Cases reported "Reflex, Abnormal"

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1/7. Bezold-Jarisch-like reflex during Brockenbrough's procedure for radiofrequency catheter ablation of focal left atrial fibrillation: report of two cases.

    Brockenbrough's puncture technique has been widely conducted in the electrophysiologic laboratory. We report here two cases exhibiting a rare complication of this procedure, which arose during the conduct of catheter ablation using radiofrequency energy delivered to the pulmonary vein for the treatment of focal left atrial fibrillation. These cases exhibited marked sinus bradycardia and profound hypotension, suggestive of a Bezold-Jarisch-like reflex, observed immediately after Brockenbrough's procedure but before radiofrequency application. ST elevation in the inferior leads was also observed in spite of normal coronary angiograms. This unanticipated transient complication was treated by intravenous administration of atropine, which had no influence on the ablation procedure or prognosis. This is speculated to be attributable to the elevation of vagal tone caused by the mechanical effects of transseptal puncture on the interatrial vagal network.
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2/7. Evaluation of Chapman's neurolymphatic reflexes via applied kinesiology: a case report of low back pain and congenital intestinal abnormality.

    OBJECTIVE: To describe the applied kinesiologic evaluation of Chapman's neurolymphatic (NL) reflexes in the management of a person with an unusual congenital bowel abnormality and its role in the manifestation of low back pain. The theoretical foundations of these reflexes will be elaborated on and practical applications discussed. CLINICAL FEATURES: A 29-year-old man had chronic low back pain. Radiographs of the patient's lumbar spine and pelvis were normal. Magnetic resonance imaging (MRI) demonstrated a mild protrusion of the fifth lumbar disk. Oral anti-inflammatory agents, cortisone injections, and chiropractic manipulative therapy provided little relief. Though generally in robust health, the patient was aware of a congenital intestinal abnormality diagnosed when he was a child; it was thought to be of no consequence with regard to his current back condition. INTERVENTION AND OUTCOME: The patient's history, combined with applied kinesiology examination, indicated a need to direct treatment to the large bowel. The essential diagnostic indicators were the analysis of the Chapman's neurolymphatic reflexes themselves, coupled with an evaluation of the traditional acupuncture meridians. The primary prescribed therapy was the stimulation of these reflexes by the patient at home. This intervention resulted in the resolution of the patient's musculoskeletal symptomatology, as well as improved bowel function. CONCLUSION: The rather remarkable outcome from the application of this relatively simple, yet valuable, diagnostic and therapeutic procedure represents a thought-provoking impetus for future study and clinical application.
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3/7. "Hypnopuncture"--a dental-emergency treatment concept for patients with a distinctive gag reflex.

    The present case report describes a newly developed dental treatment concept for patients with a distinctive gag reflex. "Hypnopuncture" is a combination therapy of hypnosis and acupuncture. Its simple, fast, and effective application autonomous of the cause makes it a valuable tool for dental-emergency treatment procedures. Physiologic and psychological aspects of gagging are influenced at the same time. The protocol is illustrated in the case of a 76-year-old patient with a severe gag reflex who was successfully treated by this combination approach. Necessary and effective therapeutic measures from both acupuncture and hypnosis are portrayed.
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4/7. A long-term therapeutic treatment for patients with a severe gag reflex.

    "Hypnopuncture," a combination treatment of hypnosis and acupuncture, provides a therapeutic treatment plan for long-term therapy for patients with a distinctive gag reflex. The treatment is applied independently of the cause. In cases of emergency treatment in dentistry, the immediate compliance of a patient is of utmost importance. The long-term goal of any therapeutic measure is control of the gag reflex. A new treatment protocol is illustrated in the case of a 50-year-old patient with a severe gag reflex. After only 5 visits, dental treatment could be conducted without any auxiliary means. hypnosis is applied in the form of hypnosedation (not as psychotherapy), while stereognosis occupies a central position for desensitization.
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5/7. Malignant pseudotumor cerebri. Report of two cases.

    Two young Arab women presented with a very rapid loss of vision, ophthalmoplegia, florid papilledema, areflexia of the lower limbs, and normal mentation. Lumbar puncture pressure was above 60 cm H2O, but no intracranial structural lesion was found in either patient. An exhaustive evaluation as to an etiology was negative in both. Under continuous lumbar cerebrospinal fluid drainage and administration of steroids, furosemide, and acetazolamide, both patients had significantly improved vision and ocular movement. In both, lumboperitoneal shunting was considered but only one eventually underwent this procedure. These two patients with pseudotumor cerebri are unique in their fulminant clinical course and severely increased intracranial pressure. Virtually inevitable blindness was prevented by timely intervention.
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6/7. Normal pressure hydrocephalus. Recognition and relationship to neurological abnormalities in Cockayne's syndrome.

    Normal pressure hydrocephalus (NPH) in adults is a well-known cause of dementia. We describe NPH in children having the recessively inherited Cockayne's syndrome (CS). Cockayne's syndrome is characterized by cachectic dwarfism, neurological dysfunction, and cutaneous sunlight sensitivity. We noted that the NPH-associated triad of dementia, gait disturbance, and incontinence developed in CS patients. Computerized tomography of the brain in our four CS patients showed hydrocephalic enlargement of the brain ventricles greatest in the older patients. There was no evidence of cortical atrophy except in the one patient who had CS with xeroderma pigmentosum. Lumbar puncture and radionuclide cisternography in the two patients tested showed normal CSF pressure, with complete blockade to flow of radionuclide above the tentorium cerebelli, ventricular reflux, and delayed absorption. Studies of NPH in CS may elucidate the pathophysiology of NPH and methods to alter its sequelae.
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7/7. External ophthalmoplegia, ataxia, and areflexia complicating acute infectious polyneuritis.

    A 13-year-old girl suddenly experienced ataxia, bilateral external ophthalmoplegia, and areflexia. She was previously healthy but several family members had had a flu-like illness. cerebrospinal fluid punctures demonstrated a persistent lymphocytosis and protein elevation. Clinical improvement occurred in several months. These findings represent a variant of Guillain-Barre-Strohl syndrome (infectious polyneuritis), a systemic illness rather than a primary ophthalmologic entity.
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