Clinical Neuroscience

[Diffuse cortical necrosis following pertussis]

CSERMELY Hubert1, FÁBER Viktor1

SEPTEMBER 01, 1959

Clinical Neuroscience - 1959;12(09)

[The neurological complications of pertussis are relatively rare but significant, with a third being fatal and, in some cases, permanent damage if survival is not achieved. (1) haemorrhage into the subdural or subarachnoid space and massive interacerebral haemorrhage, or white matter ring and globe haemorrhages, (2) cellular degenerations caused by anoxia-vascular damage, this is the true pertussis encephalopathy. 3. parainfectious encephalitis. The latter is the rarest, with only one authentic case known to date (Möller). Clinical detection of pertussis encephalopathy is more common, but pathological confirmation is rare. ]


  1. Gyöngyösi Városi Tanács Bugát Pál Kórháza és a Magyar Néphadsereg eü. szolgálata



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Clinical Neuroscience

[Anoxic brain findings in status epilepticus associated with acute alcohol intoxication]


[13-year-old boy died of acute alcohol poisoning 30-32 hours after poisoning. Clinical features were circulatory failure, decerebration and serial epileptic seizures. At autopsy, the brain was oedematous. Histopathologically, laminar necrosis was found extending over almost the entire cerebral cortex (except the area striata). Not only the cells of layers III and V were degenerated (mainly ischemic cell changes), but also the granule cells (shrinkage). The mesenchymal reaction was marked, but gliosis and marrow sheathing were not yet present, which testifies to the acute nature of the lesions. Cortical necrosis is considered to be a consequence of alcohol-induced status epilepticus.]

Clinical Neuroscience

[Clinical and EMG studies of spinal reflexes in preterm and mature infants]

FÉNYES István, GERGELY Károly, TÓTH Szabolcs

[1. The reflexes of "spinal automatism", namely the crossed extensor reflex, can only be triggered in normal preterm and mature newborns exceptionally, but not regularly, when tested with the techniques used so far. 2. Using a technique hitherto used only in animal experiments, the crossed extensor reflex can be elicited normally at very low stages of development of the nervous system. 3. The crossed inguinal extensor reflex, a variant of the crossed extensor reflex, decreases in intensity during ontogenetic development: it first appears in rudimentary forms and then gradually disappears and becomes clinically latent or clinically inactive during the first year of life. 4. EMG studies have shown that the crossed inguinal extensor reflex and the flexor reflex activate not only the muscles involved in the named reflexes but also their antagonists. 5. Thus, with the application of appropriate methodology, flexion and extensor reflexes can be elicited simultaneously at early stages of nervous system development. The phenomenon itself could be called co-reflex.]

Clinical Neuroscience

[Symposium on current encephalitis]


[Symposium on current encephalitis with 60-65 experts from 14-15 countries Symposium (S) was held at the Institut de Médicine Tropicale in Antwerp, Belgium, at the initiative of the Belgian Centre Interuniversitaire de Recherche Neuropathologiques, with the support of the World Federation of Neurology and the US National Institute of Neurology and Blindness. Ludo van Bogáért was the conceptual founder, organiser and president of the S.]

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[What happens to vertiginous population after emission from the Emergency Department?]

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[Background – Dizziness is one of the most frequent complaints when a patient is searching for medical care and resolution. This can be a problematic presentation in the emergency department, both from a diagnostic and a management standpoint. Purpose – The aim of our study is to clarify what happens to patients after leaving the emergency department. Methods – 879 patients were examined at the Semmel­weis University Emergency Department with vertigo and dizziness. We sent a questionnaire to these patients and we had 308 completed papers back (110 male, 198 female patients, mean age 61.8 ± 12.31 SD), which we further analyzed. Results – Based on the emergency department diagnosis we had the following results: central vestibular lesion (n = 71), dizziness or giddiness (n = 64) and BPPV (n = 51) were among the most frequent diagnosis. Clarification of the final post-examination diagnosis took several days (28.8%), and weeks (24.2%). It was also noticed that 24.02% of this population never received a proper diagnosis. Among the population only 80 patients (25.8%) got proper diagnosis of their complaints, which was supported by qualitative statistical analysis (Cohen Kappa test) result (κ = 0.560). Discussion – The correlation between our emergency department diagnosis and final diagnosis given to patients is low, a phenomenon that is also observable in other countries. Therefore, patient follow-up is an important issue, including the importance of neurotology and possibly neurological examination. Conclusion – Emergency diagnosis of vertigo is a great challenge, but despite of difficulties the targeted and quick case history and exact examination can evaluate the central or peripheral cause of the balance disorder. Therefore, to prevent declination of the quality of life the importance of further investigation is high.]

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Clinical Neuroscience

[Is the implementation of Vojta therapy associated with faster gross motor development in children with cerebral palsy? ]


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Clinical Neuroscience

Life threatening rare lymphomas presenting as longitudinally extensive transverse myelitis: a diagnostic challenge

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Background and aims – Description of two cases of rare intravascular large B-cell lymphoma and secondary T-cell lymphoma diagnosed postmortem, that manifested clinically as longitudinally extensive transverse myelitis (LETM). We discuss causes of diagnostic difficulties, deceptive radiological and histological investigations, and outline diagnostic procedures based on our and previously reported cases. Case reports – Our first case, a 48-year-old female was admitted to the neurological department due to paraparesis. MRI suggested LETM, but the treatments were ineffective. She died after four weeks because of pneumonia and untreatable polyserositis. Pathological examination revealed intravascular large B-cell lymphoma (IVL). Our second case, a 61-year-old man presented with headache and paraparesis. MRI showed small bitemporal lesions and lesions suggesting LETM. Diagnostic investigations were unsuccessful, including tests for possible lymphoma (CSF flow cytometry and muscle biopsy for suspected IVL). Chest CT showed focal inflammation in a small area of the lung, and adrenal adenoma. Brain biopsy sample from the affected temporal area suggested T-cell mediated lymphocytic (paraneoplastic or viral) meningoencephalitis and excluded diffuse large B-cell lymphoma. The symptoms worsened, and the patient died in the sixth week of disease. The pathological examination of the presumed adenoma in the adrenal gland, the pancreatic tail and the lung lesions revealed peripheral T-cell lymphoma, as did the brain and spinal cord lesions. Even at histological examination, the T-cell lymphoma had the misleading appearance of inflammatory condition as did the MRI. Conclusion – Lymphoma can manifest as LETM. In cases of etiologically unclear atypical LETM in patients older than 40 years, a random skin biopsy (with subcutaneous adipose tissue) from the thigh and from the abdomen is strongly recommended as soon as possible. This may detect IVL and provide the possibility of prompt chemotherapy. In case of suspicion of lymphoma, parallel examination of the CSF by flow cytometry is also recommended. If skin biopsy is negative but lymphoma suspicion remains high, biopsy from other sites (bone marrow, lymph nodes or adrenal gland lesion) or from a simultaneously existing cerebral lesion is suggested, to exclude or prove diffuse large B-cell lymphoma, IVL, or a rare T-cell lymphoma.

Clinical Neuroscience

[Neuropsychological rehabilitation following acquired brain injury]

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