摘要:

Functional magnetic resonance imaging is a relatively new, noninvasive technique which has a maximum spatial resolution in the range of 1 mm and temporal resolution of 0.1-1 s. The technique is not quantitative but results have proved reliable and reproducible and studies are quick to perform. Already substantial progress has been made in mapping the visual, sensorimotor and auditory systems and promising results achieved in the study of higher cognitive function such as memory and linguistic processing. Clinical applications have been made in epilepsy surgery, the study of schizophrenia, genetic abnormality and cerebral injury.

ISSN:0014-3022    

DOI:10.1159/000117227

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Seventy-eight asymptomatic HIV-seropositive (aHIV) subjects were examined by means of an extensive neuropsychological test battery in comparison with 32 HIV-seronegative controls. They were also tested with regard to CD4+ and serum p24 antigen. Fifty-six of them completed a clinical follow-up of 12 up to 36 months and 35 also underwent a second session of neuropsychological, CD4+ and p24 antigen assessments at a 12- to 18-month interval from the first session. Results obtained lead to the following conclusions: (a) even among aHIV subjects there is a significant prevalence (28.2%) of cognitive abnormalities for which no cause other than HIV can be found, and therefore this suggests the possible development of HIV-related brain damage since the earliest stages of infection; (b) most sensitive to early HIV-related cognitive impairment are timed psychomotor tasks and memory tasks which require attention, learning and ‘active’ monitoring or retrieval of information; (c) during the early asymptomatic stages of HIV infection, there is no clear-cut evidence of a cross-sectional relationship between cognition and immunological/ virological markers (at least in the high ranges of CD4+ cell counts considered here); only in relatively more advanced stages does this relationship become evident in the subgroup of aHIV subjects with cognitive abnormalities: (d) the presence of cognitive abnormalities in early HIV infection is predictive of a further decrease in cognitive functioning and faster progression to AIDS – this latter reflected by a faster rate of decline in the number of CD4+ cells and by an increase in positivity of serum p24 an

ISSN:0014-3022    

DOI:10.1159/000117228

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

We report a patient with primary progressive aphasia who first presented with amnesic aphasia that developed over the course of 3 years into nonfluent aphasia with buccofacial apraxia, followed in the next year by cognitive impairment and parkinsonism. Pathological findings were typical for corticobasal degeneration except for the distribution of cortical atrophy. This case suggests that corticobasal degeneration should be included in the differential diagnosis of primary progressive aphasia, especially in association with parkinsonism.

ISSN:0014-3022    

DOI:10.1159/000117229

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Low-grade non-Hodgkin B-cell lymphoma was found during the evaluation of 3 aged patients with predominantly sensory neuropathy of mild to moderate severity. Presenting manifestations were sensory ataxia and right ulnar mono-neuropathy in a 75-year-old man, and painful dysesthesias of the legs in two 78-year-old women. A neurophysiological study showed mainly axonopathic alterations. M-protein was present in all cases (Ig-K in two, triclonal gammopathy IgG(K)/IgM(K)/IgM-A, in one). The male patient had IgM antisulfatide antibody in high titer, whereas the other 2 patients had cryoglobulinemia (type II and type III, respectively). Our report emphasizes the occurrence of mild polyneuropathy as presenting manifestation of low-grade non-Hodgkin lymphoma, different from the clinicopathological entity of neurolymphomatosis, in which severe nerve damage occurs in association with manifest lymphoma, related to nerve infiltration by lymphomatous cells. Alternative pathogenetic mechanisms, such as antibody-mediated nerve damage, or vasa nervorum changes caused by cryoglobulin, may be implicated in our cases. Non-Hodgkin lymphoma should be considered in the diagnostic evaluation of polyneuropathy of unknown cause, especially in patients with paraproteinemia and/or cryoglobulinemia.

ISSN:0014-3022    

DOI:10.1159/000117230

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Quail poisoning is known to produce an acute myoglobinuric syndrome. The cause of this syndrome is still unknown. It has been suggested that a toxic effect or a genetic sensitivity plays a major role. Ten patients with a history of quail poisoning were examined to determine their present state and the course of the disease. A muscle biopsy was performed in 2 of these patients who complained of muscle cramps after exercise. The activities of several glycolytic, mitochondrial and lipolytic enzymes were estimated. In all 10 patients the physical examination, electromyogram findings and conduction velocities were normal. Serum levels of CK, aldolase and lactic acid were also within normal range. In the 2 patients with cramps, all enzyme activities were normal in muscle tissue. Our findings possibly exclude a preexisting enzyme defect as a cause of myoglobinuria in quail poisoning. Considering that 4 of our patients continued the consumption of quails without further problems, we suggest that the major factor contributing to quail poisoning must be toxic.

