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Research Interests: Humanities and Art
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ZUSAMMENFASSUNGBewegungen im Schlaf sind prinzipiell physiologisch. In der Internationalen Klassifikation von Schlafstörungen (ICSD 3) werden Bewegungen (insbesondere das Restless-legs-Syndrom) und Parasomnien aufgeführt, die durch... more
ZUSAMMENFASSUNGBewegungen im Schlaf sind prinzipiell physiologisch. In der Internationalen Klassifikation von Schlafstörungen (ICSD 3) werden Bewegungen (insbesondere das Restless-legs-Syndrom) und Parasomnien aufgeführt, die durch Beeinträchtigung des Betroffenen einer Abklärung und ggf. auch einer Therapie bedürfen. Bewegungen im Rahmen von Parasomnien können zu Verletzungen der Betroffenen und der Bettpartner führen, sexuelle Übergriffe sind möglich. Dieser Artikel soll einen Überblick über die Diagnostik und ggf. forensische Bedeutung von Parasomnien geben. Insbesondere soll auf die möglichen Therapien bzw. Vorsorgemechanismen eingegangen werden.
Research Interests: Medicine and Gynecology
Das obstruktive Schlafapnoe-Syndrom (OSAS) ist sicherlich eine der wesentlichen Ursachen fuer das Auftreten von Tagesschlaefrigkeit, daneben gibt es noch zahlreiche weitere (circa 80) verschiedene Krankheitsbilder, die zu Muedigkeit... more
Das obstruktive Schlafapnoe-Syndrom (OSAS) ist sicherlich eine der wesentlichen Ursachen fuer das Auftreten von Tagesschlaefrigkeit, daneben gibt es noch zahlreiche weitere (circa 80) verschiedene Krankheitsbilder, die zu Muedigkeit beziehungsweise Schlaefrigkeit fuehren koennen und die in der schlafmedizinischen Klaviatur der Differentialdiagnose beruecksichtigt werden muessen. Ein besonderes Augenmerk ist auf die professionellen Bus- und Lkw-Fahrer zu richten. Sichere Faktoren, die das relative Risiko, einen Unfall zu verursachen relevant erhoehen, sind die akut angegebene Muedigkeit, das Fahren zwischen 2 und 5 Uhr morgens und weniger als 5 Stunden Schlaf in den letzten 24 Stunden. Hinzu kommt, dass die Praevalenz des OSAS gerade in der Gruppe der professionellen Fahrer deutlich gegenueber dem der Normalbevoelkerung um das circa 4-fache, also auf 16 Prozent, erhoeht ist. Es handelt sich hierbei um ein Patientenkollektiv, dem aerztlicherseits besondere Aufmerksamkeit zukommen muss...
Research Interests: Medicine and Gynecology
Die Neurologische Klinik und Medizinische Klinik Ill des BG-Universitaetsklinikums Bergmannsheil-Bochum hat in Zusammenarbeit mit dem Betriebsaerztlichen Dienst Untersuchungen bei Mitarbeitern der Bochum-Gelsenkirchener Strassenbahn-AG... more
Die Neurologische Klinik und Medizinische Klinik Ill des BG-Universitaetsklinikums Bergmannsheil-Bochum hat in Zusammenarbeit mit dem Betriebsaerztlichen Dienst Untersuchungen bei Mitarbeitern der Bochum-Gelsenkirchener Strassenbahn-AG (BOGESTRA) mit einem therapierten obstruktiven Schlafapnoe-Sydrom (OSAS) durchgefuehrt. Genutzt wurden Fragebogen, computergestuetzte neuropsychologische Testverfahren und eine einstuendige Fahrsimulatoruntersuchung (CAR(R)) mit Simulation des Stadtverkehrs. Da in den bisherigen Fahrsimulatoruntersuchungen Langstreckenfahrten unter Monotoniebedingungen als Kontrollbedingung gewaehlt wurde, musste das neue Paradigma zusaetzlich an einer Kontrollgruppe normiert werden. Bisher wurden 25 BOGESTRA-Fahrer und 30 Normprobanden (mittleres Alter 50, 63 versus 48, 55 Jahre) untersucht. Der mittlere ESS-Wert (Punktzahl auf der Epworth Sleepiness-Scale) war vergleichbar, jeweils 5 Berufskraftfahrer und Normprobanden gaben einen ESS ueber 10, somit eine erhoehte T...
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Sleep disorders can be diagnosed in approximately 15 % of the population and have been shown to increase with age. The relationship between sleep disorders and neurological disorders, however, is still insufficiently considered in the... more
Sleep disorders can be diagnosed in approximately 15 % of the population and have been shown to increase with age. The relationship between sleep disorders and neurological disorders, however, is still insufficiently considered in the clinical practice. Sleep disorders can be an early symptom of the disease, such as the presence of rapid eye movement (REM) sleep behavior disorder (RBD) as an early indicator of neurodegeneration. Sleep disorders have also been shown to be a main symptom of various neurological syndromes, such as in restless legs syndrome (RLS), periodic limb movement disorder (PLMD) and narcolepsy. The international classification of sleep disorders 2nd edition (ICSD 2) describes the main diagnoses, insomnia, circadian rhythm sleep disorders, sleep-related breathing disorders and hypersomnia but all of these can also appear as symptoms in various neurological diseases. Parasomnias are largely considered a differential diagnosis to nocturnal epilepsy. In this review, ...
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Twenty-three patients (10 men, 13 women; age: from 23 to 81 years, mean 52 years) with Bell's palsy were investigated by magneto-electrical stimulation in order to evaluate the usefulness of this method for prognostication. At each... more
Twenty-three patients (10 men, 13 women; age: from 23 to 81 years, mean 52 years) with Bell's palsy were investigated by magneto-electrical stimulation in order to evaluate the usefulness of this method for prognostication. At each examination the facial nerve was electrically stimulated, and an orbicularis-oculi-reflex was elicited. Follow-up investigations were possible in 13 patients. All patients showed pathological long- and short-latency responses at the first examination. The blink reflex examination revealed a pathological result in all cases. The responses to electrical stimulation were pathological only in 35%. The follow-up examinations revealed that the analysis of the short-latency response did not give a prognostic information. In contrast, maintained elicitation of the long-latency response pointed to a favourable prognosis. In follow-up investigations, the increase of amplitude and the decrease of latency of the long-latency response correlated with a complete re...
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By means of transcranial magnetic stimulation bilateral compound muscle action potentials of long latency and ipsilateral potentials of short latency can be obtained in muscles supplied by cranial nerves. In this study motor evoked... more
By means of transcranial magnetic stimulation bilateral compound muscle action potentials of long latency and ipsilateral potentials of short latency can be obtained in muscles supplied by cranial nerves. In this study motor evoked potentials were recorded from the mentalis muscle of 14 patients with traumatic brain lesions. These results were compared with clinical and radiological as well as other neurophysiological examinations. In spite of the absence of paralysis in muscles supplied by the facial nerve, 9 patients showed pathological long-latency responses, which correlated with the localisation of the paralysis of the limbs. In contrast to this, the degree of pathological latencies of motor evoked potentials did not correspond with the degree of paresis in different patients. A prediction concerning the clinical outcome could not be made by the results of motor evoked potentials. The clinical data showed a poor correlation with the structural brain lesions seen in the CT-scan ...
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Peripheral facial palsy can occur after aural surgery and neurosurgery. Routine neurophysiological investigation (utilizing electrical stimulation and the blink reflex) does not allow the direct assessment of the site of a lesion. In the... more
Peripheral facial palsy can occur after aural surgery and neurosurgery. Routine neurophysiological investigation (utilizing electrical stimulation and the blink reflex) does not allow the direct assessment of the site of a lesion. In the present study transcranial magnetic stimulation (TMS) was applied in order to evaluate the usefulness of this method for prognosis. Twenty-three patients with postoperative facial pareses (after removals of an acoustic neuroma in 12 patients and parotid tumors in 11) were investigated. Ipsilateral short-latency and contralateral long-latency responses (after cortex stimulation) were elicited. At the first examination (11.7 +/- 9 days after onset of the palsy) the components of the blink reflex were absent in all cases. Responses to electrical stimulation were abnormal in 80%. Ipsilateral short-latency responses after TMS could be obtained in 7 patients. Pathological long-latency TMS responses were elicited in 17 patients. Follow-up investigations up to 2 years revealed no prognostic aspects from peripheral electrical stimulation, the blink reflex and the short-latency TMS response. The absence or extent of delay in long-latency responses at first examination was strongly correlated with final clinical outcomes. As improvements of the responses preceded clinical regressions of the paresis, TMS proved to be an important neurophysiological method for an early prognosis of recovery after perioperative lesions of the facial nerve.
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Es handelt sich um eine Multicenterstudie mit 6 Zentren, 62 ambulanten und stationären Patienten (41 Frauen, 21 Männer) im Alter von 20–52 Jahren, davon 24 vor und 38 unter Therapie mit IFN β-1b. Erhoben wurden demografische und klinische... more
Es handelt sich um eine Multicenterstudie mit 6 Zentren, 62 ambulanten und stationären Patienten (41 Frauen, 21 Männer) im Alter von 20–52 Jahren, davon 24 vor und 38 unter Therapie mit IFN β-1b. Erhoben wurden demografische und klinische Daten, Polysomnographie, ESS, PSQI, MFIS, HADS, IRLSS, Morgenund Abendprotokoll der DGSM. Es erfolgten 3 Untersuchungen im Abstand von 6 Monaten über einen Beobachtungszeitraum von 1 Jahr.
