摘要:

ABSTRACTThe effect of Tegretol has been investigated in 71 patients with facial pain, using a single blind technique. Tegretol was found to have an immediate good effect in 83 per cent of patients with typical trigeminal neuralgia, in 87 per cent of those with atypical neuralgia, and in 53 per cent of those with non‐neuralgiform facial pain. Pain disappeared within the first 24 hours of treatment in 69 per cent and within the following 24 hours in a further 24 per cent. The 54 patients with a good immediate effect of Tegretol continued to take the drug after discharge, and 69 per cent of these were free of pain for over two years. Complications made withdrawal of treatment necessary in 5 per cent of the patients. One patient developed cardiac pain, three rash, three headache, nausea and vomiting, and two dizziness. Tegretol acts by reducing the bulbar and spinal polysynaptic reflexes. It has a central action, in particular on the reticulo‐thalamic system. Our present knowledge of the mode of action of Tegretol supports the hypothesis that trigeminal neuralgia is due to pathological multineuronal reflexes in the trigeminal system on the level spinal trigeminal nuclei‐tha

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1970.tb05803.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

摘要:

ABSTRACTThe production of all the major symptoms of parkinsonism is attributed chiefly to the loss of the normal dopaminergic input into the striatum. This loss of dopaminergic input is due to degeneration of the cell bodies of the substantia nigra. An analogous loss of serotonin (5‐hydroxytryptamine) may be of significance in the production of parkinsonian tremor. L‐dopa ameliorates the symptoms of parkiusonism as a result of reinstitution of dopamine inhibition of the striatal neurons. L‐dopa induced dyskinesias are felt to be related to denervation hypersensitivity of striatal neurons to dopamine produced by dopaminergic denervation. Failure to respond to L‐dopa is related to degeneration of striatal dopaminergic receptors. The efficacy of amantadine hydrochloride is felt to be related to a block of the presynaptic reuptake of dopamine and thereby a prolongation of dopamine's effect at the recept

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1970.tb05804.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1970.tb05805.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

摘要:

ABSTRACTNorwegian mortality data (underlying and contributory cause) from 1951–65 have been compiled for multiple sclerosis, paralysis agitans, and pernicious anemia. Disability pension data as of Jan. 1, 1966, have been adduced for the first two diseases and municipality rates computed. For amyotrophic lateral sclerosis underlying cause mortality is presented. Place of birth has been ascertained for those who died with multiple sclerosis. The emphasis is on the geographic distribution of multiple sclerosis and pernicious anemia. The findings of the present study broadly confirm those of previous studies of the two conditions. They have a similar, but apparently not identical, pattern. It is suggested that a test be made of the hypothesis that properties of the soil is involved in the etiology of multiple sclerosis. Six pairs of one high‐risk and one low‐risk municipality are proposed for investigation. Multiple sclerosis mortality has been declining during the period 1951–68. Paralysis agitans showed no distinct geographic pattern, although the county mortality variations were similar to those of multiple sclerosis. The mortality from paralysis agitans has not shown any decreasing tendency, and there is no convincing negative association with lung

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1970.tb05806.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

摘要:

ABSTRACTThe criteria of the Schumacher committee appear to be the most practical set of requirements for the clinical diagnosis of multiple sclerosis. Multiplicity in both time and space are essential for this disease. A combination of optic nerve involvement, long‐tract signs and evidence of brain‐stem dysfunction is a constellation which is most likely to be due to multiple sclerosis in young individuals. Even here though, other disorders need be kept in mind: Leber's optic atrophy, heredofamilial spinocerebellar degenerations, nutritional disorders, ischemic and inflammatory vascular disease. When the eye is not involved, one need also consider Behçet's disease and other chronic meningoencephalitides. Regardless what the course of illness has been, a lack of spatial dissemination within the central nervous system precludes a diagnosis of MS. Brain stem or spinal cord disorders are notorious for causing disturbances suspicious of multiple lesions when in fact a single local lesion is operative. Early development of dementia or seizures, or the presence of extrapyramidal signs, stupor, aphasia, or focal atrophy with fasciculations is in each instance most unusual i

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1970.tb05807.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

摘要:

ABSTRACTScales to measure disability in multiple sclerosis have been rather numerous. One system used includes the delineation of overall neurologic dysfunction according to a Disability Status Scale which is scored on a 0 to 10 basis, with 0 being normal, the numbers rising in proportion to severity of involvement, and 10 used for death due to MS. The other part of this system is the assessment of dysfunction according to Pyramidal, Cerebellar, Brain Stem, Sensory, Bowel and Bladder, Visual, Cerebral, and Other functions, each one save the last being graded 0 to 5 or 0 to 6 according to severity of involvement. Based on some 2000 examinations over the first 20 years or so of illness in 572 male MS patients, the overall frequency of involvement according to the functional systems was Pyramidal 80 per cent, Cerebellar 72 per cent, Brain Stem 69 per cent, Sensory 52 per cent, Bowel&Bladder 33 per cent, Visual 31 per cent, Cerebral (mood) 16 per cent, Cerebral (mentation) 5 per cent, and Other 21 per cent. Seizures were present in 1.4 per cent. When symptoms referable to pyramidal and cerebellar dysfunction were distributed by limbs involved, there was a tendency toward symmetry of involvement with the lowers much more often affected than the uppers. Sensory complaints were equally common for each limb or combination of limbs, but sensory findings on exam showed the same pattern as the motor and coordination complaints. When correlated with the Disability Status Scale,eachof the functional systems showed not only increasing frequency but also increasing severity of involvement as overall disability increased. Involvement in each functional system was significantly correlated with involvement in each of the others, save for the Cerebral‐Sensory pair, and the highest correlations for each functional system were with the Disability Status Scale. Accordingly, it is concluded that as groups of MS patients worsen, they worsen in all areas. Therefore, any measure which will reflect even a part of this worsening will appear to be a valid estimate for the course of disease in groups of patients, and all of the published scales designed to evaluate disability in MS meet this criterion. Whether one system is more “correct” than another is not amenable to proof, and the choice would seem to depend more on factors such as familiarity and ease of application of the system rather than on its intrinsic m

