Filter by keywords:



Filtering documents. Please wait...

1/13. Relapsing-remitting autoimmune agrypnia.

    A woman affected by multiple cranial nerve palsy developed several episodes of total insomnia and respiratory crises resulting from central breathing depression associated with dysautonomic symptoms. Oligoclonal IgG bands were present in her cerebrospinal fluid, and immunohistochemistry showed increased binding of serum and cerebrospinal fluid on gamma-aminobutyric acid-ergic, synapse-rich neuronal cells. Immunosuppressive treatment and plasma exchange were followed by clinical improvement, with restoration of sleep architecture and disappearance of respiratory crises, suggesting autoimmune pathogenesis of the syndrome.
- - - - - - - - - -
ranking = 1
keywords = breathing
(Clic here for more details about this article)

2/13. A case of chorea-acanthocytosis with dysautonomia; quantitative autonomic deficits using CASS.

    The purpose of this study was to quantitatively assess cardiovagal, adrenergic and postganglionic sudomotor functions in a patient with chorea-acanthocytosis. We describe a 25-year-old woman with acanthocytosis, lip and tongue biting, chorea like movements and increased levels of serum creatine phosphokinase. The patient presented with orthostatic hypotension. The heart period response to deep breathing was moderately decreased and the quantitative sudomotor axon reflex test (QSART) was mildly abnormal in the lower extremities. The composite autonomic score (CASS) for this patient was 6 points which indicates moderate autonomic failure. Although a few previous reports have described autonomic dysfunction associated with chorea-acanthocytosis and have indicated that impairment is primarily sympathetic, our case study suggests that there is also parasympathetic dysfunction. We conclude that there is widespread autonomic involvement in choreaacanthocytosis and that autonomic studies are useful in monitoring their course.
- - - - - - - - - -
ranking = 1
keywords = breathing
(Clic here for more details about this article)

3/13. Resolution of diabetic autonomic neuropathy.

    Many consider diabetic autonomic neuropathy to be an irreversible complication of diabetes of long duration. Three patients developed symptoms of autonomic neuropathy which subsequently resolved. Their autonomic neuropathy was not associated with long duration of diabetes, but with weight loss. Each had marked weight loss and resolution occurred on regaining remembered premorbid weight. A woman aged 20 was admitted with anorexia nervosa (weight loss 6 kg). She complained of feeling bloated. Gastroenterological investigations showed delayed gastric emptying. RR ratio (respiration and standing) was abnormal. Resolution occurred after two years. A male aged 18 developed diabetic symptoms, which were overlooked. Twelve months later he presented underweight and ketonuric; insulin treatment was started but within one month he became impotent. Resolution occurred after 18 months. An 80 year old man presented after six months trial of diet and sulphonylurea therapy. He was underweight, had ketonuria, and such muscle loss that he was unable to sit unaided. insulin treatment was started. He developed severe symptomatic postural hypotension. This resolved six months later by which time he had regained his normal weight. These cases illustrated symptomatic autonomic neuropathy occurring in relation to weight loss with resolution on recovery of normal weight, a temporal pattern mimicking that of acute cachectic painful neuropathy. Treatment of autonomic neuropathy should be like that of cachectic neuropathy, that is with an expectation of recovery and should include strategies to regain premorbid weight and achieve glycaemic control.
- - - - - - - - - -
ranking = 3.5502608985735
keywords = respiration
(Clic here for more details about this article)

4/13. Autonomic involvement in tick-borne encephalitis (TBE): report of five cases.

