Clinical Neuroscience

[Book review]

CLEMENS Béla

SEPTEMBER 20, 1994

Clinical Neuroscience - 1994;47(09-10)

[Description of the book Surgical Treatment of the Epilepsies.]

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Clinical Neuroscience

[Evaluation of gliomas by means of multi-model techniques]

BORBÉLY Katalin

[Gliomas constitute more than 50% of brain tumours. Primary malignant forms recur within 1/2 to 1 year after surgery, and even totally removed benign forms may recur. 50% of recurrent astrocytomas are more malignant than the original tumour. The time elapsing until recurrence strongly depends on the degree of malignity and the surgical removal. However, the age of the patient also plays an important role. Survival of the patient after the establishment of diagnosis also depends on the therapy. Effective treatment requires a knowledge of the degree of malignity as well as differentiation between recurrent tumour and radiation necrosis. CT and MRI scans offer high sensitivity, but poor specificity. Evaluation of tumour metabolism by means of 18F-fluoro-deoxy-glucose positron emission tomography (PET-FDG) helps to determine the degree of malignity of the gliomas, and recurrent tumour can safely be differentiated from necrosis following radiation therapy.]

Clinical Neuroscience

[Symptomps, localization of cerebral lesions and aetiology of "letter-by-letter" reading]

SÉRA László, MÁRKUS Atilla, BERNÁTH László

[The symptoms, localization of cerebral lesions and aetiology were analysed literally data of 78 patients suffering from pure alexia (letter-by-letter reading). During the 100 years since Déjerine's first case study on the issue was been published our knowledge on the clinical and pathomorphological characteristics of pure alexia has become more exact. On the one hand, clinical symptomatology has narrowed, eg. right homonymous hemianopsia is no regarded as a compulsory concomintant symptom on the other hand, the locus of damage underlying the symptoms may be at various areas of the brain (eg. subangular), not only at the occipital regions. The role of the posterior trajectory system in the reading process emphasized. In addition however, taking into account recent neuropsychological findings, the importance of other areas of the brain is presumable. In accordance with cognitive psychological research of the reading process it is concluded that it is essential the is for our understanding of the whole reading process that all of these factors are taken into consideration.]

Clinical Neuroscience

[Transoral and posterior fixation for inveterated fracture of odontoid process - Case report]

VERES Róbert, LAKATOS István, KENÉZ József, PENTELÉNYI Tamás

[Combined operative treatment is reported of a fixed malpositioned type III. (according to Anderson-D'Alonso) oblique anterior odontoid process fracture. Due to the ventral and dorsal compression of the spinal canal a part of the dens and a part of the C.li body were transorally removed, and a part of the arch of the atlas also removed by a dorsal approach. The position was fixed by means of a combined method of a transoral Harms-plate and a posterior C.I.-C.II. fransarticular screwing according to Magerl. With this method were achiered proper decompression and stabile C.1.-C.II. arthrodesis.]

Clinical Neuroscience

[Cerebral aspergillosis]

ILLÉS Zsolt, GARZULY Ferenc, BRITTIG Ferenc, PERENYEI Miklós

[Four cases of cerebral aspergillosis are reported. Brain abscesses developed in a patient with chronic alcoholism and pyogenic urogenital process, and in a baby, treated for aplastic anaemia. Haemorrhagic necroses were found in the other two cases, one of them suffered from agressive hepatitis, the other had lymphoid leukaemia. Pulmonary alterations were observed as part of generalised aspergillosis in all the cases. Early diagnosis of pulmonary processes should be emphasized as the disease can hardly be influenced when neurologic symptoms appear.]

Clinical Neuroscience

[The effect of the cue-controlled modification of the level of vigilance on the intentional inhibition of seizure in patients with partial epilepsy]

SZUPERA Zoltán, RUDISCH Tibor, BONCZ István

[The cue-controlled modification of the level of vigilance, as one of the methods of self-control appeared to be a practicable therapeutic intervention for the intentional inhibition of epileptic seizures in some special cases of epilepsy. The authors worked out a variation of the above self-control technique, in which the aura imagined in hypnosis was associated with the change in vigilance in patients suffering from partial epilepsy, in order to enable them to try to inhibit the epileptic fits with this associated modification of the level of alertness during auras. The authors report two cases of intractable partial epileptic patients, in which the patients attained the application of this self-control method. The first patient carried out intentional seizure inhibition in 73 cases over one year, reducing the frequency of the fits from the previous 115 to 77. In the second case, the patient was able to decrease considerably even the number of epileptic auras by learning and applying the technique, consequently the number of auras decreased to 7 compared with the 38 fits observed in the previous 8 months, further he was able to terminate the attack in 6 cases out of auras. The authors think, that their method might be useful for a certain group of patients suffering from partial epilepsy to inhibit epileptic attacks, and would mean a new possibility in the management of intractable cases.]

