Clinical Neuroscience

[Congress of the German Neurosurgical Society 1967]

CSANAKY Artúr

NOVEMBER 01, 1967

Clinical Neuroscience - 1967;20(11)

[Author reports on the 1967 Congress of the German Neurosurgical Society.]

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Clinical Neuroscience

[Study of brain surface cooling in patients with epilepsy]

PÁSZTOR Emil, TOMKA Imre

[In patients with epilepsy during surgical exploration, surface cooling of the brain was performed with cold physiological kitchen salt during ECOG registration. 1. A gradual decrease in the amplitude of ECOG activity with insignificant or mild changes in frequency was observed after local surface cooling. No progressive development of slow waves was observed. 2. One to two minutes of brain surface cooling can temporarily suspend the electrical activity of a highly active epileptic focus. 3. The cooling test provides the possibility to determine the primary or secondary nature of the abnormal electrical activity in the opposite homologous area 4. Very brief (10-20 sec) cooling causes a transient increase in epileptiform activity, exclusively at active points. 5. Short brain surface cooling during ECOG could be considered as a new functional electrographic test. It is a very simple and harmless way of amplifying epileptiform activity of uncertain value and thus facilitating localisation of areas of increased excitability. ]

Clinical Neuroscience

[Data on the role of psychic induction in the generation of compulsions ]

HAITS Géza, PISZTORA Ferenc

[In five case studies, the authors analyse the role of psychic induction in the generation of compulsions. ]

Clinical Neuroscience

[Apparently sex-linked inheritance of Huntington's chorea ]

LÉNÁRD Lili

[The analysis of the family tree does not overturn the classic theory that the dominant inheritance of an autosomal gene is responsible for the transmission of Huntington's disease. Such a distribution of the sexes could be produced by the random dispersal of an autosomal dominant gene. Actio of modifier genes is also possible. A simple factor localised in the ivari chromosome, as in the case of haemophilia or colour blindness, is not indicated by the pedigree. However, the exclusivity of females and the relatively high number of males with no survival, makes it conceivable that the same gene that causes chorea in females has a lethal effect in males. It is likely that in this family, sex represents a genetic background that influences the physiologic circumstances of the action of the involved genes in profound ways. However, our observations are not sufficient to unambiguously clarify the inheritance pathway in this family. ]

Clinical Neuroscience

[Cerebral radiocirculography]

PÁLVÖLGYI Richárd, HERNÁDY Tibor

[The authors give a brief overview of the different methodologies for the study of the cerebral circulation with radioactive isotopes. They discuss in more detail Eichhorn's radiocirculography method, which, in addition to its simplicity, provides valuable data on the cerebral circulation.]

Clinical Neuroscience

[Treatment of childhood organic cerebral lesions and cerebral dysfunction with Mydeton]

KISS Zoltán

[Mydetone has been tested - at an average daily dose of 0.3 gr (3 x 2 tbl) - in 120 children with organic cerebral damage and cerebral function disorders. 21 patients (18%) became symptom-free or improved to a great extent, 87 patients (72%) improved, 12 patients (10%) unchanged. Experience to date has shown that Mydetone is a useful aid in natal and postnatal forms of aperture. It has been shown to be effective in epileptics when used as an adjuvant. And in paroxysmal atypical seizures, it seems to have a particularly good effect. Very useful in memory and attention disorders, learning problems. It is also an effective and useful aid - for emotional and vegetative symptoms of neurotic reactions that are not too acute, as well as for headaches. In cases of enuresis nocturnes, no significant effect was observed. With regard to the mechanism of action of Mydetone, it also draws attention to temporal lobe function changes inextricably linked to the formatio reticularis, based on the effect observed in memory disorders and electrophysiological observations. ]

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BALÁZS Nóra , BERECZKI Dániel, KOVÁCS Tibor

In aging societies, the morbidity and mortality of dementia is increasing at a significant rate, thereby imposing burden on healthcare, economy and the society as well. Patients’ and caregivers’ quality of life and life expectancy are greatly determined by the early diagnosis and the initiation of available symptomatic treatments. Cholinesterase inhibitors and memantine have been the cornerstones of Alzheimer’s therapy for approximately two decades and over the years, more and more experience has been gained on their use in non-Alzheimer’s dementias too. The aim of our work was to provide a comprehensive summary about the use of cholinesterase inhibitors and memantine for the treatment of Alzheimer’s and non-Alzheimers’s dementias.

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

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[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.]