    BACKGROUND: Tick-borne encephalitis (TBE) is a viral infection of the CNS with significant acute and long-term morbidity. Dysfunction of the autonomic nervous system may be a potentially harmful complication of TBE. MATERIAL AND methods: In a retrospective case series, 5 patients with acute TBE were evaluated for clinical signs of autonomic dysfunction and subject to autonomic testing. heart rate variability (HRV) with 6 per minute deep breathing was performed between day 9 to 31 after onset of meningitis. Follow-up data were available in three cases. RESULTS: All patients showed clinical signs of autonomic dysfunction, including upper and lower gastrointestinal tract symptoms, orthostatic hypotension, and urinary retention. A reduced HRV was observed in 4 patients, with sustained sinus tachycardia in 2 of them. The minimum of the HRV was reached 9 to 20 days after onset of meningitis. In one patient, normalization of the HRV occurred within 3 months. CONCLUSION: Acute TBE can be associated with autonomic dysfunction including reduced HRV and tachycardia. prospective studies are needed to analyze the incidence of autonomic dysfunction in TBE, and to clarify which patients have the highest risk for autonomic failure.
- - - - - - - - - -
ranking = 1
keywords = breathing
(Clic here for more details about this article)

5/13. respiratory insufficiency as the primary presenting symptom of multiple-system atrophy.

    BACKGROUND: Respiratory stridor, sleep-disordered breathing, and respiratory insufficiency are part of the clinical spectrum of multiple-system atrophy (MSA). We have encountered cases where these were presenting symptoms, with the diagnosis of MSA being initially unrecognized. OBJECTIVE: To describe cases in which breathing difficulties were the initial and primary manifestation of MSA. DESIGN: database review from January 1, 1996, through October 31, 2005. SETTING: Mayo Clinic, Rochester, Minn. patients: All patients diagnosed as having MSA, cross-referenced for apnea, hypopnea, or hypoventilation. On review, we included only cases in which respiratory dysfunction was the primary initial clinical event in MSA, excluding equivocal cases. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Characteristics and clinical course of patients. RESULTS: Six cases were identified in which substantial respiratory insufficiency occurred as an early, presenting symptom of MSA. Three patients had been examined emergently for acute respiratory distress before the ultimate diagnosis of MSA; the other 3 patients were diagnosed as having obstructive sleep apnea unresponsive to therapy, with bilateral vocal cord paralysis found on ear, nose, and throat examination. Stridor was noted early in the course in all. All patients required tracheostomy, and all eventually developed features consistent with probable MSA. CONCLUSIONS: Multiple-system atrophy may occasionally present as primary respiratory failure or dysfunction, with initially mild motor and autonomic symptoms. Otherwise unexplained central respiratory failure, bilateral vocal cord paralysis, stridor, or refractory central sleep apnea should prompt consideration of MSA.
- - - - - - - - - -
ranking = 2
keywords = breathing
(Clic here for more details about this article)

6/13. Pathophysiological findings in a patient with Shy-Drager and alveolar hypoventilation syndromes.

    This report describes the clinical, physiologic and pathologic findings in a patient with alveolar hypoventilation, acquired autonomic dysfunction, parkinsonism, and sensorimotor polyneuropathy. While there were pathologic findings in both central and peripheral nervous systems, there were no morphologic changes in the regions of the brainstem considered responsible for respiratory rhythmogenesis. A hypothesis is developed based on the assumption that the abnormalities in respiratory control which led to the patient's death are explained by abnormalities in the feedback control of respiration.
- - - - - - - - - -
ranking = 3.5502608985735
keywords = respiration
(Clic here for more details about this article)

7/13. Clinical studies with an aldose reductase inhibitor in the autonomic and somatic neuropathies of diabetes.

