Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0042024 (incontinence)
 13,409 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report results of Iotrolan CT-cisternography on 41 demented patients (13 males and 28 females) to find "occult normal pressure hydrocephalus". These patients were suspected to have CSF flow disturbance from clinical symptoms and simple brain CT scan findings. Their average age, duration of dementia, and score of Hasegawa's dementia scale (HDS) were 76.2 years, 5.9 years, 9.5/32.5, respectively. Before performing CT-cisternography, clinical diagnosis for their dementia were vascular dementia in 18 patients, Alzheimer type dementia in 12, suspect of NPH in 5, and other diagnoses in 6. From the results of cisternography, we found 13 patients with CSF flow disturbance (contrast material remained in the ventricle more than 48 hours after injection), and 17 patients with normal CSF flow. The former showed lower scores of HDS, higher urinary incontinence scores and smaller areas of the interhemispheric fissure on CT scan than the latter. But the former showed no significant difference from the latter in the average age, duration of dementia and width of the ventricles.
 ...
PMID:[Occult CSF flow disturbance of patients with Alzheimer type dementia and vascular dementia--results from iotrolan CT-cisternography]. 802 36

Hydrocephalus associated with spinal tumors is a well known but not common phenomenon. Over 80 such cases have been reported since 1931 by Kirieleis. Most of those cases present features of raised intracranial pressure, for instance papilledema. The histological diagnosis of the tumors is ependymoma (1/2), neurinoma (1/4) and malignant astrocytoma (1/4). On the other hand dementia as a symptom of spinal tumors has been reported only 13 times. In 11 of 13 cases presented with signs of NPH, mental status improved only by removal of the tumors without shunt operation. The histological diagnosis of the tumors is neurinoma (9 cases), ependymoma (2) and meningioma (2). Ours is the 14th case. A 59-year-old woman presented a 6 month history of memory disturbance, gait disturbance and urinary incontinence. CT scan showed ventricular dilatation. RI cisternography revealed a block at lumbar region. CSF obtained by lumbar puncture was deep yellow and turbid. CSF protein level was markedly elevated to 4073 mg/dl. MRI of the spinal cord demonstrated cauda equina mass. Total removal of the spinal tumor was performed. The histological diagnosis was neurinoma. Within 3 weeks the patient's symptoms had dramatically improved. The decrease in ventricular size was noted on CT 18 months after operation. We think one of the most important factors by which spinal tumors develop NPH is elevation of the CSF protein content. In our case, postoperative protein level decreased from 4073 to 274 mg/dl.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Neurinoma of the cauda equina associated with normal pressure hydrocephalus]. 821 13

A 67-year old male patient was admitted to our clinic because of slowly developing dementia. Severe dysfunction of memory, confusional states and urinary incontinence were observed. A diagnosis of general paresis was made by positive serology for syphilis and CSF examination. The patient's condition improved markedly after high-dose penicillin G treatment.
 ...
PMID:[Development of dementia]. 825 71

We describe six men with a slowly progressive myelopathy characterized by asymmetric, incomplete spinal cord syndrome manifested with a thoracic sensory level, mild spastic paraparesis, and urinary incontinence. The spinal cord lesions were evident by MRI in four of them. Coxiella burnetii infection was confirmed in the blood of all patients by immunofluorescence microscopic assay (IFA) and transmission electron microscopy (TEM). In two patients, we detected C burnetii by TEM and IFA using CSF from the patients inoculated onto fresh peripheral blood lymphocyte. Four patients, treated with appropriate antibiotics, responded either with partial resolution of symptoms or arrest of further neurologic progression. In three, the MRI lesions decreased in size.
 ...
PMID:Coxiella (Q fever)-associated myelopathy. 843 99

A 53-year-old right-handed woman presented with headaches and dizziness. She had been well for ten years following successful cadaveric renal transplantation and was taking prednisolone and azathioprine. Two months later she had more headaches with transient dominant hemisphere disturbances and then suffered a completed right hemisphere deficit. As this was recovering, she developed an ischemic optic neuropathy, Computerized tomography (CT) was then normal although CSF analysis showed lymphocytosis and high protein. Steroid trial led to dramatic symptomatic and clinical recovery. On tailing off steroids, progressive bilateral hemisphere disturbance occurred. She was bedbound, with fever, headache, incontinence and disturbed consciousness. New evidence of infarction in watershed territories on CT led to temporal lobe biopsy. Cortical arterioles and venules showed proliferation of lymphoid cells staining for leucocyte common antigen and B-cell markers characteristic of Neoplastic Angioendotheliomatosis (NAE). After chemotherapy she regained independence and mobility and CSF protein fell. This is the first case of NAE to our knowledge in association with immunosuppression for renal transplant and is further evidence that NAE is malignant lymphoma. Cerebrovascular disease is common in such patients, the simultaneous events in differing territories is typical of NAE. Response to chemotherapeutic agents occurred although the typical natural history was unchanged.
 ...
PMID:Neoplastic angioendotheliomatosis: a treatable "vascular dementia" occurring in an immunosuppressed transplant patient. 847 50

