Clinical Neuroscience

[Amnesticus syndrome due to Härtel's alcohol injection ]

PAP Zoltán1, ADLER Péter1

MARCH 01, 1963

Clinical Neuroscience - 1963;16(03)

[We reported a patient with severe trigeminal neuralgia in whom, by Härtel's method, part of the alcohol given into the Gasser's duct was presumably introduced into the cisterna chiasmatis and caused sterile meningitis, with encephalitis in the infundibulum area and severe damage to the mammillary bodies. This resulted in acute unconsciousness, febrile delirium, a slowly recovering foggy state of consciousness and a permanent amnestic syndrome. However, neuralgia - except for the unpleasant sensation of phonia, which still exists in branch I, has disappeared. The case is interesting not only from a psychological point of view, because of the memory disturbance, but also because of the lessons to be drawn from it. Although Dandy and Frazier-Spiller's trigeminal surgery cannot be said to be completely without risk, not to mention Sjöquist's intramedullary tractotomy, the situation is really different today from what it was in Fedor Krause's time. Härtel's confident statement, quoted above, made in 1924, has lost much of its legitimacy today. His proposal for surgical interventions, like Kirschner's electrocoagulation, was restricted to a narrower field. Despite the undoubtedly positive results, its use must always be accompanied by undesirable consequences. Its recommendation should therefore be limited to patients who are not suitable for or do not agree to intracranial surgery and who cannot be made painless by other means. ]

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  1. Hajdú-Bihar Megyei Tanács Kórháza Idegosztálya és a Debreceni Orvostudományi Egyetem Stomatológiai Klinikája

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Further articles in this publication

Clinical Neuroscience

[Reactivity, pharmacological influence and association with respiration of the periodic eeg complex in subacute panencephalitis]

FENYŐ Egon, HASZNOS Tivadar

[1. The stimuli we used could not influence the shape or periodicity of the periodic complexes. It appears that periodic eeg phenomena in penencephalitis can no longer be provoked by external stimuli when periodicity is stable. 2. No rapid activity typical of the initial stage of barbiturate anaesthesia was seen in any of our patients after intravenous Evipan. The lack of rapid activity in response to Evipan is associated with panencephalitic cortical lesions. 3. After Megimide injection, spasm potentiation initially occurred only in the section corresponding to the periodic complex. On this basis, it seems reasonable to conclude that the periodic complex represents a state of increased excitability that facilitates the appearance of spasm potentials. 4. There is a statistically highly significant difference between the number of eeg complexes occurring with increased frequency during the inspiratory and expiratory phases. If we assume that the firing of inspiratory and expiratory bulbopontine neurons facilitates the emergence of the panencephalitic eeg complex, it is reasonable to conclude that the primary anatomical lesion responsible for the emergence of the periodic complex may be the bulbopontine phase of the formatio reticularis, or at least a system intensely related to it. 5. In some cases, intravenous Relaxil G caused the characteristic periodicity of the curve to disappear and the diffuse polymorphic deltaic activity characteristic of end-stage panencephalitis to develop. The Relaxil effect suggested that the structure controlling the autorhythmicity of the periodic complex may be the diffuse thalamic system. Thus, the presence of a periodic complex implies the relative integrity of the diffuse thalamic system. 6 We have discussed the differences between the panencephalitic periodic complex, the K-complex and the Forbes' secondaerial response and, on the basis of these differences, we believe that the periodic complex cannot be identified with either the Forbes' secondaerial response or the K-complex.]

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[Text analysis of the diary of a schizophrenic patient ]

KUNCZ Elemér, THORDAI István

[Authors examine the diaries of 33-year-old female patients - 70 handwritten pages spanning a year - which can be used to track phases of immersion in a world of closed, autistic experience and self-medication tendencies. They find that, on the one hand, the diary as a form corresponds to a written monologue by which the patient, isolated from the outside world, deceives his own solitude, and, on the other hand, a certain striving for autonomy and the role of self-preservation tendencies can be discerned in the bizarre turns of phrase and conceptual changes.]

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[Dr. Adolf Juba]

PÉTERFAI János

[The author gives an account of the life and work of Dr. Adolf Juba.]

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[Glioma behaviour in tissue culture]

PÁLYI Irén, TÓTH Géza, CSÁKY László, ÁFRA Dénes, ZOLTÁN László

[1. In tissue cultures of gliomas after a single high dose of 6000 r., phosphorus metabolism was investigated 6 and 22 h after irradiation. 2. After irradiation, glioma cultures showed higher activity in the acid-soluble phosphorus fraction than controls. The lipid and DNA fractions, on the other hand, had lower activity compared to controls. 3. Normal tissues show no consistent changes in their phosphorus metabolism after a single high dose of radiation. ]

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