Clinical Neuroscience

[Symposium on current encephalitis]


SEPTEMBER 01, 1959

Clinical Neuroscience - 1959;12(09)

[Symposium on current encephalitis with 60-65 experts from 14-15 countries Symposium (S) was held at the Institut de Médicine Tropicale in Antwerp, Belgium, at the initiative of the Belgian Centre Interuniversitaire de Recherche Neuropathologiques, with the support of the World Federation of Neurology and the US National Institute of Neurology and Blindness. Ludo van Bogáért was the conceptual founder, organiser and president of the S.]



Further articles in this publication

Clinical Neuroscience

[Diffuse cortical necrosis following pertussis]


[The neurological complications of pertussis are relatively rare but significant, with a third being fatal and, in some cases, permanent damage if survival is not achieved. (1) haemorrhage into the subdural or subarachnoid space and massive interacerebral haemorrhage, or white matter ring and globe haemorrhages, (2) cellular degenerations caused by anoxia-vascular damage, this is the true pertussis encephalopathy. 3. parainfectious encephalitis. The latter is the rarest, with only one authentic case known to date (Möller). Clinical detection of pertussis encephalopathy is more common, but pathological confirmation is rare. ]

Clinical Neuroscience

[Anoxic brain findings in status epilepticus associated with acute alcohol intoxication]


[13-year-old boy died of acute alcohol poisoning 30-32 hours after poisoning. Clinical features were circulatory failure, decerebration and serial epileptic seizures. At autopsy, the brain was oedematous. Histopathologically, laminar necrosis was found extending over almost the entire cerebral cortex (except the area striata). Not only the cells of layers III and V were degenerated (mainly ischemic cell changes), but also the granule cells (shrinkage). The mesenchymal reaction was marked, but gliosis and marrow sheathing were not yet present, which testifies to the acute nature of the lesions. Cortical necrosis is considered to be a consequence of alcohol-induced status epilepticus.]

Clinical Neuroscience

[Clinical and EMG studies of spinal reflexes in preterm and mature infants]

FÉNYES István, GERGELY Károly, TÓTH Szabolcs

[1. The reflexes of "spinal automatism", namely the crossed extensor reflex, can only be triggered in normal preterm and mature newborns exceptionally, but not regularly, when tested with the techniques used so far. 2. Using a technique hitherto used only in animal experiments, the crossed extensor reflex can be elicited normally at very low stages of development of the nervous system. 3. The crossed inguinal extensor reflex, a variant of the crossed extensor reflex, decreases in intensity during ontogenetic development: it first appears in rudimentary forms and then gradually disappears and becomes clinically latent or clinically inactive during the first year of life. 4. EMG studies have shown that the crossed inguinal extensor reflex and the flexor reflex activate not only the muscles involved in the named reflexes but also their antagonists. 5. Thus, with the application of appropriate methodology, flexion and extensor reflexes can be elicited simultaneously at early stages of nervous system development. The phenomenon itself could be called co-reflex.]

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Clinical Neuroscience

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.

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. ]

Lege Artis Medicinae

[Current issues in the peripartum management of diabetic women from the perspective of an internist-diabetologist]

KERÉNYI Zsuzsanna

[In pregnancy complicated with diabetes, treatment of hyperglycaemia is of fundamental importance during delivery in order to improve the outcome parameters of both the mother and the neonate. This is particularly important in the case of mothers with type 1 diabetes and of all mothers who require insulin treatment during their pregnancy. The use of antenatal steroids for women at risk of pre-term birth further complicates the treatment of hyperglycaemia in the period immediately before delivery and requires the appropriate change of insulin therapy. The requirement of nil per os in the delivery period necessitates proper fluid, glucose and insulin treatment in the pre-delivery hours. After surgical delivery the patients may also need infusion treatment until the first meal. As there is no unified guideline for the peripartum management of diabetes, the author re­views the international literature on the internal medicine issues concerning the peripartum treatment of pregnant women with diabetes. This study reviews the characteristics of insulin treatment of women with various types of diabetes before, du­ring and di­rect­ly after delivery. It presents a dosing schedule for women who needed an antenatal steroid treatment in the period before delivery due to premature birth for the purpose of lung maturation. The study also addresses the application and programming of pe­ripartum blood glucose tests, continuous interstitial glucose monitoring (CGM) and insulin pump treatment (CSII).]

Clinical Neuroscience

The effect of sniffing Turkish coffee on olfactory disorders in COVID-19 patients: An experimental clinical study


The current study aimed to examine the effect of sniffing Turkish coffee on the sense of smell in COVID-19 patients. This study utilized the experiment-control method. Data were collected using a patient and disease information form and the Connecticut Chemosensory Clinical Research Center (CCCRC) Test. An experimental group of patients sniffed Turkish coffee, and the coffee’s effect on the patients’ sense of smell was examined. All data were analyzed using SPSS version 25 (IBM). Of the patients in the experimental group, 25% had moderate hyposmia, 58.3% had severe hyposmia, and 16.7% had anosmia prior to sniffing Turkish coffee. After sniffing the Turkish coffee, 13.3% of these patients regained their ability to smell normally, while 18.3% had mild hyposmia, 45% had moderate hyposmia, 6.7% had severe hyposmia, and 16.7% had anosmia. There was no difference in the control group between first and second measurement. COVID-19 patients who sniffed Turkish coffee intermittently regained some of their sense of smell for one hour. Turkish coffee is cheap, fragrant, widely available, and easy to access. Therefore, results of this study suggest that it may be recommended for treating olfactory disorder in COVID-19 patients.

Clinical Neuroscience

[Covid-19 associated neurological disorders]

SZÔTS Mónika, PÉTERFI Anna, GERÖLY Júlia, NAGY Ferenc

[The clinical signs of SARS-CoV-2 infection has become more recognisable in recent times. In addition to common symptoms such as fever, cough, dyspnea, pneumonia and ageusia, less common complications can be identified, including many neurological manifestations. In this paper, we discuss three Covid-19 associated neurological disorders (Case 1: Covid-19 encephalitis, Case 2: Covid-19 organic headache, Case 3: SARS-CoV-2-infection and ischaemic stroke). We emphasize in our multiple case study that during the present pandemic, it is especially important for neurologists to be aware of the nervous system complications of the virus infection, thus saving unnecessary examinations and reducing the frequency of patients’ contact with health care personnel. ]