ABSTRACT
UNLABELLED: Our study involved performing brain perfusion SPECT scans on Tourette's subjects to observe any common perfusion abnormalities involving the cerebral cortex or subcortical structures. METHOD: Six patients with Tourette's syndrome and nine normal control subjects underwent a brain SPECT study with 99mTc-HMPAO. Regions of interest were generated over the cerebral cortex, basal ganglia, thalamus and cerebellum to evaluate any relative perfusion abnormalities or asymmetry in the Tourette's subjects. RESULTS: Five of the six Tourette's subjects demonstrated a significant decrease in right basal ganglia activity which was not present in any of the normal control subjects. CONCLUSION: Our study suggests an etiology for Tourette's syndrome involving the right basal ganglia. Furthermore, brain SPECT may be useful in the evaluation of these patients if it proves to be sufficiently sensitive and specific in larger study populations.
Subject(s)
Brain/diagnostic imaging , Tomography, Emission-Computed, Single-Photon , Tourette Syndrome/diagnostic imaging , Adult , Basal Ganglia/diagnostic imaging , Basal Ganglia/physiopathology , Brain/physiopathology , Female , Functional Laterality , Humans , Male , Middle Aged , Organotechnetium Compounds , Oximes , Technetium Tc 99m Exametazime , Tourette Syndrome/physiopathologyABSTRACT
A 78-year-old woman presented with a right basal ganglia infarct 6 weeks after a left herpes zoster ophthalmicus. MR angiography showed focal segmental stenosis of the proximal segments of the anterior, middle, and posterior cerebral arteries. Varicella DNA was detected in the CSF by polymerase chain reaction (PCR). Treated with dexamethasone and acyclovir without improvement, she died 1 month later. There was focal endarteritis in the left anterior, middle, and posterior cerebral arteries at autopsy. Varicella DNA was detected by PCR of extracts from these vessels but not from the arteries on the right side. This study provides further evidence that the vasculopathy after herpes zoster ophthalmicus results from direct viral invasion of the vessel wall.
Subject(s)
Cerebral Arteries/microbiology , DNA, Viral/cerebrospinal fluid , Hemiplegia/cerebrospinal fluid , Herpesvirus 3, Human , Aged , Female , Humans , Polymerase Chain ReactionABSTRACT
BACKGROUND: A retrospective study of 138 children with Tourette's syndrome for associated school problems revealed that at the time of initial evaluation, 64 subjects (46%) experienced a school-related problem. OBJECTIVE: To survey a childhood population with Tourette's syndrome to explore the contributions of neurobehavioral concomitants to academic difficulties. RESULTS: A diagnosis of a specific learning disorder had previously been made in 30 (22%) of 138 children. Among the 108 without a diagnosis of learning disorder, 36 (33%) experienced school difficulties defined as grade retention (16 [15%]) and/or special education placement (41 [38%]). Regression analysis of subjects without a diagnosis of learning disability revealed that the presence of attention-deficit hyperactivity disorder served as a significant predictor of school problems. CONCLUSIONS: Tics represented the primary reason for referral, but did not emerge as a significant predictor of academic problems. Rather, school-related difficulties appeared to be strongly associated with comorbid attention-deficit hyperactivity disorder.
Subject(s)
Attention Deficit Disorder with Hyperactivity/diagnosis , Tourette Syndrome/diagnosis , Adolescent , Attention Deficit Disorder with Hyperactivity/psychology , Attention Deficit Disorder with Hyperactivity/therapy , Child , Child Behavior Disorders/diagnosis , Child Behavior Disorders/psychology , Child Behavior Disorders/therapy , Child, Preschool , Education, Special , Female , Humans , Male , Neuropsychological Tests , Obsessive-Compulsive Disorder/diagnosis , Obsessive-Compulsive Disorder/psychology , Obsessive-Compulsive Disorder/therapy , Personality Assessment , Retrospective Studies , Social Adjustment , Tourette Syndrome/psychology , Tourette Syndrome/therapySubject(s)
Odontogenesis , Pregnancy in Diabetics , Adolescent , Adult , Age Factors , Birth Weight , Child , Dentition, Mixed , Diabetic Nephropathies/diagnosis , Diabetic Retinopathy/diagnosis , Female , Humans , Male , Pregnancy , Statistics as TopicABSTRACT
The calculus (OHI-S) index according to Greene and Vermillion and the periodontal disease index of Kötzschke were determined in 209 male diabetics. The calculus index (CI) was significantly lower in diabetics with healthy gingivae (CI=0.40) than in diabetics with pathological periodontal findings (CI=1.40). Diabetics with advanced periodontal diseases (gingival recession, periodontitis and pockets), such as parodontopathia inflammata profunda, showed the highest CI value (1.88) which also differed significantly from the CI values for diabetics with healthy gingivae or with parodontopathia inflammata superficialis. 91% of our diabetics with pathological findings showed also concretions of calculus, subgingival concretions being detectable in 47.4% of these patients. It is concluded from results obtained that calculus formation is surely a sequela but not the only cause of periodontal diseases.
Subject(s)
Dental Calculus/complications , Diabetes Complications , Periodontal Diseases/complications , Humans , Male , Periodontal IndexABSTRACT
Using the Oral Hygiene Index (OHI) of Greene and Vermillion (1960), the author determined in 209 diabetics the degree of oral dirtiness and studied its effect on the periodontal conditions. He found that the OHI was significantly lower (1.17) in diabetics with healthy gingivae than in diabetics with periodontal diseases (1.60). In diabetics with parodontopathia mixta or parodontopathia inflammata profunda the OHI (1.67 and 1.86, respecitvely) was significantly worse than that in diabetics with clinically healthy gingivae or parodontopathia inflammata superficialis. Oral hygiene also correlated significantly (correlation coefficient r=0.206) with age at P less than 1%. The mean OHI for diabetics (1.55) was almost identical witoes not support the view that diabetes itself favours plaque formation.
Subject(s)
Dental Plaque/etiology , Diabetes Complications , Periodontal Diseases/etiology , Humans , Male , Oral Hygiene IndexABSTRACT
Gingiva biopsy samples from healthy individuals and from diabetics with different forms of periodontal disease were incubated in the Warburg apparatus for 2 hours. Considerable reduction in oxygen consumption and glucose uptake was found in each type of periodontal disease, the most marked reduction being stated in case of parodontopathia dystrophica. The extent of the metabolic disturbance as well as the appearence of periodontal disease correlated with the duration of diabetes on the one hand with the frequency and severity of diabetic retinopathy on the other hand.
