Clinical Neuroscience

[Immunological test for idiopathic inflammatory myopathies]

HORVÁTH Rita1, ALZIRA A S Carvalmo2

MARCH 20, 1994

Clinical Neuroscience - 1994;47(03-04)

[Sceletal muscle biopsy specimens from patients with various inflammatory myopathies – dermatomyositis, polymyositis and inclusion body myositis – have been investigated by immunocytochemical methods with the help of monoclonal antibodies. Conclusions about the pathomechanism of these disorders were saught. In dermatomyositis the humoral immunity and the damage of the small vessels of muscle fibres may play an important role. The appearance of class I MHC antigens on diseased muscle may make the affected tissue a target for cytotoxic T8 cells, and may thus have a role in muscle fibre damage in polymyositis and inclusion body myositis.]


  1. Jahn Ferenc Kórház Organikus Ideggyógyászati Osztály, Budapest
  2. Department of Neuropathology, Radcliffe Infirmary, Oxfordshire Health Authority



Further articles in this publication

Clinical Neuroscience

[Young neurologists XI. forum]

[Correlation between carotid artery lesions and cerebral perfusion (Carotid Duplex scan and brain SPECT). Stenosis or dissection? Differential diagnostic issues in carotid circulation disorders. AVM diagnosed by 3D TCD. Possible diagnostic errors in supraaortic duplex UH scans and angiography. Causes of diagnostic errors in duplex ultrasound studies of the carotid arteries and ways to avoid them. The role of duplex ultrasonography in the surgical evaluation of common carotid artery occlusion (case report). Follow-up of Moyamoya disease with transcranial Doppler (TCD). Platelet function tests in the acute and chronic phase of cerebral circulatory disease. Multicausal cerebral circulatory disorders. Co-occurrence of parkinsonism and giant aneurysm (case report). Teratoma adultum, germinoma, spinal and cerebral metastases in the background of intermittent headache - 5-year patient follow-up Differential diagnosis of meningeal tumours. Extracranial tumours presenting with symptoms of brain metastasis. Pitfalls in the diagnosis of craniocervical transitional and high cervical space occupying processes. Diagnosis of benign spinal tumours. Spinal dermoid cyst - data on the aetiology of low back pain syndrome. Experimental and clinical potential of brain microdialysis. Treatment of multiple intracranial tumours. Tremor and reflex tests in Parkinson's disease. HMPAO SPECT studies in Parkinson's disease. Aurorix treatment in cases of Parkinson's syndrome complicated with depression. Drug therapy of Parkinson's syndrome with special reference to diurnal performance fluctuations. Jumex in the early phase of Parkinson's syndrome. Conductive education in parkinsonism. Use of biophysical methods in the study of the pathomechanism of neurological diseases. Large blind spot syndrome. Investigation of optokinetic nystagmus in solitary frontal laesio. Hypocalcaemia and epilepsy. Difficulties in the recognition of epileptic seizures. Hypnosis treatment in partial epilepsy. Migraine, depression, anxiety. Verbalization features of headaches. Fahr's disease in our class material. CT scanning of cerebral vascular lesions and differential diagnostic difficulties. Binswanger's disease. CT lesions in patients with psychopathological symptoms. The importance of 3D MR angiography in occlusive cerebral vascular disease. Comparative study of cervical large vessel imaging. Difficulties in the diagnosis of craniocervical transition in a case report. Differential diagnosis of spinal cord disease. History and epidemiology of Parkinson's disease. Recent data on the pathomechanism of parkinsonism; experimental therapies Diagnostic errors in Parkinson's syndrome. Sinemet CR - advances in drug therapy. Oxidant phenotype studies in Parkinson's syndrome patients. Madopar-HBS treatment of patients with Parkinson's syndrome. Co-occurrence of complicated migraine and idiopathic cerebral atrophy. Family study in adreno-leuko-dystrophy. Electrophysiological study of patients with anaemia perniciosa. Cartilage drift into the sacral dura sac. Results of electrophysiological studies in patients with Parkinson's syndrome. EMG-SCAN studies in patients with Parkinson's syndrome. A case of adult myotubular myopathy in our department. Advanced picture of Kugelberg-Welander syndrome. Immunological study of idiopathic inflammatory myopathies. Recessive generalized myotonia (Becker). Differential diagnosis of myotonia in a case report. Glossopharyngeal neuralgia with syncope. Familial occurrence of multisystemic atrophy. Apert syndrome in the light of modern diagnostics. Infant with Reit syndrome (video case presentation). Juvenile cardiogenic stroke. Sneddon syndrome. Cerebrovascular patients in our department in the first half of 1993. Cerebellar haemorrhages. Changes in the assessment of prognosis in the patient population of our department. A case of medial thalamic atrophy thought to be multiple sclerosis. Extrapyramidal damage caused by stroke. Cases of bilateral occipital lobular atrophy. Case of severe brainstem lesion (central pontine myelinolysis). Long-term follow-up of the cellular and humoral immune response in patients with multiple sclerosis. Current problems of Lyme borreliosis in our departmental practice. Listeria monocytogenes as a possible causative agent of purulent meningitis. Incidence of lower limb root pains causing diagnostic difficulty in our department. Peripheral neuropathy in hypereosinophilic syndrome. Eye movement disorders caused by brain stem diseases. Depression in patients with Parkinson's syndrome, with particular reference to the possibility of presuicidal syndrome (RINGEL).]

