160 results on '"Paulson GW"'
Search Results
2. Restless legs syndrome: how to provide symptom relief with drug and nondrug therapies.
- Author
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Paulson GW
- Published
- 2000
3. Management of the patient with newly-diagnosed Parkinson's disease.
- Author
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Paulson GW
- Published
- 1993
4. Steroid-sensitive dementia
- Author
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Paulson Gw
- Subjects
Adult ,Male ,medicine.medical_specialty ,Pediatrics ,medicine.drug_class ,Biopsy ,medicine.medical_treatment ,Fulminant ,Dexamethasone ,Adrenal Cortex Hormones ,Prednisone ,medicine ,Humans ,Dementia ,Intracranial pressure ,Chemotherapy ,medicine.diagnostic_test ,business.industry ,Brain biopsy ,fungi ,Brain ,food and beverages ,Middle Aged ,Steroid sensitive ,medicine.disease ,Surgery ,Psychiatry and Mental health ,Corticosteroid ,Female ,business ,medicine.drug - Abstract
Occasional patients with senile or presenile dementia respond favorably to steroid therapy. In addition to endocrinopathy and increased intracranial pressure, inflammatory processes and vasculitides can cause dementia and be sensitive to steroids. The author reports four such cases. A brain biopsy can be of great value for definitive diagnosis; it should be considered particularly in unusual, fulminant, and unexplained cases of dementia. A trial course of several weeks of steroid therapy can be given for such cases, but steroids should not be continued if improvement is not clearly apparent.
- Published
- 1983
5. Acute anticholinergic syndrome due to Jimson seed ingestion. Clinical and laboratory observation in six cases
- Author
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C. J. Cross, Paulson Gw, and Mikolich
- Subjects
Male ,Sympathetic Nervous System ,Adolescent ,Fever ,Hallucinations ,Substance-Related Disorders ,Hyperreflexia ,Psychoses, Substance-Induced ,Transaminase ,Neurologic Manifestations ,Internal Medicine ,medicine ,Ingestion ,Humans ,Clinical syndrome ,Prothrombin time ,Datura stramonium ,Plants, Medicinal ,medicine.diagnostic_test ,business.industry ,Electroencephalography ,General Medicine ,Syndrome ,Plants, Toxic ,Anticholinergic syndrome ,Anesthesia ,Toxicity ,Acute Disease ,Laboratory observation ,medicine.symptom ,business - Abstract
Ten patients presented with acute anticholinergic syndrome secondary to Jimson seed (Datura stramonium) ingestion. Six of the 10 patients required hospitalization because of hyperpyrexia and severe neurologic derangement. Electroencephalograms recorded immediately after admission showed [1] slow wave activity, and [2] bizarre rhythmical bursts of high-voltage sharp wave activity; both of which rapidly resolved during the next 24 hours, as did the associated clinical findings of hyperreflexia, bilateral dorsiflexor Babinski responses, and decerebrate posturing. Previously unreported elevation of serum glutamic-oxalacetic transaminase and lactic dehydrogenase and prothrombin time prolongation are documented. The pathogenic mechanism accounting for abberation of these laboratory values remains undefined. All patients showed rapid clinical improvement; follow-up neurologic evaluation and electroencephalograms have been within normal limits. Because of the widespread availability and potential abuse of the Jimson seed, the clinical syndrome associated with its toxicity merits recognition.
- Published
- 1975
6. Historical comments on tardive dyskinesia: a neurologist's perspective.
- Author
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Paulson GW
- Subjects
- Antipsychotic Agents adverse effects, Antipsychotic Agents history, Dyskinesia, Drug-Induced diagnosis, History, 20th Century, Humans, Malpractice history, Prognosis, Psychiatry history, Psychiatry legislation & jurisprudence, Terminology as Topic, Dyskinesia, Drug-Induced history, Neurology history, Neurology legislation & jurisprudence
- Abstract
This article was undertaken to review the history of professional awareness of tardive dyskinesia (TD) and to address reasons for the delay in such recognition. The literature was reviewed, and selections are included to highlight some of the major issues. Personal recollections are deliberately emphasized since they may reflect the phenomenon of personal discovery familiar to others and the now widespread professional awareness of TD. TD is indeed well recognized by psychiatrists and neurologists, and most general practitioners are also aware that the syndrome exists. Physicians were once unfamiliar with the concept of a drug reaction that was so long delayed as is possible with TD, nor did they know that a drug side effect could present in this manner. The historical delay in initial recognition of TD, and the reason for such delay, remain of interest. The lack of a perfect therapy and the uncertainty regarding the precise pathophysiologic basis of TD remain as challenges. Most psychiatrists, and many neurologists, probably have vivid memories of specific patients with TD. This author, a neurologist, was blessed to work with George Crane and other investigators in the early days of TD and was witness to some of the original uncertainty regarding what seemed to be a new phenomenon. TD has reshaped our concepts of disease and our awareness that diseases can originate from deleterious late effects of beneficial agents.
