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Alcohol Neurology

"Recent alcohol neurology research publications are scanned daily from major neurology journals and updated here. Free access to full articles below"


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Neural response to alcohol stimuli in adolescents with alcohol use disorder.
Alcoholic neurology related articles

Neural response to alcohol stimuli in adolescents with alcohol use disorder.

Arch Gen Psychiatry. 2003 Jul;60(7):727-35

Authors: Tapert SF, Cheung EH, Brown GG, Frank LR, Paulus MP, Schweinsburg AD, Meloy MJ, Brown SA

BACKGROUND: Cue reactivity studies in alcohol-dependent adults have shown atypical physiological, cognitive, and neural responses to alcohol-related stimuli that differ from the responses of light drinkers. Cue reactivity and its neural substrates are unclear in youth. We hypothesized that teens with alcohol use disorder would show greater brain response than nonabusing teens to alcohol images relative to neutral beverage images in limbic and frontal brain regions. METHODS: We tested the hypotheses in a cross-sectional functional magnetic resonance imaging study. Adolescents aged 14 to 17 were recruited from local high schools. Teens with alcohol use disorders (n = 15) and demographically similar infrequent drinkers (n = 15) met strict exclusion criteria (no left-handedness or neurological, other psychiatric, or other substance use disorders). Diagnoses were determined by means of structured and semistructured clinical interviews. Subjects were shown pictures of alcoholic and nonalcoholic beverage advertisements during blood oxygen level-dependent functional magnetic resonance imaging. Self-reports of craving were obtained before and after cue exposure. RESULTS: Teens with alcohol use disorders showed substantially greater brain activation to alcoholic beverage pictures than control youths, predominantly in the left anterior, limbic, and visual system areas (P<.05; cluster threshold, 515 microL). The degree of brain response to the alcohol pictures was highest in youths who consumed more drinks per month and reported greater desires to drink. CONCLUSIONS: These results confirm previous studies by demonstrating an association between the urge to drink alcohol and blood oxygen use in areas of the brain previously linked to reward, desire, positive affect, and episodic recall. This study extends this relationship to adolescents with relatively brief drinking histories using visual alcohol stimuli, and suggests a neural basis for response to alcohol advertisements in youths with drinking problems.

Alcohol neurology related articles Alcohol neurology related articles PMID: 12860777 [PubMed - indexed for MEDLINE (Alcohol neurology related articles)]

  • Prospective study of alcohol consumption and risk of dementia in older adults.
    Alcoholic neurology related articles

    Prospective study of alcohol consumption and risk of dementia in older adults.

    JAMA. 2003 Mar 19;289(11):1405-13

    Authors: Mukamal KJ, Kuller LH, Fitzpatrick AL, Longstreth WT, Mittleman MA, Siscovick DS

    CONTEXT: Alcohol consumption has been associated with complex changes in cerebral vasculature and structure in older adults. How alcohol consumption affects the incidence of dementia is less clear. OBJECTIVE: To determine the prospective relationship of alcohol consumption and risk of dementia among older adults. DESIGN, SETTING, AND PARTICIPANTS: Nested case-control study of 373 cases with incident dementia and 373 controls who were among 5888 adults aged 65 years and older who participated in the Cardiovascular Health Study, a prospective, population-based cohort study in 4 US communities. The controls were frequency-matched on age, death before 1999, and their attendance of a 1998-1999 clinic. Participants in this study underwent magnetic resonance imaging (MRI) of the brain and cognitive testing between 1992 and 1994 and were followed up until 1999. MAIN OUTCOME MEASURES: Odds of incident dementia, ascertained by detailed neurological and neuropsychological examinations according to average alcohol consumption, assessed by self-reported intake of beer, wine, and liquor at 2 visits prior to the date of the MRI. RESULTS: Compared with abstention, the adjusted odds for dementia among those whose weekly alcohol consumption was less than 1 drink were 0.65 (95% confidence interval [CI], 0.41-1.02); 1 to 6 drinks, 0.46 (95% CI, 0.27-0.77); 7 to 13 drinks, 0.69 (95% CI, 0.37-1.31); and 14 or more drinks, 1.22 (95% CI, 0.60-2.49; P for quadratic term =.001). A trend toward greater odds of dementia associated with heavier alcohol consumption was most apparent among men and participants with an apolipoprotein E epsilon4 allele. We found generally similar relationships of alcohol use with Alzheimer disease and vascular dementia. CONCLUSIONS: Compared with abstention, consumption of 1 to 6 drinks weekly is associated with a lower risk of incident dementia among older adults.

