Clinical Neuroscience

[Seduxen treatment in certain neurological diseases (neurosis, pain, muscle spasm)]

LEHOCZKY Tibor1

DECEMBER 01, 1968

Clinical Neuroscience - 1968;21(12)

[Seduxen 5 mg tabl., produced by Kőbánya Pharmaceuticals, has been used in clinical therapeutic trials. Out of 100 patients in the ward, 77 were in different groups of neurasthenia, - neurosis, 7 patients were treated for pain caused by organic disease, 16 for muscle spasm and contracture. He discusses the 8 groups of neurasthenia-neurosis listed and finds that the highest improvement rates were in the reactiv and vasovegetative groups, 82.7% in the former and 83.3% in the latter. The overall improvement rate for all groups was 77.8%. The 75% improvement in neurasthenia anxiosa is highlighted, following the anxiolytic effect of diazepam highlighted by both foreign and national researchers. These results suggest that Seduxen is a very good tranquillant drug, which, at the right dose (3 X 14, 3 X 12, 3 X 1 tablets daily), has a sedative effect without side effects. Seduxen also has a direct analgesic and analgesic effect, not only in arthritis and arthrosis of various types, but also in polyneuritis, neuritis and neuralgia. Seduxen is an excellent muscle relaxant, which has been observed in 13 of its 16 organic patients to a marked degree and in three to a moderate degree; by reducing the dose sufficiently, a detrimental degree of muscle weakness can be avoided. Dose: 3x1/2 tablets daily is recommended as the initial dose, but in the vast majority of patients 3x1 tablets daily was adequate; in some cases 3x 14 tablets daily proved beneficial. Experience has shown that the side effects of Seduxen are mild, exceeding those of known tranquillant drugs only in cases of overdose or individual hypersensitivity. A certain degree of drowsiness is relatively common, but this, like muscle hypotension in paretic patients, can be avoided by reducing the dose appropriately. ]

AFFILIATIONS

  1. Fővárosi István Kórház Idegosztály

COMMENTS

0 comments

Further articles in this publication

Clinical Neuroscience

Principal stages in studying the problem of physiological mechanisms of mental activity in man

N. P. Bechtereva, A. Tchernysheva

Much of what happens in the brain during mental activity - especially in the most complex living tissue, the human brain - is still unclear. A major merit of the Pavlovian school is the elucidation of the physiological mechanisms that determine the diverse manifestations of the probable brain anatomofunctional schema of conditioned reflex activity, shedding light on the trait-, environment- and organism-dependent specificities of these mechanisms. An attempt has been made to adapt the conditional reflex methodology to humans in order to study higher nervous activity.

Clinical Neuroscience

[Serum glutamic acid oxaloacetic acid transaminase activity in muscle diseases]

LIPCSEY Attila, SZABADI Elemér, FEKETE Istvánné

[The authors measured GOT enzyme activity in serum from patients with muscle atrophy of various origins (myogenic and neurogenic atrophy) and in serum from individuals with various neurological diseases. Their experience has shown that in myogenic diseases, if the presence of other diseases associated with parenchymal breakdown can be excluded, the measurement of GOT activation can be used to support the myogenic nature of the process.]

Clinical Neuroscience

[Further studies to detect human-brain corticosteroid fractions]

FAZEKAS I. Gyula, FAZEKAS Attila

[1. Lobar pneumonia, sudden cardiac death from paralysis, sudden cardiac death from paralysis in alcoholic state, self-harm, lightning strike, apoplexy cerebri, carcinosis peritonei, isonicide poisoning, cyanide poisoning, barbiturate poisoning, CO poisoning, Wofatox poisoning, alcohol poisoning+freezing deaths 26-92 years of age from 5 brain areas of 18 people (11 males and 7 females) were extracted 1 1/2-10 h after death, paper chromatographed in Bush 5 system, followed by chromatography in 2 n NaOH and 0.1% tetrasolium blue 9: 1. Evaluation was based on the tetrasolium blue reaction, NaOH fluorescence, Rf. values, standards and native blue fluorescence. 2 Brain extracts were run with different amounts of tetrahydrocortisol, tetrahydrocortisol, cortisol, cortisone, corticosterone and 11-dehydrocorticosterone as standards. The brain areas tested were : 1. bridge+brain, 2. cerebellum, 3. cerebellar nuclei, 4. cerebral cortex, 5. cerebral white matter. 3. 10 corticosteroid fractions were identified in total, 6 fractions were all identical to the standards, the other 4 unidentified steroids were labelled X1, X2, X3, X4. 4. These steroids were detected in different qualities and quantities in different brain areas depending on the deaths. 5. cortisol (=hydrocortisone) was detected in almost all brain areas tested in all 18 cases. Cortisol was found in most brain areas of those who died of heart failure, self-harm, lightning, apoplexy cerebri and various poisonings, but could not be detected in brain areas of those who died of heart failure in an alcoholic state and of cyanide poisoning. Other fractions were present in varying numbers and quantities in different brain areas. 6. Most fractures and the largest number were found in the brain areas of those who died of carcinosis peritonei and pneumonia. Fewest fractures and least amount were found in brain areas of those who died of cardiac arrest in alcoholic state and various intoxications in alcoholic state, and alcohol poisoning + frostbite. 7. Consistent with our previous animal studies and our studies on human subjects, we observed in the present study that alcohol induced significantly fewer corticosteroid fractions and quantities in all areas of the human brain compared to those in the non-alcoholic state. 8. In the cases studied, the total steroid content of each brain area does not show a consistent quantitative pattern that is characteristic of each death. 9. No lawful correlations between age, sex, adrenal weight, body weight, body height and the quantity and quality of corticosteroid content in the brain were found. 10. No decrease in brain corticosteroid content within 10 hours after death was observed with increasing time.]

Clinical Neuroscience

[Tuberous sclerosis and Sturge - Weber disease co-incidence]

SZILÁRD János, MÉSZÁROS Endre

[Data from an in vivo 14-year-old female patient with predominant symptoms of tuberous sclerosis and concomitant lesions suggestive of Sturge-Weber disease are presented, along with a family history of multiple neurological lesions and tumour formation. In the context of the co-detection of two very rare conditions, we wished to draw attention to the importance of dealing with neuroectodermal disorders. We also review the literature on the various dysgenetic abnormalities associated with the two disorders. ]

Clinical Neuroscience

[Book review]

GOMBI Róza

[The author presents Bechtereva, N. P., Bondarchuk, A. N., Smirnov, B. M. and Trohachev, A. 1.: Physiology and pathophysiology of deep structures of the human brain.]

All articles in the issue

Related contents

Clinical Neuroscience

Fluoxetine use is associated with improved survival of patients with COVID-19 pneumonia: A retrospective case-control study

NÉMETH Klára Zsófia, SZÛCS Anna , VITRAI József , JUHÁSZ Dóra , NÉMETH Pál János , HOLLÓ András

We aimed to investigate the association between fluoxetine use and the survival of hospitalised coronavirus disease (COVID-19) pneumonia patients. This retrospective case-control study used data extracted from the medical records of adult patients hospitalised with moderate or severe COVID-19 pneumonia at the Uzsoki Teaching Hospital of the Semmelweis University in Budapest, Hungary between 17 March and 22 April 2021. As a part of standard medical treatment, patients received anti-COVID-19 therapies as favipiravir, remdesivir, baricitinib or a combination of these drugs; and 110 of them received 20 mg fluoxetine capsules once daily as an adjuvant medication. Multivariable logistic regression was used to evaluate the association between fluoxetine use and mortality. For excluding a fluoxetine-selection bias potentially influencing our results, we compared baseline prognostic markers in the two groups treated versus not treated with fluoxetine. Out of the 269 participants, 205 (76.2%) survived and 64 (23.8%) died between days 2 and 28 after hospitalisation. Greater age (OR [95% CI] 1.08 [1.05–1.11], p<0.001), radiographic severity based on chest X-ray (OR [95% CI] 2.03 [1.27–3.25], p=0.003) and higher score of shortened National Early Warning Score (sNEWS) (OR [95% CI] 1.20 [1.01-1.43], p=0.04) were associated with higher mortality. Fluoxetine use was associated with an important (70%) decrease of mortality (OR [95% CI] 0.33 [0.16–0.68], p=0.002) compared to the non-fluoxetine group. Age, gender, LDH, CRP, and D-dimer levels, sNEWS, Chest X-ray score did not show statistical difference between the fluoxetine and non-fluoxetine groups supporting the reliability of our finding. Provisional to confirmation in randomised controlled studies, fluoxetine may be a potent treatment increasing the survival for COVID-19 pneumonia.

