ABSTRACT
Meningeal carcinomatosis as presenting symptom is rare. We report a patient who presented with an isolated abducens nerve palsy and an unsteady gait. At autopsy the primary tumor proved to be a gallbladder carcinoma. Only one similar case has been reported. Several aspects are discussed, including the route by which the tumor cells could have reached the subarachnoid space.
Subject(s)
Adenocarcinoma/secondary , Gallbladder Neoplasms/pathology , Meningeal Neoplasms/secondary , Abducens Nerve/pathology , Adenocarcinoma/pathology , Adrenal Gland Neoplasms/pathology , Adrenal Gland Neoplasms/secondary , Adrenal Glands/pathology , Cranial Nerve Neoplasms/pathology , Cranial Nerve Neoplasms/secondary , Diagnosis, Differential , Female , Gallbladder/pathology , Humans , Meningeal Neoplasms/pathology , Middle Aged , Ophthalmoplegia/pathologyABSTRACT
In order to evaluate the usefulness of SEP with cutaneous nerve stimulation in lumbosacral radiculopathy, we investigated 19 patients by EMG including H-reflex and SEP. All patients had radiculopathy proven by myelography and/or CT scan and, if indicated, operative treatment. The findings by EMG and SEP were compared with operative and radiological findings. In this preliminary study, SEP was as sensitive as EMG in detecting lumbosacral radiculopathy. Further investigation seems justified.
Subject(s)
Electromyography , Evoked Potentials, Somatosensory/physiology , Nerve Compression Syndromes/physiopathology , Skin/innervation , Spinal Nerve Roots/physiopathology , Adult , Afferent Pathways/physiopathology , Aged , Female , H-Reflex/physiology , Humans , Male , Middle Aged , Nerve Compression Syndromes/diagnosis , Reaction Time/physiology , Somatosensory Cortex/physiopathologyABSTRACT
The results of stereotactic thalamotomy in the treatment of 32 patients with Parkinson's disease are described. The outcome is compared with reports from the literature and with the author's former results with patients not treated with levodopa preoperatively. Especially, ipsilateral tremor aggravation is caused more frequently. Also the quite disappointing results of bilateral thalamotomy are briefly mentioned. The location of the lesion and its possible relation to the side-effects are discussed. On the basis of the outcome described, the indication for the operation seems to be a tremor, not necessarily unilateral, which is resistant to all medications available for Parkinson's disease. Such medication is given for a period of some months after the pros and cons have been thoroughly discussed with the candidate.
