Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Sep 1995
Case ReportsAssociation between trigeminal neuralgia and multiple sclerosis: role of magnetic resonance imaging.
Seven consecutive patients with multiple sclerosis and trigeminal neuralgia were investigated with MRI to determine the occurrence of a lesion which would account for the patients' pain. Two patients had bilateral symptoms. In the patients with unilateral trigeminal neuralgia vascular compression of the nerve by an artery at the root entry zone on the symptomatic side was confirmed in three patients and an epidermoid tumour distorting the nerve on the symptomatic side was identified in one patient. ⋯ In those with bilateral symptoms neurovascular compression was identified on both sides in one patient and on one side only in the remaining patient. Microvascular decompression cured the pain in two patients with neurovascular compression. The variable aetiology of trigeminal neuralgia is stressed even in patients with coexistent neurological conditions such as multiple sclerosis, which can cause trigeminal neuralgia independent of other causes.
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J. Neurol. Neurosurg. Psychiatr. · Aug 1995
ReviewImpairment, disability, or handicap in peripheral neuropathy: analysis of the use of outcome measures in clinical trials in patients with peripheral neuropathies.
Outcome measures can be classified into measures of impairment, disability, and handicap. To investigate the biological effect of treatment, measures of impairment are appropriate. Studies investigating whether patients benefit from treatment in terms of improvement of functional health, however, require disability or handicap measures. ⋯ The limited use of disability and handicap measures in patients with diabetic and mixed neuropathies can be explained by the experimental nature of most studies. In four of six studies, however, in patients with chronic inflammatory demyelinating polyneuropathy or neuropathy associated with monoclonal gammopathy that were designed to assess effectiveness of treatment, the choice of outcome measures was not appropriate. It is concluded that in the design of intervention studies in patients with peripheral neuropathy more attention should be paid to a proper choice of suitable outcome measures to assess the effectiveness of treatment.
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J. Neurol. Neurosurg. Psychiatr. · Jul 1995
Frontotemporal dementia and Alzheimer's disease: retrospective differentiation using information from informants.
The study examined the feasibility of differentiating frontotemporal dementia from Alzheimer's disease on the basis of retrospective historical information obtained from relatives of patients. A structured questionnaire was devised of patients' symptoms, with emphasis on those cognitive and neuropsychiatric features found in earlier prospective clinical studies to distinguish the two conditions. The questionnaire was given to close relatives of deceased patients in whom the diagnosis of non-Alzheimer's frontotemporal degeneration of Alzheimer's disease had been verified at necropsy. ⋯ A scoring system separated out individual patients with frontotemporal dementia from those with Alzheimer's disease. It is concluded that it is possible to obtain useful information about the precise pattern of dementia from informants even many years after the patient's death. The questionnaire provides the foundation of a diagnostic instrument for use in family history studies of dementia.
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J. Neurol. Neurosurg. Psychiatr. · Jul 1995
Prediction of outcome in severe head injury based on recognition of sleep related activity in the polygraphic electroencephalogram.
This study shows that the continuing presence of activity similar to normal sleep in the EEG in conjunction with the EEG polygraph (EEGP) can be used to determine the severity of brain damage after head injury. Recordings were taken within seven days of head injury from 154 unselected patients after resuscitation and emergency surgery. Sixteen patients with ongoing seizures were excluded. ⋯ The mean follow up was 21.5 months. Groups 2 and 3 were significantly associated with a good outcome and group 5 with death or a vegetative state. Comparison between the EEG/EEGP findings and the Glasgow coma scale at the time of the recording showed the EEG/EEGP to be the better predictor of outcome, particularly for individual patients.