Clinical Neuroscience

[Report on 2 months in the Republic of Romania]

VELOK Gyula1

MARCH 01, 1959

Clinical Neuroscience - 1959;12(03)

[The author reports on his experience of 2 months in the Republic of Romania.]


  1. Debrecen, Idegklinika



Further articles in this publication

Clinical Neuroscience

[Pathophysiological features of mental disorders in old age]


[We must admit that it is through histopathological research that we have arrived at the current classification of neurological diseases, or more precisely mental diseases, that occur in later life. The knowledge of the anatomical substratum has enabled us to distinguish arteriosclerotic dementia from dementias of old age. ]

Clinical Neuroscience

[EEG in patients undergoing haemispherectomy]


[We report on serial EEG studies of five patients, 3 of whom had infantile hemiplegia maintaining epilepsy and oligophrenia, and 2 of whom underwent haemispherectomy for diffuse malignant glioma. Atrophic cerebrum was characterized by a flat polyrhythmic dysrhythmic curve with no electromic response to sensory stimuli and no sleep stages. Preoperative electromagnetic seizure potentials of the "intact" side may not be a contraindication to surgery if the electromic epileptiform discharges of the atrophic side are more pronounced. After surgery, the clinical manifestations of epilepsy also improve, and in favourable cases the patient is seizure-free (if the preoperative seizure potentials of the intact side are secondary discharges.) Removal of abnormal structures may ensure normalization of the abnormal electromagnetic activity of otherwise intact preoperative images. ]

Clinical Neuroscience

[Psychopathological changes in chronic schizophrenic patients under LSD intoxication]


[In a chronic schizophrenic patient, a series of LSD experiments convinced us that LSD intoxication did not change the patient's underlying symptoms. The LSD psychosis, which could be induced in a healthy individual, combined with the patient's underlying symptoms. Within the merged picture, however, we also observed a modifying effect of LSD on the basic psychosis, which was manifested in changes in extensity and intensity without a qualitative difference. Increased LSD tolerance on successive days of administration has been reported in the literature (L. S. Cholden: in schizophrenics; H. Ishell: in narcomaniacs). Our studies confirm the experimental results of IV. A. Stoll and Anderson and Rawnsley. Toxic symptoms were neither quantitatively nor qualitatively proportional to the dose and the patient's baseline symptoms were also dose-independently enhanced or attenuated. In the development of model psychosis, the interacting forces of several constellative factors (changes in the dose administered, biological and psychopathological status, and experimental situation) must be taken into account. ]

Clinical Neuroscience

[The issue of schizophrenic thinking disorder]


[We attempted to analyse the symptoms and behaviour of a schizophrenic patient in the light of normal psychological criteria and psychopathological research findings. In our patient, besides a relative retention of emotional functions, a very advanced formal disturbance of thinking was observed. We investigated his performance in a specific situation and assessed this performance in such a way that the retention of emotional functions allowed for a relatively good performance. Moreover, we attempted to justify the failure to perform relatively well by the retained but irregular emotional reactios. In particular, we wished to emphasise the importance of using occupational therapy in appropriate cases, in the sense that it is perhaps permissible to generalise that in cases showing relative intactness of emotional life it may be attempted, all the more so since, as our case illustrates, abandonment of regular employment, even in such cases, results in a deepening of the disorder of thinking, i.e., progression of the pathology.]

Clinical Neuroscience

[Vascular effects of sleep and nicotinic acid]


[After reviewing the literature on the vascular response to nicotinic acid, the author thought it appropriate to examine the influence of a fundamental central function, sleep, on what was previously thought to be a purely peripheral response.]

All articles in the issue

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Clinical Neuroscience

Late simultaneous carcinomatous meningitis, temporal bone infiltrating macro-metastasis and disseminated multi-organ micro-metastases presenting with mono-symptomatic vertigo – a clinico-pathological case reporT

JARABIN András János, KLIVÉNYI Péter, TISZLAVICZ László, MOLNÁR Anna Fiona, GION Katalin, FÖLDESI Imre, KISS Geza Jozsef, ROVÓ László, BELLA Zsolt

