Clinical Neuroscience

[On current problems in psychiatric methodology]

PETHŐ Bertalan1

SEPTEMBER 01, 1967

Clinical Neuroscience - 1967;20(09)

[Science is a systematically structured system. Today, the scientific status of psychiatry is threatened by the lack of a unified system for the many different views and schools of thought. The main reason for this critical situation is the lack of clarity of methodological problems. The methodological problem, taking into account its historical development, can be briefly outlined as follows. ]


  1. Budapesti Orvostudományi Egyetem II. sz. Neurológiai és Psychiatriai Klinikája



Further articles in this publication

Clinical Neuroscience

[Effect of anxiety on Achilles tendon reflex semi-relaxation time]

FEJÉR Arthur

[In states of anxiety, the duration of the f. r. i. of the Achilles reflex decreases, although the decrease rarely reaches the extent of the decrease in f. r. i. induced by hyperthyroidism. Both placebo injections and exam situations cause a decrease in f.r.i., but the latter effect is several times greater than the former. In a patient in a state of anxiety, 10 mg. Frenolone i.m. 1 hour after the sedative effect, a significant increase in f.r. i. is observed. This effect is significantly greater than that observed in normal controls after administration of the same dose of the drug. In hyperthyroid patients, the f.r. i. of 10 mg. Frenolone hardly alters the effect. The different behaviour of normal controls and hyperthyroid subjects from anxious patients is presumably due to the fact that Frenolone only favourably affects the central arousal associated with anxiety. During psychopharmacon therapy of anxious neurotic and psychotic patients, a gradual elongation of f.r. i. is observed as the patients calm down. This provides an opportunity to objectively monitor the effect of the therapy. ]

Clinical Neuroscience

[Valium (Diazepam) effects on epileptic crises and certain epileptic mechanisms]


[In addition to the generally observed good effect, we observed one case in which Valium worsened the epileptic mechanism (case 6). This observation seems to contradict the many reports in the literature that Valium has a good effect in petit mal and spike-wave mechanism. However, a distinction should be made between the different spike-wave mechanisms. In our other patient (case 3) we also observed a beneficial effect of Valium in spike-wave mechanism. However, this latter case was a spike-wave variant, slow spike-wave pattern. However, our case 6 showed a classic 3 c/s spike-wave pattern with clinical absances. It is not clear from the literature whether Valium is effective in all 3 c/s spike-wave mechanisms. Further experience in this direction is needed. Apart from the neuroleptic effect, no other "side effects" were observed. ]

Clinical Neuroscience

[Data for the Autogen Training methodology and indicative questions]

KORONKAI Bertalan, HORVÁTH Szabolcs

[The authors outline the main factors involved in the development, practice and spread of AT. They briefly describe Schultz's classical method. They describe in more detail the methodology they developed, which they applied to groups of 6-10 patients and in which they attach great importance to suggestive support. They share their experience with AT treatment, which they find useful for AT indicatio: all personality types except H and I are suitable for learning the exercises. Of the psychic symptoms, mood disorders, feelings of insecurity, inner tension and anxiety in particular improved, and of the autonomic disorders, sweating, tremor, hypertension, enteral disturbances, insomnia and cephalgia responded most favourably. Based on their experience, they discuss the current and perspectivicus possibilities of AT in their department. In their opinion, a gradual diffusion of AT treatment can be expected due to its advantages over other psychotherapeutic methodologies and for the practical and theoretical reasons discussed. ]

Clinical Neuroscience

[Persistent expansive-productive confabulatory image after contusio cerebri]


[The authors describe a 35-year-old male patient who developed a specific expansive confabulosis after contusio cerebri, which persisted and even progressed after the other symptoms of amnestic syndrome had resolved. The patient was re-examined 21 months after his first admission: the confabulosis persisted and was embedded in the symptoms of personality development suggestive of post-traumatic encephalopathy. The authors refer to their previous communication describing the medical history of four of their patients. Their new case analysis confirms their earlier findings and provides a catamnestic data set for this rare form of posttraumatic confabulosis. ]

Clinical Neuroscience

[Diffuse demyelinating giant cell reticulomascoma metastases ]

ÉDER Mária

[In a circumscribed case of metastatic reticulum sarcoma, severe oedema and demyelination were observed in both hemispheres. In the clinical picture, local symptoms attributable to the direct effect of the tumour were accompanied by bilateral hemisphaerial white matter lesions. In all cases of brain tumours, but especially in sarcoma metastases, bilateral symptoms should be considered not only bilateral tumour formation but also bilateral white matter oedema-necrosis.]

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Electrophysiological investigation for autonomic dysfunction in patients with myasthenia gravis: A prospective study


Myasthenia gravis (MG) is an autoimmune disorder of neuromuscular transmission. Autonomic dysfunction is not a commonly known association with MG. We conducted this study to evaluate autonomic functions in MG & subgroups and to investigate the effects of acetylcholinesterase inhibitors. This study comprised 30 autoimmune MG patients and 30 healthy volunteers. Autonomic tests including sympathetic skin response (SSR) and R-R interval variation analysis (RRIV) was carried out. The tests were performed two times for patients who were under acetylcholinesterase inhibitors during the current assessment. The RRIV rise during hyperventilation was better (p=0.006) and Valsalva ratio (p=0.039) was lower in control group. The SSR amplitudes were lower thereafter drug intake (p=0.030). As much as time went by after drug administration prolonged SSR latencies were obtained (p=0.043).Valsalva ratio was lower in the AchR antibody negative group (p=0.033). The findings showed that both ocular/generalized MG patients have a subclinical parasympathetic abnormality prominent in the AchR antibody negative group and pyridostigmine has a peripheral sympathetic cholinergic noncumulative effect.

Clinical Neuroscience

Atypical presentation of late-onset Sandhoff disease: a case report

SALAMON András , SZPISJAK László , ZÁDORI Dénes, LÉNÁRT István, MARÓTI Zoltán, KALMÁR Tibor , BRIERLEY M. H. Charlotte, DEEGAN B. Patrick , KLIVÉNYI Péter

Sandhoff disease is a rare type of hereditary (autosomal recessive) GM2-gangliosidosis, which is caused by mutation of the HEXB gene. Disruption of the β subunit of the hexosaminidase (Hex) enzyme affects the function of both the Hex-A and Hex-B isoforms. The severity and the age of onset of the disease (infantile or classic; juvenile; adult) depends on the residual activity of the enzyme. The late-onset form is characterized by diverse symptomatology, comprising motor neuron disease, ataxia, tremor, dystonia, psychiatric symptoms and neuropathy. A 36-year-old female patient has been presenting progressive, symmetrical lower limb weakness for 9 years. Detailed neurological examination revealed mild symmetrical weakness in the hip flexors without the involvement of other muscle groups. The patellar reflex was decreased on both sides. Laboratory tests showed no relevant alteration and routine electroencephalography and brain MRI were normal. Nerve conduction studies and electromyography revealed alterations corresponding to sensory neuropathy. Muscle biopsy demonstrated signs of mild neurogenic lesion. Her younger brother (32-year-old) was observed with similar symptoms. Detailed genetic study detected a known pathogenic missense mutation and a 15,088 base pair long known pathogenic deletion in the HEXB gene (NM_000521.4:c.1417G>A; NM_000521:c.-376-5836_669+1473del; double heterozygous state). Segregation analysis and hexosaminidase enzyme assay of the family further confirmed the diagnosis of late-onset Sandhoff disease. The purpose of this case report is to draw attention to the significance of late-onset Sandhoff disease amongst disorders presenting with proximal predominant symmetric lower limb muscle weakness in adulthood.

Lege Artis Medicinae

[A short chronicle of three decades ]


[Hungarian professional periodicals started quite late in European context. Their publish­ing, editing and editorial philosophy were equally influenced by specific historical and political situations. Certain breaking points of history resulted in termina­tion of professional journals (War of In­de­pendence 1848-1849, First and Se­cond World Wars), however there were pe­riods, which instigated the progress of sciences and founding of new scientific journals. Both trends were apparent in years after the fall of former Hungarian regime in 1990. The structure of book and journal publishing has changed substantially, some publishers fell “victim” others started successfully as well. The latters include the then-established publishing house Literatura Medica and its own scientific journal, Lege Artis Me­di­cinae (according to its subtitle: New Hun­garian Medical Herald) issued first in 1990. Its appearance enhanced significantly the medical press market. Its scientific publications compete with articles of the well-established domestic medical journals however its philosophy set brand-new trends on the market. Concerning the medical community, it takes on its problems and provides a forum for them. These problems are emerging questions in health care, economy and prevention, in close interrelation with system of public health institutions, infrastructure and situation of those providing individual health services. In all of them, Lege Artis Medicinae follows consequently the ideas of traditional social medicine.]

Lege Artis Medicinae

[Second game, 37th move and Fourth game 78th move]

VOKÓ Zoltán

[What has Go to do with making clinical decisions? One of the greatest intellectual challenges of bedside medicine is making decisions under uncertainty. Besides the psychological traps of traditionally intuitive and heuristic medical decision making, lack of information, scarce resources and characteristics of doctor-patient relationship contribute equally to this uncertainty. Formal, mathematical model based analysis of decisions used widely in developing clinical guidelines and in health technology assessment provides a good tool in theoretical terms to avoid pitfalls of intuitive decision making. Nevertheless it can be hardly used in individual situations and most physicians dislike it as well. This method, however, has its own limitations, especially while tailoring individual decisions, under inclusion of potential lack of input data used for calculations, or its large imprecision, and the low capability of the current mathematical models to represent the full complexity and variability of processes in complex systems. Nevertheless, clinical decision support systems can be helpful in the individual decision making of physicians if they are well integrated in the health information systems, and do not break down the physicians’ autonomy of making decisions. Classical decision support systems are knowledge based and rely on system of rules and problem specific algorithms. They are utilized widely from health administration to image processing. The current information revolution created the so-called artificial intelligence by machine learning methods, i.e. machines can learn indeed. This new generation of artificial intelligence is not based on particular system of rules but on neuronal networks teaching themselves by huge databases and general learning algorithms. This type of artificial intelligence outperforms humans already in certain fields like chess, Go, or aerial combat. Its development is full of challenges and threats, while it presents a technological breakthrough, which cannot be stopped and will transform our world. Its development and application has already started also in the healthcare. Health professionals must participate in this development to steer it into the right direction. Lee Sedol, 18-times Go world champion retired three years after his historical defeat from AlphaGo artificial intelligence, be­cause “Even if I become the No. 1, there is an entity that cannot be defeated”. It is our great luck that we do not need to compete or defeat it, we must ensure instead that it would be safe and trustworthy, and in collaboration with humans this entity would make healthcare more effective and efficient. ]

Journal of Nursing Theory and Practice

[Assessing Quality of life of Women with Cervical Cancer After Treatment]


[To assess sexual function, functionality and quality of life in women with cervical cancer. Descriptive, cross-sectional, quantitative, non-random, purposive sampling of women (N=91) with FIGO stage I/II/III cervical cancer, more than 5 months after last treatment. The study used standard questionnaires with self-designed questions. Data were analysed using Microsoft Excel, descriptive and mathematical statistics (p<0.05). Completers who received radiotherapy scored significantly higher in functional status (p<0.05) and emotional function than those who did not receive radiotherapy (p<0.05). Completers with lower levels of emotional well-being were significantly more likely to have lower levels of sexual function and higher levels of gynaecological problems (p<0.05). Women affected by cervical cancer often experience somatic and psychological disturbances that reflect on quality of life associated with the disease and treatment.]