Clinical Neuroscience

[Pathophysiology of subacute encephalopathies]


OCTOBER 01, 1969

Clinical Neuroscience - 1969;22(10)

[The author concludes, on the basis of neuropathological studies, that the criteria for the classification of Creutzfeldt-Jakob disease and related conditions into groups, neither by the quality of histological lesions nor by their topographical distribution, are sufficiently certain to be implemented without objection. In the vast majority of cases, histopathological signs of subacute spongiform encephalopathy are present; the classic Creutzfedt-Jakob syndrome is rare. The nature of the lesions suggests exogenous pathogenesis, primarily through damage to astrocytes. He attributes histological signs suggestive of a pathogenetic responsibility of the circulatory, oxidative or vasodilator (area maxima near poles or at vascular boundaries) to general craniocerebral dynamics known in diffuse brain diseases and not primarily to pathological factors. It argues that Creutzfeldt-Jakob disease is a disorder distinct from Pick's and Alzheimer's disease. Nevertheless, there are difficulties in differentiating (circumscribed brain atrophy, argyrophilic lesions). In one case of amyotrophic dementia, hyaline inclusions were observed in motor neurons of the spinal cord.]


  1. Országos Ideg- és Elmegyógyintézet Neuropathologiai Laboratórium és az Orvostovábbképző Intézet Ideggyógyászati Tanszék



Further articles in this publication

Clinical Neuroscience

[Choosing how to explore in lumbar hernia operations, based on 373 cases over four years - 1965-1968]


[It is the authors' understanding that the most important criteria for the successful surgical treatment of lumbar hernias are the correct indication and timing of surgery, avoidance of myelography, minimal bone resection, but always complete root decompression. These criteria were applied in 373 operations between 1965 and 1968, with inter-arch exploration in 87.64% of cases. The situations which make each type of exploration possible or necessary are analysed. It is stressed that inter-arch exploration can be used to remove hernias causing cauda-unusual hernias and that this method of exploration can also be used in reoperations. ]

Clinical Neuroscience

[About granulomas in the dorsal root ganglia of the spinal cord]

BALÓ József

[In the study of spinal ganglion cysts, we have monitored granulomas that occur in the posterior gyri of the spinal cord. Although these granulomas also contain a chronic inflammatory component, they are also populated by endothelial, or more recently meningothelial, cells of the arachnoid. According to Verga and Rexed and Wennström, these granulomas are important as causative factors in the formation of cysts in spinal ganglia. Veith has observed granulomas in the root nerves in connection with chronic infectious diseases of other organs (chronic polyarthritis, chronic cholecystitis, and malignant tumours), which he considers to be of non-specific origin. He raised the question of whether Richter's tabes granulomas are specific or non-specific. In cases of pemphigus, granulomas similar to those described by Veith in various chronic infectious diseases occur in the dorsal root ganglia of the spinal cord. The question of whether Richter's specific syphilitic granulomas are identical to Veith's non-specific granulomas due to chronic infectious diseases needs further investigation. A similar finding was reported on the subject raised, that of a disease which started with chronic inflammation (tuboovarial abscess) and was associated with granulomas in the root nerves, the clinical course leading to death in the form of multiple neurotic gangrene of the skin.]

Clinical Neuroscience

Mélanoblastose et neurofibromatose

LUDO Van Bogaert

Les observations cliniques et génétiques rapportées indiquent que la blastomatose méningée et cutano-méningée, lorsqu'elle se présente comme une blastomatose isolable et sévère, entretient un lien, en apparence et surtout en familiarité, avec les dysplasies génétiques du système nerveux central. La conception mésoectodermique de l'ontogenèse de la mélanine explique non seulement l'apparition des neurinomes, des gliomes et des méningiomes, mais aussi la possibilité d'observer des processus mélaniques dans des phacomatoses telles que la neurofibromatose, la sclérose tubéreuse et l'angiomatose.

Clinical Neuroscience

[Encephalodystrophy progressiva paranatalis]


[The author analyses the histopathological picture of the subacute and chronic stages of paranatal asphyxia based on 3 observations. In the chronic stage, he suggests the name "status microcysticus" for the spongy loosening of the cortex and cortical bone, which should be distinguished from the van Bogaert and Leigh type "status spongiosus". The status microcysticus is the result of a functional or organic vascular lesion. Finally, he discusses Alpers' disease and considers that the majority of the findings to date do not correspond to Alpers' disease.]

Clinical Neuroscience

Oro-lingual dyskinesia: a neurological enigma


Author draws attention to a specialised dystonic syndrome involving mainly the muscles of the mouth, lips and tongue. Spasms can become so extensive that they can prevent the patient from writing, walking and standing. In particular, the muscles of the face and tongue may be affected. The pathogenesis and pathogenesis are not uniform. In the past, most cases of the disease were late complications of encephalitis. Nowadays this pathology is unlikely. Some cases strongly suggest a psychogenic origin, others are more likely to be of degenerative or ischaemic origin. This is particularly the case in elderly patients. Finally, in a proportion of cases, an organic syndrome due to unusual sensitivity to prolonged use of phenothiazides or other medications is likely.

All articles in the issue

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Clinical Neuroscience

The effect of starting a meal with salt and date palm on taste impairment caused by COVID-19


This study was conducted to examine the effect of starting a meal with salt and date palm on the sense of taste in COVID-19 patients. This study was conducted using a randomized controlled method. Patient and disease information forms and Visual Analog Scale were used for data collection. Salt and date palm were used to stimulate the sense of taste in two different experimental groups. No procedure was made in the control group except for the practice of the clinic. The results were analyzed using SPSS version 25. The mean ages of all groups were between 43.42 ± 8.60 and 47.22 ± 12.04 years. Fever, sore throat, dry mouth, cough, muscle weakness, and similar symptoms were present in all groups. Significant improvements were found in patients with hypoageusia and ageusia after date palm and salt application (p<0.01). For taste impairment caused by COVID-19, consumption of date palm and tasting very little salt for therapeutic purposes may help to alleviate taste impairment. Based on the data obtained from this study, the pathophysiology of the effects of date palm and salt on taste complications should be investigated.

Clinical Neuroscience

Uric acid: The role in the pathophysiology and the prediction in the diagnosis of Parkinson’s disease: A Turkish-based study

ARI Cagla Buse , TUR Kobak Esma , DOMAC Mayda Fusun , KENANGIL Ozgen Gulay

Oxidative stress has been associated as an essential contributor to the development of neurodegenerative diseases. Recent developments in the field of Parkinson’s Disease (PD) pathophysiology have led to a renewed interest in this field. As an antioxidant, uric acid (UA) has arisen as a potential neuroprotectant. Higher concentrations of UA are linked to reducing the risk of the development of the disease and preventing its progression. However, the expositions are unsatisfactory because the outcomes of these reports have not been consistent. This study is set out to assess the association of whether lower UA concentrations increased the PD risk by investigating its relationship with patients’ demographic and clinical data, and to determine whether previous studies are compatible with the Turkish-sampled population. Furthermore, we aimed to determine UA’s probability of being an early-stage diagnostic marker. A total of 305 patients and 100 healthy controls were included. Serum UA levels of patients and controls were compared with clinical features. We classified the patients into three motor subtypes and determined the disease severity by modified Hoehn&Yahr Staging Scale (mH&Y) and Unified Parkinson’s Disease Rating Scale (UPDRS). Standardized Mini-Mental State Examination (MMSE-TR) was assessed for cognition. There were not any significant differences of age and sex between patients and controls (p=0.030, p=0.132). The mean UA was 5.06±1.33 mg/dL in patients and 5.46±1.44 in controls, and a statistical significance was detected (p=0.022). The mean MMSE-TR were 24.83±4.35 in patients and 27.09±2.13 in controls, and statictical significance was revealed (p=0.001). The mean duration of the disease was 6.31±4.16 years, mean UPDRS scores were 59.74±22.33, and mH&Y scores were 2.29±0.91. In binary comparisons, patients with tremor-dominant motor subtype had lower UA concentrations than controls (p=0.014). ROC curve analysis revealed UA’s cut-off as ≤9.15, the specificity was 99.3, the sensitivity was 10.0, and the area under the curve was 0.576 (p<0.005). Regression analysis revealed age as an independent risk factor on UA values. Oxidative stress might be a factor in the development of PD, and UA may be a possible prospective protecting factor in the clinical course of the disease. However, it does not affect the severity. Our results support that lower uric acid concentrations are associated with PD; however, it is not a powerful indicator for predicting PD risk. As we reveal more about UA and its effect in further investigations, its significant role will become well-defined.

Clinical Neuroscience

TLR4 (Toll-like receptor-4) expression and frontal-cingulate volumes in schizophrenia

LI Hua, KÉRI Szabolcs

Evidence suggests that pathogen-associated pattern recognition receptors (Toll-like receptors, TLRs) are implicated in the pathophysiology of schizophrenia. TLRs are important in both peripheral immune responses and neuronal plasticity. However, the relationship between peripheral TLR expression and regional brain volumes is unknown in schizophrenia. We therefore assessed 30 drug-naïve, first-episode patients with schizophrenia. TLR4+/TLR1+ monocytes were measured using flow-cytometry. High resolution magnetic resonance images (T1 MRI) were obtained and analyzed with FreeSurfer. Results revealed significant negative correlations between the percentage of TLR4+ monocytes, mean fluorescent intensities, and brain volumes in frontal and anterior cingulate regions. The measures of TLR1+ monocytes did not show significant relationships with regional brain volumes. These results raise the possibility that abnormal TLR-activation is associated with decreased brain volumes in schizophrenia.

Clinical Neuroscience

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Acquired idiopathic generalised anhidrosis is an uncommon sweating disorder characterized by loss of sweating in the absence of any neurologic, metabolic or sweat gland abnormalities. Although some possible immunological and structural mechanisms have been proposed for this rare entity, the definitive pathophysiology is still un­clear. Despite some successfully treated cases with systemic corticosteroid application, the dose and route of steroid application are controversial. Here, we present a 41-year-old man with lack of genera­lised sweating who has been successfully treated with high dose pulse intravenous prednisolone. We have discussed his clinical and histopathological findings as well as the treatment options in view of the current literature.

Clinical Neuroscience

Fatal outcome of cervical myelopathy caused by fibrocartilaginous embolism. Rare cause of spinal vascular damage

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Fibrocartilaginous embolism is a rare cause of ischemic myelopathy. Authors report a case of a 39-year-old woman with progressive tetraparesis and severe autonomic dysfunction. Despite of the detailed examinations, the definite diagnosis was verified by autopsy. The patient was admitted because of progressive pain and numbness of the upper extremities and tetraparesis. Hypotonic muscles of the lower extremities with mild tetraparesis were observed. Magnetic resonance imaging showed an intramedullary lesion at the level of the cervical V-VII vertebral. Patient’s tetraparesis worsened gradually to plegia with urinary retention. Expansive, rapidly progressing multiple decubiti developed, which were resistant to therapy. In spite of the complex therapy, the patient died. No internal disease was found to explain the death by autopsy. Multiple subacute infarctions of the cervical myelon (involving the lateral columns as well) in the territory of the anterior spinal artery were verified by neuropathological examination. The occluded vessels were filled by a material containing cartilaginous cells, while signs of atherosclerosis or thrombosis were not present. Cartilaginous embolism of spinal arteries was diagnosed.