Although vertigo is one of the most common complaints, intracranial malignant tumors rarely cause sudden asymmetry between the tone of the vestibular peripheries masquerading as a peripheral-like disorder. Here we report a case of simultaneous temporal bone infiltrating macro-metastasis and disseminated multi-organ micro-metastases presenting as acute unilateral vestibular syndrome, due to the reawakening of a primary gastric signet ring cell carcinoma. Purpose – Our objective was to identify those pathophysiological steps that may explain the complex process of tumor reawakening, dissemination. The possible causes of vestibular asymmetry were also traced. A 56-year-old male patient’s interdisciplinary medical data had been retrospectively analyzed. Original clinical and pathological results have been collected and thoroughly reevaluated, then new histological staining and immunohistochemistry methods have been added to the diagnostic pool. During the autopsy the cerebrum and cerebellum was edematous. The apex of the left petrous bone was infiltrated and destructed by a tumor mass of 2x2 cm in size. Histological reexamination of the original gastric resection specimen slides revealed focal submucosal tumorous infiltration with a vascular invasion. By immunohistochemistry mainly single infiltrating tumor cells were observed with Cytokeratin 7 and Vimentin positivity and partial loss of E-cadherin staining. The subsequent histological examination of necropsy tissue specimens confirmed the disseminated, multi-organ microscopic tumorous invasion. Discussion – It has been recently reported that the expression of Vimentin and the loss of E-cadherin is significantly associated with advanced stage, lymph node metastasis, vascular and neural invasion and undifferentiated type with p<0.05 significance. As our patient was middle aged and had no immune-deficiency, the promoting factor of the reawakening of the primary GC malignant disease after a 9-year-long period of dormancy remained undiscovered. The organ-specific tropism explained by the “seed and soil” theory was unexpected, due to rare occurrence of gastric cancer to metastasize in the meninges given that only a minority of these cells would be capable of crossing the blood brain barrier. Patients with past malignancies and new onset of neurological symptoms should alert the physician to central nervous system involvement, and the appropriate, targeted diagnostic and therapeutic work-up should be established immediately. Targeted staining with specific antibodies is recommended. Recent studies on cell lines indicate that metformin strongly inhibits epithelial-mesenchymal transition of gastric cancer cells. Therefore, further studies need to be performed on cases positive for epithelial-mesenchymal transition.

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.

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.]

Clinical Neuroscience

[Is the implementation of Vojta therapy associated with faster gross motor development in children with cerebral palsy? ]


[Vojta therapy has been reported as clinically beneficial for strength, movement and gross motor activities in individual cases and is being included within the second of three levels of evidence in interventions for cerebral palsy. The goal of this study is to understand the effect of Vojta therapy on the gross motor function. Our clinical trial followed a one group, pre-post design to quantify rates of changes in GMFM-88 after a two-months period undergoing Vojta therapy. A total of 16 patients were recruited. Post-intervention acceleration rates of GMFM-88-items acquisition (0.005; p<0.001) and Locomotor Stages (1.063; p<0.0001) increased significatively following Vojta the­rapy intervention. In this study, Vojta therapy has shown to accelerate the acquisition of GMFM-88-items and Loco­motor Stages in children with cerebral palsy younger than 18 months. Because functional training was not utilised, and other non-Vojta therapy intervention did not influence the outcome, Vojta therapy seems to activate the postural control required to achieve uncompleted GMFM-88-items. ]

Clinical Neuroscience

A variant of Guillain-Barre syndrome after SARS-CoV-2 vaccination: AMSAN

TUTAR Kaya Nurhan, EYIGÜRBÜZ Tuğba, YILDIRIM Zerrin, KALE Nilufer

Introduction - Coronavirus disease 2019 (COVID-19) is a respiratory infection that has rapidly become a global pandemic and vaccines against SARS-CoV-2 have been developed with great success. In this article, we would like to present a patient who developed Guillain-Barré syndrome (GBS), which is a serious complication after receiving the inactive SARS-CoV-2 vaccine (CoronaVac). Case report – A 76-year-old male patient presented to the emergency department with nine days of progressive limb weakness. Two weeks prior to admission, he received the second dose of CoronaVac vaccine. Motor examination revealed decreased extremity strength with 3/5 in the lower extremities versus 4/5 in the upper extremities. Deep tendon reflexes were absent in all four extremities. Nerve conduction studies showed predominantly reduced amplitude in both motor and sensory nerves, consistent with AMSAN (acute motor and sensory axonal neuropathy). Conclusion - Clinicians should be aware of the neuro­logical complications or other side effects associated with COVID-19 vaccination so that early treatment can be an option.