摘要:

ABSTRACTA review is presented of the electrical activity of the brain and its global and regional blood flow and metabolism in the different stages of sleep and in wakefulness in animals and humans. During slow‐wave sleep (SWS), the blood flow and metabolism of the brain decrease slightly below the level of wakefulness. During rapid eye movement the activity of the brain increases above that of SWS and sometimes above that of wakefulness. Some studies suggest that both at sleep onset and at arousal the brain stem‐cerebellar complex (BSC) may be activated before the cortex and the right hemisphere before the left. Variation of hemispheric dominance seems to be a phenomenon of both wakefulness and sl

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1989.tb03915.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACTPOEMS or Crow‐Fukase syndrome is a multisystemic, clinically malignant disorder of obscure etiology. Peripheral neuropathy and plasma cell dyscrasia are central features. The authors now report 7 Chinese patients with this syndrome in which PCD or paraproteinemia were absent in 6, and 2 had a lymph node histology resembling that of hyaline‐vascular Castleman's disease. Immunological abnormalities consisted of either increased or decreased numbers of B‐ and T‐cells in 2 cases, and an elevated OKT4/OKT8 ratio with paradoxical dissociation of the lymphocyte transformations to various concentrations and types of mitogens in 1 case. This suggests that the underlying abnormalities of POEMS syndrome are heterogeneous and that it may be an immunologically related syndrome of varying e

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1989.tb03916.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACTAnalysis of the fatty acids in the erythrocyte lipid of multiple sclerosis patients in Italy gave no indication of any difference in composition compared with that of a healthy control group. Supplementation of the diet of another group of similar patients with polyunsaturated fatty acids led to increases in the erythrocyte levels of linoleate and docosahexaenoate, with concomitant falls in oleate and elaidate. Levels of fatty acids such as lignocerate and nervonate that are found predominantly in sphingomyelin were similar in all 3 groups.

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1989.tb03917.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACTFrom 1969–1985, 106 people contracted tetanus in Finland. The outcome of the disease was good in 78 cases (returned to work), poor in 27 (12 died, 5 institutionalized and 10 retired) and unknown in 1. Poor outcome was the result of a disease requiring respirator treatment. Other clinical factors significantly correlated with poor outcome were blood pressure lability, hyperglycemia, hyperthermia, tachycardia and anticoagulation therapy. Forty people who were representative of the whole series with regard to sex, age and severity of disease attended a follow‐up study on average 7 years and 4 months later. Forty age‐ and sex‐matched controls had the same examinations, and compared with them, the 40 patients still had significantly more muscle fatigue and cramps, nervousness, decreased mental capacity and difficulties in balance, speech and memory. They also had more clinical findings, such as peripheral paresis, muscular atrophy, decreased or absent tendon reflexes and decreased mental capacity than the c

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1989.tb03918.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACTOphthalmologists and neurologists from a catchment area of 1.5 million people were asked to refer all patients with symptoms and signs of optic neuritis (ON) to our neurological department immediately. A total of 68 consecutive patients were extensively screened for known etiologies of ON. Eleven had definite multiple sclerosis (MS); 7 patients could not participate for various reasons. The cerebrum, cerebellum and brainstem of the remaining 50 untreated patients with monosymptomatic ON were MRI scanned at 1.5 T with 2 sequences (slice thickness 4 mm, voxel size 1.2 × 1.2 × 4 mm3): double spin‐echo (TR = 1.8 s, TE = 30 and 90 ms, 12 slices axially) and inversion recovery (TR = 2.45 s, TI = 400 ms, TE = 30 ms, 5 slices sagittally). Magnetic resonance imaging (MRI) was performed within 3–49 (median 16) days from onset of symptoms. MRI demonstrated multiple asymptomatic central nervous system (CNS) lesions in 62% of patients. The appearance, locations and extents of lesions were consistent with demyelination. A scoring system based on number and size of lesions is proposed. Seven of 50 patients developed definite MS during a median follow‐up of 11 months; they all had CNS lesions on the first scan. MRI has thus improved the pathophysiological knowledge of idiopathic ON, which from the very onset is a manifestation of MS in at least two thirds of cases. Patients who have early CNS lesions run a much higher risk of later developing clinically defi

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1989.tb03919.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACTDemented patients with early‐onset Alzheimer's disease (AD) (n= 17), late‐onset Alzheimer's disease (n= 30) and vascular dementia (VD) (n= 20) were studied with computed tomography of the brain. Semiquantitative evaluation of white matter low attenuation (WMLA) and central and cortical atrophy was performed without knowledge of the clinical diagnosis. In early onset AD there was almost complete absence of WMLA and central atrophy compared with the other groups, which showed moderate to severe changes. This suggests that early‐onset AD should be separated from the late‐onset form. The increased systolic blood pressure found in the WMLA group supports the opinion that WMLA has a vascular origin. The high percentage of WMLA in VD andlate‐onset AD indicates that subcortical factors have to be considered in the pathogenesis of these

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1989.tb03920.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACTTwenty‐nine patients with late‐onset epilepsy were followed prospec‐tively for a mean period of 4.9 years; 14 had CT evidence of occult cerebral infarction and 15 had normal scans. The prognosis was similar in the 2 groups; 57% and 53% respectively became seizure‐free. One patient in each group had a myocardial infarction and one patient with occult cerebrovascular disease had a stroke. A separate study was made of the prognosis of 24 patients with epilepsy following stroke (mean follow‐up 5.9 years). Twelve of 12 patients with seizure onset within 2 weeks of the stroke became seizure‐free, compared with 7/12 with more deiayed onset. Late‐onset epilepsy has a favourable prognosis, and excellent control should be expected if seizures commence within 2 we

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1989.tb03921.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACTExistence of clinical subgroups among cases of Wilson's disease has long been postulated and various classifications suggested but none statistically tested. This study analyses, by means of pattern recognition techniques, 400 cases from 4 series including our own (n= 195). Factor analysis (to summarise variables) and cluster analysis (to derive groups of patients) were performed. From each series 4 clusters were derived, each containing a “hepatic” and at least one “neurological” cluster, other clusters being “mixed hepatic&neurological” (3 series) and “asymptomatic” (3 series). Two series contained 2 “neurological” clusters; one dividing in terms of age and the other in terms of presence or absence of psychopathology. At least 2 factors, “hepatic” and “neurological”, emerged from each series. Reasons for differences are discussed. In conclusion, Wilson's disease is not homogenous: clinical groupings are supported by

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1989.tb03922.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACTThe precipitation of seizures by external stimulation (evoked seizures) is well known. Less well known is the precipitation of seizures by a change in the patient's thinking or feelings. This artick uses Lockhart's monkey model of focal epilepsy to propose that there is a close relationship between seizures and ongoing brain activity. Thus, seizures precipitated by both voluntary and spontaneous changes in behaviour and thinking must commonly occur. Clinical examples of such seizure precipitation is described.

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1989.tb03923.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACTThe inhibition of seizure activity by behavioural methods is becoming more popular. Lockhart's monkey model of focal epilepsy suggests a theoretical approach to behavioural seizure inhibition. Behaviour, by changing the pattern of excitation and inhibition surrounding a focus, is thus able to inhibit seizure activity. This article describes single case studies in which the behavioural methods of cued arousal, covert desensitization and relaxation have brought about a decrease in seizure frequency.

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1989.tb03924.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY