Frank Thömke

University of Applied Sciences Worms

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H. Hopf

Johannes Gutenberg University Mainz

Marianne Dieterich

Ludwig-Maximilians-Universität München

Peter Stoeter

Instituto Tecnológico de Santo Domingo

Sabine Fitzek

Neurology, Inc

Wibke Müller‐Forell

Johannes Gutenberg University Mainz

Clemens Fitzek

Asklepios Fachklinikum Brandenburg

J. J. Marx

Icahn School of Medicine at Mount Sinai

H. C. Hopf

University of Lausanne

Péter Urbán

University of Pecs

Jürgen Marx

Johannes Gutenberg University Mainz

Cooperative Institutions

Johannes Gutenberg University Mainz

University Medical Center of the Johannes Gutenberg University Mainz

University of Applied Sciences Mainz

Klinik und Poliklinik für Neurologie

Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie

Medical University of Vienna

Heidelberg University

Goethe University Frankfurt

Neurology, Inc

RWTH Aachen University

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Aktueller Stand der Hirntoddiagnostik in Deutschland

Medizinische Klinik (2000)

Frank Thömke L. S. Weilemann

Coma (optics)

Brain damage

10.1007/bf03044989

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Citations (6)

Brainstem diseases causing isolated ocular motor nerve palsies

Neuro-Ophthalmology (2003)

Frank Thömke

There is a significant number of individual patients with ocular motor nerve palsies as the only clinical sign of MRI- and, less frequently, CT-documented small brainstem lesions with a predominance of infarctions and hemorrhages in the 3 rd and 4 th nerves and demyelinating lesions in the 6 th nerve. The 3 rd nerve is most commonly and the 6 th and 4 th nerves less frequently involved. An intra-axial basis for isolated ocular motor nerve palsies may be underestimated if based on MRI-documented lesions only, as electrophysiologic abnormalities indicating brainstem lesions may be independent of MRI-documented lesions.This paper reviews neuroimaging and electrophysiological data on brainstem diseases manifesting as isolated ocular motor nerve palsies. It supports the concept that small pontine and mesencephalic lesions are an underestimated cause of isolated ocular motor nerve palsies and the main cause of nontraumatic 3 rd and 6 th nerve palsies in the middle-aged and elderly population.

Motor nerve

Oculomotor nerve

10.1076/noph.28.2.53.23741

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Assessing Prognosis Following Cardiopulmonary Resuscitation and Therapeutic Hypothermia

Deutsches Ärzteblatt international (2013)

Frank Thömke

Background: The prognosis of patients who are comatose after cardiopulmonary resuscitation (CPR) is poor but can be improved by mild therapeutic hypothermia.We studied the question whether the known, reliable indicators of a poor prognosis after CPR are also valid for patients treated with CPR and hypothermia.Methods: This review is based on a selective search of the PubMed database for recent articles on the assessment of prognosis in persons who are comatose after CPR and therapeutic hypothermia.Results: On the basis of 21 clinical trials, 4 of which yielded level I evidence, 9 level II evidence, and 8 level III evidence, the following were identified as reliable indicators of a poor prognosis: generalized myoclonus, bilateral absence of the pupillary light response or of the corneal reflex, bilateral absence of the cortical components of median nerve somatosensory evoked potentials, a burst-suppression or isoelectric EEG, continuous generalized epileptiform discharges, and an elevated serum concentration of neuron-specific enolase (with a higher cutoff value than for normothermic patients).Conclusion: If the prognosis is poor, this should be thoroughly discussed with the patient's family, and the nature and extent of further intensive treatment should be reconsidered.The patient's wishes, if known, are paramount.Any decision to withhold care should be taken only if there are multiple concurrent indicators of a poor prognosis.If only one such indicator is present, or if the findings are inconsistent, such decisions should be postponed.►Cite this as:

Somatosensory evoked potential

10.3238/arztebl.2013.0137

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Citations (28)

Eosinophilic Meningitis due toAngiostrongylus cantonensisin Germany

Journal of Travel Medicine (2009)

Felix Luessi Janina Sollors Michael Torzewski Harald D. Müller Ekkehard Siegel

We report a case of eosinophilic meningitis due to Angiostrongylus cantonensis in a patient who returned from Thailand. The presence of a compatible epidemiologic history and eosinophilia in cerebrospinal fluid (CSF) lead to the diagnosis, which was confirmed by detection of specific antibodies. After treatment with albendazole and corticosteroids he recovered completely.

Albendazole

Angiostrongyliasis

10.1111/j.1708-8305.2009.00337.x

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Dissection of the internal carotid artery after chiropractic manipulation of the neck

Neurology (1995)

Mallory Peters J. Böhl Frank Thömke K-J. Kallen K. Mahlzahn

A 29-year-old woman died from a right hemispheric infarction caused by dissection and subsequent thrombosis of the internal carotid artery after chiropractic manipulations of the neck. Pathologic study of several arteries of muscular and elastic type revealed a mediolytic arteriopathy with widespread mucoid degeneration and cystic transformation of the vessel wall caused by segmental degeneration of smooth muscle cells of the tunica media. We hypothesize that mediolytic arteriopathy was a predisposing factor for the dissection of the internal carotid artery after chiropractic manipulations in our patient. NEUROLOGY 1995;45: 2284-2286

Tunica media

Cervical Artery

Degeneration (medical)

10.1212/wnl.45.12.2284

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Citations (121)

[Frequently occurring forms of dizziness and their treatment].

PubMed (2007)

Frank Thömke

Vestibular disorders

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Plasmapheresis as effective treatment in chronic active Cogan-I-syndrome

Immunology Letters (2013)

Christoph Best Frank Thömke Walter Hitzler Marianne Dieterich

Plasmapheresis

10.1016/j.imlet.2012.12.010

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Citations (6)

Successful treatment of postanoxic generalized myoclonus with propofol – The prognosis remains poor

Klinische Neurophysiologie (2010)

Frank Thömke Sacha L. Weilemann

Background: There is evidence from single patients that propofol may control generalized myoclonus (GM) after cardiopulmonary resuscitation (CPR).

10.1055/s-0030-1250993

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Listerien-Rhombenzephalitis: NMR-Befund und Elektrophysiologie

Verhandlungen der Deutschen Gesellschaft für Neurologie (1987)

Günter Krämer R. Besser Mike Just S. Schuster L. Weilemann

10.1007/978-3-642-83201-7_152

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A topodiagnostic investigation on body lateropulsion in medullary infarcts

Neurology (2005)

Frank Thömke J. J. Marx Gian Domenico Iannetti G. Cruccu Sabine Fitzek

Body lateropulsion may occur without signs of vestibular dysfunction and vestibular nucleus involvement. The authors examined 10 such patients with three-dimensional brainstem mapping. Body lateropulsion without limb ataxia reflected an impairment of vestibulospinal postural control caused by a lesion of the descending lateral vestibulospinal tract, whereas body lateropulsion with limb ataxia was probably the consequence of impaired or absent proprioceptive information caused by a lesion of the ascending dorsal spino-cerebellar tract.

Proprioception

10.1212/01.wnl.0000152040.27264.1a

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Citations (79)