    Alcohol neurology related articles Alcohol neurology related articles PMID: 12636463 [PubMed - indexed for MEDLINE (Alcohol neurology related articles)]

  • Psychotic symptoms in an urban general medicine practice.
    Alcoholic neurology related articles

    Psychotic symptoms in an urban general medicine practice.

    Am J Psychiatry. 2002 Aug;159(8):1412-9

    Authors: Olfson M, Lewis-Fernández R, Weissman MM, Feder A, Gameroff MJ, Pilowsky D, Fuentes M

    OBJECTIVE: The authors' goals were to estimate the prevalence of psychotic symptoms among adults attending an urban general medical practice that serves a low-income population and to describe the mental health, social and occupational functioning, and mental health treatment of these patients. METHOD: Data were drawn from a recent study of adult primary care patients (N=1,005) in a large, urban, university-affiliated general medicine practice. During a medical visit, patients completed the psychotic disorders section of the Mini International Neuropsychiatric Interview, the Primary Care Evaluation of Mental Disorders, a drug use disorders screen, the Sheehan Disability Scale, and a questionnaire that probed demographic characteristics, health status, and mental health treatment. RESULTS: Two hundred ten (20.9%) patients reported one or more psychotic symptoms, most commonly auditory hallucinations. There was an inverse correlation between family income and the prevalence of psychotic symptoms and a positive association between prevalence and Hispanic ethnicity. Compared with patients without psychotic symptoms, patients with psychotic symptoms were significantly more likely to have major depression (42.4% versus 12.6%), panic disorder (24.8% versus 4.0%), generalized anxiety disorder (38.6% versus 8.4%), and alcohol use disorder (12.9% versus 5.0%). They were also more likely to report current suicidal ideation (20.0% versus 3.5%), recent work loss (55.0% versus 35.6%), and marital distress (28.6% versus 13.0%). Approximately one-half of the patients with psychotic symptoms (47.6%) had taken a prescribed psychotropic medication during the last month. CONCLUSIONS: Psychotic symptoms were highly prevalent in this primary care practice. These patients were at risk for several common mental disorders and often reported impaired work and social functioning. Future research should clarify the extent to which psychotic symptom reports among Hispanic patients are affected by culturally patterned idioms of distress. Clinicians who work in primary care practices that serve low-income patient populations should routinely inquire about psychotic symptoms.

    Alcohol neurology related articles Alcohol neurology related articles PMID: 12153836 [PubMed - indexed for MEDLINE (Alcohol neurology related articles)]

  • Dietary intake of antioxidants and risk of Alzheimer disease.
    Alcoholic neurology related articles

    Dietary intake of antioxidants and risk of Alzheimer disease.

    JAMA. 2002 Jun 26;287(24):3223-9

    Authors: Engelhart MJ, Geerlings MI, Ruitenberg A, van Swieten JC, Hofman A, Witteman JC, Breteler MM

    CONTEXT: Laboratory findings have suggested that oxidative stress may contribute to the pathogenesis of Alzheimer disease. Therefore, the risk of Alzheimer disease might be reduced by intake of antioxidants that counteract the detrimental effects of oxidative stress. OBJECTIVE: To determine whether dietary intake of antioxidants is related to risk of Alzheimer disease. DESIGN AND SETTING: The Rotterdam Study, a population-based, prospective cohort study conducted in the Netherlands. PARTICIPANTS: A total of 5395 participants who, at baseline (1990-1993), were aged at least 55 years, free of dementia, and noninstitutionalized and had reliable dietary assessment. Participants were reexamined in 1993-1994 and 1997-1999 and were continuously monitored for incident dementia. MAIN OUTCOME MEASURES: Incidence of Alzheimer disease, based on Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition (DSM-III-R) criteria and National Institute of Neurological and Communicative Disorders and Stroke and Alzheimer Disease and Related Disorders Association (NINCDS-ADRDA) criteria, associated with dietary intake of beta carotene, flavonoids, vitamin C, and vitamin E. RESULTS: After a mean follow-up of 6 years, 197 participants developed dementia, of whom 146 had Alzheimer disease. When adjustments were made for age, sex, baseline Mini-Mental State Examination score, alcohol intake, education, smoking habits, pack-years of smoking, body mass index, total energy intake, presence of carotid plaques, and use of antioxidative supplements, high intake of vitamin C and vitamin E was associated with lower risk of Alzheimer disease (rate ratios [RRs] per 1-SD increase in intake were 0.82 [95% confidence interval [CI], 0.68-0.99] and 0.82 [95% CI, 0.66-1.00], respectively). Among current smokers, this relationship was most pronounced (RRs, 0.65 [95% CI, 0.37-1.14] and 0.58 [95% CI, 0.30-1.12], respectively) and also was present for intake of beta carotene (RR, 0.49 [95% CI, 0.27-0.92]) and flavonoids (RR, 0.54 [95% CI, 0.31-0.96]). The associations did not vary by education or apolipoprotein E genotype. CONCLUSION: High dietary intake of vitamin C and vitamin E may lower the risk of Alzheimer disease.

