Colin R. Bamford

Seasonal variation of multiple sclerosis exacerbations in Arizona

We studied 178 MS patients and 82 controls for 5 years. A monthly pattern in the frequency of exacerbations in Arizona differed from the patterns seen in other regions of the world. Exacerbations were most common in warmer months. No explanation for this was found. In this prospective study, the frequency of viral infections in the MS patients was lower than in the controls.

Uveitis, perivenous sheathing and multiple sclerosis.

Pars planitis (peripheral uveitis) and perivenous sheathing are two ocular phenomena associated with multiple sclerosis (MS). A total of 163 ocular examinations were performed on 127 MS patients at the university of Arizona Health Sciences Center. The prevalence of pars planitis in our study is lower (2.4 percent) than found by others, but significantly higher than its occurrence in the general population. We attribute our lower prevalence to the method of ocular examination (scleral depression and indirect ophthalmoscopy), as well as to firmly defined criteria necessary to make the diagnosis of pars planitis. The incidence of perivenous sheathing (11 percent) reported by us is consistent with the experience of others; however, this finding was noted more frequently in patients with the progressive form of MS. No perivenous sheathing was found to develop within the first few weeks following 31 exacerbations, and no association was identified between its presence and the severity of neurologic disability.

L-dopa in uremic patients with the restless legs syndrome

Restless legs syndrome (RLS) is a poorly understood, often distressing condition that is particularly prevalent among patients with chronic renal failure. A wide variety of medications have been used to treat RLS with variable results. In order to evaluate the efficacy of carbidopa/levodopa therapy, eight consecutive uremic patients with RLS on maintenance hemodialysis were treated with doses ranging from 25/100 to 25/250 twice daily. Six of eight patients obtained satisfactory relief which has continued for 3 months follow-up. Carbidopa-levodopa appears to be an effective opinion in management of RLS in patients with chronic rental failure.

Trauma as an etiologic and aggravating factor in multiple sclerosis

We carried out a retrospective and prospective epidemiologic study designed to detect an association between trauma and multiple sclerosis in 130 patients and 82 age- and sex-matched controls. Electrical injury was followed by an increased frequency of exacerbation, which did not achieve statistical significance. There was no statistically significant association between other types of trauma and onset or deterioration of the disease. These findings do not prove that such an association cannot exist for any one individual patient; however, they do not provide evidence to support this idea.

Pain and Sensory Symptoms in Parkinson's Disease

In this communication we discuss the clinical features and pathophysiology of primary sensory symptoms in Parkinsons disease.

Migrainous ischemic optic neuropathy.

Anterior ischemic optic neuropathy (AION) is a stroke syndrome of the eye seen in isolation or as a manifestation of underlying disease. A case of migrainous AION is reported, and the implications of anterior visual pathway migraine discussed.

Spinal Cord Mechanisms in Amitriptyline Responsive Restless Legs Syndrome in Parkinson's Disease

We discuss a case of a patient with restless legs syndrome that was responsive to administration of amitriptyline. The possible mode of action of amitriptyline in ameliorating this patients symptoms is discussed.

Gonadotropin deficiency in tourette's syndrome: A preliminary communication

Plasma baseline levels of gonadotropins and sex steroids were measured in 17 patients with Tourettes Syndrome (TS). In addition, a Gonadotropin Stimulation test, using a synthetic Gonadotropin releasing factor analogue (GnRH, 100 micrograms, i.v.), was performed in 7 patients. Plasma levels of Luteinizing Hormone (LH) were uniformly low in all patients, while those of Follicle Stimulating hormone (FSH) and sex steroids were less depressed in some patients and in the normal range in others. In all patients, stimulation with GnRH analogue produced a marked rise in LH levels, but the FSH responses were much less dramatic and did not significantly exceed that of normal controls. Our findings indicate reduced gonadotropin release in patients with TS, and support the hypothesis of hypothalamic involvement in the disease.

Toxoplasmosis mimicking a brain abscess in an adult with treated scleroderma

Toxoplasmosis was found in a 41-year-old man whose presenting symptoms suggested the presence of a space-occupying cerebral lesion and meningitis. The diagnosis was confirmed histologically and serologically. Sulfisoxazole and pyrimethamine therapy resulted in resolution of the meningitis within 2 weeks, but no significant clinical change was otherwise observed. The pathology and epidemiology of similar cases are reviewed.

L-Trypiophan in Neuroleptic-Induced Tardive Dyskinesia

Administration of the serotonin precursor L-tryptophan in a patient with neuroleptic-induced tardive dyskinesia, produced a dramatic reduction in the severity of the abnormal movements within 24 hours. This report supports our hypothesis that alterations in the function of serotoninergic neurotransmission are implicated in the pathophysiology of neuroleptic-induced tardive dyskinesia.