Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Jul 1996
Emotional, neuropsychological, and organic factors: their use in the prediction of persisting postconcussion symptoms after moderate and mild head injuries.
After mild and moderate head injuries a range of postconcussion symptoms (PCS) are often reported by patients. Both organic and psychogenic factors can contribute to these. Full recovery from PCS usually occurs within three months of the injury. A significant minority, however, continue to experience symptoms beyond this time. To date, no means of identifying these patients early after injury has been reported. This study investigates whether a combination of neuropsychological, emotional, and traditional measures of severity of head injury taken early after the injury can help predict severity of PCS three months after injury. ⋯ A combination of measures may significantly aid the prediction of persistent PCS. Five measures: HADS, post-traumatic amnesia, SOMC, PASAT, and RPQ are recommended for their predictive value and clinical utility. Independent cross validation studies are required before these results can be generally applied. They do, however, provide valuable indications regarding those measures that are most likely to demonstrate utility.
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J. Neurol. Neurosurg. Psychiatr. · Jul 1996
Comparative StudyChronic dysimmune demyelinating polyneuropathy: a clinical and electrophysiological study of 93 patients.
To identify clinical, electrophysiological, and immunological characteristics of chronic immune demyelinating polyneuropathy to define for each group the appropriate therapeutic strategies. ⋯ The idiopathic CDDP group is heterogeneous with probably different subgroups. Patients with IgM MGUS polyneuropathy and anti-MAG antibodies have characteristics which distinguish them significantly from other CDDP and suggest different immune mechanisms and responses to treatment.
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J. Neurol. Neurosurg. Psychiatr. · Apr 1996
Case ReportsMotor neuron disease presenting as acute respiratory failure: a clinical and pathological study.
Respiratory failure is rarely a presenting symptom of motor neuron disease. Seven patients with motor neuron disease who presented with acute respiratory failure of unknown cause and required mechanical ventilation were studied. They all had symptoms and signs suggestive of diaphragmatic weakness. ⋯ Weaning from the ventilator was unsuccessful in all cases. The four patients examined at necropsy showed severe loss of anterior horns cells in the cervical cord, with only minimal upper motor neuron involvement. Motor neuron disease should be recognised as a cause of acute respiratory failure, secondary to diaphragmatic paralysis from involvement of phrenic motor neurons.
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J. Neurol. Neurosurg. Psychiatr. · Apr 1996
Somatosensory findings in patients with spinal cord injury and central dysaesthesia pain.
To determine whether central pain in patients with spinal cord injury is only dependent on the lesioning of spinothalamic pathways. ⋯ Because pain and thermal sensory perception are primarily mediated to the brain via spinothalamic pathways, whereas the sensations of touch, vibration and joint position are primarily mediated by dorsal column-medial lemniscal pathways, the results indicate that central pain is not only dependent on the lesioning of either dorsal column-medial lemniscal pathways or spinothalamic pathways. The findings of abnormal evoked pain (allodynia and wind up-like pain) may be consistent with the experimental findings of hyperexcitability in nociceptive spinothalamic tract neurons, that may be involved in the pathogenesis of central pain.