Clinical Neuroscience

[Fundus examinations in connection with electrohock]

KLIMES Károly1, ERŐSS Sándor1

JULY 29, 1952

Clinical Neuroscience - 1952;5(02)

[The introduction and use of cumulative electroshock (ES) in our clinic, in addition to the therapeutic results, has also provided an opportunity to further investigate the basic and concomitant phenomena of the spasm mechanism. In this brief, quasi-preliminary report, we describe the ocular fundus lesions associated with spasm. As the essence of shock therapy is seen by many authors (Abély, Delay, Morin, Gastant, Cain) in the stimulation of the diencephalon, and Krienberg and Eberhardt have drawn attention to the fundamental importance of cerebral blood circulation in the mechanism of shock, the study of the orbital vessels of the fundus is of prime importance. The behaviour of the fundus blood vessels provides an analogous picture of the probable identical behaviour of the cerebral blood vessels, and the vasovegetatively congruent state of the pupils and fundus blood vessels also provides information on the fluctuations of the vegetative tone.]

AFFILIATIONS

  1. Budapesti Orvostudományi Egyetem Elme- és Idegkórtani Klinikájának II. Sz. Szemészeti Klinikája

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Clinical Neuroscience

[A new version of Jacod's syndrome]

MARIA Filipowicz

[Brain symptoms in nasopharyngeal tumours were observed as early as the second half of the 19th century. Observations on the frequency of certain brain lesions have been supplemented by descriptions of the pathways by which nasopharyngeal tumours penetrate the inside of the skull. For some time there were two opposing views on the origin and development of tumours. According to some authors, the tumour originates either from the nasopharynx or from the connective tissue of the skull base, and thus invades the skull from the outside, destroying the cranial nerves in its path. Others have argued that, on the contrary, elements within the skull are the starting point of the tumour, and that the process in the nasopharynx is independent or has been considered as a tumour metastasis from the inside of the skull to the outside. Doubts in this respect have only been dispelled by detailed study. It was found that in the majority of cases the nasopharyngeal space was the starting point. ]

Clinical Neuroscience

[Schizophrenia in childhood]

LÓRÁND S. Blanka

[According to the prevailing psychiatric view, schizophrenia is rare in childhood, and some authors, such as Vogt and Weichbrodt, have denied that it occurs before adolescence. However, a critical review of the older literature on childhood psychosis leads to the conclusion that it is not so much the rarity of childhood schizophrenia as its recognition and correct pathology: in the older descriptions, we often find images of childhood schizophrenia that are typified by the current understanding. ]

Clinical Neuroscience

[Data for the pathogenesis of morphinismus]

GARTNER Pál, KELEMEN Endre

[Since December 1950, authors have performed morphine withdrawal treatment on 32 morphine users referred from the KEKSZ. Their procedure is as follows: morphine is withdrawn immediately. On the first day of withdrawal, the patient receives 0.1-0.1 ccm of 2% morphine intracutaneously into the flexor aspect of both forearms, for a total of 4 mg. The same is given for the next 3 days. The fifth day is a break. On the sixth and seventh days he receives the same again. In addition: on days 1-3-6, another 3-5-10 ccm of foreign group blood is given intravenously. If there is an obstacle to hetero-blood injection, 10 ccm Resactor is given intramuscularly instead. This procedure is used to minimise withdrawal symptoms, and mood correctors are rarely needed. Patients usually leave on day 10 with no symptoms or complaints. The pathogenesis of morphinism is thought to be essentially immunobiological. They consider their new withdrawal treatment to be intracutaneous desensitisation and attribute the success of the treatment to the reduction in tolerance induced by the binding of morphine antibodies. Hetero-blood or Resactor injections mobilise antibodies through their effect on the RES system, which enhances the efficacy of the treatment. Treatment does not resolve the issue of relapse. ]

