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Review [Somatic factors in cognitive impairment] 2009
Etgen T, Brönner M, Sander D, Bickel H, Sander K, Förstl H. · Neurologische Klinik, Klinikum Traunstein, Cuno-Niggl-Strasse 3, Traunstein. · Fortschr Neurol Psychiatr. · Pubmed #19221969 No free full text.
Abstract: Mild cognitive impairment describes a cognitive decline greater than expected for an individual's age and education level that does not interfere significantly with activities of daily life. In the recent years concepts of "mild cognitive impairment" with divergent definitions have been discussed as potential preclinical forms of dementia. The etiology of cognitive impairment is heterogeneous and it can be promoted or caused by numerous somatic factors. Relevant somatic factors include hypertension, diabetes mellitus, heart failure, chronic obstructive airways disease and bronchial asthma. Cognitive impairment may be facilitated by hypercholesterolemia, chronic renal failure, hypothyroidism, testosterone deficiency, minimal hepatic encephalopathy, HIV- and hepatitis C-infection. Knowledge and diagnosis of these somatic factors is essential in cognitive impairment, as diligent treatment may lead to improve cognitive performance and postpone the manifestation of dementia.
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Article Hemiballism with insular infarction as first manifestation of Takayasu's arteritis in association with chronic hepatitis B. 2003
Etgen T, Winbeck K, Conrad B, Sander D. · Department of Neurology, Technical University of Munich, Möhlstrasse 28, 81675 München, Germany. · J Neurol. · Pubmed #12574956 No free full text.
Abstract: BACKGROUND: Takayasu's arteritis is a chronic inflammatory idiopathic disease involving large arteries like the aorta and its primary branches. Cell-mediated autoimmunity leading to vascular injury has been suspected in its pathogenesis although the antigen inducing the process remains unknown. CASE REPORT: A 50-year-old male patient suffered from acute hemiballism. Neuroimaging showed an infarction of right temporal insular cortex. Neurosonology and MR-Angiography revealed bilateral long-distant subtotal stenosis of the common carotid artery and left-sided occlusion of the subclavian artery. Positive hepatitis B serology with active viral replication was found. In the absence of other vasculitis or inflammation markers, Takayasu's arteritis was diagnosed and steroid therapy was started. CONCLUSIONS: Unilateral insular lesions may lead to transient hemiballistic movements which could be the result of decreased inhibitory output of the insula to basal ganglia. The hepatitis B virus possibly contains a surface antigen inducing a specific cellular immune response leading to Takayasu's arteritis.
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