- Published
- 2005
- Full Text
- View/download PDF
7. A dominantly inherited progressive deafness affecting distal auditory nerve and hair cells.
- Author
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Starr A, Isaacson B, Michalewski HJ, Zeng FG, Kong YY, Beale P, Paulson GW, Keats BJ, and Lesperance MM
- Subjects
- Acoustic Impedance Tests, Audiology, Cochlear Implants, Cochlear Nerve pathology, Evoked Potentials, Auditory, Female, Genes, Dominant, Hair Cells, Auditory pathology, Hearing Loss, Sensorineural therapy, Humans, Male, Neural Conduction, Neurologic Examination, Pedigree, Phenotype, Psychophysics, Reaction Time, Speech Perception, Cochlear Nerve physiopathology, Hair Cells, Auditory physiopathology, Hearing Loss, Sensorineural genetics, Hearing Loss, Sensorineural physiopathology
- Abstract
We have studied 72 members belonging to a large kindred with a hearing disorder inherited in an autosomal dominant pattern. We used audiological, physiological, and psychoacoustic measures to characterize the hearing disorders. The initial phenotypic features of the hearing loss are of an auditory neuropathy (AN) with abnormal auditory nerve and brainstem responses (ABRs) and normal outer hair cell functions [otoacoustic emissions (OAEs) and cochlear microphonics (CMs)]. Psychoacoustic studies revealed profound abnormalities of auditory temporal processes (gap detection, amplitude modulation detection, speech discrimination) and frequency processes (difference limens) beyond that seen in hearing impairment accompanying cochlear sensory disorders. The hearing loss progresses over 10-20 years to also involve outer hair cells, producing a profound sensorineural hearing loss with absent ABRs and OAEs. Affected family members do not have evidence of other cranial or peripheral neuropathies. There was a marked improvement of auditory functions in three affected family members studied after cochlear implantation with return of electrically evoked auditory brainstem responses (EABRs), auditory temporal processes, and speech recognition. These findings are compatible with a distal auditory nerve disorder affecting one or all of the components in the auditory periphery including terminal auditory nerve dendrites, inner hair cells, and the synapses between inner hair cells and auditory nerve. There is relative sparing of auditory ganglion cells and their axons.
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- 2004
- Full Text
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8. Genetics of pediatric movement disorders.
- Author
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Paulson HL and Paulson GW
- Subjects
- Child, Humans, Pediatrics, Movement Disorders genetics
- Abstract
Movement disorders in children often have a genetic basis. An explosion of genetic information in the past decade has led to the discovery of genetic defects in many forms of ataxia, parkinsonism, dystonia, tremor, and spastic paraparesis. This review focuses on genetically defined, early-onset diseases characterized primarily or exclusively by movement disorders. Particular emphasis is placed on disorders for which clinical or research testing is available.
- Published
- 2003
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9. Idiopathic Parkinson's disease(s) may follow subclinical episodes of perivenous demyelination.
- Author
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Nelson DA and Paulson GW
- Subjects
- Female, Humans, Infections complications, Male, Demyelinating Diseases complications, Parkinson Disease etiology, Vascular Diseases complications, Veins
- Abstract
Three case studies of postvaccinal parkinsonism (PVP) demonstrated signs and symptoms identical to conventional diagnostic standards of idiopathic Parkinson's disease (PD). PVP is a sub-type of acute disseminated encephalomyelitis (ADE) that also includes postinfectious parkinsonism (PIP) and postinfectious encephalomyelitis (PIE). All ADE has a unitary pathology consisting of monophasic perivenous inflammation followed by demyelination compared with PD in which Lewy bodies are present in only 75% of studies. We hypothesize that: (1) The seminal event in PD is latent viral invasion emanating from cranial and dorsal root ganglia. (2) Viruses intermittently invade and damage neuropigmented cells secondary to perivenous demyelination. This may explain the numerous clinical and pathological manifestations of PD. Evidence is presented that this pathoetiology probably accumulates subclinically over a long timespan prior to Levy body formation and presentation of clinical signs. This hypothesis has key features similar to one previously published that will be summarized concerning multiple sclerosis., (Copyright 2002 Elsevier Science Ltd.)
- Published
- 2002
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10. Whipple's disease mimicking progressive supranuclear palsy: the diagnostic value of eye movement recording.
- Author
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Averbuch-Heller L, Paulson GW, Daroff RB, and Leigh RJ
- Subjects
- Biopsy, Diagnosis, Differential, Female, Humans, Intestine, Small microbiology, Intestine, Small pathology, Middle Aged, Polymerase Chain Reaction, Saccades, Eye Movements, Supranuclear Palsy, Progressive diagnosis, Whipple Disease diagnosis
- Abstract
Treatable causes of parkinsonian syndromes are rare; Whipple's disease is one of them. A patient is described who presented with a parkinsonian syndrome and abnormal vertical gaze. Measurement of eye movements showed marked slowing of upward saccades, moderate slowing of downward saccades, a full range of voluntary vertical eye movements, curved trajectories of oblique saccades, and absence of square wave jerks. These features, atypical of progressive supranuclear palsy, suggested the diagnosis of Whipple's disease, which was subsequently confirmed by polymerase chain reaction analysis of intestinal biopsy material. Precise measurement of the dynamic properties of saccadic eye movements in parkinsonian patients may provide a means of identifying treatable disorders.
- Published
- 1999
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11. Family with Pelizaeus-Merzbacher disease/X-linked spastic paraplegia and a nonsense mutation in exon 6 of the proteolipid protein gene.
- Author
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Bond C, Si X, Crisp M, Wong P, Paulson GW, Boesel CP, Dlouhy SR, and Hodes ME
- Subjects
- Adult, Base Sequence, Brain pathology, Child, Preschool, Codon, Nonsense genetics, DNA genetics, Diffuse Cerebral Sclerosis of Schilder pathology, Female, Genetic Linkage, Humans, Male, Paraplegia pathology, Pedigree, Polymorphism, Single-Stranded Conformational, Spinal Cord pathology, Diffuse Cerebral Sclerosis of Schilder genetics, Myelin Proteolipid Protein genetics, Paraplegia genetics, Point Mutation, X Chromosome genetics
- Abstract
We report on a C-to-T transition in exon 6 of the PLP gene in a male with Pelizaeus-Merzbacher disease/X-linked spastic paraplegia. The transition changes a glutamine at amino acid residue 233 to a termination codon. This premature stop codon probably results in a truncated protein that is not functional. Six other relatives were analyzed for the mutation and two female carriers were identified. Autopsy data on one male are presented.
- Published
- 1997
12. Lou Gehrig and amyotrophic lateral sclerosis. Is vitamin E to be revisited?
- Author
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Reider CR and Paulson GW
- Subjects
- Amyotrophic Lateral Sclerosis drug therapy, Baseball history, Famous Persons, History, 20th Century, Humans, United States, Vitamin E therapeutic use, Amyotrophic Lateral Sclerosis history, Vitamin E history
- Abstract
Investigators are beginning to reexamine the use of vitamin E for the treatment of amyotrophic lateral sclerosis. Vitamin E was isolated in the 1920s, and the results of animal studies led rapidly to clinical use. Regrettably, vitamin E did not ameliorate the progression of amyotrophic lateral sclerosis for Lou Gehrig, but more recent advances may identify subpopulations that do respond to vitamin E.
- Published
- 1997
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13. Effects of thalamic deep brain stimulation based on tremor type and diagnosis.
- Author
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Hubble JP, Busenbark KL, Wilkinson S, Pahwa R, Paulson GW, Lyons K, and Koller WC
- Subjects
- Adolescent, Adult, Aged, Disability Evaluation, Electrodes, Implanted, Follow-Up Studies, Humans, Middle Aged, Treatment Outcome, Videotape Recording, Electric Stimulation, Parkinson Disease, Thalamus, Tremor therapy
- Abstract
It has been suggested that deep brain stimulation (DBS) is less effective in alleviating proximal than distal postural arm tremor reduction is said to be less in essential tremor (ET) than in Parkinson's disease (PD). We analyzed blinded rater's tremor scores and subjects' disability ratings at 3-month follow-up to examine the effects of DBS based on tremor type (rest, kinetic, distal postural, proximal postural) and diagnosis (ET, PD). An independent examiner provided tremor scores using randomized videotaped footage of 19 ET and 10 PD subjects at baseline and at follow-up with DBS "on." Subjects provided self-ratings of disability at baseline and at follow-up. Comparisons of baseline and follow-up tremor scores and disability ratings were made using the Mann-Whitney U and Wilcoxon rank sum W test; correlation analyses were performed using Spearman rank order correlation test. There were significant and essentially equal improvements in tremor scores of test, kinetic, distal postural, and proximal postural tremor at follow-up. Only one subject had no improvement in tremor. Tremor improved significantly and to the same extent in ET and PD subjects in each position except "at rest," which was most improved in PD (p = 0.0003). ET and PD subjects did not differ in the extent of disability improvement. Improved disability correlated only with improved postural tremor scores; proximal postural and distal postural (r = 0.41, p = 0.03; r = 0.47, p = 0.01). DBS is effective in alleviating tremor and disability in both ET and PD. Resting, kinetic, distal postural, and proximal postural tremor can be reduced to an equal degree. However, DBS produces the greatest improvement in disability in association with improved postural tremor in both ET and PD.
- Published
- 1997
- Full Text
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14. Visual hallucinations in the elderly.
- Author
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Paulson GW
- Subjects
- Hallucinations physiopathology, Humans, Vision Disorders physiopathology, Aged psychology, Hallucinations etiology, Mental Disorders complications, Vision Disorders etiology
- Abstract
Visual hallucinations, without auditory hallucinations and in the elderly, are not usually based on previous psychiatric illness. The elderly can, of course, hallucinate as part of severe depression or a life-long schizophrenia, but the clinician should assume that there is an organic basis when an elderly individual begins to develop visual hallucinations for the first time. Representative cases that illustrate visual hallucinations due to ophthalmological, vascular, or degenerative processes are presented. Visual hallucinations can be linked to disorders in multiple parts of the nervous system. Even when related to medications, dementia may also be contributory, as is illustrated by the hallucinations seen in those with Parkinson's disease. Treatment of visual hallucinations is treatment of the underlying cause although some newer drugs such as clozapine may also be helpful for selected patients.
- Published
- 1997
- Full Text
- View/download PDF
15. Issues related to DNA testing for Huntington's disease in symptomatic patients.
- Author
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Paulson GW and Prior TW
- Subjects
- Adult, Female, Humans, Huntington Disease psychology, Male, Middle Aged, DNA Mutational Analysis, Ethics, Medical, Genetic Counseling psychology, Huntington Disease diagnosis, Huntington Disease genetics
- Abstract
The DNA test for Huntington's disease simplifies diagnosis, but does not eliminate clinical and ethical issues. Records of 80 consecutive patients who had testing were reviewed; 54 had a positive result. We present seven examples of the variety of problems disclosed by our review. Among the issues that remain unsettled are: (1) Who should do needed counseling and how much? (2) When, if ever, is presymptomatic testing for this incurable disease indicated? (3) Should the patient have access to information about the length of repeats, as the age of onset is affected by the length of repeat? (4) Is it true that insurance companies or relatives have no right to learn the results of DNA testing on a patient?
