Clinical Neuroscience

[Acute necrotizing encephalitic herpes virus encephalitis of childhood ]


MARCH 01, 1967

Clinical Neuroscience - 1967;20(03)

[The author describes the histopathological picture of a fatal encephalitis of a 3 and a half year old girl child, which has 4 features: 1. extensive meningocortical massive infiltration, 2. diffuse coagulative necrosis of the cortex, 3. reactive glial-mesenchymal proliferation, 4. inclusion bodies. On the basis of a combined consideration of the clinical and pathological picture, his diagnosis is herpes virus encephalitis.]


  1. MÁV Kórház Prosecturája



Further articles in this publication

Clinical Neuroscience

[Data on the surgical management of posterior-scalene meningiomas ]

ZOLTÁN László, FÉNYES István

[Authors have tried to provide some data on the surgical management of infratentorial meningiomas based on data from 41 of their own patients and literature reviews. Their experience, together with the available literature data, suggests that the greatest possible radicality should be carried through in the surgical resolution of posterior-scalene meningiomas. They are aware that the neurosurgeon has always tried to perform complete excision of any tumour, but especially extracerebral tumours, within the limits of possibility. However, the assessment of the possibility of radicality is not an absolute concept. It depends, first and foremost, on the use of one's own experience and that of the literature in a given situation to determine the mortality rate and the manner and quality of recovery from similar operations carried out up to that point. When considering the surgical solution of posterior meningiomas in the future, they recommend their modest experience: in evaluating the surgical situation, the chosen method should preferably be radical extirpation, even if this seems to be too high a risk in the given situation. ]

Clinical Neuroscience

[The role of succinimides in the treatment of childhood epilepsy]

KISZELY Katalin, MÁTTYUS Adorján

[We report on 42 children with epilepsy treated with Zarontin (Suxinutin) and Celontin, who had defied all therapies until then. 9 of 11 "classic" petit mal (3 c/s spike-wave) were seizure-free, 2 improved greatly. 7 of 13 children with petit mal varians EEG became seizure-free, 4 improved greatly. Of 9 cases with "other generalised" EEG (clinically mostly mixed GM and PM), 4 had no seizures, 1 had a severe seizure disorder. Of 8 focal epilepsies, 1 improved moderately, 2 greatly. Side effects were unpleasant, but no bone marrow, liver or kidney lesions occurred. Based on therapeutic results, succinimides are considered to be very effective and relatively non-toxic compounds, provided that they are administered under constant supervision and on the basis of an appropriate indication.]

Clinical Neuroscience

[About Melkersson-Rosenthal syndrome ]


[The authors describe 5 patients with Melkersson-Rosenthal syndrome. No neurological symptoms other than the classic symptom triad were observed. The clinical features and histological changes of the disease are reviewed, and questions of aetiology and therapy are addressed. We would like to thank Dr. György Czappán, Adjunct Professor, for kindly allowing us to present case 5. ]

Clinical Neuroscience

[Alcoholism and endogenous psychoses]


[Chronic alcoholism is not a nosological category, but a clinical umbrella term: it encompasses different syndromes of habitual drunkenness and of real and symptomatic alcoholism, which are built up by a combination of co-pathogenic factors. Authors have studied cases of symptomatic alcoholism where daily or periodic alcohol abuse is associated with other psychiatric pathologies. They report on their studies of coincidences of endogenous psychoses and alcoholism. On the basis of the literature and 23 cases they observed, they identified five possibilities for typical forms of pathoplastic interactions between schizophrenia and alcoholism, which they described and illustrated with an example. On the basis of a psychopathological analysis of their cases, they have shown, on the one hand, how the clinical picture of atypical alcoholic psychosis is modified by latent schizophrenia and, on the other hand, how the organic psychosyndrome of chronic alcohol intoxication, leading to a specific emotional incontinence and personality changes, masks or prevents in some cases the more severe emotional blunting, the deepening of autism and the extinction of social contacts. Therefore, the prognosis of "alcoholic" schizophrenics seems to be more favourable than that of untreated schizophrenics. The frequency of coincidences between cyclothymia and alcoholism was approached from the cyclothymia perspective, in contrast to previous data. They found alcohol abuse in 19 of their 100 non-selected cases of manic-depressive patients, and in eight of these cases there was an interaction between the two disorders that led to alcohol habituation, i.e. habitual drinking. They observed a close pathogenetic relationship between cyclothymia and dipsomaniac syndrome in their patients and noted that the particular forms of abuse and intoxication associated with the immune phase, resembling manic or depressive exaltation, are important signs for the correct diagnosis and timely treatment of patients. It has been pointed out that, unlike the coincidences of schizophrenia and alcoholism, where in some cases pathoplastic interactions are found that modify the prognosis of the dual illness, but presumably only pathoplastic interactions are found, endogenous and endoreactive disturbances of emotional life are also involved in the pathogenesis of alcoholism syndromes, especially in women.]

