Cerebral dysfunction

Vinpocetine (2), another dmg initially categorized as a cerebral vasodilator, is a member of the vinca alkaloid family of agents (7). However, interest in this compound as a potential dmg for learning and memory deficits comes from its abiUty to act as a neuronal protectant. This compound was evaluated in 15 patients with AD over a one-year period and was ineffective in improving cognitive deficits or slowing the rate of decline (8). However, in studies of patients with chronic vascular senile cerebral dysfunction (9) and organic psycho syndrome (10), vinpocetine showed beneficial results. 

Balestreri R, Fontana L and Astengo F (1987). A double-blind placebo controlled evaluation of the safety and efficacy of vinpocetine in the treatment of patients with chronic vascular senile cerebral dysfunction. Journal of the American Geriatrics Society, 35, 425—430. 

Rapid cooling by tepid sponging, fan-assisted evaporation and cooled intravenous fluids is the first step. Paralysis and ventilation may be necessary, especially if the patient is non-compliant as a result of cerebral dysfunction, or is shivering, indicating that thermoregulation has broken down. 

Lou, H.C., Henriksen, L., and Bruhn, P. (1990) Focal cerebral dysfunction in developmental learning disabilities. Lancet 335 S-11. 

In one case, beta-adrenoceptor blockade masked an unexpected thyroid crisis, resulting in severe cerebral dysfunction before the diagnosis was made (184). 

Mil. Menkes, J. H., Hurst, P. L., and Craig, J. M., New syndrome progressive familial infantile cerebral dysfunction associated with unusual urinary substance. Pediatrics 14, 462-466 (1954). 

Molecules A and B were synthesized in order to compare their eventual activity against cerebral dysfunction, namely, memory disruption, with that of reference compound piracetam. Tested on mice, pyrrolizidine (A) delays this dysfunction better than piracetam (27.8% versus 21.7%). The ethylenediamine derivative (B) behaves similarly.501... 

London ED, Simon SL, Berman SM, Manderlkern MA, Lichtman AM, Bramen J, Shinn AK, Miotto K, Learn J, Dong Y, Matochik JA, Kurian V, Newton T, Woods RP, Rawson R, Ling W. Regional cerebral dysfunction associated with mood disturbances in abstinent methamphetamine abusers. Arch Gen Psychiatry 2004 61 73-84. 

Psychiatric adverse effects have not previously been reported with azathioprine. Neither does the database of the WHO Uppsala Monitoring Centre mention obsessive-compulsive symptoms or panic attacks as a possible adverse effect of azathioprine. However, the time course in this case and the absence of symptoms before and after azathioprine therapy suggest a causal relation. It is possible that the combination of subtle cerebral dysfunction as a result of the vasculitis and the use of azathioprine may have caused the symptoms in this patient. 

TIA described as "the occurrence of single or multiple episodes of cerebral dysfunction lasting no longer than one hour and clearing without significant residuum"... 

P. Altmann et al, Disturbance of cerebral funaion in people exposed to drinking water contaminated with aluminium sulphate retrospective study of the Camelford water incident , British Medical Journal, 319 (1999), 807-11 V Murray et al, Cerebral dysfunction in Camelford inappropriate study, inappropriate conclusions , British Medical Journal (13 Dec. 1999), Letters T. 1. Lidsky (Altmann) Study has several methodological shortcomings , ibid. 

In the case of cerebral dysfunction, it is possible for these disorders to be reflected individually in differing states of intensity and in a variety of combinations. This results in a very varied pathophysiological and clinical picture of encephalopathy. Such a collective term for restrictions in the function of the brain does not, however, yield any statement as to their origins or pathogenesis. Encephalopathy can be triggered by some 50-60 disorders and aetiological factors - including liver diseases. (see chapter 15)... 

Zeegen, R., Drinkwater, J.E., Dawson, A.M. Method for measuring cerebral dysfunction in patients with hver disease. Brit. Med. X 1970 2 633-636... 

Hypokalaemia Hypokalaemia increases the activity of renal glutaminase, so that more ammonia is formed and transported back via the blood of the renal vein. A lack of potassium in the brain cells is in itself a further cause of serious cerebral dysfunction, (s. fig. 15.2)... 

Subclinical (latent) PSE is founded on observations made by H. Penin (1967), who noticed that patients with liver cirrhosis may display personality changes despite normal EEG findings. In 1970 R. Zeegen observed minor cerebral dysfunction in 40% of his cirrhotic patients, (s. p. 200) Changes in the form of a psychosyndrome with neurasthenic features were summarized by F. Erbsloeh et al. in 1974 as chronic subclinical cirrhosis-related encephalopathy . 

Forton, D.M., Taylor-Robinson, S.D., Thomas, H.C. Cerebral dysfunction in chronic hepatitis C infection (review). J. Viral Hepat. 2003 10 81-86... 

Methotrexate Acute meningitis acute fatal cerebral dysfunction chronic leukoencephalopathy... 

Extracts from the leaves of G. biloba are marketed in some countries for the treatment of cerebral dysfunction and of intermittent claudication. In a review it was concluded that seven out of eight controlled trials of good quality showed positive effects of G. biloba compared with placebo on the following symptoms memory difficulties, dizziness, tinnitus, headache, and emotional instability with anxiety (3). For intermittent claudication, the evidence for efficacy was judged unconvincing. 

The diagnosis of hepatic encephalopathy is made on clinical grounds. Plasma ammonia concentrations are rarely helpful, either for diagnosis or for monitoring the patient s disorder normal ammonia concentrations are helpful in excluding hepatic encephalopathy as a cause of cerebral dysfunction. An exception is a patient who presents with acute encephalopathy of unknown cause. Elevated ammonia concentrations in that situation suggest acute hepatic failure or Reye s syndrome. 

Menkes syndrome (Menkes steely-hair syndrome) is a rare, X-linked recessive disorder in which infants have low levels of copper in serum and in most tissues except kidney and intestine, where the concentration is very high. They also have greatly reduced plasma ceruloplasmin levels. Hair of the affected infants has a characteristic color and texture (pili torti, twisted hair ). It appears tangled and dull, has an ivory or grayish color, and is friable. Weakness and depigmentation of hair and defects in arterial walls (leading to aneurysms) are explained by loss of activity of copper-dependent enzymes (Table 37-5). Cerebral dysfunction may be due to a disturbance in energy metabolism or neurotransmitter synthesis secondary to decreased activity of cytochrome oxidase and dopamine... 

The relationship between electric impulse transmission and visual stimuli was examined in a group of 21 patients with chronic carbon disulfide exposure in a rayon production plant for 20-36 years and control groups of 25 or 36 healthy unexposed males (Sikora et al. 1990). A significant correlation was observed in latency and amplitude of response. The correlations suggest cerebral dysfunction of the visual pathway and diminished ability to transform visual information to motor reaction at the level of the cortical association center. The study was limited by the lack of quantification of exposure levels and the variability in responses in the exposed group. 

Chandra V, Philipose V, Bell PA, et al Case-control study of late onset probable Alzheimer s disease. Neurology 37 1295-1300, 1987 David A Cerebral dysfunction after water pollution incident in Camelford results were biased by self selection of cases (letter). BMJ 320 1337-1337, 2000 Delaney JF Spinal fluid aluminum levels in patients with Alzheimer disease. Ann Neurol 5 580-581,1979... 

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