Clinical Neuroscience

[Schizophrenia in childhood]

LÓRÁND S. Blanka1

JULY 29, 1952

Clinical Neuroscience - 1952;5(02)

[According to the prevailing psychiatric view, schizophrenia is rare in childhood, and some authors, such as Vogt and Weichbrodt, have denied that it occurs before adolescence. However, a critical review of the older literature on childhood psychosis leads to the conclusion that it is not so much the rarity of childhood schizophrenia as its recognition and correct pathology: in the older descriptions, we often find images of childhood schizophrenia that are typified by the current understanding. ]

AFFILIATIONS

  1. Hárshegyi Állami Gyermek Ideg- és Elmeosztály

COMMENTS

0 comments

Further articles in this publication

Clinical Neuroscience

[A new version of Jacod's syndrome]

MARIA Filipowicz

[Brain symptoms in nasopharyngeal tumours were observed as early as the second half of the 19th century. Observations on the frequency of certain brain lesions have been supplemented by descriptions of the pathways by which nasopharyngeal tumours penetrate the inside of the skull. For some time there were two opposing views on the origin and development of tumours. According to some authors, the tumour originates either from the nasopharynx or from the connective tissue of the skull base, and thus invades the skull from the outside, destroying the cranial nerves in its path. Others have argued that, on the contrary, elements within the skull are the starting point of the tumour, and that the process in the nasopharynx is independent or has been considered as a tumour metastasis from the inside of the skull to the outside. Doubts in this respect have only been dispelled by detailed study. It was found that in the majority of cases the nasopharyngeal space was the starting point. ]

Clinical Neuroscience

[Data for the pathogenesis of morphinismus]

GARTNER Pál, KELEMEN Endre

[Since December 1950, authors have performed morphine withdrawal treatment on 32 morphine users referred from the KEKSZ. Their procedure is as follows: morphine is withdrawn immediately. On the first day of withdrawal, the patient receives 0.1-0.1 ccm of 2% morphine intracutaneously into the flexor aspect of both forearms, for a total of 4 mg. The same is given for the next 3 days. The fifth day is a break. On the sixth and seventh days he receives the same again. In addition: on days 1-3-6, another 3-5-10 ccm of foreign group blood is given intravenously. If there is an obstacle to hetero-blood injection, 10 ccm Resactor is given intramuscularly instead. This procedure is used to minimise withdrawal symptoms, and mood correctors are rarely needed. Patients usually leave on day 10 with no symptoms or complaints. The pathogenesis of morphinism is thought to be essentially immunobiological. They consider their new withdrawal treatment to be intracutaneous desensitisation and attribute the success of the treatment to the reduction in tolerance induced by the binding of morphine antibodies. Hetero-blood or Resactor injections mobilise antibodies through their effect on the RES system, which enhances the efficacy of the treatment. Treatment does not resolve the issue of relapse. ]

Clinical Neuroscience

[Fundus examinations in connection with electrohock]

KLIMES Károly, ERŐSS Sándor

[The introduction and use of cumulative electroshock (ES) in our clinic, in addition to the therapeutic results, has also provided an opportunity to further investigate the basic and concomitant phenomena of the spasm mechanism. In this brief, quasi-preliminary report, we describe the ocular fundus lesions associated with spasm. As the essence of shock therapy is seen by many authors (Abély, Delay, Morin, Gastant, Cain) in the stimulation of the diencephalon, and Krienberg and Eberhardt have drawn attention to the fundamental importance of cerebral blood circulation in the mechanism of shock, the study of the orbital vessels of the fundus is of prime importance. The behaviour of the fundus blood vessels provides an analogous picture of the probable identical behaviour of the cerebral blood vessels, and the vasovegetatively congruent state of the pupils and fundus blood vessels also provides information on the fluctuations of the vegetative tone.]

Clinical Neuroscience

[Foreign Language Summaries]

[A summary of the articles published in the issue in Russian and German]

All articles in the issue

Related contents

Clinical Neuroscience

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

BOCZÁN Judit, KLIVÉNYI Péter, KÁLMÁN Bernadette, SZÉLL Márta, KARCAGI Veronika, ZÁDORI Dénes, MOLNÁR Mária Judit

[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.]

