Clinical Neuroscience

[In memoriam Professor Ervin Paraicz (1927-2012)]

GYÖRGY Ilona

SEPTEMBER 30, 2012

Clinical Neuroscience - 2012;65(09-10)

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Clinical Neuroscience

[Multiple sclerosis coexisting with spinal cord ependymoma: a case report]

EYLEM Degirmenci

[Background - In this paper, we report a coexistence of multiple sclerosis and an intradural spinal cord tumor. Case report - A 34-year-old woman who had a history of relapsing-remitting multiple sclerosis for the last 15-years presented with acute sensory loss and spasticity in her left lower limb and her spinal magnetic resonance imaging study revealed an intradural spinal cord tumor in the lumbar spine, further diagnosed as ependymoma. Conclusion - We call attention to this rare association of MS and a spinal cord tumor, emphasizing the need for investigation of new symptoms during the evolution of MS.]

Clinical Neuroscience

[Burning sensation in oral cavity - burning mouth syndrome in everyday medical practice]

GERLINGER Imre

[Burning mouth syndrome (BMS) refers to chronic orofacial pain, unaccompanied by mucosal lesions or other evident clinical signs. It is observed principally in middle-aged patients and postmenopausal women. BMS is characterized by an intense burning or stinging sensation, preferably on the tongue or in other areas of the oral mucosa. It can be accompanied by other sensory disorders such as dry mouth or taste alterations. Probably of multifactorial origin, and often idiopathic, with a still unknown etiopathogenesis in which local, systemic and psychological factors are implicated. Currently there is no consensus on the diagnosis and classification of BMS. This study reviews the literature on this syndrome, with special reference to the etiological factors that may be involved and the clinical aspects they present. The diagnostic criteria that should be followed and the therapeutic management are discussed with reference to the most recent studies.]

Clinical Neuroscience

[Neuroophthalmology Judit Somlai, Tibor Kovács (eds)]

CSIBA László

Clinical Neuroscience

[A prospective study evaluating the clinical characteristics of cluster headache]

ERTSEY Csaba, VESZA Zsófia, BANGÓ Márta, VARGA Tímea, NAGYIDEI Diána, MANHALTER Nóra, BOZSIK György

[Introduction - Although cluster headache (CH) is one of the most severe human pain syndromes, its symptoms and therapeutic possibilities may be suboptimally recognised in current medical practice in Hungary. Aim - To present the clinical characteristics of CH based on a prospective study of patients attending the Headache Service of the Department of Neurology, Semmelweis University. Methods - We collected information about the symptoms, diagnosis and previous treatment of CH patients by filling in a 108-item questionnaire during outpatient visits. Results - In the 5-year period between 2004 and 2008 we obtained data from 78 CH patients (57 males and 21 females; mean age: 44.6±14.6 years). The male:female ratio did not change in subgroups based on disease onset (calendar years). Ninety-three percent considered CH the most severe pain state of their life. The pain was strictly unilateral, affecting the territory of the 1st trigeminal division in all patients. The attacks were accompanied by signs of ipsilateral cranial parasympathetic activation (lactimation 83%, conjunctival injection 67%, rhinorrhea 56%, nasal congestion 43%); less frequently, signs of sympathetic dysfunction (ptosis 48%, miosis 7%) were also present. Two patients had attacks showing the typical localisation, severity and time course of CH attacks, but not accompanied by autonomic phenomena. A considerable part of the patients also observed symptoms that are usually ascribed to migraine (nausea 41%, vomiting 18%, photophobia 68%, phonophobia 58%). This may have been instrumental in the fact that, regardless of the characteristic clinical symptoms, the diagnosis of CH took 10 years on average. At the time of their examination 63% of patients were not using adequate abortive medications and 59% did not have an adequate prophylactic measure. Discussion - Cluster headache is characterised by attacks of devastating pain that warrant an early diagnosis and adequate treatment. Our study underlines that information about the diagnosis and therapy of CH should be emphasized on occasions of neurology specialty training and continuing medical education.]

Clinical Neuroscience

[Hungarian neurologists, Gyula Donáth (1849-1944)]

HALÁSZ Péter

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[The theoretical background of peritoneal dialysis dates back to the 18th and 19th century. It was in 1923 when the first experimental and clinical experiences were summarised by Ganter from Munich. Of the Hungarian researchers Stephen Rosenak’s name can be mentioned, who was working in this field in Bonn in 1926 and later in London and New York. Obstacles to the spread of this treatment method was the lack of appropriate abdominal catheters, biocompatible solutions and equipment. The intermittent technique of the method was time consuming and, due to the conditions of that time, peritonitis frequently developed. The spread of the method was facilitated by the catheter constructed by Tenchkoff towards the end of the 1960s, the automatization of the treatment and later continuous ambulatory peritoneal dialysis (CAPD) described by Popovich and Moncrief. Further development of the method became possible by the use of the two-litre plastic bags instead of the bottled solution and later a twin-bag system employing the “flush before fill” technique. The occurrence of peritonitis developing during the treatment gradually decreased, in which Stephen I. Vas of Hungarian origin, working in Toronto as a professor of microbiology played an important role by constantly improving and modifying the principles of the therapy. Besides the infection in the abdominal cavity the bioincompatibility of the dialysis fluid presented another problem, which was solved by the use of essential amino acids, icodextrin instead of glucose and bicarbonate instead of lactate. By the turn of the century it became clear that the survival rate of peritoneal dialysis is very similar to that of hemodialysis in the second and third years following the treatment, while in relation to the quality of life it proved to be better. This observation has been proved in numerous clinical studies in the past decade and has been refined with regard to patients’ age, their primary and accompanying diseases. It is my intention to give account of the Hungarian experiences with peritoneal dialysis in the second part.]

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[In memoriam György Fényes (1924-1998)]

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