A 74-year-old woman presented with gait impairment, urinary incontinence, and dementia. She showed lymphocytic CSF pleocytosis and pronounced intrathecal Borrelia burgdorferi antibody production, indicating active Lyme neuroborreliosis. The syndrome of normal-pressure hydrocephalus (NPH) fully remitted after ceftriaxone treatment. Lyme neuroborreliosis may cause NPH by interfering with subarachnoid CSF flow.
 ...
PMID:Lyme neuroborreliosis disguised as normal pressure hydrocephalus. 864 83

In a prospective series of symptomatic adult hydrocephalus characterized by gait disturbance, cognitive impairment, and/or urinary incontinence, 88 of 118 patients (75%) had additional akinetic, tremulous, hypertonic, or hyperkinetic movement disorders. Their prevalence was highest in patients with idiopathic normal pressure hydrocephalus (NPH) of the elderly (56/65 patients, 86%), and they were less frequent in patients with secondary NPH (10/15, 66%), with nonhydrodynamic atrophic/other hydrocephalus (20/33, 61%), and with obstructive hydrocephalus/aqueductal stenosis (2/5, 40%). Akinetic symptoms were found in 73 of 118 patients (62%), and the most frequent movement disorder was upper extremity bradykinesia (55%). Akinetic, tremulous, hypertonic, and hyperkinetic movement disorders were exclusively secondary to causes not related to hydrocephalus in 24 of 118 patients (20%). The proportion of patients with movement disorders not attributable to only such causes was highest in the idiopathic NPH group (44/65, 68%). Thirteen of 118 patients (11%) presented with a parkinsonian syndrome. There was evidence for coexistent Parkinson's disease in four of these patients. Parkinsonism was found to be secondary to NPH in five patients and was found improved after shunting. Akinetic symptoms in patients with NPH generally responded favorably to CSF diversion, which was evident in 80% of a subset of this group. Various other movement disorders did not show definite improvement. The high prevalence of bradykinesia and other akinetic symptoms in NPH and the beneficial effect of shunting on such symptoms suggest that NPH may cause a more generalized disorder of motor function.
 ...
PMID:Movement disorders in adult hydrocephalus. 899 54

Micturitional disturbance is rarely mentioned in human herpetic brainstem encephalitis although the pontine tegmentum, called the pontine micturition centre, seems to regulate the lower urinary tract in experimental animals. The case of a 45 year old man, who developed subacute coma and hiccup-like dysrhythmic breathing, and needed assisted ventilation is reported. Examination of CSF showed mononuclear pleocytosis and antibody against herpes simplex virus type 1, but the opening pressure was 90 cm H2O. Brain CT showed brain swelling, predominantly in the posterior fossa, and bilateral subdural effusion. Herpetic brainstem encephalitis was diagnosed, and he received 900 mg/day vidarabine. On regaining consciousness, he had left trochlear nerve palsy, left corectopia, ageusia, and urinary retention. Brain MRI showed right side dominant, bilateral pontine segmental lesions extending slightly to the midbrain and medulla. After two weeks he was able to urinate but showed nocturnal urinary frequency, urinary incontinence, and voiding difficulty. Urodynamic studies showed a residual urine volume of 350 ml and detrusor hyporeflexia on voiding. Micturitional disturbance gradually disappeared together with the neurological signs. The bilateral pontine tegmental lesions in this patient are similar to those in previous findings on brainstem strokes, evidence of the presence of a pontine micturition centre in humans.
 ...
PMID:Micturitional disturbance in herpetic brainstem encephalitis; contribution of the pontine micturition centre. 948 47

One man and two women (aged 30, 44 and 46, respectively) were seen between 1987 and 1992 with a myelopathy caused by the human T-cell lymphotropic virus type I (HTLV-I). The first symptoms were impaired gait in the man and micturition disorders in the women. Diagnosing took 2 to 4 years, possibly due to the fact that many Dutch physicians are unfamiliar with the disease. The diagnosis was based on originating from an endemic area (i.e. Surinam and the Caribbean basin), the clinical picture and the presence of antibodies against HTLV-I in blood and CSF. The disease in a number of years leads to spastic paraparesis, incontinence for urine and dependence on a wheelchair.
 ...
PMID:[Progressive myelopathy caused by human T-cell lymphotropic virus type I (HTLV-I) in 3 patients in The Netherlands]. 955 1

We examined CSF levels of markers of neuronal degeneration and astrogliosis-the light subunit of the neurofilament triplet protein (NFL) and the glial fibrillary acidic protein (GFAP)-in 65 patients with normal pressure hydrocephalus (NPH). NFL was increased sixfold (864 +/- 1,538 [mean +/- SD] versus 156 +/- 81 ng/L; p < or = 0.001) and GFAP twofold (1,116 +/- 1,085 versus 637 +/- 295 ng/L; p < or = 0.01) in NPH patients compared with neurologically healthy age-matched controls. No correlation was found between any particular symptom or sign and GFAP levels in CSF. The levels of NFL, on the other hand, were higher in patients with severe symptoms compared with those with moderate or no symptoms. Furthermore, there was a correlation between a high level of NFL and gait disturbance, incontinence, psychometric incapability, and social dysfunction. A high preoperative NFL level was associated with favorable outcome after shunt surgery. This indicates that NFL is a marker of ongoing and possibly still-reversible axonal damage in NPH.
 ...
PMID:CSF neurofilament and glial fibrillary acidic protein in normal pressure hydrocephalus. 956 5


<< Previous 1 2 3 4 5 6 7 8 9 Next >>