Moshe Elyakim Brooks

The prevalence of hypertension, ischaemic heart disease and diabetes in traumatic spinal cord injured patients and amputees

The clinical impression that spinal cord injured and traumatic lower limb amputees are more prone to develop degenerative diseases was investigated by comparing the prevalance of hypertension, ischaemic heart disease, and diabetes mellitus in these two patient groups with the prevalence of these diseases among a group of healthy age-matched controls. Seventy seven spinal cord injured patients and 53 amputees fulfilled the criteria for inclusion in this study. Our results show a significant increased incidence of hypertension and ischaemic heart disease among those with spinal cord injuries compared with their controls; and among the amputees, a significant increased incidence of ischaemic heart disease and of diabetes mellitus.

Treatment of retrograde ejaculation using imipramine.

We describe 2 cases of retrograde ejaculation in diabetic patients. Treatment with the alpha-adrenergic stimulator, imiprimine, resulted in reversal of seminal trajectory.

Shoulder complications as a cause of delay in rehabilitation of spinal cord injured patients. (Case reports and review of the literature).

We describe ten patients with spinal cord disease or injury who developed upper extremity and shoulder complications during rehabilitation. These shoulder complications caused delay in rehabilitation. We discuss the aetiology, treatment and management of shoulder complications in spinal patients and in patients with other neurological diseases.

The rehabilitation of patients with severe Guillain-Barré syndrome.

Twenty four of more than 800 patients admitted to our centre presented with a severe Guillain-Barré Syndrome. The length of hospitalisation, duration of illness, treatment, and the rehabilitation course of these patients are discussed. Suggestions are made concerning the necessity to obtain maximal rehabilitation for these patients.

Oxybutynin chloride (ditropan)—Clinical uses and limitations

Eighteen patients treated with oxybutynin chloride are presented. The effect of the drug on the hyperactive detrusor is shown and discussed. Side effects and limitations are described and related to treatment.

Hyperprolactinemia, galactorrhea and amenorrhea in women with a spinal cord injury

Six women with a traumatic spinal cord injury (SCI) developed hyperprolactinemia, amenorrhea and galactorrhea. Five of them had thoracic level lesions and 1 had a lumbosacral lesion. Two were postpartum and 1 was pregnant at the time of injury. Transient diabetes insipidus developed in 1 patient. Temporary administration of bromocriptine decreased prolactin levels, caused cessation of lactation and restored ovulatory cycles. The syndrome disappeared spontaneously in all 6 patients. Pituitary stalk concussion resulting from the trauma might cause this phenomenon, with the level of the cord injury playing a role. Being pregnant or early postpartum can predispose women to develop this syndrome.

Urologic complications after surgery on lumbosacral spine

Forty-five of 74 patients (60%) postsurgery for disk disease showed findings of neurogenic bladders. Sixty-nine of these patients had no complaints before surgery and presented with complaints only after surgery. We believe this is a high surgical morbidity, and all patients should have a presurgical urodynamic diagnostic evaluation to aid in selection of patients in whom surgery will be most helpful and to establish a presurgical baseline for further postsurgical urodynamic comparison.

Is the polio virus responsible for late central nervous system tumors

A hypothesis is advanced concerning the relationship of poliomyelitis viruses and late developing neoplasia in the central nervous system. The literature is surveyed, and several experimental approaches based upon known evidence of viral and neoplastic behaviour are advanced. The present status of world polio incidence is discussed as it applies to this possible relationship.

Conservative versus surgical treatment of the cervical and thoracolumbar spine in spinal trauma

Conservative versus surgical treatment of the cervical and thoracolumbar spine in spinal trauma

Misdiagnosis of spinal cord injuries--the physiatrist's point of view.

Thirteen different patients involving spinal cord pathology with delayed or false diagnosis are presented and these diagnostic pitfalls are discussed. Many seemingly simple explanations for para or quadriplegia are suddenly quite complex upon scrutiny. The problem of proper diagnosis is capital in instituting proper therapy, advising the patient and his family, and unfortunately in todays medical climate, for medical legal reasons.