- Published
- 1997
- Full Text
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16. Visual hallucinations associated with Parkinson disease.
- Author
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Sanchez-Ramos JR, Ortoll R, and Paulson GW
- Subjects
- Aged, Aged, 80 and over, Aging, Depression complications, Female, Humans, Male, Parkinson Disease drug therapy, Parkinson Disease psychology, Hallucinations etiology, Parkinson Disease complications
- Abstract
Objective: To determine factors that are predictive for the development of hallucinations associated with Parkinson disease (PD)., Background: Hallucinations are a common difficulty for patients with established PD, and hallucinations and psychosis may be the most common causes for nursing home placement. The characteristics of the hallucinations associated with PD differ from the hallucinations associated with schizophrenia or cocaine abuse. Multiple factors have been suggested as causal., Design and Methods: A total of 214 consecutive patients were interviewed during routine visits to the Parkinson's Disease Clinics in Columbus, Ohio, and Miami, Fla, using a hallucination questionnaire, Folstein Mini-Mental State Examination, and an attempt to correlate age, duration of disease, medication, and psychological or sleep disorders with the hallucinations., Results: Hallucinations were almost exclusively visual and were present in 55 of the 214 patients. Dementia, age, duration of disease, history of depression, or history of sleep disorder were strongly associated with the hallucinations., Conclusions: While reduction in levodopa and anticholinergic medication doses is appropriate in the management of hallucinations, the factors that predispose patients to hallucinations include dementia and advancing age. The phenomena of visual hallucinations associated with PD, while not fully explained, are unique enough to be of interest to all neurologists and neuroscientists.
- Published
- 1996
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17. Comments of a consultant to primary care physicians.
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Paulson GW
- Subjects
- Humans, Communication, Interprofessional Relations, Primary Health Care, Referral and Consultation
- Published
- 1996
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18. Botulinum toxin is unsatisfactory therapy for fibromyalgia.
- Author
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Paulson GW and Gill W
- Subjects
- Double-Blind Method, Female, Humans, Injections, Intramuscular, Lidocaine administration & dosage, Male, Shoulder, Treatment Failure, Botulinum Toxins administration & dosage, Fibromyalgia drug therapy, Pain drug therapy
- Published
- 1996
- Full Text
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19. Event-related potentials in Parkinson's disease.
- Author
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Aotsuka A, Weate SJ, Drake ME Jr, and Paulson GW
- Subjects
- Aged, Aged, 80 and over, Electroencephalography, Female, Humans, Male, Middle Aged, Event-Related Potentials, P300 physiology, Parkinson Disease physiopathology
- Abstract
The increasingly recognized occurrence of dementia in Parkinson's disease (PD) has prompted study of cognitive evoked potentials in this disorder. The P300 wave is related to cognitive performance, while the contingent negative variation (CNV) may reflect dopaminergic function. We measured P300 and CNV in 21 nondemented PD patients and compared them to elderly controls. The P300 was recorded from Cz with linked ear reference. 3,000 and 1,000 Hz tones were presented in an 80:20 ratio at 76 dBSL interstimulus interval was 1.1 seconds, and filter bandpass was 1-100 Hz. CNV recording utilized a 2000 Hz tone followed after 1.5 seconds by a light flash and button press, and was recorded from Fz with linked ear reference, 10-second analysis time, and 0.1-20 Hz filter bond pass. N200 and P300 amplitudes were significantly longer and latency significantly lower in PD patients than in controls, and P300 latency was correlated with composite score on cognitive tests. CNV amplitude was significantly reduced in PD patients, but was correlated with measures of motor disability rather than cognition. These findings suggest that bradyphrenia may occur in nondemented PD patients, and that P300 may measure cognitive changes in PD. CNV may be a dopaminergic slow potential and may correlate with motor function in nondemented PD patients.
- Published
- 1996
20. Pseudo-multiple sclerosis.
- Author
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Paulson GW
- Subjects
- Adult, Diagnosis, Differential, Female, Humans, Middle Aged, Multiple Sclerosis psychology, Multiple Sclerosis diagnosis, Somatoform Disorders diagnosis
- Abstract
Multiple sclerosis (MS) is among the most crippling diseases of the nervous system in young adults, and diagnosis can be difficult. It is true that MS can exist without magnetic resonance imaging or cerebrospinal fluid abnormalities, but whenever there are an atypical clinical pattern and no confirmatory laboratory tests, then "pseudo-MS" might be considered. Six cases of presumed pseudo-MS are reported. Psychologic treatment of these cases was unsatisfactory. Treatment in all such cases will be difficult, but more so when MS cannot be disproved and when the patient resists a psychogenic explanation for the symptoms.
- Published
- 1996
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21. Headaches in women, including women who are pregnant.
- Author
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Paulson GW
- Subjects
- Adolescent, Adult, Aged, Child, Emergencies, Female, Humans, Middle Aged, Migraine Disorders complications, Migraine Disorders therapy, Pregnancy, Tension-Type Headache complications, Tension-Type Headache therapy, Headache complications, Headache etiology, Headache therapy, Pregnancy Complications etiology, Pregnancy Complications therapy
- Abstract
There are new concepts in headache definition and pathophysiologic characteristics, but both classification and management remain largely the responsibility of the principal care physician. Women are particularly vulnerable for some types of headache. When a woman needs medical help she usually turns to their personal physician, who can be expected to diagnose and successfully treat most headaches.
- Published
- 1995
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22. Amantadine, livedo reticularis, and antiphospholipid antibodies.
