Clinical Neuroscience

[Data on temporal lobe symptomatology Pick's atrophy ]


JULY 01, 1963

Clinical Neuroscience - 1963;16(07)

[Three cases of Pick's atrophy in which atrophy spread from the primary shrinkage center in temporopolar to T, T, and Tz are described. Individual differences in the further pathway of atrophy were discernible: in case 1, it extended only to the frontal basis, in case 2, it extended additionally to F, and in case 3, it extended, albeit to a small extent, to the whole frontal convexity. In the first two cases, the atrophy was more pronounced on the left side, in the third on the right. The symptoms were partly the same in all three cases according to the common pathological lesions and partly variable from case to case according to the specific pathological lesions and the predominance of laterality. Common symptoms included initial mnestic disruption and subsequent severe dementia associated with bilateral temporal lobe atrophy and personality changes upon spread to the frontal base. Aphasic symptoms are modified not only by the predominance of the lesion on the lesion side, but also by the frontal spread. The aphasia in the period of temporal atrophy is transcortical motor typus; this was accompanied by echolalia in case 2 when the frontal supplementary motor regio was impaired. The "oral tendencies" and hypersexuality in our case 3 are similar to Klüver-Bucy syndrome and are probably related to particularly severe bilateral temporal atrophy.]


  1. Pécsi Orvostudományi Egyetem Ideg- és elmeklinikája



Further articles in this publication

Clinical Neuroscience

[Glioma behaviour in tissue culture III. Comparative study of in vivo irradiated gliomas ]

ZOLTÁN László, PÁLYI Irén, ÁFRA Dénes

[1. We performed a comparative study of four gliomas after first and recurrent surgery. Simultaneous tissue culture of the surgical material was performed. 2. Two patients operated on with glioblastoma multiforme and one with astrocytoma malignum received radiotherapy after the first surgery, whereas one patient operated on with astrocytoma malignum did not receive radiotherapy. 3. Irradiation resulted in a reduction in the ability of tumour cells to grow for longer periods of time in tissue culture, which was already reflected in the degeneration that occurred. The decrease in biological activity of irradiated tumour cells can be considered as a consequence of the radiation effect. 4. In one case, a malignant lesion was observed in non-irradiated tumour tissue after histological processing during recurrent surgery. 5. In one case, the activity of the tumour tissue removed at the first surgery showed a malignant astrocytoma in culture, which predicted a malignant lesion in the tissue removed at the second surgery. ]

Clinical Neuroscience

[Clinical group psychotherapy for neurotics]

HIDAS György

[Group psychotherapy uses a whole with new characteristics, created by the human social relationships and mutual interaction between the patients and the psychotherapist doctor, to heal. The conscious behaviour and psychotherapeutic work of the doctor play a crucial role. Psychotherapeutic groups for neurotic patients in hospital are open, heterogeneous, with 6-8 members Group psychotherapy is not only a therapeutic method but also a diagnostic one, and the development of interpersonal relationships is observed in statu nascendi. The structure of a psychotherapeutic group in a hospital setting is determined by the neurotic tendency factor and the need for addiction. This creates a formation centred around the group leader. A crucial stage of therapy is the transformation of the group structure into a group-centred group. This requires and brings with it the patients' sense of autonomy, active work and a greater sense of responsibility. A psychotherapy group is also a "working group", which works on solving the problems that arise in order to achieve recovery. There is a conflict between the working group and the need for addiction, with the psychotherapeutic doctor as the dynamic point of conflict. The doctor's task is to create a tolerant atmosphere in the group, to establish the modus operandi and to keep the group psychotherapy process moving with his interpretations. An optimal degree of negative or positive emotional tension is required in group psychotherapy. One source of negative tension is the conflict between the patient's need to receive and the doctor's refusal to do so. Therapeutic factors in group psychotherapy are: positive emotions between the doctor and the patient, universalisation, catharsis, reflective reactions, interpretations, intellectual and emotional insight, self-awareness and enrichment of knowledge, counselling, group reality testing. In the course of group psychotherapy, healthy, self-healing forces are mobilised, healthy adaptability increases, a sense of community is extended, and feelings of isolation are reduced. The doctor is involved in the group psychotherapy process in an emotional way. This is necessary in order to help patients adequately, but his perception may be disturbed by his emotions. The participation of an observing physician in a group psychotherapy session is a support and learning experience for the therapist. The results of group psychotherapy are: patients get to know each other better, the patient-physician relationship becomes more intense. The psychotherapeutic atmosphere of the ward is improved by channeling the patients' conflicts with the hospital and with each other. The patients' sense of community is strengthened and their interpersonal relationships improve. There is an opportunity to change the neurotic way of coping. The spontaneous interaction of patients, which often leads to negative effects, is used for healing in hospital through conscious intervention and guidance in group psychotherapy. ]