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1970.tb05808.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

摘要:

ABSTRACTOne hundred patients with a 3rd ventricle width ≧ 12 mm in the pneumoencephalogram were followed‐up for the third time after an average observation period of 14 years. 56 had died, 14 were in need of care and supervision, 19 were unable to work, and 11 were partly able to work.The causes of death could be divided into 3 groups: (1) The cause of death seemed to be related to the underlying brain disorder. (2) The cause of death seemed to be much the same as in the population at large. (3) Death seemed to follow minor disorders usually not leading to death.A poor long‐term prognosis seemed to be related to: (1) serious associated disease, (2) a relatively high age on first admission (i.e. more than 50 years of age), (3) symptoms and signs of cardio‐vascular disease, (4) marked degree of central cerebral ventricular enlargement, (5) marked symmetrical enlargement of the temporal horns, (6) several and/or marked neurological signs of cerebral disease, and (7) marked and progressive intellectual deterioration.A relatively good prognosis seemed to be related to the following factors: (1) a moderate degree of ventricular enlargement, (2) roent‐genological evidence of intracerebral anomalies or early acquired brain lesion with little progressive tendency, (3) only few neurological signs, and (4) age below 50 years at the time of the first

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1970.tb05809.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

摘要:

ABSTRACTIn a series of Parkinsonian patients subjected to stereotaxic surgery, the mental function was studied by means of psychological tests. The purpose was to throw light on the possible postoperative mental changes which together with fear of speech disturbances seem to be the most important contra‐indications for neurosurgical treatment. In the study, 41 patients operated on for Parkinsonism were subjected to preoperative and postoperative psychological tests (average observation period 8.7 months). Bilateral operation was performed in seven cases. The mean age of the patients was 60 years. The tests used were the Wechsler Adult Intelligence Scale and the Rorschach test. In the series as a whole, no significant quantitative changes in the postoperative mental function were revealed by the two tests. The Rorschach test revealed as an interesting finding that all the Parkinsonian patients preoperatively showed some mental reduction and that there was no significant difference between the patients with paralysis agitans and those with postencephalitic Parkinsonism. Slight postoperative changes, viz. a diminished and more rigid activity, were demonstrated in three clinical groups: patients subjected to operation on the globus pallidus, patients with postencephalitic Parkinsonism, and those with unilateral affection in the dominant hemisphere. The results of the study thus seem to indicate that a certain reluctance should be exercised in offering stereotaxic surgery to postencephalitic patients and to those with unilateral affection in the dominant hemisphere. Apart from this, it seems justified to conclude that in patients who otherwise meet the indications, the risk of postoperative mental impairment does not constitute a contra‐indication for this type of surg

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1970.tb05810.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

摘要:

ABSTRACTA survey of tumours of the central nervous system in Iceland has been carried out. The period chosen was 1954–1963. At the beginning of this period the population of Iceland (1 Dec. 1953) was 152,500 and at the end of the period 187,314. The survey is composed partly of neuro‐surgical material from the Department of Neurosurgery, University Hospital, Copenhagen, partly of necropsy material from the Department of Pathology, University of Iceland, Reykjavík. During the period of the survey 234 patients with brain tumours were encountered, and of these 186 were primary and 48 metastatic. 27 spinal tumours were found and of these one was metastatic. Metastatic tumours to the vertebral column were not included. A relatively high incidence of bloodvessel tumours was encountered. The metastatic tumours are believed to be underreported. The male/female rate in all patients recorded with brain tumours was 1.04, 1.00 for primary and 1.18 for metastatic. The male/female rate for spinal tumours was 1.25. The frequency of seizures in all patients recorded was for primary brain tumours 19.4 per cent and 8.3 per cent for metastatic tumours. Of 18 patients with blood‐vessel tumours localized in the cerebral hemispheres only 3 presented with convulsions. The average annual incidence rate per 100,000 population 1954–1963 was for all types of brain tumours 10.6. It was 7.8 for primary brain tumours, 2.8 for metastatic brain tumours, and 1.1 for spinal tumours. Age‐specific incidence rates for primary brain tumours rose steadily from 3.4 at age 0–19 to 28.5 at age 80 +. The prevalence rate on 31 Dec. 1963 per 100,000 population was for all types of brain tumours 43.2 and 42.2 for primary tumours. The prevalence rate for spinal tumours was 10.1. The average annual death rate per 100,000 population for the period of the survey was for primary brain tumours 6.3, for metastatic tumours 2.7, and spinal tumours 0.5. The average annual death rate for all tumours of the central nervous system in Iceland during the years 1954–1963 was 9.4 or 1.4 per cent

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1970.tb05811.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

摘要:

ABSTRACTOxygen tension in lumbar cerebrospinal fluid was monitored during halothane‐N2O anaesthesia in 6 patients undergoing craniotomy. Beckman's oxygen‐micro electrode was used. Results showed (1) a rise in oxygen tension during the beginning of the anaesthesia which is largely ascribed to an increase in cerebral blood flow induced by the anaesthetic, (2) a fall in oxygen tension during 30 minutes of hyper‐ventilation where arterial CO2tension decreased to 20 mm Hg, (3) a minimum oxygen tension measured during hyperventilation which is within the limits of normal CSF oxygen tension reported by others. It is argued that lumbar CSF oxygen tension may represent an average tissue oxygen tension of the central nervous s

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1970.tb05812.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY