Clinical Neuroscience

[Minutes of the meeting]

ÁDÁM György1, KUKORELLI Tibor1, ÁNGYÁN L.G.T. Sakhiulina2, GRASTYÁN E.2, KLINBERG F. 2, KARMOS G.2, CZOPF J.2, ENDRŐCZI E.3, LISSÁK K.3, HARTMAN G.3, NIKOLITS Ilona4, KERTAI Pál4, DÉSI Illés4, CZABALAI László4, MAGYAR István5, ASZALÓS Zoltán5, OBÁL F.6, MADARÁSZ I.7, ZOLTÁN Ö. T.7, FÖLDI M.7, FEHÉR Ottó8, MECHLER Ferenc8, HALÁSZ Péter8, KAJTOR F.9, ÓVÁRY I.10, ZSADÁNYI O.11, KASZÁS T.11, NAGY Tibor12, BOHÁR Anna12, WALSA Róbert13, RÁBAI Kálmán14, HASZNOS T. , FENYŐ E.15, ANTAL J.15, TOMKA Imre16, REMENÁR László16, FORNADI F.17, FRATER R.18, SZEGEDI L.17, SZENDE Otto19, NEMESSURI Mihály19, FÉNYES István20, BÖTSKEY O.21, KRECSÁNYI J.21

JULY 01, 1963

Clinical Neuroscience - 1963;16(07)

[The VI. scientific meeting of the Hungarian EEG Society was held in Budapest on 8-9 February 1963. of the VI. meeting of the EEG.]

AFFILIATIONS

  1. Budapest, Élettani Intézet
  2. Pécsi Orvostudományi Egyetem, Élettani Intézet
  3. Pécsi Élettani Intézet
  4. Budapesti Kórélettani Intézet és OKI
  5. Budapesti Honvéd Kórház
  6. Élettani Intézet és II. sz. Belklinika Szeged
  7. Élettani Intézet és II. sz. Belklinika, Szeged
  8. Debreceni Orvostudományi Egyetem, Élettani Intézet és Ideg-Elmeklinika
  9. Debreceni Orvostudományi Egyetem, Ideg-és Elmeklinika
  10. Debreceni Orvostudományi Egyetem, Ideg-Elmeklinika és Gyerekklinika
  11. Debreceni Orvostudományi Egyetem, Ideg-Elmeklinika és Gyermekklinika
  12. Budapesti Országos Ideg-Elmegyógyintézet
  13. Budapesti Központi Honvéd Kórház
  14. Budapesti MÁV Kórház
  15. Budapesti Orvostudományi Egyetem, Neurológiai Klinika
  16. Budapesti Országos Idegsebészeti Intézet
  17. Budapesti Orvostudományi Egyetem Elmegyógyászati Klinika
  18. Budapesti Orvostudományi Egytem Elmegyógyászati Klinika
  19. Budapesti Testnevelés-és Sportegészségügyi Intézet
  20. Országos Idegsebészeti Tudományos Intézet
  21. Szombathely Megyei Kórház

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Further articles in this publication

Clinical Neuroscience

[Glioma behaviour in tissue culture III. Comparative study of in vivo irradiated gliomas ]

ZOLTÁN László, PÁLYI Irén, ÁFRA Dénes

[1. We performed a comparative study of four gliomas after first and recurrent surgery. Simultaneous tissue culture of the surgical material was performed. 2. Two patients operated on with glioblastoma multiforme and one with astrocytoma malignum received radiotherapy after the first surgery, whereas one patient operated on with astrocytoma malignum did not receive radiotherapy. 3. Irradiation resulted in a reduction in the ability of tumour cells to grow for longer periods of time in tissue culture, which was already reflected in the degeneration that occurred. The decrease in biological activity of irradiated tumour cells can be considered as a consequence of the radiation effect. 4. In one case, a malignant lesion was observed in non-irradiated tumour tissue after histological processing during recurrent surgery. 5. In one case, the activity of the tumour tissue removed at the first surgery showed a malignant astrocytoma in culture, which predicted a malignant lesion in the tissue removed at the second surgery. ]

Clinical Neuroscience

[Clinical group psychotherapy for neurotics]

HIDAS György

[Group psychotherapy uses a whole with new characteristics, created by the human social relationships and mutual interaction between the patients and the psychotherapist doctor, to heal. The conscious behaviour and psychotherapeutic work of the doctor play a crucial role. Psychotherapeutic groups for neurotic patients in hospital are open, heterogeneous, with 6-8 members Group psychotherapy is not only a therapeutic method but also a diagnostic one, and the development of interpersonal relationships is observed in statu nascendi. The structure of a psychotherapeutic group in a hospital setting is determined by the neurotic tendency factor and the need for addiction. This creates a formation centred around the group leader. A crucial stage of therapy is the transformation of the group structure into a group-centred group. This requires and brings with it the patients' sense of autonomy, active work and a greater sense of responsibility. A psychotherapy group is also a "working group", which works on solving the problems that arise in order to achieve recovery. There is a conflict between the working group and the need for addiction, with the psychotherapeutic doctor as the dynamic point of conflict. The doctor's task is to create a tolerant atmosphere in the group, to establish the modus operandi and to keep the group psychotherapy process moving with his interpretations. An optimal degree of negative or positive emotional tension is required in group psychotherapy. One source of negative tension is the conflict between the patient's need to receive and the doctor's refusal to do so. Therapeutic factors in group psychotherapy are: positive emotions between the doctor and the patient, universalisation, catharsis, reflective reactions, interpretations, intellectual and emotional insight, self-awareness and enrichment of knowledge, counselling, group reality testing. In the course of group psychotherapy, healthy, self-healing forces are mobilised, healthy adaptability increases, a sense of community is extended, and feelings of isolation are reduced. The doctor is involved in the group psychotherapy process in an emotional way. This is necessary in order to help patients adequately, but his perception may be disturbed by his emotions. The participation of an observing physician in a group psychotherapy session is a support and learning experience for the therapist. The results of group psychotherapy are: patients get to know each other better, the patient-physician relationship becomes more intense. The psychotherapeutic atmosphere of the ward is improved by channeling the patients' conflicts with the hospital and with each other. The patients' sense of community is strengthened and their interpersonal relationships improve. There is an opportunity to change the neurotic way of coping. The spontaneous interaction of patients, which often leads to negative effects, is used for healing in hospital through conscious intervention and guidance in group psychotherapy. ]

Clinical Neuroscience

[Data on temporal lobe symptomatology Pick's atrophy ]

BALAJTHY Béla

[Three cases of Pick's atrophy in which atrophy spread from the primary shrinkage center in temporopolar to T, T, and Tz are described. Individual differences in the further pathway of atrophy were discernible: in case 1, it extended only to the frontal basis, in case 2, it extended additionally to F, and in case 3, it extended, albeit to a small extent, to the whole frontal convexity. In the first two cases, the atrophy was more pronounced on the left side, in the third on the right. The symptoms were partly the same in all three cases according to the common pathological lesions and partly variable from case to case according to the specific pathological lesions and the predominance of laterality. Common symptoms included initial mnestic disruption and subsequent severe dementia associated with bilateral temporal lobe atrophy and personality changes upon spread to the frontal base. Aphasic symptoms are modified not only by the predominance of the lesion on the lesion side, but also by the frontal spread. The aphasia in the period of temporal atrophy is transcortical motor typus; this was accompanied by echolalia in case 2 when the frontal supplementary motor regio was impaired. The "oral tendencies" and hypersexuality in our case 3 are similar to Klüver-Bucy syndrome and are probably related to particularly severe bilateral temporal atrophy.]

Clinical Neuroscience

[The "benign" form of multiple sclerosis]

LEHOCZKY Tibor, HALASY Margit

[62 patients with multiple sclerosis are reported to be in the "benign" group of the disease. Cases of each of the three subgroups are described. Methods (palliative care, rehabilitation plan, etc.) are discussed to hope for a favourable outcome: stabilisation of the disease, making it stationary. The need to set up convalescent resorts and rehabilitation centres is stressed. Examples of the former are TB sanatoria and the latter poliomyelitis outpatient clinics.]

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Clinical Neuroscience

[Sleep habits among preschool- and schoolchildren]

FUSZ Katalin, RITECZ Bernadett, BALOGH Brigitta, TAKÁCS Krisztina, SOMLAI Eszter, RAPOSA L. Bence, OLÁH András

[Objective - Our aim is to evaluate sleep habits, sleep quality and influencing factors among preschool- and schoolchildren. Method - Two questionnaires were recorded. Questionnaire 1 dealt with sleeping habits, breastfeeding and health behavior of preschool children and infant, and it contained the abbreviated version of the Children’s Sleep Habits Questionnaire. Questionnaire 2 dealt with health behavior and the application of sleep hygiene rules, as well as it contained the Athens Insomnia Scale. Subjects - We assessed a total of 1063 questionnaires: 516 kindergarten children participated in our online survey across the country; 547 primary and secondary school students participated in the 2nd questionnaire survey in Szolnok. Results - Parents’ observation shows that the average nighttime sleeping time of kindergarten children is 10 hours 20 minutes on weekdays and 10 hours 36 minutes on weekends. The most popular sleeping habits in kindergarten age: teal reading (65.1%) and co-sleeping (42.8%). Parents of infants used breastfeeding (50.4%) and rocking (43.2%) most frequently before sleep. Co-sleeping has a positive influence on the length of lactation. Among the preschool sleeping habits we have proved a number of positive effects of teal reading, while watching television have negative effects. The sleep quality of school-age children according to the Athens Insomnia Scale is 6.11 points (SD: 4.11), 19% of the children are insomniac. Their sleep time is 7 hours 31 minutes on weekdays and 9 hours 30 minutes on weekends. The usage of good health behavior and sleep hygiene rules positively influence sleep quality and sleep duration. Conclusions - With our results, we would like to draw the attention of children and parents to the importance of sleeping and using sleep hygiene rules.]

Clinical Neuroscience

The effects of 30 Hz, 50 Hz AND 100 Hz continuous theta burst stimulation via transcranial magnetic stimulation on the electrophysiological parameters in healthy individuals

OZDEMIR Zeynep, ACAR Erkan, SOYSAL Aysun

Transcranial magnetic stimulation is a non-invasive procedure that uses robust magnetic fields to create an electrical current in the cerebral cortex. Dual stimulation consists of administering subthre­shold conditioning stimulation (CS), then suprathreshold test stimulation (TS). When the interstimulus interval (ISI) is 1-6 msec, the motor evoked potential (MEP) decreases in amplitude; this decrease is termed “short interval intracortical inhibition” (SICI); when the ISI is 7-30 msec, an increase in MEP amplitude occurs, termed “short interval intracortical facilitation” (SICF). Continuous theta burst stimulation (cTBS), often applied at a frequency of 50 Hz, has been shown to decrease cortical excitability. The primary objective is to determine which duration of cTBS achieves better inhibition or excitation. The secondary objective is to compare 50 Hz cTBS to 30 Hz and 100 Hz cTBS. The resting motor threshold (rMT), MEP, SICI, and SICF were studied in 30 healthy volunteers. CS and TS were administered at 80%-120% and 70%-140% of rMT at 2 and 3-millisecond (msec) intervals for SICI, and 10- and 12-msec intervals for SICF. Ten individuals in each group received 30, 50, or 100 Hz, followed by administration of rMT, MT-MEP, SICI, SICF immediately and at 30 minutes. Greater inhibition was achieved with 3 msec than 2 msec in SICI, whereas better facilitation occurred at 12 msec than 10 msec in SICF. At 30 Hz, cTBS augmented inhibition and suppressed facilitation, while 50 Hz yielded less inhibition and greater inter-individual variability. At 100 Hz, cTBS provided slight facilitation in MEP amplitudes with less interindividual variability. SICI and SICF did not differ significantly between 50 Hz and 100 Hz cTBS. Our results suggest that performing SICI and SICF for 3 and 12 msec, respectively, and CS and TS at 80%-120% of rMT, demonstrate safer inhibition and facilitation. Recently, TBS has been used in the treatment of various neurological diseases, and we recommend preferentially 30 Hz over 50 Hz cTBS for better inhibition with greater safety and less inter-individual variability.

Clinical Neuroscience

Simultaneous subdural, subarachnoideal and intracerebral haemorrhage after rupture of a peripheral middle cerebral artery aneurysm

BÉRES-MOLNÁR Anna Katalin, FOLYOVICH András, SZLOBODA Péter, SZENDREY-KISS Zsolt, BERECZKI Dániel, BAKOS Mária, VÁRALLYAY György, SZABÓ Huba, NYÁRI István

The cause of intracerebral, subarachnoid and subdural haemorrhage is different, and the simultaneous appearance in the same case is extremely rare. We describe the case of a patient with a ruptured aneurysm on the distal segment of the middle cerebral artery, with a concomitant subdural and intracerebral haemorrhage, and a subsequent secondary brainstem (Duret) haemorrhage. The 59-year-old woman had hypertension and diabetes in her medical history. She experienced anomic aphasia and left-sided headache starting one day before admission. She had no trauma. A few minutes after admission she suddenly became comatose, her breathing became superficial. Non-contrast CT revealed left sided fronto-parietal subdural and subarachnoid and intracerebral haemorrhage, and bleeding was also observed in the right pontine region. The patient had leucocytosis and hyperglycemia but normal hemostasis. After the subdural haemorrhage had been evacuated, the patient was transferred to intensive care unit. Sepsis developed. Echocardiography did not detect endocarditis. Neurological status, vigilance gradually improved. The rehabilitation process was interrupted by epileptic status. Control CT and CT angiography proved an aneurysm in the peripheral part of the left middle cerebral artery, which was later clipped. Histolo­gical examination excluded mycotic etiology of the aneu­rysm and “normal aneurysm wall” was described. The brain stem haemorrhage – Duret bleeding – was presumably caused by a sudden increase in intracranial pressure due to the supratentorial space occupying process and consequential trans-tentorial herniation. This case is a rarity, as the patient not only survived, but lives an active life with some residual symptoms.

Clinical Neuroscience

[The long-term follow-up of enzyme replacement treatment in late onset Pompe disease]

MOLNÁR Mária Judit, BORSOS Beáta, VÁRDI Visy Katalin, GROSZ Zoltán, SEBÕK Ágnes, DÉZSI Lívia, ALMÁSSY Zsuzsanna, KERÉNYI Levente, JOBBÁGY Zita, JÁVOR László, BIDLÓ Judit

[Pompe disease (PD) is a rare lysosomal disease caused by the deficient activity of acid alpha-glucosidase (GAA) enzyme due to mutations in the GAA gene. The enzymatic deficiency leads to the accumulation of glycogen within the lysosomes. Clinically, the disease has been classically classified in infantile and childhood/adult forms. Presently cc. close to 600 mutations distributed throughout the whole gene have been reported. The c.-32-13T>G splice mutation that is very common in patients of Caucasian origin affected by the childhood/adult form of the disease, with an allelic frequency close to 70%. Enzyme replacement treatment (ERT) is available for the patients with Pompe disease (Myozyme). In this paper, we are presenting the long term follow up of 13 adult onset cases treated more than 5 years. The longest follow up was 15 years. To evaluate the treatment efficacy, the 6 minutes walking test (6MWT) and the respiratory functions were monitored annually. The analysis revealed that at the beginning of ERT for 3-4 years the 6MWT had been generally increasing, then it declined, and after 10 years it was lower in 77% of the cases than it had been at the start of the treatment. In 23% of the cases the 6MWT increased during the follow up time. Only one of the patients become wheelchair dependent during the follow-up period. The respiratory function showed similar results especially in supine position. A high degree of variability was observed among patients in their responses to the treatment, which only partially associated with the antibody titer against the therapeutic protein. The efficacy of the ERT was associated with the type of the disease causing mutation, the baseline status of the disease, the lifestyle and the diet of the patient. The long-term follow up of the patients with innovative orphan drugs is necessary to really understand the value of the treatment and the need of the patients.]

Clinical Neuroscience

Delirium due to the use of topical cyclopentolate hydrochloride

MAHMUT Atum, ERKAN Çelik, GÜRSOY Alagöz

Introduction - Our aim is to present a rare case where a child had delirium manifestation after instillation of cyclopentolate. Case presentation - A 7-year old patient was seen in our outpatient clinic, and cyclopentolate was dropped three times at 10 minutes intervals in both eyes. The patient suddenly developed behavioral disorders along with gait disturbance, and complained of visual hallucinations 20-25 minutes after the last drop. The patient was transferred to intensive care unit and 0.02 mg/kg IV. physostigmine was administered. The patient improved after minutes of onset of physostigmine, and was discharged with total recovery after 30 minutes. Conclusion - Delirium is a rare systemic side effect of cyclopentolate. The specific antidote is physostigmine, which can be used in severely agitated patients who are not responding to other therapies.