Clinical Neuroscience

[Acut isonicotinsav-hydrazid intoxicatio két esete]


JANUARY 01, 1969

Clinical Neuroscience - 1969;22(01)

[The authors report two successfully treated cases of acute INH intoxication. Among the explanations for the effects in the literature, they consider the nervous system and the general organ parenchymal damage to the liver to be the most important. The epileptic status epilepticus in the first seizure, as well as the diffuse cerebral laesio, reversible cerebral oedema, also detected by EEG, support the above pathomechanism. They wish to draw attention to the increasing prevalence of INH.]


  1. Győr-Sopron Megyei Tanács Kórháza Ideg-Elme 1. osztálya



Further articles in this publication

Clinical Neuroscience

[Autoimmune aspects of myasthenia gravis]


[Recent research suggests that an autoimmune process may also play a role in the pathomechanism of myesthenia gravis. In our own studies, 45 patients with myasthenia were serologically tested for antibodies against striated muscle, anti-gammaglobulin factor and anti-thyroid antibodies, and 46.6% were found to have anti-muscle antibodies. No serological reactions against muscle were detected in 52 control subjects. The positivity of anti-muscle immune reactions showed no correlation with patient age, sex, clinical status, prognosis, thymus surgery or irradiation. There are several possibilities for interpreting the immune positivity observed in myesthenia. One such possibility is the question of myasthenia beginning with respiratory tract infection, with a percentage approximately equal to the incidence of positive immune reactions and lymphorrhagia in muscle. The pronounced role of thymoma in the initiation of immune reactivity has not been established. Considering the possibility of a somatic mutation, the immunostimulatory role of the processes involved cannot be verified. The role of immune-serologically positive diseases associated with myasthenia is emphasized, based on the literature and our own material, but no explanation for the immunological implications of myasthenia is obtained based on disease association. Based on our studies, we outline our hypothesis that the immunobiological link of myasthenia is not causal and direct, but an indirect mechanism via the thymus. ]

Clinical Neuroscience

[Neurotic images in old age ]


[Authors analysed the medical histories of 250 patients aged 55 to 75 years with neurosis, in whom vascular encephalopathy, other organic brain disease or psychotic symptoms could be excluded, who were first admitted to the Budapest Psychiatric Clinic between 1958 and 1966 and who had been treated for at least 2 weeks. They conclude: 1. that there is some correlation between age group and symptomatology, but it is not significant, 2. that there is no correlation between the underlying cause (conflict substance) and the nature of the symptomatology, but that the symptomatology is significantly related to premorbid personality and intellectual level. 3. the outcome of the syndrome is significantly related to a, the intellectual level, b, the age group, and c, the individual's activity level. ]

Clinical Neuroscience

[Periodic paroxysmal discharges with occlusion of the middle cerebral artery]


[Cerebral aneurysms due to a hemispherical occlusion of the middle cerebral artery develop a specific EEG activity, consisting of alternating discharges, some of which are single periodic paroxysmal discharges and others which are a series of discharges connected by flat segments. Based on the functional specificity of the electrical phenomena and the electropathological correlations, the two types of alternating activity observed in this patient can be analogized with the two main types of periodic paroxysmal phenomena; suppression-burst activity showing periodic complexes (panencephalitis-like) and cortical denervation pattern. A common pathomechanism can be discerned in these EEG phenomena, in which the specific metabolic state of the vascularly damaged and denervated cortex plays a crucial role. ]

All articles in the issue

Related contents

Hypertension and nephrology

[SARS-CoV-2 fertőzés során kialakult alsó végtagi akut artériás elzáródás esete. „Örülök, hogy élek…”]


Clinical Neuroscience

[Hypertension and it’s therapy in acut phase of stroke]


[The elevation of blood pressure above normal and premorbid values within the first 24 hours of symptom onset in patients with stroke is relatively common. This acute hypertensive response is usually managed by different group of physicians, including general practitioners, emergency physicians, neurologists, internists, intensivisists. Management strategies of this phenomenon vary considerably. The first consideration in blood pressure management in this clinical setting is to determine whether the patient might be a candidate for thrombolytic therapy. For those patients are not entitled to that therapy premorbide blood pressure values and the type of stroke are the key data for sufficient control of hypertension. In patients with chronic hypertension, the lower end of the autoregulation curve is shifted toward high pressure and an impaired autoregulation due to acute stroke may increase the risk for further brain tissue damage if the blood pressure is inadequately controlled. The current guidelines recommend lowering blood pressure in patients with an intracranial haemorrhage below 160- 180/100-105 mmHg, if the patient is normotensive, while the target level is 180/105 mmHg in hipertensive patients. However, in ischaemic stroke no treatment is recommended if systolic blood pressure <220 mmHg and/or diastolic blood pressure <120 mmHg in the acute stage. Clinical studies are rare which assess the effectiveness of different antihipertensive drugs in acute stroke. The first strong evidence came from the ACCESS (The Acute Candesartan Cilexetil Therapy in Stroke Survivors) trial which suggested that a 7-day course of candesartan after an acute ischaemic stroke significantly improves cardiovascular morbidity and mortality.]