    Alcohol neurology related articles Alcohol neurology related articles PMID: 12076218 [PubMed - indexed for MEDLINE (Alcohol neurology related articles)]

  • Tone abnormalities are associated with maternal cigarette smoking during pregnancy in in utero cocaine-exposed infants.
    Alcoholic neurology related articles

    Tone abnormalities are associated with maternal cigarette smoking during pregnancy in in utero cocaine-exposed infants.

    Pediatrics. 2000 Jul;106(1 Pt 1):79-85

    Authors: Dempsey DA, Hajnal BL, Partridge JC, Jacobson SN, Good W, Jones RT, Ferriero DM

    OBJECTIVE: Maternal cigarette smoking, alcohol use, and other factors confound studies of in utero cocaine exposure. Our goal was to determine whether in utero cocaine exposure is associated with an abnormal neurologic examination in infants, while controlling for concomitant cigarette smoke exposure and other confounding variables. DESIGN: Healthy newborns with birth weights > or =2000 g were prospectively enrolled into a race-matched study of cocaine-exposed and cocaine-unexposed infants. Urine and meconium samples were analyzed for illicit drugs, the cocaine metabolite, benzoylecgonine, and the nicotine metabolite, cotinine. A detailed neurological examination was performed at approximately 6 weeks of age by an examiner blinded to history. RESULTS: At 6 weeks of age, 40 cocaine-exposed infants and 56 cocaine-unexposed infants were examined. Tone abnormalities were the only neurologic abnormalities discovered, predominantly generalized hypertonia. Logistic models found that maternal urine cotinine levels were predictive of an abnormal neurologic examination, whereas cocaine exposure or benzoylecgonine levels were not. No interaction was found between maternal cigarette smoking and cocaine exposure. Race, ethanol exposure, prenatal care, homelessness, and head circumference were not predictive of an abnormal tone examination. The odds ratio for an abnormal examination was 2.9 (95% confidence interval: 1.04-8.25), if the maternal urine cotinine level was >200 ng/mL. CONCLUSION: Our findings suggest that maternal cigarette smoking may be the major predictor of tone abnormalities reported in cocaine-exposed infants.

    Alcohol neurology related articles Alcohol neurology related articles PMID: 10878153 [PubMed - indexed for MEDLINE (Alcohol neurology related articles)]

  • Presence of diarrhea and absence of tendon xanthomas in patients with cerebrotendinous xanthomatosis.
    Alcoholic neurology related articles

    Presence of diarrhea and absence of tendon xanthomas in patients with cerebrotendinous xanthomatosis.

    Arch Neurol. 2000 Apr;57(4):520-4

    Authors: Verrips A, van Engelen BG, Wevers RA, van Geel BM, Cruysberg JR, van den Heuvel LP, Keyser A, Gabreëls FJ

    BACKGROUND: Cerebrotendinous xanthomatosis (CTX) is an autosomal recessive disorder of bile acid synthesis. A diagnosis of CTX should be considered in patients with premature bilateral cataracts, intractable diarrhea, neurological signs and symptoms, and tendon xanthomas, especially in the Achilles tendons. The prevalence of these signs and symptoms increases with age. OBJECTIVES: To investigate signs and symptoms, age at onset, and age at diagnosis in 32 patients with biochemically and genetically confirmed CTX, and to compare this clinical spectrum with reports in the literature. METHODS: Retrospective analysis of records of all patients with CTX at our hospital (27 adults and 5 children). After a MEDLINE (Alcohol neurology related articles) search in the English, French, and German literature, 181 patients with CTX (165 adults and 16 children) were identified worldwide. RESULTS: Of our 32 patients with CTX, 31 (97%) had cataracts and neurological signs and symptoms, predominantly pyramidal signs (26 [81%]); 21 (66%) had low intelligence and 18 (56%) had cerebellar signs. Only 13 (41%) had visible or palpable tendon xanthomas at the time of diagnosis. In total, 16 patients (50%) had chronic, intractable diarrhea that started in childhood. These findings were in contrast with the literature, where tendon xanthomas were reported in 89% and diarrhea in only 2 patients. CONCLUSIONS: We believe that CTX is underdiagnosed worldwide. We recommend that the presence of 2 of the 4 clinical hallmarks of CTX prompt thorough metabolic screening, including determination of urine bile alcohol excretion and serum cholestanol level, because CTX is a treatable disease.