Clinical Neuroscience

[Dementia and related problems '93. an overview]


[Based on extensive investigations carried out the epidemiology of dementias in the last decade in Europe the methodology has become unified. The most important elements are: two-step screening in two time periods, population of 4000 or more, unified screening and diagnostic methods. The incidence was 1 p.c. established in the population between the ages of 60–64; the proportion nearly doubled in each 5 year period. Regarding the recently published risk factors of Alzheimer's disease (AD) the possible protective role of smoking and the low educational level seem to be very interesting. In the group of AAMI the biological life events as possible causative factors seem to be of importance. The functional assesment scale of Reisberg is reported from psychometric tests. An outline is given about the clinical diagnostic criteria of AD and vascular dementias based on the widely discussed system published on the latter in 1993. The problems of different clinical subtypes of AD with relevance to biochemical markers are discussed as are the diganostic criteria of Lewy body type dementia. A summary on some new etological results (genetic heterogenety, new possible ways of amyloidogenesis, glutamate-theory, etc.) is given. After highlihgting the importance of the different kinds of psychotherapy and mental training, social factors are stressed, and some ethical conflict situations (driving, coercive measures, etc.) are shortly presented.]

Clinical Neuroscience

[The history of Hungarian neurology (Part I)]


[Every nation has its great people of whom it is proud. In our country, intellectuals think that Hungarians are particularly talented in music and mathematics. However, our outstanding geneticist believes that the genetic background of different abilities is equal between nations and that the different results are caused by external circumstances. Indeed, the "accumulation" of great Hungarian conductors and musicians in the United States, and the careers of many Nobel Prize-winning mathematicians and physicists in the United States, were made possible by the fact that they had to leave their homeland for political reasons. Contrary to what is suggested above, the first 50 years of a very successful and internationally respected period of Hungarian neuroscience were hampered by these circumstances. All the more reason to appreciate the neurological output of this period. I would be glad if the readers of this work would share this opinion. I have selected those publications for illustration which appeared in the so-called 'world languages'. The only exceptions are monographs, theses and one or two major works, some of which have already been published in a foreign language. Due to the limitations of space, many areas of neuroscience could not be discussed. Thus, I have not been able to write about international greats in neuroanatomy such as Mihály Lenhossék, Apáthy, Szentágothai; about neurophysiologists, especially those working on the cochleovestibular system such as Hőgyes, Bárány, Békésy; about neuroendocrinology or about many details of neurochemistry. The importance of neurosurgery, which is closely related to our subject, calls for a separate presentation. A small monograph on the history of Hungarian neuroscience was published in 1976 by István Környey, a great teacher and scholar of Hungarian neurology. In 1992, Zoltán Nagy published a history of Hungarian neurology in the last century under the title Hungarian Neurology in The Last Century. These historical summaries were important precursors to my present work. ]

Clinical Neuroscience

[Voltage mapping studies of generalized spike- wave patterns associated with absence seizures]


[In this retrospective study, scalp electric fields of ictal generalized spike-wave discharges were analized by the so-called topographic voltage mapping method. The 17 patients displaying absences (with or without other seizures) belonged to different age groups and diverse epileptic syndromes. Main results: 1. Maps derived at the points of the spike and the wave components belong to different classes. A-type spikes show frontal, P-type spikes show posterior voltage maxima. Also atypical spike (map) configurations exist. 2. A spike maps frequently show a characteristic modification along the GSW pattern. 3. Waves can display bilateral (L) or medial (M) frontal voltage maxima. 4. At least in the time window of several weeks, the dominant spike map pattern and the pattern of the waveform was characteristic to each patient. Configurations of the different spike and wave components show some relation to a limited set of clinical data. The combination of A- spikes with L-waves was found in children who had , typical" absence- epilepsies. On the contrary, irregular spectrum of different spikes and M-waves was found in elder absence patients showing rather unfavorable course of their illness.]

Clinical Neuroscience

[Is there a relationship between CT morphology and the MMS scale achievements in patients with dementia?]

PÉK Márta, BARSI Péter, NAGY Zoltán

[An attempt is made to establish relationships between CT parameters and the achievements on the Mini Mental State (MMS) scale of patients suffering from various types of dementia. The results suggest that the Mini Mental State scores change together in Alzheimer's type of dementias, referring to the global deterioration of functions in contrast to the vascular type of dementias, where the scores on each item change independently of each other. In the combined examination of the two groups the parietal lobe and the volume of the ventricles showed mainly connection with the neuropsychological functions. ]

All articles in the issue

Related contents

Clinical Neuroscience

[Diagnosis and therapy of mitochondrial diseases]

PÁL Endre

[Mitochondrial diseases are a significant part of neuromuscular diseases. Majority of them is multisystemic disorder. The diagnosis can be established in more and more cases. Beyond the routine neurological examination imaging methods (MRI and MR-spectroscopy) and electrophysiology (EMG, ENG, EEG, evoked potential tests) might be helpful in setting the diagnosis. Raised blood lactate level supports the diagnosis. Muscle biopsy demonstrates mitochondrial abnormalities in the majority of cases. The positivity of genetic tests is low, because the amount of mitochondrial DNA alterations is different in tissues. Therefore other tissue than blood (mainly muscle) is necessary for genetic tests. The other reason is that the respiratory chain is under double -mitochondrial and nuclear - genetic control, and testing the nuclear genes are available only in selected laboratories. The treatment is limited, mainly symptomatic.]

Lege Artis Medicinae

[Rituximab therapy in idiopathic inflammatory myopathies]

BODOKI Levente, VINCZE Melinda, GRIGER Zoltán, CSONKA Tamás, CSERI Karolina, HORTOBÁGYI Tibor, DANKÓ Katalin

[Idiopathic inflammatory myopathies are systemic autoimmune diseases characterized by symmetrical weakness of proximal limb muscles. In the everyday practice it is not easy to treat idiopathic inflammatory myopathies. First-line therapy is based on corticosteroids. If there is no improvement in the symptoms and complaints in two months, a new immunosuppressant therapy has to be initiated. The aim of this summary is to present the biological agent rituximab in the therapy of this condition.]

Clinical Neuroscience

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

MAIHOUB Stefani, MOLNÁR András, CSIKÓS András, KANIZSAI Péter, TAMÁS László, SZIRMAI Ágnes

[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.]