Clinical Neuroscience

[Efficacy of anticoagulation with vitamin K antagonists in acut stroke patients with atrial fibrillation - Hungarian results]

SAS Attila, CSONTOS Krisztina, LOVÁSZ Rita, VALIKOVICS Attila

[Background and objective - An estimated 20% of ischemic strokes are of cardiogenic origin, half of which is associated with atrial fibrillation (AF). Anticoagulation treatment of patients with this arrhythmia reduces their risk of stroke. Effectiveness and safety of oral anticoagulant therapy with vitamin K antagonists (VKA) is limited, however, by their well-known narrow therapeutic window and the substantial inter- and intraindividual variability of INR values depending on genetic and dietary factors as well as drug interactions. Our objective was to evaluate the prevalence of adequate anticoagulation and the level of anticoagulant effect actually achieved among patients with AF hospitalized for acute stroke. Methods - Patients with AF admitted to our hospital ward in 2012 for acute stroke (n=226) were included in the analysis. Using descriptive statistics, relevant clinical and therapeutic characteristics of the patients were assessed, with special reference to the INR values on admission (among patients with known AF), and the clinical outcomes. Results - Of the study cohort, 170 patients had a diagnosis of AF before the admission for stroke, but 47% of them did not take anticoagulants. Patients who suffered stroke while on anticoagulants (83 on VKA, 7 on low-molecular-weight heparins), were in most cases (75%) out of the therapeutic INR range, typically undertreated (INR<2). Overall, inadequate or completely absent anticoagulation was documented in 81% of the stroke cases occurring in patients with known AF. Of the entire study cohort, 41% was discharged home, 34% required continued institutional care, and 25% died. Conclusions - The inadequacy or lack of anticoagulation was observed in the vast majority of acute strokes in patients with known AF. These cases are often related to the well-documented limitations of VKA therapy in terms of its safety, tolerability and/or practical aspects. To prevent them, important changes are warranted in the anticoagulation practice, including the closer control of VKA therapy and the broader use of new oral anticoagulants.]


[Normal values of total body mineral content in the Hungarian female population]


[BEVEZETÉS - A magyar nők egész test ásványianyagtartalmának populációs normálértékeit kívántuk meghatározni. VIZSGÁLT SZEMÉLYEK ÉS MÓDSZEREK - Hétszáz egészséges, különböző életkorú nőt vizsgáltunk kettős energiájú röntgenfoton-abszorpciometriával. A vizsgálat során meghatároztuk az egész test tömegét (TBM), ásványianyag-tartalmát (TBMC), lágyrész-tartalmát (TSTM), zsírtartalmát (fat), az ásványi anyag és a zsírmentes szövet hányadosát (TBMC/LBM), valamint a különböző testtájak (fej, törzs, jobb és bal kar, lábak) ásványianyag- és lágyrész-tartalmát, továbbá a testsúlyból és a testmagasságból számolt testtömegindexet (BMI). EREDMÉNYEK - A magyar nők egész test ásványianyagtartalma a 20-30 év közötti korcsoportban a legmagasabb. Ez nem változik lényegesen a 46-50 éves korcsoportig, ahol jelentősebb csökkenés következik be. Az ásványianyagtartalom további nagyobb mérséklődése az 56-60 éves korcsoportban észlelhető, majd 60 éves kortól a csökkenés fokozatosan, nagyobb lépcsők nélkül következik be. Az egész test lágyrész-tartalma ellentétes változást mutat, mint az egész test ásványianyag-tartalma. A lágyrész-tartalom az életkorral párhuzamosan egyre nő, de ez a növekedés az egész test zsírtartalmának emelkedéséből származik. A testtájak ásványianyag-tartalmát összehasonlítva a végtagok ásványianyag-tartalmának fokozatos csökkenése észlelhető. Megfigyelhető a két kar közötti különbség, ez a domináns jobbkezességből adódik. A törzs ásványianyag-tartalma az életkor előrehaladtával folyamatosan csökken. KÖVETKEZTETÉSEK - Az egész test ásványianyagtartalmának vizsgálata egyre jelentősebb szerephez jut a szekunder osteoporosisok vizsgálatánál, így a populációs normálértékek meghatározásának különösen nagy a jelentősége.]

Lege Artis Medicinae



[Methods of nuclear cardiology have been applied for several decades and there is continuous development in this area. The most commonly used modality is the myocardial perfusion scintigraphy (MPS). During stress MPS, the presence and the severity of ischaemic heart disease (IHD) can be detected. Resting MPS can show a freshly developing acut myocardial infarction (AMI) immediately, but new and old infarcted myocardial areas can not be distinguished by this method. Using SPECT (single photon emission tomography) examination and quantitative analysis can improve the accuracy of MPS. With gated SPECT we can analyse both the perfusion and the function of left ventricle. To examine the function of left and right ventricle the “gold standard” non-invasive method is MUGA (multiple gated acquisition) of blood pool scintigraphy. After only a few hours of the onset of AMI we can detect it with the socalled infarct avid scintigraphy using radiopharmaceuticals which accumulate in affected area. Following an AMI it is essential to differentiate among high and low risk patients for revascularisation treatment, therefore distinguishing the viable (hibernating) and non-viable (necrotic) myocardium with imaging techniques is an important task. Preserved metabolism as the sign of viable myocardium can be detected both by SPECT (most accurately by thallium rest-redistribution scintigraphy) and PET (detecting glucose metabolism by F-18-FDG). Adrenerg receptor scintigraphy can show the sympathetic innervation: in the case of a transplanted heart it can detect the reinnervation and in the case of malignant ventricular tachyarrhythmias the risks and the severity of the illness.]