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Research Interests: Psychology, Electrophysiology, Transcranial Magnetic Stimulation, Medicine, Evoked Potentials, and 13 moreHumans, Female, Male, Electromagnetic Fields, Differential Diagnosis, Clinical Sciences, Middle Aged, Adult, Somatoform disorders, Hemifacial spasm, Somatoform disorder, Diagnostic Tool, and Electric stimulation
Research Interests: Medicine and Pneumologie
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Multivariable-adjusted linear regression analysis for the influence of health status questionnaires on PSQI controlling for age, gender, EDSS, and duration of disease at baseline. (DOCX 17 kb)
Correlations between primary and secondary outcome variables. (PDF 153 kb)
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Bewegungen im Schlaf sind physiologischer Natur; im Rahmen von Parasomnien können sie zu Verletzungen der Betroffenen und der Bettpartner führen, sexuelle Übergriffe sind möglich. Dieser Artikel erläutert die forensische Bedeutung von... more
Bewegungen im Schlaf sind physiologischer Natur; im Rahmen von Parasomnien können sie zu Verletzungen der Betroffenen und der Bettpartner führen, sexuelle Übergriffe sind möglich. Dieser Artikel erläutert die forensische Bedeutung von Parasomnien, insbesondere deren Differenzialdiagnostik und mögliche Therapien bzw. Vorsorgemechanismen.
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5 patients (3 men, 2 women, aged from 28 to 51 years) with unilateral facial palsy after surgery of a cerebellopontine angle tumour have been investigated by transcranial magnetic stimulation. The purpose was to evaluate the prognostic... more
5 patients (3 men, 2 women, aged from 28 to 51 years) with unilateral facial palsy after surgery of a cerebellopontine angle tumour have been investigated by transcranial magnetic stimulation. The purpose was to evaluate the prognostic aspects of this method, which was compared with the electrical stimulation of the facial nerve and the elicitation of an orbicularis-oculi reflex. The components of the blink reflex were absent in all cases. In 3 patients electrical stimulation was possible (compound muscle action potentials were delayed). With transcranial magnetic stimulation ipsilateral short-latency and contralateral long-latency responses (stimulation of the cortex) were elicited and registered from the M. mentalis as well as 3 times from the M. orbicularis oculi. The short-latency response revealed no prognostic aspects. Despite the missing response, a recovery was possible. Long-latency responses could be evoked in all patients. The extent of delay in latency was strongly correlated with clinical improvement of the paresis. Interestingly, this correlation could also be observed in the single rami of the facial nerve when two muscles were investigated in a patient. Transcranial magnetic stimulation is an important improvement in electrophysiological diagnosis of perioperative lesion of facial nerve to prove continuity of the nerve and to evaluate the clinical course.
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... Svenja Happe 1 ,; Heike Bene 2 ,; Magdolna Hornyak 3 ,; Sylvia Kotterba 4 ,; Geert Mayer 5 ,; Karin Stiasny-Kolster 6 ,; Mitglieder der Arbeitsgemeinschaft Motorik und Schlaf'' der Deutschen ... 1 Abteilung... more
... Svenja Happe 1 ,; Heike Bene 2 ,; Magdolna Hornyak 3 ,; Sylvia Kotterba 4 ,; Geert Mayer 5 ,; Karin Stiasny-Kolster 6 ,; Mitglieder der Arbeitsgemeinschaft Motorik und Schlaf'' der Deutschen ... 1 Abteilung Klinische Neurophysiologie, Klinikum Bremen-Ost/Universität Göttingen. 2 ...
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Patients with obstructive sleep apnoea syndrome (OSAS) commonly complain about daytime sleepiness and a decline of cognitive functions. Several diagnostic tools have been established to judge objectively vigilance and cognitive... more
Patients with obstructive sleep apnoea syndrome (OSAS) commonly complain about daytime sleepiness and a decline of cognitive functions. Several diagnostic tools have been established to judge objectively vigilance and cognitive impairment. Forty OSAS patients aged between 34 and 74 years were examined via several neuropsychological tests (e.g. vigilance test of the Wiener Testsystem, number connection test ("Zahlenverbindungstest-ZVT") to assess working velocity and information processing, d2-test to rate concentration on exertion) before starting continuous positive airway pressure (CPAP) therapy. In addition, visual evoked event-related potentials (ERPs) were recorded; the P3-component was evaluated. All patients subjectively stated daytime sleepiness and cognitive dysfunctions to variable degrees. Each patient showed at least one pathological result in the neuropsychological tests; vigilance impairment could be revealed only in 7 patients. P3-latencies were increased in...
