Clinical Neuroscience - 1996;49(01-02)

Clinical Neuroscience

JANUARY 20, 1996

[Differential diagnosis of Parkinson's syndrome]

FERENC Fornádi

[The fundamental improvement of therapy in Parkinson's disease during the last 25 years also led to specific requirements in differential diagnosis of Parkinson-like diseases. It has become rapidly apparent that the idiopathic Parkinson's syndrome can be treated by a substitutional levodopa therapy very well in the beginning. Considering this fact especially in the case of a so-called "primary levodopa failure" a profound differential diagnosis is necessary. On the other hand an initially diagnosed Parkinson's disease can change its character and develops a widening if symptoms secondary to a reduced levodopa responsiveness. This process can be explained bz a spread of affected cerebral systems known as multy system atrophy (MSA). In former times the differentiation of Parkinson-like diseases could only be done by clinical examination and with regard to a missing levodopa responsiveness. In the last decade diagnostic availabilities became more and more. In addition to MRI and SPECT the 18-FDG- and 18-F-levodopa-PET-scan is very helpful in the cases mentioned above. The following presentation of differential diagnosis in Parkinson-like diseases outlines especially the possibilities of PET-screening.]

HUN 1996;49(01-02)

Clinical Neuroscience

JANUARY 20, 1996

[Sumatriptan autoinjection in the acute treatment of migraine attack]

ERTSEY Csaba, JELENCSIK Ilona, ÁFRA Judit, BOZSIK György

[The authors report the results of the first Hungarian trial of 5-HT1 receptor agonist sumatriptan autoinjector in the acute treatment of migraine. During the treatment of 400 attacks in 67 patients a significant headache relief was reported in 41% after 30 minutes p. i. and 80.5% after 120 minutes p. i., respectively. In the same time frame complete dissolution of the headache was reported in 39.5% and 72%. The majority of the accompanying symptoms disappeared before the headache relief. Migraine recurrence was frequently noted (45.1% of all attacks). Slight side-effects were experienced in 36% of the attacks treated; in one case skin rash and in another one a temporary chest pain was reported. Using the autoinjector device did not pose serious problems to the patients.]

HUN 1996;49(01-02)

Clinical Neuroscience

JANUARY 20, 1996

[Vasoreactivity changes of healthy volunteers investigated by transcranial doppler]

VALIKOVICS Atilla, OLÁH László, FÜLESDI Béla, MUNKÁCSY Csaba, CSIBA László

[Transcranial Doppler (TCD) was used to measure the effect of 1 g acetazolamide (Diamox, Lederle) on blood flow velocity in the middle cerebral artery of 50 healthy volunteers (aged 20-70 years). Parameters of blood flow, blood pressure, heart rate and blood gas values were determined before and after intravenous administration of Diamox. The reserve capacity was expressed as a percentage change of baseline values. The acetazolamide did not result in significant blood pressure and blood gas changes. The mean velocity of blood flow before Diamox administration was 59.8+14.4 cm/s. The velocity of flow significantly increased after acetazolamide, peaking after 10 minutes. The extent of reserve capacity was the greatest in the age group of 31-40 years and the smallest in the 61-70 years group. The reaction was longer lasting in age groups over 50 years. Significantly higher flow parameters and greater reserve capacity was found in women than in men at each measuring time point. The reserve capacity depended on age and gender.]

HUN 1996;49(01-02)

Clinical Neuroscience

JANUARY 20, 1996

[Distant neuromuscular effect of locally injected botulinum toxin]

DIÓSZEGHY Péter, GLAUB Teodóra, MECHLER Ferenc

[Distant neuromuscular effect of locally infiltrated botulinum toxin was studied. The extensor digitorum communis muscle far from the place of injection was sampled with single-fiber EMG in patients treated for spasmodic torticollis. In 2 and 8–16 weeks after the infiltration the mean jitter values increased significantly compared to that of the results before the treatment. Extremely increased jitter values and blocks were found, too. The fiber density was also higher after the botulinum toxin infiltration. The electrophysiological changes may be a consequence of presynaptic blockade, the botulinum toxin induced terminal sprouting of motor axons and formation of new neuromuscular junctions. Parallel with the electrophysiological abnormalities no remote clinical effects were found. The single-fiber EMG proved to be a sensitive method to control the remote neuromuscular effect of botulinum toxin.]

HUN 1996;49(01-02)

Clinical Neuroscience

JANUARY 20, 1996

[Schizophrenia-like psychotic episode in Multiple sclerosis]

SIMÓ Magdolna, RÓZSA Csilla, BODROGI László, TAKÁTS Annamária

[A case is presented of a twenty-year-old female with multiple sclerosis. In 1990 the patient had three exacerbations with cerebellar, optic and pyramidal symptoms. After a four-year period of remission she was hospitalized with acute schizophrenia-like psychosis. Acute psychosis is an uncommon manifestation of multiple sclerosis which may cause difficulties in differential diagnosis.]

HUN 1996;49(01-02)

Clinical Neuroscience

JANUARY 20, 1996

[MIET headache section II. Continuing Education Conference, Abstracts]

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HUN 1996;49(01-02)

Clinical Neuroscience

JANUARY 20, 1996

[Hungarian Society of Neurologists and Mental Physicians SZOTE neurological round table]

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HUN 1996;49(01-02)