| 1. |
- Link, Yumin, et al.
(författare)
-
Retinal changes associated with multivitamin deficiency before and after supplementation
- 2021
-
Ingår i: Acta Neurologica Scandinavica. - : Wiley. - 0001-6314 .- 1600-0404. ; 144:2, s. 209-215
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Nutritional visual defects are apparently uncommon nowadays in developed nations. Retinal change-related visual defects caused by hypovitaminoses may be underdiagnosed. Aim of the study: To investigate the retinal structural and functional changes in a patient with multivitamin deficiency before and during vitamin supplementation. Methods: A 51-year-old female had been on vegetarian diet as a child, and on restrict vegan diet during the last 2 years, developing severe bilateral deterioration of visual function and polyneuropathy. Blood test revealed low levels of vitamin A, B6 and D. The patient underwent examinations with optical coherence tomography (OCT), computerized visual field examination (VF), electroretinography (ERG), visual evoked potentials (VEP) and neurography before and after vitamin supplementation. Results: Visual acuity (VA) was 20/1000 and VF examination showed central scotoma in both eyes. Color vision was significantly affected. Full-field ERG showed normal rod and cone function, but a clearly reduced central peak was registered in multifocal ERG (mf-ERG), indicating impaired fovea function. VEP showed delayed latency and low amplitude of P100 in both eyes. Neurography showed sensory polyneuropathy. OCT showed significant thinning of macular ganglion cell plus inner plexiform layer (GCIPL) with rapid progression. Retinal nerve fiber layer (RNFL) was preserved and normal, which is in contrast to neuroinflammatory conditions. After 2.5 years of multivitamin supplementation, the visual functions were improved. GCIPL thickness was stable without further deterioration. Conclusions: Multivitamin deficiency results in progressive thinning of GCIPL with severe visual deterioration. In contrast to neuroinflammation, RNFL is preserved and normal. Stabilized GCIPL during vitamin supplementation was associated with improved visual function. OCT provides a sensitive and objective measure for differential diagnosis, monitoring retinal change and response to therapy.
|
|
| 2. |
- Crafoord, Kristina, 1950-, et al.
(författare)
-
Pelvic floor neuropathy in relation to symptoms, anatomy and outcome of vaginal prolapse surgery : a neurophysiologic study
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- The aims of this study were to analyze whether neurophysiologic findings of pelvic floor muscles could predict preoperative symptoms of pelvic floor dysfunction and the extent and degree of pelvic organ prolapse and to investigate associations between neurophysiologic findings and the anatomic and subjective outcome of surgery. Forty two women with prolapse stage 2-3 were preoperatively examined with pudendal nerve neurography and concentric needle electromyography of the pubococcygeus and the external anal sphincter muscles. Posterior colporrhaphy was part of the prolapse surgery in all women. Anatomical and subjective outcomes were evaluated median six years postoperatively. The electromyographic findings of the pelvic muscles showed some associations with symptoms of pelvic floor dysfunction but none with degree of prolapse; no discriminatory values were obtained. EMG findings could not predict the outcome of pelvic organ prolapse surgery in terms of changes in symptoms of pelvic floor dysfunction or anatomical outcome.
|
|
| 3. |
- Engman, Maria, et al.
(författare)
-
Surface electromyography diagnostics in women with partial vaginismus with or without vulvar vestibulitis and in asymptomatic women
- 2004
-
Ingår i: Journal of Psychosomatic Obstetrics & Gynecology. - : Informa UK Limited. - 0167-482X .- 1743-8942. ; 25:3/4, s. 281-294
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate to what extent women with superficial dyspareunia can be diagnosed for both partial vaginismus (PaV) and vulvar vestibulitis (VVS) and to discover to what extent surface electromyography (sEMG) of the pelvic floor muscles (PFM) can distinguish between women with PaV solely, PaV + VVS, and asymptomatic women. A total of 224 consecutive women with superficial dyspareunia were examined clinically for both PaV and VVS diagnoses. We examined 47 women with PaV ± VVS and 27 asymptomatic women with sEMG of the PFM. The results showed that 102/224 women with superficial dyspareunia and 33/47 women with PaV in the sEMG part of the study had both PaV and VVS. All women with VVS had vaginismus, while 42/224 had PaV but not VVS. sEMG measurements revealed no significant differences between the three groups of women (PaV solely, PaV + VVS, and asymptomatic). Almost half of the women with superficial dyspareunia referred to our clinic have both the diagnosis PaV and VVS. sEMG was not a method of any value to distinguish between women with PaV solely, PaV + VVS, or asymptomatic women. The increased tone found clinically in the PFM of women with PaV ± VVS may be of other origin than electrogenic contractions.
|
|
| 4. |
- Frånlund, Karin, et al.