- Author
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Paulson GW and Brandt JT
- Subjects
- Humans, Skin Diseases, Vascular immunology, Amantadine adverse effects, Antibodies, Antiphospholipid immunology, Skin Diseases, Vascular chemically induced
- Published
- 1995
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23. Are death certificates reliable to estimate the incidence of Parkinson's disease?
- Author
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Paulson GW and Gill WM
- Subjects
- Humans, Incidence, Ohio, United States, Death Certificates, Parkinson Disease epidemiology
- Published
- 1995
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24. Can smoking be detected from cerebrospinal fluid?
- Author
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Paulson GW and Olson BL
- Subjects
- Humans, Cotinine cerebrospinal fluid, Smoking
- Published
- 1995
- Full Text
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25. Congenital mirror movements.
- Author
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Paulson GW and Gill WM
- Subjects
- Female, Fingers physiology, Humans, Middle Aged, Movement Disorders physiopathology, Functional Laterality physiology, Hand physiology, Movement Disorders diagnosis
- Published
- 1995
- Full Text
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26. Therapy of patients with Parkinson's disease.
- Author
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Paulson GW
- Subjects
- Carbidopa administration & dosage, Drug Combinations, Humans, Levodopa administration & dosage, Parkinson Disease drug therapy
- Published
- 1994
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27. Relationship of oral microflora with oral health status in Parkinson's disease.
- Author
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Kennedy MA, Rosen S, Paulson GW, Jolly DE, and Beck FM
- Subjects
- Aged, Analysis of Variance, Bacteria, Anaerobic isolation & purification, Behavior, Addictive complications, Behavior, Addictive etiology, Colony Count, Microbial, DMF Index, Feeding and Eating Disorders complications, Female, Gingivitis etiology, Humans, Male, Middle Aged, Mouth Mucosa, Parkinson Disease physiopathology, Periodontal Index, Statistics, Nonparametric, Stomatitis etiology, Sucrose, Dental Caries etiology, Dental Plaque microbiology, Feeding and Eating Disorders etiology, Parkinson Disease complications
- Abstract
Parkinson's disease (PD) patients report an increased craving for sweets, which may have an effect on microflora. We compared patients of PD who crave sweets with PD patients who do not. Age- and sex-matched control subjects were used, with 14 subjects in each group. A plaque sample was taken from tooth #18 with a curette and placed into RTF, homogenized, and plated onto selective and non-selective media. Microflora were expressed as % CFU's of total anaerobes. Statistical analysis was performed by ANOVA and Newman-Keuls on log-transformed data. No statistical difference was observed among the three groups for lactobacilli, bacteroides, fusobacteria, veillonella, and actinomyces. S. mutans was lower in controls than in PD patients. Apparently, the craving for sweets in PD patients does not result in a significant increase in % of total anaerobes of certain microflora. PD patients showed a significant increase in mucositis compared with the control groups.
- Published
- 1994
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28. Parkinsonian syndromes.
- Author
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Paulson GW and Aotsuka A
- Subjects
- Gait, Humans, Parkinson Disease physiopathology, Parkinson Disease, Secondary physiopathology
- Published
- 1993
- Full Text
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29. Oral and facial movements in the aged.
- Author
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Paulson GW and Gill WM
- Subjects
- Age Factors, Aged, Humans, Nursing Assessment, Facial Muscles, Movement Disorders diagnosis, Movement Disorders etiology, Movement Disorders physiopathology, Movement Disorders therapy
- Abstract
Orofacial movements are often outward manifestations of many generalized organic processes. When muscle weakness and hyperactivity are present, tumors and lesions at the base of the skull should be ruled out. Treatments involving myotomies and denervations are drastic, but can be effective even if disfiguring. Botulinum toxin offers short-term (weeks to months) relief, and when used sparingly the muscles involved are only modestly impaired. Since the etiology of many of these movements is unknown, treatments are usually only palliative and remissions rare.
- Published
- 1993
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30. Addiction to nicotine is due to high intrinsic levels of dopamine.
- Author
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Paulson GW
- Subjects
- Humans, Models, Neurological, Parkinson Disease epidemiology, Parkinson Disease etiology, Risk Factors, Tobacco Use Disorder etiology, Dopamine metabolism, Nicotine adverse effects, Parkinson Disease physiopathology, Smoking physiopathology, Tobacco Use Disorder physiopathology
- Abstract
Smokers are less likely to develop Parkinson's disease (PD) than is true of non-smokers, and PD is the only disease inversely related to smoking. PD is associated with a reduced level of dopamine. Although nicotine can affect the receptors, including dopamine receptors, it seems unlikely that use of nicotine is protective in PD. An alternative explanation is that just as PD is associated with a lower than normal level of dopamine, addiction to smoking is linked with a higher than normal level of dopamine. This high innate level of dopamine facilitates addiction to nicotine.
- Published
- 1992
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31. Reflexes and neurologists.
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Paulson GW
- Subjects
- Brain physiopathology, Central Nervous System Diseases diagnosis, Central Nervous System Diseases physiopathology, Dominance, Cerebral physiology, Humans, Reflex, Abnormal physiology, Spinal Cord physiopathology, Neurologic Examination, Reflex physiology
- Abstract
Neurologists are particularly concerned with elicitation of reflexes, interpret them as indicative of levels of the nervous system and its development or dissolution. This article reviews selected aspects of reflex action. No longer simply reflexology, clinical neurology will still make new observations about reflexes and, more relevant, clinical neurologists will enjoy the process. The breadth of interests of George Bruyn is a permanent reminder to future neurologists of what complexities can be constructed on basic observations such as have been done on "our" reflexes.
- Published
- 1992
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32. Is there a premorbid personality typical for Parkinson's disease?
- Author
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Paulson GW and Dadmehr N
- Subjects
- Affect, Diseases in Twins, Humans, Mental Disorders complications, Parkinson Disease complications, Parkinson Disease metabolism, Smoking, Parkinson Disease psychology, Personality
- Abstract
For decades clinicians have postulated a characteristic preexisting personality in patients who develop Parkinson's disease (PD). They are described as moralistic, law-abiding, conscientious, and averse to risk-taking. The limited personality surveys tend to be confirmatory, but most of the literature is anecdotal or replete with unprovable psychodynamic postulates. In addition to an apparent stability of marriages and lack of alcoholism, patients with PD are less likely than controls to be smokers. It has been suggested that nicotine and its byproducts are not actually protective against PD, and it could be postulated that higher-than-average intrinsic dopamine may facilitate addiction. Smoking for the patient who is later to develop PD may be particularly unrewarding. In addition, the postulated personality for PD may predispose to hard work, perspiration, and increased exposure to putative trace elements in the water supply.
- Published
- 1991
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33. Magnetic resonance imaging in Parkinson's disease.
- Author
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Huber SJ, Chakeres DW, Paulson GW, and Khanna R
- Subjects
- Adult, Aged, Female, Functional Laterality, Humans, Male, Middle Aged, Brain pathology, Magnetic Resonance Imaging, Parkinson Disease diagnosis
- Abstract
Magnetic resonance imaging was utilized to examine changes in the pars compacta associated with Parkinson's disease. We found a reduction in average width of the pars compacta in advanced- but not early-stage patients. Conversely, a significant difference in width (right minus left) was observed in early- but not late-stage patients. Width asymmetry may be a sensitive magnetic resonance imaging indicator for the early detection of Parkinson's disease when there is a predominance of unilateral clinical symptoms.
- Published
- 1990
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34. The pattern of depressive symptoms varies with progression of Parkinson's disease.
- Author
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Huber SJ, Freidenberg DL, Paulson GW, Shuttleworth EC, and Christy JA
- Subjects
- Adult, Aged, Aged, 80 and over, Depression etiology, Humans, Middle Aged, Parkinson Disease complications, Psychiatric Status Rating Scales, Severity of Illness Index, Depression physiopathology, Parkinson Disease physiopathology
- Abstract
Whether or not depressive symptoms increase in severity with progression of Parkinson's disease (PD) remains uncertain. Unlike previous studies, we examined whether the severity of specific features of depression (mood, self reproach, vegetative, and somatic symptoms) differ with respect to the progression of PD. Results indicated that symptoms related to both mood and self-reproach were present in the early stages of PD but did not increase in severity with advancing disease. Somatic features of depression were evident early and increased with disease progression, and vegetative symptoms were seen only in the later stages of PD. The different patterns of these depressive features with progression of PD may account in part for the variations seen in previous studies.
- Published
- 1990
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35. Weightlifters headache.
- Author
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Paulson GW
- Subjects
- Adolescent, Adult, Humans, Male, Athletic Injuries, Headache etiology, Ligaments injuries, Neck, Sports, Weight Lifting
- Published
- 1983
- Full Text
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36. Lioresal in Huntington's disease.
- Author
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Paulson GW
- Subjects
- Dantrolene adverse effects, Dantrolene therapeutic use, Diazepam therapeutic use, Drug Evaluation, Gait, Growth Hormone blood, Humans, Huntington Disease physiopathology, Prolactin blood, gamma-Aminobutyric Acid adverse effects, gamma-Aminobutyric Acid analogs & derivatives, gamma-Aminobutyric Acid therapeutic use, Aminobutyrates therapeutic use, Baclofen therapeutic use, Huntington Disease drug therapy
- Published
- 1976
37. Tardive dyskinesia as a possible sequel of long-term therapy with phenothiazines.
- Author
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Paulson GW, Rizvi CA, and Crane GE
- Subjects
- Adolescent, Child, Chlorpromazine adverse effects, Clinical Trials as Topic, Diagnosis, Differential, Dystonia Musculorum Deformans diagnosis, Female, Hospitalization, Hospitals, Psychiatric, Humans, Intellectual Disability drug therapy, Male, Movement Disorders diagnosis, Parkinson Disease diagnosis, Thioridazine adverse effects, Trifluoperazine adverse effects, Movement Disorders chemically induced, Phenothiazines adverse effects
- Published
- 1975
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38. Headaches associated with orgasm.