ISSN:0014-3022    

DOI:10.1159/000117231

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Felbamate is a novel anti-epileptic drug (AED) which has recently been associated with reports of aplastic anaemia and liver failure. We have conducted an open-label add-on assessment of the tolerability and efficacy of this compound in 111 adult patients with refractory epilepsy attending a tertiary referral centre. The mean follow-up period was 4 months (range 1–8 months). Sixty-three (57%) were ongoing, 38 (34%) had discontinued felbamate and a further 10 (9%) were withdrawing. Reasons for discontinuing felbamate were adverse events in 23 (21%), increase in seizures in 11 (10%) and lack of efficacy in 14 (12%). Behavioural disturbances occurred in 14 patients, being the most likely adverse event to result in discontinuation. No cases of aplastic anaemia or liver failure were observed in this group. Felbamate appears to be a broad-spectrum AED. Seven percent of the patients had more than 95% seizure reduction (2 patients were seizure free), whilst a further 13% had significant improvement (>50% reduction in seizure frequency). In conclusion, felbamate seems to be an effective AED. In view of its association with potentially life-threatening complications, its use should however be restricted to patients with medically refractory epileps

ISSN:0014-3022    

DOI:10.1159/000117232

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Point mutations of the mitochondrial genome are often considered to be the cause of certain neurodegenerative disorders and mitochondrial myopathies. Recently, there has been a report on Alzheimer’s disease (AD) point mutations at position 5460 of the mitochondrial genome located within the ND2 gene. Using allele-specific PCR with a sensitivity of detection of less than 1% mutated mtDNA, we investigated postmortem brain samples from 48 patients with AD and blood samples of 15 patients with clinically diagnosed AD. In addition, we investigated tissue samples of patients with different neuromuscular disorders and patients with Downs syndrome. Independent of the tissue analysed very few of all the tested samples of patients showed a point mutation at nt 5460 with a base substitution from G to A. Two out of 19 brain and 48 blood samples from controls carried this mutation. The G to T transversion was not found in any of the so far tested samples. Our results do not support the previously reported significant high frequency of these mutations in AD. A polymorphism seems more likel

ISSN:0014-3022    

DOI:10.1159/000117233

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

The aim of this study was to investigate procedural learning in idiopathic Parkinson’s disease (PD) patients. For this purpose, 18 nondemented PD patients and 20 age-matched healthy subjects were trained to learn a visuoperceptual skill (mirror reading) and a cognitive skill with a motor demand (puzzle assembly task). In 3-day sessions, the patients were requested to perform with repeated and unrepeated stimuli, in order to distinguish between pure procedural learning and skill learning at least partially supported by explicit memory retrieval. In the mirror reading task, the PD patients showed normal improvement in reading times for repeated words but no improvement at all for unrepeated stimuli. In the puzzle assembly task, PD patients did not show any significant learning either for repeated or unrepeated stimuli. These results, which document deficient learning of procedures in parkinsonians, are discussed in the light of conflictig data reported regarding implicit memory in P

ISSN:0014-3022    

DOI:10.1159/000117234

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

We identified 15 patients with serological evidence of current Chlamydia pneumoniae infection when we studied 263 patients with central nervous system infections among an adult population of 3 million in 1993. In 9 of the 15 patients no other associated or etiological agents were found. One patient died. Sequelae appeared in 7 patients. In neurological infections, C pneumoniae may be more prevalent as an associated agent than appreciated, and adequate antibiotic therapy may be life-saving.

ISSN:0014-3022    

DOI:10.1159/000117235

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

We evaluated bromocriptine monotherapy during the early stage of Parkinson’s disease (Hoehn and Yahr stage I or II). Of the 120 patients registered as participants in this trial, 96 were studied. The follow-up period was 48 weeks. For the first 24 weeks they were all placed on bromocriptine with or without anticholinergic drugs; for the second 24 weeks, 75 of them were still kept on the same medication, with 21 requiring additional levodopa. Clinically, the former group showed a good response to the bromocriptine monotherapy, while the latter responded poorly to it (requiring in addition levodopa). We think that Parkinson’s disease encompasses a heterogeneous group of patients of whom about 75% are well treated by bromocriptine alone at the early stages of the illn

ISSN:0014-3022    

DOI:10.1159/000117236

出版商:S. Karger AG    

年代:1996

数据来源: Karger