ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1992.tb06031.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

A battery of neuropsychological tests was examined to establish its value in differentiating mild dementia from depression. The battery was applied to 84 subjects: 31 dementia patients of several etiologies, 31 patients with major depression and 22 volunteers whose age and educational level was similar to that of the patients. The battery consisted of tests for immediate, recent and remote memory, the Mini Mental State examination, a screening test for language disorders, and tests measuring abstraction, calculation, judgement, praxic and gnosic functions. The results showed significant differences among the three groups in all memory tests. Deficits of abstraction, calculation, praxis and language functions were strongly associated with dementia. The epidemiological analysis of efficiency increment, with determination of sensitivity and specifity, showed a highly significant enhancement of efficiency for diagnostic purposes when the results of the tests were combined. These findings suggest that the entire battery of neuropsychological tests should be applied, and their results compared using the efficiency increment procedure, in order to establish a firm differential diagnosis between dementia and depression, and/or to detect the former when it is at a mild early stage.

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1992.tb06032.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

In an unselected series of patients with monoclonal gammopathy of undetermined significance (MGUS) we found neuropathy in 2 of 34 patients with IgG (6%), 2 of 14 with IgA (14%), and 8 of 26 with IgM MGUS (31%). The neuropathy was subclinical in 6 patients (1 IgG, 1 IgA, and 4 IgM). Patients with IgG or IgA MGUS had a prominent motor impairment with electrophysiologic and morphologic findings suggestive of predominant axonal degeneration. No deposit of the M‐protein in sural nerve and no reactivity of the M‐protein with nerve was detected in these patients. Patients with IgM MGUS had a prominent sensory impairment with evidence of predominant demyelination. In 6 of these patients the M‐protein reacted with the myelin‐associated glycoprotein (MAG). The higher prevalence of neuropathy in patients with IgM MGUS may be related to the frequent reactivity of IgM M‐proteins

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1992.tb06033.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The population‐based Helsinki Aging Study was comprised of three age groups: 75‐, 80‐ and 85‐year‐olds. A random sample of 511 subjects completed the Mini Mental State Examination (MMSE) and were assessed on the Clinical Dementia Rating ‐ scale (CDR). According to the CDR results 446 subjects were screened as non‐demented. Of these subjects 30% scored below or at 24 MMSE points. Age, education and social group had a significant effect on the MMSE scores, even after excluding the demented cases. Together they explained 10% of the total variance within the MMSE. Social group correlated with education. The MMSE scores were corrected according to age and education. Adjustment of the originally used cutpoint of 24 resulted in cutpoints of 25 and 26 among the 75‐year‐olds, in the low and high education groups respectively; 23 and 26 in the 80‐year‐olds; 22 and 2

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1992.tb06034.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Three patients with wasting confined to a single lower limb are reported. The characteristic features were: sporadic occurrence, insidious onset with slow progression and in 2 cases arrested course for at least 4 years, wasting out of proportion with disability, absence of sensory, pyramidal tract or bulbar signs. CK, motor and sensory conductions, and lumbar MRI were normal. Muscle CT showed selective loss of muscle tissue and fat replacement in posterior leg muscles. Quantitative electromyography and histologic findings revealed neurogenic features not only in the affected legs, but also in clinically uninvolved limbs. Monomelic amyotrophy of lower limb is a variant of spinal muscular atrophy with a benign course. However, as in the early stages of the disease there are no distinctive clinical or laboratory findings with other motor neuron diseases, the diagnosis of monomelic amyotrophy may be made only retrospectively after a prolonged observation.

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1992.tb06035.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Neurolathyrism is a toxic nutritional disorder induced by the ingestion of the chick‐pea “lathyrus sativus” and characterized by a pure motor spastic paraparesis. Eight patients with long‐standing disease underwent nerve conduction and electromyographic studies. Two of them (25%) showed electrophysiological signs of lower motor neuron disease in their lower limbs. Subclinical affection of the anterior horn cells occurs probably more frequently than expected in chronic neurola

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1992.tb06036.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

In four patients with bacterial meningitis a primary intranasal encephalocele was found as portal of entry. In two of the cases the malformation had been misdiagnosed as a nasal polyp and operated upon. In two patients a cerebrospinal fluid fistula developed spontaneously at the age of 54 years. None of the patients had associated symptoms indicating the presence of a cleft. Encephaloceles can be readily visualized by computed tomography particularly in coronal sections. The treatment of choice is transcranial surgical repair.

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1992.tb06037.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The aim of this study was to compare age at onset of multiple sclerosis (MS) in North African‐born and French‐born patients. The migrant group consisted of 246 patients who arrived in France during the period 1960–1965. Among these migrants, 27 (11%) had first symptoms before migration. The French‐born group consisted of MS patients of same sex and age at the time of the study as migrants who were randomly selected from a large national sample. After controlling for various biases which could explain differences between migrants and French‐born patients, we found no differences in mean age at MS onset between the two groups. Therefore, it is likely that MS was acquired by the same age in migrants as in French‐born patients. This finding may constitute an indirect support for the hypothesis that the unknown causative factors of MS are equally frequent whatever the latitud

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1992.tb06038.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Eight patients, 3 with systemic lupus erythematosus (SLE) or “SLE‐like” disease, 1 with sarcoidosis, and 4 with no connective tissue disease had transient ischemic attacks (TIA) or cerebral infarctions associated with high levels of anticardiolipin antibodies (ACA). Cerebral ischemic events included amaurosis fugax, recurrent hemispheric TIA, cerebral infarction, and multiinfarction dementia. Treatment with acetylsalicylic acid was ineffective in 3 patients. Warfarin, alone or in combination with dipyridamol or steroids, may reduce the risk of further cerebrovascular e

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1992.tb06039.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

We report 20 cases of right unilateral spatial neglect caused by lesions in the left cerebral hemisphere. Differences in neuropsychological symptoms and lesion sites are discussed in connection with handedness. Of the right‐handed patients, 6 had severe aphasia, 4 had Gerstmann's syndrome, and 1 had pure agraphia, but unilateral spatial neglect in these cases disappeared after a number of months. Six of the non‐right‐handed patients had moderate‐to‐severe aphasia, while the other 3 cases had no aphasia at all. Eight of the 9 cases in this group continued to have right unilateral spatial neglect for more than 6 months. Lesion site as determined by CT differed as to hemisphere, but all fell into the common area previously mentioned in connection with such disorders: i.e., the temporal, parietal and occipi

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1992.tb06040.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY