Clinical Neuroscience

[Lessons learned from 200 Andaxin treatments]

KARDOS György1, SIMKÓ Alfréd1

MAY 01, 1960

Clinical Neuroscience - 1960;13(05)

[In half a year (first half of 1959) 200 patients were treated with Andaxin. Our experience has shown that Andaxin has an excellent effect in abnormal experiential reactions, especially when the premorbid personality does not show abnormal, "psychopathic" features; in the latter case it has a more favourable effect than Hibernal (chlorpromazine) and Rausedyl (rauwolfia), an important factor being that the side-effects are fewer and considerably milder. Another important aspect in outpatient psychiatry is that the drug is non-toxic, practically harmless and not suicidal. In schizophrenic patients, chlorpromazines are more effective, but combination with Andaxin seems preferable when the clinical picture (mainly defect syndromes) is dominated by anxious or hostile irritability, or when a parkinsonoid syndrome or akathisia-like obsessive-compulsive hyperkinesia has developed. Andaxin can be a useful adjunct to the treatment of chronic alcoholics, cerebro sclerotic patients and parkinsonism. It is likely to be most effectively used in combination with Tofranil for depression and with chlorpromazine for manic states. Side effects are few and harmless. These include "adynamia" at the start of treatment, mild allergic reactions in about 5% of cases and, finally, three cases of "loss of tone" which are not well understood.]


  1. Fővárosi Ideggondozó Intézet



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[We report a case of brainstem syndrome associated with a right temporal tumour, partly as a reflex rhythm and partly of localisational significance.]

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[Experiences and conclusions from using Hirepin]


[My experience with Hirepin in 22 patients and the conclusions I have drawn from it are summarised below: 1. the potential for parkinsonoid symptoms caused by Hibernal and Rausedyl to occur is increased when the two drugs are used together, which is otherwise desirable, and sometimes inhibits further effective treatment. 2. The use of Hirepin, while retaining the psychopharmacological benefits of Hibernal 4- Rausedyl, virtually eliminates the occurrence of parkinsonoid symptoms. 3. Hirepin has produced psychiatric improvement above the level of Hibernal 4- Rausedyl that causes parkinsonoid symptoms without the above symptoms, so parkinsonoid symptoms are not a necessary concomitant of psychiatric improvement, but are a necessary indicator of the individually effective level of medication.]

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[Treatment of anaesthetic poisoning with beta-beta-methyl-ethyl glutarimide (Megimide) ]


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[Operated intracerebral haemorrhages]

HARASZTI Erzsébet, HULLAY József

[In addition to a brief review of the literature on intracerebral haemorrhages and their surgical management, we described the clinical and surgical management of 12 cases. The clinical picture is characterized by acute onset and bloody or xantochromic cerebrospinal fluid, the development of nodal symptoms and progressive intracranial pressure increase, which may be pathognomic for apoplexy in the case of advanced age and hypertension, otherwise most often for haemorrhage from cerebral haemorrhage, the latter especially when paroxysmal phenomena are present before the acute onset. The cause of bleeding in our cases was, according to the literature, hypertension, angioma, aneurysm, trauma and unknown cause. The surgical solution consisted of aspiration of the haemorrhage or excision of the hemorrhage from the capsule and, where possible, resolution of the occult lesion. Of 12 patients, none were lost after surgery and the outcome was satisfactory in 11 cases. Our conclusion on the question of surgery for non-hypertensive haemorrhages is the same as the general principles, but for hypertensive haemorrhages it avoids any generalised constraint on the choice of time. ]

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Evaluation of the effectiveness of transforaminal epidural steroid injection in far lateral lumbar disc herniations

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[Non-pharmacological prevention and treatment for postoperative delirium in elderly patients with hip fracture - a systematic review]

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[Delirium is defined as a disturbance of consciousness and cognition that develops over a short period of time and fluctuates over time. During the last decade, the number of publications dealing with different aspects of delirium have been grown. The key points in most articles are pharmacological prevention and treatment, but because the rise of health care expenditures, all activities, which cost-effectively support the care process, is getting more and more important. The aim of the study: The aim of this research is to review the non-pharmacological prevention and treatment possibilities of delirium in elderly patients undergoing hip surgery. Systematic review, using articles published between 1999 and 2019 in PubMed and Wiley Online Libraries. Non-pharmacologic treatments significantly reduced the incidence (p=0.003–0.045) and duration (p=0.009–0.03) of delirium. The interventions also contributed to decrease the number of episodes (p=0.03), and to make the symptoms lighter. Early mobilisation and adequate fluid and electrolyte intake are key factors in reducing the incidence of delirium. Measuring oxygen saturation and support, appropriate nutrition, effective pain treatment, minimizing drug-interactions, maintaining good sleep and managing sensory dysfunctions have an effect on incidence, duration and severity of delirium.]

Clinical Neuroscience

[Consensus statement of the Hungarian Clinical Neurogenic Society about the therapy of adult SMA patients]

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[Background – Spinal muscular atrophy (SMA) is an autosomal recessive, progressive neuromuscular disorder resulting in a loss of lower motoneurons. Recently, new disease-modifying treatments (two drugs for splicing modification of SMN2 and one for SMN1 gene replacement) have become available. Purpose – The new drugs change the progression of SMA with neonatal and childhood onset. Increasing amount of data are available about the effects of these drugs in adult patients with SMA. In this article, we summarize the available data of new SMA therapies in adult patients. Methods – Members of the Executive Committee of the Hungarian Clinical Neurogenetic Society surveyed the literature for palliative treatments, randomized controlled trials, and retrospective and prospective studies using disease modifying therapies in adult patients with SMA. Patients – We evaluated the outcomes of studies focused on treatments of adult patients mainly with SMA II and III. In this paper, we present our consensus statement in nine points covering palliative care, technical, medical and safety considerations, patient selection, and long-term monitoring of adult patients with SMA. This consensus statement aims to support the most efficient management of adult patients with SMA, and provides information about treatment efficacy and safety to be considered during personalized therapy. It also highlights open questions needed to be answered in future. Using this recommendation in clinical practice can result in optimization of therapy.]

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[In recent decades it has become increasingly important to involve patients in their diagnostic and treatment process to improve treatment outcomes and optimize compliance. By their involvement, patients can become active participants in therapeutic developments and their observations can be utilized in determining the unmet needs and priorities in clinical research. This is especially true in rare diseases such as Pompe disease. Pompe disease is a genetically determined lysosomal storage disease featuring severe limb-girdle and axial muscle weakness accompanied with respiratory insufficiency, in which enzyme replacement therapy (ERT) now has been available for 15 years. In our present study, patient reported outcome measures (PROMs) for individuals affected with Pompe disease were developed which included questionnaires assessing general quality of life (EuroQoL, EQ-5D, SF36), daily activities and motor performance (Fatigue Severity Score, R-PAct-Scale, Rotterdam and Bartel disability scale). Data were collected for three subsequent years. The PROM questionnaires were a good complement to the physician-recorded condition assessment, and on certain aspects only PROMs provided information (e.g. fatigue in excess of patients’ objective muscle weakness; deteriorating social activities despite stagnant physical abilities; significant individual differences in certain domains). The psychological effects of disease burden were also reflected in PROMs. In addition to medical examination and certain endpoints monitored by physicians, patient perspectives need to be taken into account when assessing the effectiveness of new, innovative treatments. With involvement of patients, information can be obtained that might remain uncovered during regular medical visits, although it is essential in determining the directions and priorities of clinical research. For all orphan medicines we emphasize to include patients in a compulsory manner to obtain general and disease-specific multidimensional outcome measures and use them as a quality indicator to monitor treatment effectiveness.]