Clinical Neuroscience

[Tracing trace elements in mental functions]

JANKA Zoltán

[Trace elements are found in the living organism in small (trace) amounts and are mainly essential for living functions. Essential trace elements are in humans the chromium (Cr), cobalt (Co), copper (Cu), fluorine (F), iodine (I), iron (Fe), manganese (Mn), molybdenum (Mo), selenium (Se), zinc (Zn), and questionably the boron (B) and vanadium (V). According to the biopsychosocial concept, mental functions have biological underpinnings, therefore the impairment of certain neurochemical processes due to shortage of trace elements may have mental consequences. Scientific investigations indicate the putative role of trace element deficiency in psychiatric disorders such in depression (Zn, Cr, Se, Fe, Co, I), premenstrual dysphoria (Cr), schizophrenia (Zn, Se), cognitive deterioration/de­mentia (B, Zn, Fe, Mn, Co, V), mental retardation (I, Mo, Cu), binge-eating (Cr), autism (Zn, Mn, Cu, Co) and attention deficit hyperactivity disorder (Fe). At the same time, the excess quantity (chronic exposure, genetic error) of certain trace elements (Cu, Mn, Co, Cr, Fe, V) can also lead to mental disturbances (depression, anxiety, psychosis, cognitive dysfunction, insomnia). Lithium (Li), being efficacious in the treatment of bipolar mood disorder, is not declared officially as a trace element. Due to nutrition (drinking water, food) the serum Li level is about a thousand times less than that used in therapy. However, Li level in the red cells is lower as the membrane sodium-Li countertransport results in a Li efflux. Nevertheless, the possibility that Li is a trace element has emerged as studies indicate its potential efficacy in such a low concentration, since certain geographic regions show an inverse correlation between the Li level of drinking water and the suicide rate in that area. ]

Clinical Neuroscience

[Personalised epilepsy treatment]

ALTMANN Anna

[Epilepsy is one of the most common chronic neurological disease in childhood. Patients with epilepsy – even with so-called benign epilepsy – need medication for years. During this time, children go through a very big change, not only gaining weight and height, but also changing hormonal and metabolic processes. Maturation processes in different brain areas also take place at different rates depending on age. All of these should be considered when preparing a therapeutic plan. In everyday practice after the diagnosis of epilepsy, the applied drug is most often selected based on the shape and type of seizure. However, a number of other factors need to be considered when designing a therapeutic strategy: 1. efficacy (form of epilepsy, type of seizure), 2. age, gender, 3. pharmacological properties of the drug, 4. adverse drug reaction profile, 5. lifestyle (community), figure (skinny, corpulent, obese), 6. other comorbidities (nutrition, behavioral and learning problems, circulatory disorders, kidney or liver disease), 7. expected interactions with other drugs already used, 8. genetics, 9. other aspects (drug registration and prescription rules). The purpose of this article is to help to decide which antiepileptic drugs are expected to have the least side effects in a particular child with different comorbidities and which medications should be avoided if possible.]

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.

Lege Artis Medicinae

[The role of intergenerational stress in the background of anorexia nervosa]

TÚRY Ferenc, PÁSZTHY bea

[In childhood and adolescence, family therapy is a crucial therapeutic method in the treatment of anorexia nervosa. Among the family stress factors there are the tensions often too obvious between the parental and grandparental generations. Three case reports are presented, where the transgenerational tensions played an important role in the family of a young patient, suffering from anorexia nervosa. During the family therapy, the treat­ment of interrelated family stress factors and focusing on transgenerational relations proved to be crucial in the successful outcomes. While treating anorexia nervosa by family therapy there are not only important the recognition and treatment of tensions within the nuclear family, but also those of stressed relations emerging from grandparental generation through multigenerational transfer mechanisms. This treatment may be successful either with the grandparent’s inclusion, or exclusion. ]