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Zentrale Aufgabe neurotraumatologischer Gutachten ist die Beurteilung von Zusammenhangsfragen, also die Kausalitatsbegutachtung. Gleichzeitig sind die Unfallfolgen und ihre funktionellen Auswirkungen im Sinne einer Zustandsbegutachtung zu... more
Zentrale Aufgabe neurotraumatologischer Gutachten ist die Beurteilung von Zusammenhangsfragen, also die Kausalitatsbegutachtung. Gleichzeitig sind die Unfallfolgen und ihre funktionellen Auswirkungen im Sinne einer Zustandsbegutachtung zu erfassen und zu bewerten. Auch psychoreaktive Storungen nach Unfallen mussen ggf. beurteilt werden, weiterhin sind Fragen nach einer unfallbedingten Hilfs- und Pflegebedurftigkeit zu beantworten sowie seltener solche zur Fahreignung, Geschaftsfahigkeit oder auch zur strafrechtlichen Verantwortlichkeit.
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We report on a 69-year-old woman who presented with myalgia, hearing impairment, fever, night sweats, weight loss, muscular weakness, paresthesia, hypesthesia, and hypalgesia. Sural nerve biopsy showed demyelinative and axonal... more
We report on a 69-year-old woman who presented with myalgia, hearing impairment, fever, night sweats, weight loss, muscular weakness, paresthesia, hypesthesia, and hypalgesia. Sural nerve biopsy showed demyelinative and axonal polyneuropathy due to necrotizing vasculitis with fibrinoid necrosis. A positive test for antineutrophil cytoplasmic antibodies (ANCA) with a perinuclear immunofluorescence pattern directed against myeloperoxidase was more suggestive of microscopic polyangiitis (MPA) than of polyarteritis nodosa (PAN), the possible differential diagnoses. In addition, positive tests for cytomegalovirus (CMV) antibodies (immunoglobulin (Ig)M and IgG) and the detection of CMV-DNA in sputum specimens by polymerase chain reaction (PCR) were indicative of active CMV infection. Treatment with ganciclovir and anti-CMV immunoglobulin in addition to prednisolone medication for 6 months resulted in rapid improvement of the clinical symptoms without relapse. CMV infection has been described to be related to ANCA-associated vasculitis in non-immunocompromized patients and may be either a causative agent or an opportunistic infection. Identification of a viral etiology in patients with atypical ANCA-associated vasculitides may lead to different, less aggressive treatment approaches, including antiviral therapy.
Research Interests: Medicine, Humans, Female, Cytomegalovirus, Etiology, and 15 moreClinical Sciences, Association, Aged, Hearing Impaired, Necrosis, Cytomegalovirus Infections, ANCA Associated Vasculitis, Immunoglobulins, Myeloperoxidase, Immunoglobulin, Ganciclovir, opportunistic infection, Polyarteritis Nodosa, Opportunistic Infections, and Antiviral Therapy
Research Interests: Biomedical Engineering, Attention, Electrocardiography, Narcolepsy, Evoked Potentials, and 15 moreHumans, Computer Simulation, Obstructive sleep apnea, Cerebral Cortex, Female, Male, Middle Aged, Arousal, Adult, Pupillary light reflex, Sensitivity and Specificity, Biomedizinische Technik, Automobile driving, Neuropsychological Tests, and Accidents Traffic
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Die Amyotrophe Lateralsklerose (ALS) ist eine chronische und rasch fortschreitende neurologische Erkrankung, deren Ursache ungeklart ist. Die betroffenen Patienten erleben eine zunehmende Lahmung (Parese, griech. paresis „Erschlaffen“)... more
Die Amyotrophe Lateralsklerose (ALS) ist eine chronische und rasch fortschreitende neurologische Erkrankung, deren Ursache ungeklart ist. Die betroffenen Patienten erleben eine zunehmende Lahmung (Parese, griech. paresis „Erschlaffen“) unterschiedlicher Muskelgruppen. Pathologisch- anatomisch findet sich ein Zugrundegehen (Degeneration) ausschlieslich motorischer (fur die Bewegung verantwortliche) Nervenzellen im Gehirn und Ruckenmark. Dies fuhrt zu zunehmender Bewegungsunfahigkeit, Schluckstorungen und Unfahigkeit, selbstandig zu atmen. Dies erleben die Betroffenen bei vollem Bewustsein. Daher ist es gerade fur ALS-Patienten sinnvoll, fruhzeitig die Wunsche zu weiteren Behandlungen, insbesondere zur Frage der Beatmung und kunstlichen Ernahrung in Patientenverfugungen festzulegen.