Clinical Neuroscience

[Study of diencephalon function in elderly (involutional) depression]

LÁNG Sándor, HAITS Géza

[The authors report their studies in involutional depression with appropriate controls and verified by mathematical-statistical calculations. In elderly depressive states, biochemical changes can be detected in patients in the body. These changes are mainly manifested in the abnormal running of sugar curves following carbohydrate loading and reduced reactivity of adrenal cortex function. After recovery, most of the abnormal symptoms disappear.]

All articles in the issue

Related contents

Clinical Neuroscience

Late simultaneous carcinomatous meningitis, temporal bone infiltrating macro-metastasis and disseminated multi-organ micro-metastases presenting with mono-symptomatic vertigo – a clinico-pathological case reporT

JARABIN András János, KLIVÉNYI Péter, TISZLAVICZ László, MOLNÁR Anna Fiona, GION Katalin, FÖLDESI Imre, KISS Geza Jozsef, ROVÓ László, BELLA Zsolt

Although vertigo is one of the most common complaints, intracranial malignant tumors rarely cause sudden asymmetry between the tone of the vestibular peripheries masquerading as a peripheral-like disorder. Here we report a case of simultaneous temporal bone infiltrating macro-metastasis and disseminated multi-organ micro-metastases presenting as acute unilateral vestibular syndrome, due to the reawakening of a primary gastric signet ring cell carcinoma. Purpose – Our objective was to identify those pathophysiological steps that may explain the complex process of tumor reawakening, dissemination. The possible causes of vestibular asymmetry were also traced. A 56-year-old male patient’s interdisciplinary medical data had been retrospectively analyzed. Original clinical and pathological results have been collected and thoroughly reevaluated, then new histological staining and immunohistochemistry methods have been added to the diagnostic pool. During the autopsy the cerebrum and cerebellum was edematous. The apex of the left petrous bone was infiltrated and destructed by a tumor mass of 2x2 cm in size. Histological reexamination of the original gastric resection specimen slides revealed focal submucosal tumorous infiltration with a vascular invasion. By immunohistochemistry mainly single infiltrating tumor cells were observed with Cytokeratin 7 and Vimentin positivity and partial loss of E-cadherin staining. The subsequent histological examination of necropsy tissue specimens confirmed the disseminated, multi-organ microscopic tumorous invasion. Discussion – It has been recently reported that the expression of Vimentin and the loss of E-cadherin is significantly associated with advanced stage, lymph node metastasis, vascular and neural invasion and undifferentiated type with p<0.05 significance. As our patient was middle aged and had no immune-deficiency, the promoting factor of the reawakening of the primary GC malignant disease after a 9-year-long period of dormancy remained undiscovered. The organ-specific tropism explained by the “seed and soil” theory was unexpected, due to rare occurrence of gastric cancer to metastasize in the meninges given that only a minority of these cells would be capable of crossing the blood brain barrier. Patients with past malignancies and new onset of neurological symptoms should alert the physician to central nervous system involvement, and the appropriate, targeted diagnostic and therapeutic work-up should be established immediately. Targeted staining with specific antibodies is recommended. Recent studies on cell lines indicate that metformin strongly inhibits epithelial-mesenchymal transition of gastric cancer cells. Therefore, further studies need to be performed on cases positive for epithelial-mesenchymal transition.