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[A short chronicle of three decades ]

KAPRONCZAY Katalin

[Hungarian professional periodicals started quite late in European context. Their publish­ing, editing and editorial philosophy were equally influenced by specific historical and political situations. Certain breaking points of history resulted in termina­tion of professional journals (War of In­de­pendence 1848-1849, First and Se­cond World Wars), however there were pe­riods, which instigated the progress of sciences and founding of new scientific journals. Both trends were apparent in years after the fall of former Hungarian regime in 1990. The structure of book and journal publishing has changed substantially, some publishers fell “victim” others started successfully as well. The latters include the then-established publishing house Literatura Medica and its own scientific journal, Lege Artis Me­di­cinae (according to its subtitle: New Hun­garian Medical Herald) issued first in 1990. Its appearance enhanced significantly the medical press market. Its scientific publications compete with articles of the well-established domestic medical journals however its philosophy set brand-new trends on the market. Concerning the medical community, it takes on its problems and provides a forum for them. These problems are emerging questions in health care, economy and prevention, in close interrelation with system of public health institutions, infrastructure and situation of those providing individual health services. In all of them, Lege Artis Medicinae follows consequently the ideas of traditional social medicine.]

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[Non-pharmacological prevention and treatment for postoperative delirium in elderly patients with hip fracture - a systematic review]

VIDA Nóra, PAPP László

[Delirium is defined as a disturbance of consciousness and cognition that develops over a short period of time and fluctuates over time. During the last decade, the number of publications dealing with different aspects of delirium have been grown. The key points in most articles are pharmacological prevention and treatment, but because the rise of health care expenditures, all activities, which cost-effectively support the care process, is getting more and more important. The aim of the study: The aim of this research is to review the non-pharmacological prevention and treatment possibilities of delirium in elderly patients undergoing hip surgery. Systematic review, using articles published between 1999 and 2019 in PubMed and Wiley Online Libraries. Non-pharmacologic treatments significantly reduced the incidence (p=0.003–0.045) and duration (p=0.009–0.03) of delirium. The interventions also contributed to decrease the number of episodes (p=0.03), and to make the symptoms lighter. Early mobilisation and adequate fluid and electrolyte intake are key factors in reducing the incidence of delirium. Measuring oxygen saturation and support, appropriate nutrition, effective pain treatment, minimizing drug-interactions, maintaining good sleep and managing sensory dysfunctions have an effect on incidence, duration and severity of delirium.]

Clinical Neuroscience

REM sleep, REM parasomnias, REM sleep behaviour disorder

SZÛCS Anna , MUTTI Carlotta, PAPP Anikó, HALÁSZ Péter, PARRINO Liborio

We review the literature on REM parasomnias, and their the underlying mechanisms. Several REM parasomnias are consistent with sleep dissociations, where certain elements of the REM sleep pattern emerge in an inadequate time (sleep paralysis, hypnagogic hallucinations and cataplexy) or are absent/partial in their normal REM sleep time (REM sleep without atonia, underlying REM sleep behavior disorder). The rest of REM parasomnias (sleep related painful erection, catathrenia) may have other still unclear mechanisms. REM parasomnias deserve attention, because in addition to disturbing sleep and causing injuries, they may shed light on REM sleep functions as well as the heterogeneous etiologies of parasomnias. One of them, REM sleep behavior disorder has special importance as a warning sign of evolving neurodegenerative conditions mainly synucleinopathies (some cases synucleinopathies themselves) and it is a model parasomnia revealing that parasomnias may have by autoimmune, iatrogenic and even psychosomatic etiologies.

Clinical Neuroscience

Neuroscience highlights: The mirror inside our brain

KRABÓTH Zoltán, KÁLMÁN Bernadette

Over the second half of the 19th century, numerous theories arose concerning mechanisms involved in understanding of action, imitative learning, language development and theory of mind. These explorations gained new momentum with the discovery of the so called “mirror neurons”. Rizzolatti’s work inspired large groups of scientists seeking explanation in a new and hitherto unexplored area of how we perceive and understand the actions and intentions of others, how we learn through imitation to help our own survival, and what mechanisms have helped us to develop a unique human trait, language. Numerous studies have addressed these questions over the years, gathering information about mirror neurons themselves, their subtypes, the different brain areas involved in the mirror neuron system, their role in the above mentioned mechanisms, and the varying consequences of their dysfunction in human life. In this short review, we summarize the most important theories and discoveries that argue for the existence of the mirror neuron system, and its essential function in normal human life or some pathological conditions.

Clinical Neuroscience

[Neuropsychological rehabilitation following acquired brain injury]

TAMÁS Viktória, KOVÁCS Noémi, TASNÁDI Emese

[Neuropsychological rehabilitation or rehabilitation neuropsychology is a field within applied neuropsychology. It originally diverges from applied clinical and functional neuropsychology, although it could not be entirely differed from them. The unique nature of this area over the complexity is given by its process-controlled and system-approach aspects. In Hungary the number of neurorehabilitation centres and departments requiring neurocognitive rehabilitation has been continually increasing. Nevertheless, the number is still low; accordingly in our country this field is relatively young and isn’t well known. Authors of this review would like to draw attention to the importance of rehabilitation of patients with acquired brain injury and improvement of their quality of life with the theoretical and practical knowledge, as well as the necessity of future alterations and challenges emphasizing the need of a significant change of this narrow domain. ]