    Alcohol neurology related articles Alcohol neurology related articles PMID: 10768627 [PubMed - indexed for MEDLINE (Alcohol neurology related articles)]

  • Neurological damage and duodenopancreatic reflux in the pathogenesis of alcoholic pancreatitis.
    Alcoholic neurology related articles

    Neurological damage and duodenopancreatic reflux in the pathogenesis of alcoholic pancreatitis.

    Arch Surg. 2000 Mar;135(3):278-85

    Authors: McCutcheon AD

    OBJECTIVE: To present a new theory on the pathogenesis of acute alcoholic pancreatitis based on experimental data, the significance of which has not been recognized, and on evidence from the current literature. HYPOTHESIS: That chronic alcoholism damages muscarinic receptors in the pancreas, duodenum, and Oddi sphincter, producing heightened sensitivity to acetylcholine, stimulation of protein-rich pancreatic juice, hypertonicity of the duodenum and esophagus, relaxation of the Oddi sphincter, and intraduodenal pressures exceeding those shown to cause duodenopancreatic reflux and acute pancreatitis in humans and experimental animals. OUTCOME: The duodenopancreatic reflux mechanism can explain all of the clinical features of acute alcohol pancreatitis, including the intraductal site and rapid activation of zymogens by enterokinase, the recurrent episodes of pancreatitis, the precipitation of protein plugs by partial proteolytic hydrolysis, the severe vascular changes, the relation to infection by the most direct route, and the progression to chronic pancreatitis via the necrosis-fibrosis sequence. CONCLUSIONS: Damage to the nervous system, with a time lag of 5 to 15 years between the onset of heavy drinking and the development of neurological disorders (peripheral neuropathy and cerebellar degeneration), is a characteristic complication of chronic alcoholism. The similarity to events in alcoholic pancreatitis is striking.

    Alcohol neurology related articles Alcohol neurology related articles PMID: 10722028 [PubMed - indexed for MEDLINE (Alcohol neurology related articles)]

  • Embolization for vertebral metastases of follicular thyroid carcinoma.
    Alcoholic neurology related articles

    Embolization for vertebral metastases of follicular thyroid carcinoma.

    J Clin Endocrinol Metab. 2000 Mar;85(3):989-94

    Authors: Smit JW, Vielvoye GJ, Goslings BM

    The technique of selective embolization has been applied for years in the treatment of vascular anomalies, severe hemorrhage and benign or malignant tumors, notably vertebral metastases of renal cell carcinoma. Because this technique is relatively easy to perform and offers immediate relief of symptoms, it is an attractive option for patients with vertebral metastases of thyroid carcinoma with signs of spinal cord compression. In these patients, other treatment modalities like radioactive iodine, external irradiation, or surgery are more cumbersome or less effective in the short term. We describe four patients with metastasized follicular thyroid carcinoma, presenting with neurological symptoms due to vertebral metastases. All patients had undergone total thyroidectomy, ranging from 1 month to 4 yr before embolization. Embolization was combined with iodine-131 therapy when appropriate. Selective catheterization of the arteries feeding the metastases was performed, followed by infusion of polyvinyl alcohol particles (Ivalon). The procedure was technically successful in all patients without adverse effects. In the patients described, embolization resulted in rapid resolution of neurological symptoms, sometimes within hours. The therapeutic effect lasted from months to years. We conclude that embolization of vertebral metastases of follicular thyroid carcinoma is an attractive palliative therapeutic option that may offer rapid relief of symptoms.

    Alcohol neurology related articles Alcohol neurology related articles PMID: 10720028 [PubMed - indexed for MEDLINE (Alcohol neurology related articles)]

  • Antepartum risk factors for newborn encephalopathy: the Western Australian case-control study.
    Alcoholic neurology related articles

    Antepartum risk factors for newborn encephalopathy: the Western Australian case-control study.

    BMJ. 1998 Dec 5;317(7172):1549-53

    Authors: Badawi N, Kurinczuk JJ, Keogh JM, Alessandri LM, O'Sullivan F, Burton PR, Pemberton PJ, Stanley FJ

    OBJECTIVE: To ascertain antepartum predictors of newborn encephalopathy in term infants. DESIGN: Population based, unmatched case-control study. SETTING: Metropolitan area of Western Australia, June 1993 to September 1995. SUBJECTS: All 164 term infants with moderate or severe newborn encephalopathy; 400 randomly selected controls. MAIN OUTCOME MEASURES: Adjusted odds ratio estimates. RESULTS: The birth prevalence of moderate or severe newborn encephalopathy was 3.8/1000 term live births. The neonatal fatality was 9.1%. The risk of newborn encephalopathy increased with increasing maternal age and decreased with increasing parity. There was an increased risk associated with having a mother who was unemployed (odds ratio 3.60), an unskilled manual worker (3.84), or a housewife (2.48). Other risk factors from before conception were not having private health insurance (3.46), a family history of seizures (2.55), a family history of neurological disease (2.73), and infertility treatment (4.43). Risk factors during pregnancy were maternal thyroid disease (9.7), severe pre-eclampsia (6.30), moderate or severe bleeding (3.57), a clinically diagnosed viral illness (2.97), not having drunk alcohol (2.91); and placenta described at delivery as abnormal (2.07). Factors related to the baby were birth weight adjusted for gestational age between the third and ninth centile (4.37) or below the third centile (38.23). The risk relation with gestational age was J shaped with 38 and 39 weeks having the lowest risk. CONCLUSIONS: The causes of newborn encephalopathy are heterogeneous and many of the causal pathways start before birth.

    Alcohol neurology related articles Alcohol neurology related articles PMID: 9836652 [PubMed - indexed for MEDLINE (Alcohol neurology related articles)]

  • Reduced Purkinje cell size in the cerebellar vermis of elderly patients with schizophrenia.
    Alcoholic neurology related articles

    Reduced Purkinje cell size in the cerebellar vermis of elderly patients with schizophrenia.

    Am J Psychiatry. 1998 Sep;155(9):1288-90

    Authors: Tran KD, Smutzer GS, Doty RL, Arnold SE

    OBJECTIVE: The authors' goal was to compare the size and linear density of Purkinje cells in the cerebellar vermis of subjects with and without schizophrenia. METHOD: Blocks of alcohol-fixed cerebellar vermis were dissected at autopsy from the brains of 14 elderly patients with schizophrenia and 13 elderly subjects with no history of neuropsychiatric illness. The blocks of vermis were sectioned and stained with 1% cresyl violet. The linear density and cross-sectional area of Purkinje cells were measured by using computer-assisted image analysis. The subjects with schizophrenia had been assessed with clinical rating scales within 1 year prior to death. RESULTS: The average cross-sectional areas of Purkinje cells of the patients with schizophrenia were significantly smaller (by 8.3%) than those of the subjects without neuropsychiatric illness. No difference in Purkinje cell linear density was observed between the two groups. Significant correlations were seen between Purkinje cell size and scores on the Mini-Mental State, the Brief Psychiatric Rating Scale, and the antipsychotic drug dose. CONCLUSIONS: These data indicate cerebellar involvement in schizophrenia; they are also consistent with reports of reduced neuronal size in other brain regions of patients with schizophrenia. These findings support a model of wide-spread central nervous system abnormality in schizophrenia.

    Alcohol neurology related articles Alcohol neurology related articles PMID: 9734558 [PubMed - indexed for MEDLINE (Alcohol neurology related articles)]

  • Use of intensive care units for patients with low severity of illness.
    Alcoholic neurology related articles

    Use of intensive care units for patients with low severity of illness.