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[Rehabilitation results after severe traumatic brain injury ]

DÉNES Zoltán, MASÁT Orsolya

[To assess the rehabilitation outcome after severe traumatic brain injury. Retrospective evaluation of the rehabilitation process and prospective follow-up five years after discharge. Patients – Patients treated in 2013 at the Traumatic Brain Injury Unit, National Institute for Medical Rehabilitation were included in the study (n = 232). Ninety-nine of 232 patients were treated with severe traumatic brain injury. Data were available for 66/99 patients (67%). Fifty patients (13 women and 37 men) were successfully contacted for follow-up (51%), three patients deceased. The mean age of the patients was 42 years (range: 22-72). The majority of them (36/50) was injured in traffic accidents. The mean duration of coma and post-traumatic amnesia were 19 (1-90) and 45 days (5-150), respectively. Patients were admitted for rehabilitation on the 44th (11-111) day after the injury and were rehabilitated for 95 days (10-335). Thirty-eight patients became independent at daily living activity during the rehabilitation period, and none during the follow-up. Two patients needed moderate and one a little help for the daily life. After successful rehabilitation 4 patients continued their higher education, 24 patients worked (six in sheltered, six in the original, 12 in other workplaces). Twenty-two patients did not have permanent jobs, two of whom were retired. The majority of the patients were successfully reintegrated into society. More than half of the patients returned to work or continued their studies. These successes were greatly facilitated by the 40 years of experience and the multidisciplinary team working in the National Institute for Medical Rehabilitation. ]

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[Rehabilitation possibilities and results after neurosurgical intervention of brain tumors ]

DÉNES Zoltán, TARJÁNYI Szilvia, NAGY Helga

[Objectives - Authors examined the rehabilitation possi­bi­lities, necessities, and results of patients after operation with brain tumor, and report their experiences. Method - Retrospective, descriptive study at the Brain Injury Rehabilitation Unit, in National Institute for Medical Rehabilitation. Patients - Patients were admitted consecutively after rehabilitation consultation, from different hospitals, following surgical intervention of brain tumors, between 01 January 2001 and 31 December 2016. Patients participated in a postacute inpatient rehabilitation program, in multidisciplinary team-work, leaded by Physical and Rehabilitation Medicine specialist included the following activities: rehabilitation nursing, physical, occupational, speech, psychological and neuropsychological therapy. Results - At the rehabilitation unit, in the sixteen-year period 84 patients were treated after operation with brain tumor. Patients arrived at the unit after an average of 41 days to the time of the surgical intervention (range: 10-139 days), and the mean length of rehabilitation stay was 49 days (range: 2-193 days). The mean age of patients was 58 years (20-91), who were 34 men and 50 women. The main symptoms were hemiparesis (64), cognitive problems (26), dysphagia (23), aphasia (16), ataxia (15), tetraparesis (5), and paraparesis (1). The mean Barthel Index at the time of admission was 35 points, whereas this value was 75 points at discharge. After the inpatient rehabilitation, 73 patients improved functionally, the status of 9 patients did not show clinically relevant changes, and 2 patients deteriorated. During the rehabilitation 10 patients required urgent interhospital transfer to brain surgery units, 9 patients continued their oncological treatment, two patients continued rehabilitation treatment at another rehabilitation unit, and after rehabilitation 73 patients were discharged to their homes. Conclusions - Inpatient rehabilitation treatment could be necessary after operation of patients with brain tumor especially when functional disorders (disability) are present. Consultation is obligatory among the neurosurgeon, rehabilitation physician and the patient to set realistic rehabilitation goals and determine place and method of rehabilitation treatment, but even at malignancies cooperation with oncological specialist also needed. Authors’ experience shows benefits of multidisciplinary rehabilitation for patients after brain tumor surgery. ]

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[Mental and physical health in light of health behaviours among sexual and gender minorities]

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[In a large proportion the reason behind enlisting both primary and secondary care are psychophysiologic disorders or symp­toms. In this current study we reviewed the literature regarding the physical and mental health of a subpopulation (sexual and gender minorities) and their patterns of health behavior. The literature examined in our study contains publications from January of 2009 to March of 2019. Based on the minority stress theory and the biopsychosocial model, the people from sexual and gender minorities face increased level of stress which affects their health and health behaviour in a negative way. Because of the factors mentioned above this group is more exposed to certain illnesses than the majority society – such conditions are cardiovascular diseases, lung diseases and several types of tumors and cancer. Furthermore the excess stress affects their psychological wellbeing and mental health. Summarizing the literature regarding the health and health behavior of people belonging to sexual and gender minorities our aim was to create an inventory of information for health care workers to help enhance the quality of care the members of these minorities receive. It could also support developement of cultural competence for the circle of professionals in education, law enforcement agencies, social care and health care system, in additional it might decreas health inequity.]