Lege Artis Medicinae

[Vaccines against COVID-19 pandemic]


[The rapidly spreading SARS-CoV2 respiratory virus has evoked an epidemic with serious aftermath around the world. In addition to the health effects, the global economic damage is actually unpredictable. At the same time, the pandemic has launched a series of unprecedented collaborative scientific research, including the development of vaccines. This study summarizes up-to-date information on vaccines, immune memory, and some emerging clinical effects.]

Clinical Neuroscience

A variant of Guillain-Barre syndrome after SARS-CoV-2 vaccination: AMSAN

TUTAR Kaya Nurhan, EYIGÜRBÜZ Tuğba, YILDIRIM Zerrin, KALE Nilufer

Introduction - Coronavirus disease 2019 (COVID-19) is a respiratory infection that has rapidly become a global pandemic and vaccines against SARS-CoV-2 have been developed with great success. In this article, we would like to present a patient who developed Guillain-Barré syndrome (GBS), which is a serious complication after receiving the inactive SARS-CoV-2 vaccine (CoronaVac). Case report – A 76-year-old male patient presented to the emergency department with nine days of progressive limb weakness. Two weeks prior to admission, he received the second dose of CoronaVac vaccine. Motor examination revealed decreased extremity strength with 3/5 in the lower extremities versus 4/5 in the upper extremities. Deep tendon reflexes were absent in all four extremities. Nerve conduction studies showed predominantly reduced amplitude in both motor and sensory nerves, consistent with AMSAN (acute motor and sensory axonal neuropathy). Conclusion - Clinicians should be aware of the neuro­logical complications or other side effects associated with COVID-19 vaccination so that early treatment can be an option.

Clinical Neuroscience

Acute transverse myelitis after inactivated COVID-19 vaccine

ERDEM Şimşek Nazan, DEMIRCI Seden, ÖZEL Tuğba , MAMADOVA Khalida, KARAALI Kamil , ÇELIK Tuğba Havva , USLU Ilgen Ferda, ÖZKAYNAK Sibel Sehür

Vaccines against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been rapidly developed to prevent coronavirus disease 2019 (COVID-19) pandemic. There is increasing safety concerns regarding COVID-19 vaccines. We report a 78-year old woman who was presented with tetraparesis, paresthesias of bilateral upper extremities, and urinary retention of one-day duration. Three weeks before these symptoms, she was vaccinated with CoronaVAC vaccine (Sinovac Life Sciences, China). Spine magnetic resonance imaging showed longitudinally extensive transverse myelitis (TM) from the C1 to the T3 spinal cord segment. An extensive diagnostic workup was performed to exclude other possible causes of TM. We suggest that longitudinally extensive TM may be associated with COVID-19 vaccination in this case. To the best of our knowledge, this is the first report of longitudinally extensive TM developing after CoronaVac vaccination. Clinicians should be aware of neurological symptoms after vaccination of COVID-19.

Clinical Neuroscience

[Consensus statement of the Hungarian Clinical Neurogenic Society about the therapy of adult SMA patients]

BOCZÁN Judit, KLIVÉNYI Péter, KÁLMÁN Bernadette, SZÉLL Márta, KARCAGI Veronika, ZÁDORI Dénes, MOLNÁR Mária Judit

[Background – Spinal muscular atrophy (SMA) is an autosomal recessive, progressive neuromuscular disorder resulting in a loss of lower motoneurons. Recently, new disease-modifying treatments (two drugs for splicing modification of SMN2 and one for SMN1 gene replacement) have become available. Purpose – The new drugs change the progression of SMA with neonatal and childhood onset. Increasing amount of data are available about the effects of these drugs in adult patients with SMA. In this article, we summarize the available data of new SMA therapies in adult patients. Methods – Members of the Executive Committee of the Hungarian Clinical Neurogenetic Society surveyed the literature for palliative treatments, randomized controlled trials, and retrospective and prospective studies using disease modifying therapies in adult patients with SMA. Patients – We evaluated the outcomes of studies focused on treatments of adult patients mainly with SMA II and III. In this paper, we present our consensus statement in nine points covering palliative care, technical, medical and safety considerations, patient selection, and long-term monitoring of adult patients with SMA. This consensus statement aims to support the most efficient management of adult patients with SMA, and provides information about treatment efficacy and safety to be considered during personalized therapy. It also highlights open questions needed to be answered in future. Using this recommendation in clinical practice can result in optimization of therapy.]