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

Evaluation of the effectiveness of transforaminal epidural steroid injection in far lateral lumbar disc herniations

EVRAN Sevket, KATAR Salim

Far lateral lumbar disc herniations (FLDH) consist approximately 0.7-12% of all lumbar disc herniations. Compared to the more common central and paramedian lumbar disc herniations, they cause more severe and persistent radicular pain due to direct compression of the nerve root and dorsal root ganglion. In patients who do not respond to conservative treatments such as medical treatment and physical therapy, and have not developed neurological deficits, it is difficult to decide on surgical treatment because of the nerve root damage and spinal instability risk due to disruption of facet joint integrity. In this study, we aimed to evaluate the effect of transforaminal epidural steroid injection (TFESI) on the improvement of both pain control and functional capacity in patients with FLDH. A total of 37 patients who had radicular pain caused by far lateral disc herniation which is visible in their lumbar magnetic resonance imaging (MRI) scan, had no neurological deficit and did not respond to conservative treatment, were included the study. TFESI was applied to patients by preganglionic approach. Pre-treatment Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) scores of the patients were compared with the 3rd week, 3rd month and 6th month scores after the procedure. The mean initial VAS score was 8.63 ± 0.55, while it was 3.84 ± 1.66, 5.09 ± 0.85, 4.56 ± 1.66 at the 3rd week, 3rd month and 6th month controls, respectively. This decrease in the VAS score was found statistically significant (p = 0.001). ODI score with baseline mean value of 52.38 ± 6.84 was found to be 18.56 ± 4.95 at the 3rd week, 37.41 ± 14.1 at the 3rd month and 34.88 ± 14.33 at the 6th month. This downtrend of pa­tient’s ODI scores was found statistically significant (p = 0.001). This study has demonstrated that TFESI is an effective method for gaining increased functional capacity and pain control in the treatment of patients who are not suitable for surgical treatment with radicular complaints due to far lateral lumbar disc hernia.

Clinical Neuroscience

Comparison of direct costs of percutaneous full-endoscopic interlaminar lumbar discectomy and microdiscectomy: Results from Turkey

ÜNSAL Ünlü Ülkün, ŞENTÜRK Salim

Microdiscectomy (MD) is a stan­dard technique for the surgical treatment of lumbar disc herniation (LDH). Uniportal percutaneous full-endoscopic in­terlaminar lumbar discectomy (PELD) is another surgical op­tion that has become popular owing to reports of shorter hos­pitalization and earlier functional recovery. There are very few articles analyzing the total costs of these two techniques. The purpose of this study was to compare total hospital costs among microdiscectomy (MD) and uniportal percutaneous full-endoscopic interlaminar lumbar discectomy (PELD). Forty patients aged between 22-70 years who underwent PELD or MD with different anesthesia techniques were divided into four groups: (i) PELD-local anesthesia (PELD-Local) (n=10), (ii) PELD-general anesthesia (PELD-General) (n=10), (iii) MD-spinal anesthesia (MD-Spinal) (n=10), (iv) MD-general anesthesia (MD-General) (n=10). Health care costs were defined as the sum of direct costs. Data were then analyzed based on anesthetic modality to produce a direct cost evaluation. Direct costs were compared statistically between MD and PELD groups. The sum of total costs was $1,249.50 in the PELD-Local group, $1,741.50 in the PELD-General group, $2,015.60 in the MD-Spinal group, and $2,348.70 in the MD-General group. The sum of total costs was higher in the MD-Spinal and MD-General groups than in the PELD-Local and PELD-General groups. The costs of surgical operation, surgical equipment, anesthesia (anesthetist’s costs), hospital stay, anesthetic drugs and materials, laboratory wor­kup, nur­sing care, and postoperative me­dication diffe­red significantly among the two main groups (PELD-MD) (p<0.01). This study demonstrated that PELD is less costly than MD.

Clinical Neuroscience

Cholinesterase inhibitors and memantine for the treatment of Alzheimer and non-Alzheimer dementias

BALÁZS Nóra , BERECZKI Dániel, KOVÁCS Tibor

In aging societies, the morbidity and mortality of dementia is increasing at a significant rate, thereby imposing burden on healthcare, economy and the society as well. Patients’ and caregivers’ quality of life and life expectancy are greatly determined by the early diagnosis and the initiation of available symptomatic treatments. Cholinesterase inhibitors and memantine have been the cornerstones of Alzheimer’s therapy for approximately two decades and over the years, more and more experience has been gained on their use in non-Alzheimer’s dementias too. The aim of our work was to provide a comprehensive summary about the use of cholinesterase inhibitors and memantine for the treatment of Alzheimer’s and non-Alzheimers’s dementias.