of multiple sclerosis (MS). A G→A transition in the TNFα promotor at position –308 (TNF2 allele) has been shown to be associated with increased TNFα production. This study was designed to detect wether the TNF2 allele is associated with disease progression in MS. We examined the TNFα–308 polymorphism with an allelic discrimination PCR to detect the G→A transition in the genomic DNA of 283 MS patients from Germany and in 72 patients with amyotrophic lateral sclerosis (ALS) and 66 with stroke from the same genetic background who served as controls. Disease severity was defined by the progression index (PI) and by progression to the important clinical landmarks of Extended Disability Status Score (EDSS) 3.5 and 6. In addition, we evaluated the TNFα mRNA expression in whole blood with quantitative PCR. No differences were found between the presence of the TNF2 allele in MS, ALS, or stroke patients. Among the MS patients the TNF2 allele was not associated with a certain disease course. No association was found between the accumulation of neurological deficits and progression to clinical landmarks. Although MS patients with the TNF2 allele tended to progress more rapidly from EDSS 3.5 to EDSS 6 this difference was nonsignificant (P = 0.2). Nevertheless, we observed significantly higher TNFα mRNA expression in blood cells of stable patients carrying the TNF2-allele in comparison to the group with the wild type (P = 0.024). To examine the effect of genetic background we examined the DNA of 60 MS patients and 20 healthy controls in a Cypriot population of Greek origin. There was a significantly lower frequency of the TNF2 allele in the Cyprus population than in Germans (P = 0.01). No significant differences were found between the frequencies of the TNF2 allele in Cypriot MS patients and controls. Although the TNF2 allele is associated with higher TNFα mRNA baseline levels, our data indicate that this allele appears not to contribute to MS susceptibility or severity. In addition our data demonstrate that the TNFα–308 polymorphism is segregated differentially in two European populations of different genetic origin.
    Type of Medium: Electronic Resource
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  • 19
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Heimbeatmung ; Neuromuskuläre Erkrankungen ; Amyotrophe Lateralsklerose ; IPPV ; Respiratorische Insuffizienz ; Key words Home ventilation ; Neuromuscular disorders ; Amyotrophic lateralsclerosis ; Positive- pressure ventilation ; Respiratory insufficiency
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary During recent years home ventilation has been shown to be useful for a growing number of patients with neuromuscular diseases and respiratory insufficiency caused by weakness of the respiratory muscles. Despite its technical simplicity, home ventilation leads to a number of social, ethical, medical and infrastructural problems. This consensus paper discusses the special situation of patients with neuromuscular diseases in home ventilation and describes the current thinking in the following topics: (1) definition of home ventilation; (2) aims of home ventilation; (3) indications and preconditions of home ventilation; (4) techniques and forms of home ventilatory support; (5) preparation for and practical questions of home ventilation; (6) stopping home ventilation.
    Notes: Zusammenfassung In den letzten Jahren wird eine zunehmende Zahl von Patienten mit neuromuskulären Erkrankungen und begleitender Ateminsuffizienz zu Hause oder in speziellen Einrichtungen dauerhaft oder intermittierend beatmet. Die praktische Durchführung einer Heimbeatmung wirft jedoch eine Fülle von organisatorischen, sozialen, ethischen und medizinischen Problemen auf. Mit dem Ziel, eine effiziente Durchführung von Heimbeatmungen zu gewährleisten, wurden die folgenden Empfehlungen der bayerischen Muskelzentren in der DGM unter besonderer Berücksichtigung der Situation von Patienten mit neuromuskulären Erkrankungen formuliert. Es wird im einzelnen zu folgenden Themenbereichen Stellung genommen: • Definition der Heimbeatmung, • Ziele der Heimbeatmung, • Indikationsstellung der Heimbeatmung und deren Voraussetzung, • technische Durchführung der Heimbeatmung, • Vorbereitung und praktische Durchführung der Heimbeatmung und • Beendung der Heimbeatmung auf Wunsch des Patienten.
    Type of Medium: Electronic Resource
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  • 20
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Myelits ; Querschnittssymptomatik ; Multiple Sklerose ; ADEM ; RDEM ; Key words Myelitis ; Tetraparesis ; Multiple sclerosis ; ADEM ; RDEM
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Recurrent transverse myelitis is a rare inflammatory demyelinating disorder, which is distinguished from acute monophasic transverse myelitis and from MS. We present two patients with recurrent transverse myelitis, who developed an acute remitting tetraparesis and sensible deficits with a cervical level. They were followed for 4 and 5 years. MRI showed an isolated lesion with contrast enhancement in the spinal cord but no pathological cranial findings. Oligoclonal bands were negative in repeated lumbar punctures. One patient showed lymphocytic pleocytosis during the first and second attack. Somatosensory and motor evoked potentials were abnormal during relapses while visually and brainstem acustically evoked potentials (VEP and BAEP) stayed within limits. Laboratory examinations for bacterial, viral or parasitic infections, antinuclear antibodies, Angiotensin-converting enzyme and the sedimentation rate were also normal. The differential diagnosis will be discussed in view of previously reported series. We give a review of the current literature and discuss the differential diagnoses.
    Notes: Zusammenfassung Die rezidivierende Querschnittsmyelitis (RQM) ist eine seltene entzündliche, vorwiegend demyelinisierende Erkrankung des Rückenmarks, die von der akuten monophasischen Querschnittsmyelitis und von der multiplen Sklerose mit Rückenmarksbeteiligung abgegrenzt wird. Wir stellen 2 Patienten mit mehrfach jeweils akut auftretender Tetraparese vor. In der Beobachtungszeit von 4 bzw. 5 Jahren zeigte die Magnetresonanztomographie (MRT) bei beiden einen solitären Herdbefund im Rückenmark bei jeweils unauffälligem cranialen Befund. Oligoklonale Banden wurden bei mehrfachen Liquoruntersuchungen nicht nachgewiesen. Bei einem Patienten fand sich im Liquor eine lymphozytäre Pleozytose während der ersten 2 Schübe. Die motorisch- und somatosensorisch-evozierten Potentiale (MEP und SSEP) waren pathologisch verändert, die visuell und akustisch evozierten Potentiale hingegen immer unauffällig. Laboruntersuchungen zum Nachweis bakterieller, vitaler und parasitärer Erreger, antinukleärer Antikörper, Angiotensin-konvertierendem Enzym sowie der BSG erbrachten keinen pathologischen Befund. Diese Patienten werden mit differentialdiagnostischen Überlegungen beschrieben und vor dem Hintergrund der Literatur diskutiert.
    Type of Medium: Electronic Resource
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