(författare)
-
Cortical auditory evoked potentials (P1 latency) in children with cochlear implants in relation to clinical language tests
- 2023
-
Ingår i: International Journal of Audiology. - : Routledge. - 1499-2027 .- 1708-8186.
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To study the correlation between P1 latency and the results of clinical language tests (Reynell III and TROG-2), the latter were used as they are recommended for follow-up assessments of children with cochlear implants (Cis) by the Swedish National Quality Register for children with hearing impairment.Design: A clinical cohort study.Study sample - Cross-sectional and consecutive sampling of 49 children with CIs coming for clinical follow-up assessment from March 2017 - December 2019.Results: For all children tested, there was a significant negative correlation (Spearman's rho= -0.403, p = 0.011) between hearing age and P1 latency. A significant correlation between P1 latency and the Reynell III result (Spearman's rho = -0.810, p = 0.015) was found. In the TROG-2 group, there was no significant correlation between their P1 latency and their language test results (Spearman's rho -0.239, p = 0.196).Conclusion: This method seems to be feasible and easily accepted. The study was conducted in a heterogeneous group of children that we meet daily in our clinic. The results indicated that P1 latency has a negative correlation with language development among our youngest patients fitted with CIs and might be a clinical tool to assess the maturation of central auditory pathways.
|
|
| 5. |
|
|
| 6. |
- Huang-Link, Yu-Min, et al.
(författare)
-
Acute optic neuritis : retinal ganglion cell loss precedes retinal nerve fiber thinning.
- 2015
-
Ingår i: Neurological Sciences. - : Springer Science and Business Media LLC. - 1590-1874 .- 1590-3478. ; 36:4, s. 617-620
-
Tidskriftsartikel (refereegranskat)abstract
- Optic neuritis (ON) causes axonal loss as reflected by thinning of retinal nerve fiber layer (RNFL) and can be tracked by optical coherence tomography (OCT) about 6 months after ON onset, when swelling of optic nerve head (ONH) has vanished. Changes of macular ganglion cell layer (GCL) thickness provide another window to track the disease process in ON. GCL thinning over time in relation to RNFL change after ON remains elusive. Using OCT, we followed 4 patients with acute unilateral isolated ON for more than 9 months. A diagnosis of multiple sclerosis (MS) was established in all 4 patients. First follow-up was 2-3 weeks after ON onset, and thereafter every 2-3 months. RNFL swelling peaked during first month after acute ON, followed by rapidly reduced swelling (pseudoatrophy) during following 2 months, and thereafter successively vanished 6 months after ON onset. GCL thinning was observed 1-3 months after ON onset, i.e. already during optic disk swelling and before real RNFL thinning. The results imply that quantifying GCL thickness provides opportunities to monitor early axonal loss and ON-to-MS progression, and facilitates distinguishing real atrophy from pseudoatrophy of RNFL after acute ON.
|
|
| 7. |
- Landtblom, Anne-Marie, et al.
(författare)
-
Insular cortex activation in a patient with "sensed presence"/ecstatic seizures
- 2011
-
Ingår i: EPILEPSY and BEHAVIOR. - : Elsevier Science B.V., Amsterdam. - 1525-5050. ; 20:4, s. 714-718
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: Seizures with an aura of a "sensed presence," a religious emotion, or feelings of euphoria (ecstatic seizures) are characterized by heightened self-awareness. A previous case report on a patient with epilepsy and "sensed presence" as an aura described hypoperfusion in both temporal lobes and a local ictal increase in the left frontoparietal area. A reexamination of the data was suggested by a recent study of patients with ecstatic seizures, which proposed that hyperactivation of the left anterior insula might be a potential cause. Methods: We reanalyzed the laboratory data on the case with "sensed presence" aura using a fusion of SPECT and MR images of the brain, which had not previously been available, and a close examination of the subdural ictal EEG registrations. Results: Examination of the ictal EEG recordings from subdural strip electrodes implanted subtemporally and temporally on both sides showed that seizure activity occurred first at the most medial subtemporal electrode on the left side. From an anatomical point of view, this electrode position is close to the ventral aspect of the left anterior insula, and it is possible that the seizure activity was initiated there. Reexamination of the SPECT data after fusion with contemporary MR images clearly indicated that the region of strong hyperactivation overlies the left anterior insula. Hyperactive regions also appear on the midinsula bilaterally. Together with the neurophysiological ictal EEG, this evidence supports a reinterpretation that this aura of "sensed presence" can be attributed to hyperactivation of the left anterior insula. Conclusion: The present findings support the proposal that ecstatic seizures or "sensed presence" auras can originate from the left anterior insula, a region that has been suggested to engender self-awareness associated with positive feelings.