    Arch Intern Med. 1998 May 25;158(10):1144-51

    Authors: Rosenthal GE, Sirio CA, Shepardson LB, Harper DL, Rotondi AJ, Cooper GS

    OBJECTIVE: To determine variations among hospitals in use of intensive care units (ICUs) for patients with low severity of illness. DESIGN: Retrospective cohort study. SETTING: Twenty-eight hospitals with 44 ICUs in a large metropolitan region. PATIENTS: Consecutive eligible patients (N=104,487) admitted to medical, surgical, neurological, or mixed medical-surgical ICUs from March 1, 1991, to March 31, 1995. OUTCOME MEASURES: The predicted risk of in-hospital death for each patient was assessed using a validated method that is based on age, ICU admission source, diagnosis, severe comorbid conditions, and abnormalities in 17 physiologic variables. Admissions were classified as low severity if the patient's predicted risk of death was less than 1%. In a subset of 12,929 consecutive patients, use of 19 specific interventions typically delivered in ICUs was examined. RESULTS: Twenty thousand four hundred fifty-one admissions (19.6%) were categorized as low severity, including 23.6% of postoperative and 16.9% of nonoperative admissions. Alcohol and other drug overdoses accounted for 40.2% of nonoperative low-severity admissions; laminectomy and carotid endarterectomy accounted for 52.3% of postoperative low-severity admissions. Mortality among patients with low-severity illness was 0.3%, and only 28.6% received an ICU-specific intervention during the first ICU day. Although mean ICU length of stay was shorter (P<.001) in low-severity admissions (2.2 vs 4.7 days in nonoperative and 2.4 vs 4.2 days in postoperative admissions), low-severity admissions accounted for 11.1% of total ICU bed days. Rates of low-severity admissions varied (P<.001) across hospitals, ranging from 5% to 27% for nonoperative and 9% to 68% for postoperative admissions. CONCLUSIONS: A large proportion of patients admitted to the ICU have a low probability of death and do not receive ICU-specific interventions. Rates of low-severity admissions varied among hospitals. The development and implementation of protocols to target ICU care to patients most likely to benefit may decrease the number of low-severity ICU admissions and improve the cost-effectiveness of ICU care.

    Alcohol neurology related articles Alcohol neurology related articles PMID: 9605788 [PubMed - indexed for MEDLINE (Alcohol neurology related articles)]

  • A case-control study of Leber's hereditary optic neuropathy.
    Alcoholic neurology related articles

    A case-control study of Leber's hereditary optic neuropathy.

    Brain. 1996 Oct;119 ( Pt 5):1481-6

    Authors: Charlmers RM, Harding AE

    Fifty patients with Leber's hereditary optic neuropathy (LHON) with an associated pathogenic mutation of mitochondrial DNA (mtDNA) at base pair (bp) 11778 (35 cases), 14484 (eight cases) or 3460 (seven cases) were matched with 50 controls. The frequency of additional neurological features in LHON and the role of a number of past medical and environmental factors in the development of the disease were investigated using a case-control study. Additional neurological features were reported by 15 patients. Four patients had a multiple sclerosis-like illness; one had focal dystonia. Ten patients had tremor, which occurred at significantly higher frequency in patients than in controls. Alcohol and tobacco consumption were similar in patients with the 11778 mutation and matched controls, but were significantly increased in patients with the 3460 and 14484 mutations. No other associated past medical or environmental factors were identified.

    Alcohol neurology related articles Alcohol neurology related articles PMID: 8931573 [PubMed - indexed for MEDLINE (Alcohol neurology related articles)]

  • Indication for computed tomography of the brain in patients with first uncomplicated generalised seizure.
    Alcoholic neurology related articles

    Indication for computed tomography of the brain in patients with first uncomplicated generalised seizure.

    BMJ. 1994 Oct 15;309(6960):986-9

    Authors: Schoenenberger RA, Heim SM

    OBJECTIVES--To assess the yield of emergency computed tomography of the brain in patients with a first generalised epileptic seizure and to evaluate a four item screening questionnaire on alcohol misuse (CAGE questionnaire) as a triage tool to avoid unnecessary scans in cases of seizures related to withdrawal from alcohol. DESIGN--Prospective, observational. SETTING--Medical casualty unit in a university hospital. PATIENTS--119 adult patients presenting to casualty within one hour of a generalised seizure. MEASUREMENTS--A clinical examination focusing on focal neurological symptoms, the CAGE questionnaire, and computed tomography of the brain with contrast enhancement. RESULTS--Computed tomography showed a focal, structural lesion of the brain in 40 patients (34% (95% confidence interval 25% to 42%)). In 20 patients (17% (10% to 24%)) an important therapeutic intervention resulted. The presence of a focal neurological deficit had a sensitivity of 50% and a specificity of 89% in predicting focal lesions on computed tomography. Answering "yes" to fewer than two CAGE questions had a sensitivity of 90% and specificity of 44% in identifying patients with focal computed tomography lesions. Focal lesions were not detected on computed tomography in any of the 35 patients (0% (0% to 10%)) who showed no focal neurological symptoms and answered "yes" to two or more CAGE questions. CONCLUSIONS--The diagnostic yield of computed tomography of the brain in adults after a first generalised seizure is high. Combined with the clinical examination, the CAGE questionnaire can reliably identify patients with uncomplicated seizures related to withdrawal from alcohol, in whom computed tomography may not be absolutely necessary.

    Alcohol neurology related articles Alcohol neurology related articles PMID: 7950718 [PubMed - indexed for MEDLINE (Alcohol neurology related articles)]

  • Alcohol consumption as a risk factor for poor outcome after aneurysmal subarachnoid haemorrhage.
    Alcoholic neurology related articles

    Alcohol consumption as a risk factor for poor outcome after aneurysmal subarachnoid haemorrhage.

    BMJ. 1992 Jun 27;304(6843):1663-7

    Authors: Juvela S

    OBJECTIVE--To evaluate the effect of factors existing before aneurysmal subarachnoid haemorrhage on outcome of haemorrhage. DESIGN--Prospective follow up study. SETTING--Helsinki University Hospital. PATIENTS--291 consecutive patients (149 men) aged 15 to 65 years admitted within 96 hours after the bleeding. MAIN OUTCOME MEASURES--Potential risk factors (baseline characteristics, health habits, and clinical variables) for poor outcome after haemorrhage (dependent state in the activities of daily living, or death) were studied using multiple logistic regression. RESULTS--One year after haemorrhage, 179 (62%) patients were independent in the activities of daily living and 28 (10%) dependent; 84 (29%) had died. Risk of poor outcome was predicted, after adjustment for sex and age, by clinical condition at admission according to the Glasgow coma scale (p less than 0.0001); occurrence of rebleeding (relative risk 7.1, 95% confidence interval 2.8 to 18.0, p less than 0.0001) or delayed cerebral ischaemia (10.3, 4.2 to 25.4, p less than 0.0001); surgery on an aneurysm (0.13, 0.05 to 0.35, p less than 0.0001); and heavy consumption of alcohol (4.5, 1.8 to 11.0, p = 0.0014). Heavy drinking remained a significant risk factor after additional adjustment for hypertension, body mass index, and presence of intracerebral haematoma. Heavy drinkers had a more unfavourable outcome after rebleeding and delayed ischaemia than did others with rebleeding or ischaemia. Those who had salicylates in urine on admission had delayed ischaemia with fixed neurological deficits less commonly than others. CONCLUSIONS--Heavy drinking impairs outcome mainly through severe rebleeding and delayed ischaemia and to a lesser extent through a poor initial condition and presence of intracerebral haematoma.

    Alcohol neurology related articles Alcohol neurology related articles PMID: 1633519 [PubMed - indexed for MEDLINE (Alcohol neurology related articles)]

  • The effects on children and adolescents of parents' excessive drinking: an international review.
    Alcoholic neurology related articles

    The effects on children and adolescents of parents' excessive drinking: an international review.

    Public Health Rep. 1989 Sep-Oct;104(5):433-42

    Authors: Plant MA, Orford J, Grant M

    The effects during childhood, adolescence, and adulthood of having a parent with a drinking problem has interested researchers in several countries. The greatest number of reports related to this subject have appeared in the U.S. literature and in the literature from countries of Eastern Europe. This review encompasses the findings of researchers in these countries as well as workers in Western Europe, Latin America, and Japan. This review does not include biological, physiological, or neurological data. The epidemiologic evidence from several countries shows significant points of agreement. Problem drinking by a parent markedly increases health risks to children and adolescents. Such risks include diminished intellectual capacity and development, increased neuroticism, and a wide range of psychological and behavioral disorders. Parents who drink excessively are also likely to have children who experience long-term adverse consequences. These include heavy and problem-causing psychoactive substance use, criminality, suicide, depression, personality disorders, and psychological and behavioral disturbances. Parents who drink heavily are also especially likely to produce children who subsequently abstain from alcohol or drink only lightly.

    Alcohol neurology related articles Alcohol neurology related articles PMID: 2508172 [PubMed - indexed for MEDLINE (Alcohol neurology related articles)]

  • Blood alcohol tests, prevalence of involvement, and outcomes following brain injury.
    Alcoholic neurology related articles

    Blood alcohol tests, prevalence of involvement, and outcomes following brain injury.

    Am J Public Health. 1989 Mar;79(3):294-9

    Authors: Kraus JF, Morgenstern H, Fife D, Conroy C, Nourjah P

    We collected data on all residents of San Diego County, California who were hospitalized for or died from a brain injury in 1981. The objectives were to assess the frequency of blood alcohol concentration (BAC) testing and the associations of BAC prevalence with the external cause of the brain injury and case outcome. We found that high BAC levels were most frequent among brain-injured subjects between the ages of 25 and 44 and among those subjects involved in motor vehicle crashes and assaults. Contrary to expectations, injury severity and hospital mortality were inversely related to BAC level, controlling for other predictors. We believe that these inverse associations might be due to differential rates of BAC testing by severity. Among brain-injured survivors with more severe injuries, however, we found that BAC level was positively associated with the prevalence of physician-diagnosed neurological impairment at discharge and with the length of hospitalization.