Clinical Neuroscience

[The "benign" form of multiple sclerosis]


[62 patients with multiple sclerosis are reported to be in the "benign" group of the disease. Cases of each of the three subgroups are described. Methods (palliative care, rehabilitation plan, etc.) are discussed to hope for a favourable outcome: stabilisation of the disease, making it stationary. The need to set up convalescent resorts and rehabilitation centres is stressed. Examples of the former are TB sanatoria and the latter poliomyelitis outpatient clinics.]

Clinical Neuroscience

[Minutes of the meeting]


[The VI. scientific meeting of the Hungarian EEG Society was held in Budapest on 8-9 February 1963. of the VI. meeting of the EEG.]

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We aimed to investigate the association between fluoxetine use and the survival of hospitalised coronavirus disease (COVID-19) pneumonia patients. This retrospective case-control study used data extracted from the medical records of adult patients hospitalised with moderate or severe COVID-19 pneumonia at the Uzsoki Teaching Hospital of the Semmelweis University in Budapest, Hungary between 17 March and 22 April 2021. As a part of standard medical treatment, patients received anti-COVID-19 therapies as favipiravir, remdesivir, baricitinib or a combination of these drugs; and 110 of them received 20 mg fluoxetine capsules once daily as an adjuvant medication. Multivariable logistic regression was used to evaluate the association between fluoxetine use and mortality. For excluding a fluoxetine-selection bias potentially influencing our results, we compared baseline prognostic markers in the two groups treated versus not treated with fluoxetine. Out of the 269 participants, 205 (76.2%) survived and 64 (23.8%) died between days 2 and 28 after hospitalisation. Greater age (OR [95% CI] 1.08 [1.05–1.11], p<0.001), radiographic severity based on chest X-ray (OR [95% CI] 2.03 [1.27–3.25], p=0.003) and higher score of shortened National Early Warning Score (sNEWS) (OR [95% CI] 1.20 [1.01-1.43], p=0.04) were associated with higher mortality. Fluoxetine use was associated with an important (70%) decrease of mortality (OR [95% CI] 0.33 [0.16–0.68], p=0.002) compared to the non-fluoxetine group. Age, gender, LDH, CRP, and D-dimer levels, sNEWS, Chest X-ray score did not show statistical difference between the fluoxetine and non-fluoxetine groups supporting the reliability of our finding. Provisional to confirmation in randomised controlled studies, fluoxetine may be a potent treatment increasing the survival for COVID-19 pneumonia.

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

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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.

Clinical Neuroscience

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Clinical Neuroscience

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Sandhoff disease is a rare type of hereditary (autosomal recessive) GM2-gangliosidosis, which is caused by mutation of the HEXB gene. Disruption of the β subunit of the hexosaminidase (Hex) enzyme affects the function of both the Hex-A and Hex-B isoforms. The severity and the age of onset of the disease (infantile or classic; juvenile; adult) depends on the residual activity of the enzyme. The late-onset form is characterized by diverse symptomatology, comprising motor neuron disease, ataxia, tremor, dystonia, psychiatric symptoms and neuropathy. A 36-year-old female patient has been presenting progressive, symmetrical lower limb weakness for 9 years. Detailed neurological examination revealed mild symmetrical weakness in the hip flexors without the involvement of other muscle groups. The patellar reflex was decreased on both sides. Laboratory tests showed no relevant alteration and routine electroencephalography and brain MRI were normal. Nerve conduction studies and electromyography revealed alterations corresponding to sensory neuropathy. Muscle biopsy demonstrated signs of mild neurogenic lesion. Her younger brother (32-year-old) was observed with similar symptoms. Detailed genetic study detected a known pathogenic missense mutation and a 15,088 base pair long known pathogenic deletion in the HEXB gene (NM_000521.4:c.1417G>A; NM_000521:c.-376-5836_669+1473del; double heterozygous state). Segregation analysis and hexosaminidase enzyme assay of the family further confirmed the diagnosis of late-onset Sandhoff disease. The purpose of this case report is to draw attention to the significance of late-onset Sandhoff disease amongst disorders presenting with proximal predominant symmetric lower limb muscle weakness in adulthood.

Lege Artis Medicinae

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