|
|
| 8. |
- Lindehammar, Hans
(författare)
-
Hand strength in juvenile chronic arthritis : a two-year follow-up
- 2003
-
Ingår i: Acta Paediatrica. - 0001-656X. ; 92:11, s. 1291-1296
-
Tidskriftsartikel (refereegranskat)abstract
- AIM: To describe changes in muscle strength in the hands of children with juvenile chronic arthritis (JCA) and to examine the relationship between muscle strength, presence of local arthritis and disease subtype. METHODS: Twenty children (10 girls and 10 boys) with JCA aged 7 to 18 y were followed for two years. Isometric muscle strength in wrist dorsiflexors and handgrip strength were measured repeatedly. The results were compared with reference values for the same methods. Arthritis severity in the hand was scored every third month. Nerve conduction velocities were measured twice. RESULTS: Seven out of 20 patients had initially low or decreasing strength in one or both of the two tests. Five out of 20 children had reduced strength (more than two standard deviations below the mean of the reference group) in at least one test. Four children showed a significant reduction in muscle strength in at least one test during the observation time. The greatest reduction in strength was measured in four children with polyarticular disease. These children also had local arthritis in the hand. A greater proportion of children with polyarthritis had low or decreasing strength compared with children with oligoarthritis. The same was true for children with active arthritis in the hand. Nerve conduction velocities were normal in all cases and did not change. CONCLUSION: The majority of children with JCA have normal strength in the hand. Some children, especially those with polyarthritis and hand arthritis, have reduced muscle strength in the hand. Risk factors for low or decreasing strength are polyarthritis and/or active arthritis in the hand.
|
|
| 9. |
- Lindehammar, Hans, et al.
(författare)
-
Measurement of Quadriceps Muscle Strength and Bulk in Juvenile Chronic Arthritis : A Prospective, Longitudinal, 2 Year Survey
- 1998
-
Ingår i: Journal of Rheumatology. - 0315-162X. ; 25:11, s. 2240-2248
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: In a prospective survey over a 2-year period we studied strength and bulk of the quadriceps muscle in the thighs of children with juvenile chronic arthritis (JCA). METHODS: Every third month for 2 years we measured isometric muscle strength in knee extensors with a hand-held dynamometer in 20 children with JCA. Ultrasound equipment was used to measure thigh muscle bulk. A joint evaluation was made using a standard severity score. The children had their ordinary medical treatment and physiotherapy during the observation period. RESULTS: Children with high severity scores in the knee or hip had least strength and muscle bulk. In the 4 children with the highest severity scores muscle strength was reduced to half of that expected. In 10 of the children there were clear variations in severity scores during the study period, for either better or worse. In these children an increase in the severity score correlated significantly with reduction in muscle strength and bulk (p < 0.05). The muscle strength and bulk changed in parallel in these children. Other factors, although not independent, such as polyarticular JCA, long duration of disease, and steroid treatment, also reduced muscle strength. CONCLUSION: The presence and intensity of local arthritis is one important factor affecting muscle function in JCA. Normal muscle strength and bulk is rapidly lost near an inflamed joint. It is difficult to maintain or achieve normal muscle function in the presence of active arthritis despite medical and physical treatment. We assume that the muscle weakness is in part caused by atrophy of the muscle, which is influenced by local arthritis.
|
|
| 10. |
- Lindehammar, Hans, et al.
(författare)
-
Muscle function in Juvenile Chronic Arthritis
- 1995
-
Ingår i: Journal of Rheumatology. - 0315-162X. ; 22:6, s. 1159-1165
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE. Muscle strength and thickness were studied in children with juvenile chronic arthritis (JCA) to evaluate their muscle function. METHODS. We studied voluntary isometric, isokinetic, and nonvoluntary isometric muscle strength, as well as muscle thickness, in 20 children with JCA. Thickness of the quadriceps muscle was measured by ultrasound. Results were compared with reference values for healthy children and a matched control group. RESULTS. Isometric muscle strength in knee extensors, elbow flexors, and wrist dorsiflexors was reduced in children with JCA. In muscles near an inflamed joint, the strength was 45-65% of expected value. In muscles without adjacent arthritis, the strength was slightly decreased (80-90% of expected value). Isometric and isokinetic strength in ankle dorsiflexors was reduced only in children with ankle arthritis. Nonvoluntary muscle strength in thumb adductors during electrical stimulation of the ulnar nerve was reduced in children with arthritis in the hand. Thickness of the quadriceps muscle was reduced both in children with and without knee arthritis (75 and 90% of expected). CONCLUSION. Children with JCA have reduced muscle strength and thickness, which is most pronounced in muscles near an inflamed joint.
|
|