- Author
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Paulson GW
- Subjects
- Female, Humans, Male, Headache etiology, Orgasm
- Published
- 1975
39. The concept of subcortical dementia.
- Author
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Huber SJ and Paulson GW
- Subjects
- Agnosia diagnosis, Alcohol Amnestic Disorder diagnosis, Alcohol Amnestic Disorder physiopathology, Alcohol Amnestic Disorder psychology, Alzheimer Disease diagnosis, Alzheimer Disease physiopathology, Alzheimer Disease psychology, Aphasia diagnosis, Apraxias diagnosis, Brain physiopathology, Bulbar Palsy, Progressive physiopathology, Bulbar Palsy, Progressive psychology, Dementia physiopathology, Dementia psychology, Diagnosis, Differential, Humans, Huntington Disease physiopathology, Huntington Disease psychology, Memory Disorders diagnosis, Memory Disorders physiopathology, Memory Disorders psychology, Parkinson Disease physiopathology, Parkinson Disease psychology, Bulbar Palsy, Progressive diagnosis, Dementia diagnosis, Huntington Disease diagnosis, Parkinson Disease diagnosis
- Abstract
The authors review the concept of subcortical dementia, specifically the dementia associated with Huntington's disease, Parkinson's disease, and progressive supranuclear palsy, all subcortical processes that involve deterioration of mental abilities. Subcortical dementia affords a unique opportunity to study the progressive memory loss associated with dementia because, in contrast to cortical dementias such as Alzheimer's disease, this relatively circumscribed syndrome does not involve dysfunction of language (aphasia) and perception (agnosia and apraxia). Research strategies are proposed to examine the concept of subcortical dementia, an entity that remains controversial and not well understood. The subcortical dementias may constitute a group of partially treatable forms of dementia.
- Published
- 1985
- Full Text
- View/download PDF
40. Spastic dysphonia.
- Author
-
Paulson GW and Barnes JE
- Subjects
- Adult, Aged, Basal Ganglia Diseases complications, Female, Humans, Male, Middle Aged, Speech Disorders therapy, Speech Therapy, Syndrome, Spasm complications, Speech Disorders etiology
- Published
- 1976
41. Migraine headaches in children.
- Author
-
Paulson GW
- Subjects
- Adolescent, Age Factors, Child, Child, Preschool, Female, Humans, Male, Prognosis, Migraine Disorders drug therapy, Migraine Disorders etiology
- Published
- 1979
42. Neurological complications of laparoscopy.
- Author
-
Paulson GW and DeVoe K Jr
- Subjects
- Adult, Female, Humans, Hypotension etiology, Brain Diseases etiology, Laparoscopy adverse effects
- Published
- 1981
- Full Text
- View/download PDF
43. "Recreational" misuse of nitrous oxide.
- Author
-
Paulson GW
- Subjects
- Adult, Humans, Male, Paresthesia chemically induced, Nitrous Oxide adverse effects, Substance-Related Disorders
- Abstract
With the use of nitrous oxide increasing, overuse and excessive exposure to this gas are also more prevalent. Neuropathy, expressed as amnesia, aphasia or weakness, numbness, and incoordination affecting all extremities, is the common result of frequent overexposure. For optimal dental treatment, it is recommended that both patient and dentist be aware that nitrous oxide can be an exogenous toxin, damaging to neuronal structures, if used in excess.
- Published
- 1979
- Full Text
- View/download PDF
44. Early Alzheimer's disease or dementia from another cause?
- Author
-
Paulson GW
- Subjects
- Adult, Aged, Aging, Alzheimer Disease physiopathology, Craniocerebral Trauma complications, Dementia etiology, Dementia physiopathology, Emotions, Factitious Disorders etiology, Factitious Disorders therapy, Humans, Middle Aged, Parkinson Disease complications, Reflex, Alzheimer Disease diagnosis, Dementia diagnosis
- Abstract
It is unusual for Alzheimer's disease to present with focal neurologic abnormalities. Most patients have generalized and progressive dementia without signs of systemic disease. Perhaps the most characteristic feature is the absence of significant medical or focal neurologic abnormalities in the presence of severe dementia.
- Published
- 1985
- Full Text
- View/download PDF
45. Progressive supranuclear palsy: pneumoencephalography, electronystagmography and treatment with methysergide.
- Author
-
Paulson GW, Lowery HW, and Taylor GC
- Subjects
- Aged, Basal Ganglia Diseases drug therapy, Basal Ganglia Diseases psychology, Female, Humans, Male, Middle Aged, Saccades, Basal Ganglia Diseases diagnosis, Electronystagmography, Methysergide therapeutic use, Pneumoencephalography
- Abstract
15 patients with progressive supranuclear palsy (PSP) are presented with discussion of the value of pneumoencephalography (PEG) and electronystagmography (ENG) in confirming the diagnosis. PEG was performed in 6 patients, and revealed atrophy in the area of the pons and colliculi. ENG, which also was performed in 6 patients, 4 of whom had PEG, confirmed the defects in extraocular movement. Methysergide, which has been suggested as therapy for PSP, was utilized in 6 patients with no evidence of significant improvement.
- Published
- 1981
- Full Text
- View/download PDF
46. Cortical excision as a supplementary treatment for epilepsy.
- Author
-
Paulson GW, Sayers MP, and Calhoun R
- Subjects
- Adolescent, Adult, Anticonvulsants therapeutic use, Epilepsy drug therapy, Female, Follow-Up Studies, Humans, Male, Cerebral Decortication, Epilepsy surgery