    Clinical investigations with the aldose reductase inhibitor (ARI) sorbinil in diabetic patients with neuropathy are described. Cardiac autonomic neuropathy was studied in 36 patients, in a double-blind, placebo-controlled, randomized, noncrossover trial. patients received sorbinil (250 mg qd) or placebo over 6 weeks after a one-week baseline period. Diabetic control did not change over the study period, as indicated by unchanged glycohemoglobin. Response was assessed by expiration/inspiration (E/I) ratios on EKG during 6 c/min respiration and resting minimum heart rate, both measures of vagal function. In the sorbinil group, E/I ratios improved from 1.074 /- 0.012 to 1.096 /- 0.020 (P less than 0.03) with a slight decrease in the placebo group from 1.112 /- 0.023 to 1.105 /- 0.023 (P = NS). The difference between the week 6 and week 0 changes in each group was significant (P less than 0.01). Resting minimum heart rate decreased in the sorbinil group from 76.4 /- 2.3 to 66.8 /- 2.4 beats/min (P less than 0.001), with a mean change of 10 /- 2. In the placebo group, heart rate was unchanged (77.9 /- 3.9 to 77.5 /- 3.3). The two sample t tests of the within-group differences were likewise significant (P less than 0.001). These changes in both E/I ratio and resting minimum heart rate are consistent with a sorbinil-related improvement in cardiac parasympathetic nerve function. Several isolated cases with apparent sorbinil-related improvement in autonomic symptoms will also be described. Studies of somatic neuropathy have previously shown improvement in nerve conduction velocities with sorbinil. In a study of 11 patients with severely painful diabetic neuropathy treated with sorbinil for 3 weeks [placebo-controlled in single-blind fashion (n = 8)], pains (as assessed on a 0 to 20 rating scale) improved from a mean score of 16 down to 8, with deterioration following drug withdrawal. Objective improvements in sensation and strength were observed in some cases. In this group of patients, statistically significant improvements in nerve conduction velocity, E/I ratios, and resting minimal heart rate, similar to those previously discussed, were also documented. Somatosensory-evoked potentials studies in the 36-patient study showed significant improvements in peripheral conduction and cortical responses. Sorbinil toxicity in 106 patients was 11.3%, with sex incidence of 7/73 males (9.6%) and 5/33 females (15.2%).(ABSTRACT TRUNCATED AT 400 WORDS)
- - - - - - - - - -
ranking = 3.5502608985735
keywords = respiration
(Clic here for more details about this article)

8/13. Failure of automatic control of ventilation (Ondine's curse) associated with viral encephalitis of the brainstem: a clinicopathologic study of one case.

    A case of Ondine's curse associated with hypothalamic dysfunction in an 8-year-old boy is described. The neuropathological examination revealed a viral encephalitis affecting the hypothalamus and the brainstem. In the medulla the inflammatory process involved the reticular formation and the nuclei considered to control automatic respiration such as the dorsal motor nucleus of the vagus, the nucleus tractus solitarii and the nucleus ambiguous. Although Ondine's curse following viral infection of the central nervous system has been previously reported this represents the first case of viral encephalitis to be pathologically documentated.
- - - - - - - - - -
ranking = 3.5502608985735
keywords = respiration
(Clic here for more details about this article)

9/13. respiration and sleep in Parkinson's disease.

    sleep and respiration during sleep were studied in patients with idiopathic Parkinson's disease, patients with Parkinsonism with autonomic disturbance, and normal age and sex matched controls. patients with idiopathic Parkinson's disease showed significantly reduced REM sleep, and more frequent and prolonged waking throughout the night. hypoventilation and sleep apnoea did not occur in the idiopathic Parkinson's disease or normal groups, but respiration was disorganised with frequent central and obstructive apnoeas in the autonomic disturbance group. respiratory rate during non rapid eye movement sleep was similar in the idiopathic Parkinson's disease and normal groups, but patients with idiopathic Parkinson's disease showed tachypnoea awake and during REM sleep.
- - - - - - - - - -
ranking = 7.100521797147
keywords = respiration
(Clic here for more details about this article)

10/13. Reversible parasympathetic dysautonomia following stinging attributed to the box jelly fish (Chironex fleckeri).

    Following a box jelly fish sting, a 52 year old Chinese fisherman developed acute abdominal distension, inability to pass urine and failure of erection. Examination revealed gaseous abdominal distension and a distended urinary bladder. Absence of lachrimation and absence of changes in the R-R interval in the ECG during breathing and carotid sinus massage gave further evidence of parasympathetic dysautonomia. The patient made a complete recovery. The case highlights the occurrence of reversible parasympathetic dysautonomia following box jelly fish sting.
- - - - - - - - - -
ranking = 1
keywords = breathing
(Clic here for more details about this article)
| Next ->


Leave a message about 'Autonomic Nervous System Diseases'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.