    Alcohol neurology related articles Alcohol neurology related articles PMID: 2916714 [PubMed - indexed for MEDLINE (Alcohol neurology related articles)]

  • Alcohol-related birth defects: an update.
    Alcoholic neurology related articles

    Alcohol-related birth defects: an update.

    Public Health Rep. 1988 Nov-Dec;103(6):638-42

    Authors: Warren KR, Bast RJ

    Historically, mankind has at least suspected that alcohol was somehow connected with undesirable effects on progeny. In the 18th century, physicians became aware that maternal alcohol consumption resulted in excess fetal and neonatal mortality, low birth weight, and many other deleterious effects. Perhaps as a response to the temperance and Prohibition periods, scientists lost sight of or interest in the effects of alcohol in pregnancy. In the late 1960s and early 1970s, the issue surfaced again, and scientists began systematic and in-depth studies of fetal alcohol syndrome (FAS) and alcohol-related birth defects (ARBD). Epidemiologic research now suggests that FAS has outranked Down's syndrome and spina bifida in prevalence and is now the leading known cause of mental retardation. Further, it is the only one of these three that is preventable. Because a safe limit of alcohol consumption in pregnancy is not defined, abstinence during pregnancy is the most prudent preventive measure. Factors such as race, beer drinking, maternal weight gain, and low socioeconomic status are associated with a statistical increase in the incidence of FAS. In families where one child has been diagnosed as having FAS, the incidence rate can be as much as 405-fold higher than the worldwide average. Neurobehavioral deficits can occur in the offspring of drinking mothers in the absence of a diagnosis of full FAS. The deficits differ with age and seem to persist into adulthood. Mental retardation or borderline mental retardation is a nearly ubiquitous neurological deficit in diagnosed FAS.(ABSTRACT TRUNCATED AT 250 WORDS)

    Alcohol neurology related articles Alcohol neurology related articles PMID: 3141958 [PubMed - indexed for MEDLINE (Alcohol neurology related articles)]

  • Toxicity of bone marrow in dentists exposed to nitrous oxide.
    Alcoholic neurology related articles

    Toxicity of bone marrow in dentists exposed to nitrous oxide.

    Br Med J (Clin Res Ed). 1985 Aug 31;291(6495):567-9

    Authors: Sweeney B, Bingham RM, Amos RJ, Petty AC, Cole PV

    The morphology of the bone marrow of 21 dentists who habitually used nitrous oxide in their surgeries was investigated. Exposure to nitrous oxide was measured with an atmospheric sampling device, and each dentist was invited to fill in a questionnaire giving details of medical history, diet, and intake of alcohol. During the trial a full neurological and haematological investigation was carried out and a bone marrow aspirate was examined both morphologically and by the deoxyuridine suppression test. Mean exposures to nitrous oxide ranged from 159 to 4600 parts per million. In all subjects serum vitamin B12 and folate concentrations were within normal limits. Abnormal results of deoxyuridine suppression tests were obtained in three of the 20 dentists tested; two of these three had abnormal white cells in their peripheral blood films. This study provides direct evidence that occupational exposure to nitrous oxide may cause depression of vitamin B12 activity resulting in measurable changes in bone marrow secondary to impaired synthesis of deoxyribonucleic acid.

    Alcohol neurology related articles Alcohol neurology related articles PMID: 3929875 [PubMed - indexed for MEDLINE (Alcohol neurology related articles)]

  • Alcohol and the fetus in the west of Scotland.
    Alcoholic neurology related articles

    Alcohol and the fetus in the west of Scotland.

    Br Med J (Clin Res Ed). 1983 Jul 2;287(6384):17-20

    Authors: Beattie JO, Day RE, Cockburn F, Garg RA

    Forty children with the fetal alcohol syndrome were identified in the west of Scotland. All were growth retarded and had abnormal facial features, and all those who were tested were found to have neurological or developmental abnormalities. Two children died of associated physical defects. Most of the mothers were socially deprived, and all had drunk heavily while pregnant. Three women had subsequently died. These findings provide clear evidence that in the west of Scotland maternal alcohol abuse during pregnancy is a significant cause of morbidity and mortality in children.

    Alcohol neurology related articles PMID: 6190532 [PubMed - indexed for MEDLINE (Alcohol neurology related articles)]


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