- Published
- 1975
47. Predictive tests in Huntington's disease.
- Author
-
Paulson GW
- Subjects
- Age Factors, Electroencephalography, Eye Movements, Female, Glutamate Decarboxylase metabolism, Growth Hormone metabolism, Handwriting, Homovanillic Acid metabolism, Humans, Huntington Disease diagnosis, Huntington Disease physiopathology, Iron metabolism, Male, Mental Disorders physiopathology, Movement, Pneumoencephalography, Sex Factors, Speech, gamma-Aminobutyric Acid metabolism, Genetic Counseling, Huntington Disease genetics
- Abstract
HD is a dominantly inherited disorder that affects mental and motor systems and includes a rigid form as well as the better known choreic form. Many articles have been devoted to predicting the future onset of the disease in patients who are at risk, but none of the suggested predictors is currently considered completely reliable. Members from individual families do tend to show a similar age of onset, and similar intellectual and motor abnormalities do develop within a single family; but the presence or absence of this dominant gene of high penetrance is not usually certain until the obvious physical signs appear. Predictive tests are of importance not only to decide which person may develop the disorder, but they may also offer a clue to associated or causal features of the disease. This chapter is a review of reported predictive tests in HD, emphasizing the rationale for their use. Psychological testing has often been abnormal early in the course of the disease of some patients, particularly when motor dexterity or apraxia is tested. Family members often insist that various psychological traits enable them to predict which members are affected by the gene. These opinions are summarized. Neurophysiologic tests are briefly reviewed, including new data on increased liklihood of H-reflexes in HD. Electroencephalography was once touted as a possible predictive test but, although there is frequently an association of a low voltage EEG activity with HD, this change is too variable for certainty in prediction. Pneumoencephalography with specific measurements of caudate atrophy is of clinical interest, but a pneumoencephalogram is rarely needed for diagnosis and caudate atrophy may not actually be an early sign. Metabolic changes in HD include the biochemical effects of hypothalamic dysfunction, changes in growth hormone, and reported change in GABA levels in the CSF or brain. Provocative tests have utilized numerous drugs in an attempt to predict the onset of the disease, including particularly physostigmine and L-DOPA. All of the tests elucidate peculiarities of the disease, and all are of ethical as well as neurological interest. Many of the provocative tests utilize quantification of known neurologic features of the disease, such as reduction in saccadic movements of the eye, increased reflexes, or patterns of movement. The ethical problems in predictive tests, especially tests intended to provoke features of the disease, have been a matter of quiet controversy. Should a nontreatable disease be overtly diagnosed? And if so, will it benefit the patient? Can any of the tests tend to accelerate the patient's decline, either by physical or by psychological trauma? This chapter reviews the various predictive tests and their rationale and concludes that none of the tests are totally reliable. Many offer interesting insights into the effects of HD and do broaden the overall significance of this fascinating disorder of basal ganglion function.
- Published
- 1976
48. Teratogenic effects of valproate in the CD-1 mouse fetus.
- Author
-
Paulson RB, Sucheston ME, Hayes TG, and Paulson GW
- Subjects
- Abnormalities, Drug-Induced pathology, Animals, Brain abnormalities, Female, Fetal Diseases pathology, Mice, Mice, Inbred Strains, Pregnancy, Skull abnormalities, Abnormalities, Drug-Induced etiology, Fetal Diseases chemically induced, Valproic Acid adverse effects
- Abstract
Valproate sodium has been implicated in the production of spina bifida in humans; this article reports an animal model. Teratogenicity of valproate sodium was studied by oral administration of single doses of 225, 340, and 560 mg/kg to pregnant CD-1 mice on days 7 through 12 of gestation. All fetuses were examined on day 17. Treated fetuses demonstrated external malformations and a decrease in weight. The incidence of malformations was greater at the higher dosage levels of 340 mg/kg and 560 mg/kg, with a predominance of exencephaly, open eyelids, and gross skeletal defects. There was a significant increase in the resorption rate of the fetuses in the treated groups. There was also a significant increase in the malformations observed per litter and per live fetus population when compared with controls.
- Published
- 1985
- Full Text
- View/download PDF
49. Essential vocal tremor: clinical characteristics and response to therapy.
- Author
-
Massey EW and Paulson GW
- Subjects
- Adult, Female, Humans, Male, Middle Aged, Speech Disorders diagnosis, Tremor diagnosis, Speech Disorders therapy, Tremor therapy
- Abstract
We evaluated four patients with an initial and predominant voice tremor. All were referred for evaluation for suspected parkinsonism, though vocal tremor was the only symptom. These three women and one man ranged in age from 37 to 59 years. Neurologic evaluation and laryngeal examination were unremarkable. No signs of parkinsonism were present. All patients had a family history of tremor, though in only one family was vocal tremor the sole manifestation. Tremor was suppressed by alcohol ingestion in all patients and with whisper in two. Duration of tremor before evaluation ranged from eight months to six years. Visual representation of tremor was obtained in three, with frequencies ranging from 4 to 10 cps. Three patients responded to treatment with propranolol (Inderal), and one did well with voice training. Follow-up was six months to ten years. Although previous cases of essential vocal tremor with concurrent tremor elsewhere have been noted, only six cases of isolated voice tremor had been reported and response to therapy was not mentioned. Essential tremor may also be isolated to the head, chin, and hands.
- Published
- 1985
50. Phenytoin and carbamazepine in production of cleft palates in mice. Comparison of teratogenic effects.
- Author
-
Paulson RB, Paulson GW, and Jreissaty S
- Subjects
- Animals, Carbamazepine blood, Cleft Palate embryology, Dose-Response Relationship, Drug, Female, Mice, Phenytoin blood, Pregnancy, Carbamazepine adverse effects, Cleft Palate chemically induced, Phenytoin adverse effects
- Abstract
The teratogenic activity of two anticonvulsant drugs, phenytoin sodium and carbamazepine, was studied in pregnant mice fed phenytoin and carbamazepine during days 8 to 13. Incidence of palatal defects and other abnormalities correlated with increasing dosages and blood levels of the drugs. Phenytoin produced a much higher incidence of teratogenic effects than carbamazepine.
- Published
- 1979
- Full Text
- View/download PDF
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