Clinical Neuroscience

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Clinical Neuroscience

Cases of inborn errors of metabolism diagnosed in children with autism

CAKAR Emel Nafiye, YILMAZBAS Pınar

Autism spectrum disorder is a neurodevelopmental disorder with a heterogeneous presentation, the etiology of which is not clearly elucidated. In recent years, comorbidity has become more evident with the increase in the frequency of autism and diagnostic possibilities of inborn errors of metabolism. One hundred and seventy-nine patients with diagnosis of autism spectrum disorder who presented to the Pediatric Metabolism outpatient clinic between 01/September/2018-29/February/2020 constituted the study population. The personal information, routine and specific metabolic tests of the patients were analyzed retrospectively. Out of the 3261 patients who presented to our outpatient clinic, 179 (5.48%) were diagnosed with autism spectrum disorder and were included in the study. As a result of specific metabolic examinations performed, 6 (3.3%) patients were diagnosed with inborn errors of metabolism. Two of our patients were diagnosed with classical phenylketonuria, two with classical homocystinuria, one with mucopolysaccharidosis type 3D (Sanfilippo syndrome) and one with 3-methylchrotonyl Co-A carboxylase deficiency. Inborn errors of metabolism may rarely present with autism spectrum disorder symptoms. Careful evaluation of the history, physical examination and additional findings in patients diagnosed with autism spectrum disorder will guide the clinician in the decision-making process and chose the appropriate specific metabolic investigation. An underlying inborn errors of metabolism may be a treatable cause of autism.

Lege Artis Medicinae

[The author’s response to the comment on “Exploratory study of outcomes of blood sample mass examinations by rank correlations”]

Clinical Neuroscience

[The connection between the socioeconomic status and stroke in Budapest]

VASTAGH Ildikó, SZŐCS Ildikó, OBERFRANK Ferenc, AJTAY András, BERECZKI Dániel

[The well-known gap bet­ween stroke mortality of Eastern and Western Euro­pean countries may reflect the effect of socioeconomic diffe­rences. Such a gap may be present between neighborhoods of different wealth within one city. We set forth to compare age distribution, incidence, case fatality, mortality, and risk factor profile of stroke patients of the poorest (District 8) and wealthiest (District 12) districts of Budapest. We synthesize the results of our former comparative epidemiological investigations focusing on the association of socioeconomic background and features of stroke in two districts of the capital city of Hungary. The “Budapest District 8–12 project” pointed out the younger age of stroke patients of the poorer district, and established that the prevalence of smoking, alcohol-consumption, and untreated hypertension is also higher in District 8. The “Six Years in Two Districts” project involving 4779 patients with a 10-year follow-up revealed higher incidence, case fatality and mortality of stroke in the less wealthy district. The younger patients of the poorer region show higher risk-factor prevalence, die younger and their fatality grows faster during long-term follow-up. The higher prevalence of risk factors and the higher fatality of the younger age groups in the socioeconomically deprived district reflect the higher vulnerability of the population in District 8. The missing link between poverty and stroke outcome seems to be lifestyle risk-factors and lack of adherence to primary preventive efforts. Public health campaigns on stroke prevention should focus on the young generation of socioeconomi­cally deprived neighborhoods. ]

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[Association between cyclothymic affective temperament and hypertension]

NEMCSIK János, BATTA Dóra, KŐRÖSI Beáta, RIHMER Zoltán

[Affective temperaments (cyclothymic, hypertymic, depressive, anxious, irritable) are stable parts of personality and after adolescent only their minor changes are detectable. Their connections with psychopathology is well-described; depressive temperament plays role in major depression, cyclothymic temperament in bipolar II disorder, while hyperthymic temperament in bipolar I disorder. Moreover, scientific data of the last decade suggest, that affective temperaments are also associated with somatic diseases. Cyclothymic temperament is supposed to have the closest connection with hypertension. The prevalence of hypertension is higher parallel with the presence of dominant cyclothymic affective temperament and in this condition the frequency of cardiovascular complications in hypertensive patients was also described to be higher. In chronic hypertensive patients cyclothymic temperament score is positively associated with systolic blood pressure and in women with the earlier development of hypertension. The background of these associations is probably based on the more prevalent presence of common risk factors (smoking, obesity, alcoholism) with more pronounced cyclothymic temperament. The scientific importance of the research of the associations of personality traits including affective temperaments with somatic disorders can help in the identification of higher risk patient subgroups.]

Lege Artis Medicinae

[Comment to the article titled “Exploratory study of outcomes of blood sample mass examinations by rank correlations”]