Clinical Neuroscience

[The aeromedical significance of electroencephalographic studies]

SZÁK János1

JANUARY 01, 1968

Clinical Neuroscience - 1968;21(01)

[1. It is necessary to stress that in the case of airplanes it is particularly important to look for correlations with the clinical in the case of anomalies. 2. We should not make a decision of unfitness based on eeg, findings alone. 3. We must make sure that the eeg. lesion found is permanent or temporary and make a decision on the basis of this information. 4. Because of the many questions that still need to be investigated, we cannot yet formulate a comprehensive opinion, even in the absence of sufficient material, and can only rely on our experience in the literature. 5. There is no doubt that seafarers with a definite history of epilepsy and organic neurological disorders are not suitable for the occupation, 6. Posterior delta, theta or polymorphic waveforms over the middle regions, especially if they are activating and if there is no neurological history and if the picture is mainly decrescendo, should not be considered as grounds for disqualification, subject to the necessary clinical examination. 7. Essentially the same is true for cases of left temporal focus if there is no detectable mental instability. In cases where there is, it is necessary to remove them from the job because of the latter. 8. Unilateral alpha, beta-reductions are not considered abnormal in the absence of other aspects. 9. The neurological clinic should make the judgement on the inventible, let us call them "functional" eeg. syndromes, if they manifest as signs of brainstem, diencephalic labilitas. 10. With regard to disorientation, if there is no otherwise excluding cause, e.g. narcolepsy, etc., a pathological judgement is not necessarily required. 11. For candidates, the assessment is stricter and we do not consider major irregularity, instability, ", functional" eeg. syndromes as suitable.]

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[Based on our experience with zoster cases, we have examined the spinal ganglia of 82 cases of pemphigus over the last 20 years to see if there are any phenomena that could explain the skin lesions. The lesions found, partly macroscopic but mainly histopathological, suggest that such a link between lesions in the spinal ganglia and skin disease exists. In addition to the acute signs of inflammation, there are also lesions that can be classified as chronic, such as those involving nerve fibres, nuclei, supporting tissue of the ganglia and lesions of the meninges. Diseases of the spinal ganglia are projected onto the skin, which makes pemphigus a cutaneous trophoneurosis. In addition to the morphological phenomena, the question is what aetiological factors are involved in its creation. This remains to be determined in the future. ]

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In drawing the foregoing generalisations it is necessary to realise their limitations. We must agree with the conclusions arrived at by Mitchell, who recognised at least three psychological categories: (1) the “calculating prodigies — who may be persons of inferior intellectual calibre and who rely upon ingenious shortcuts; (2) arithmetical prodigies like Colburn, and Dase, with a moderately well developed knowledge of arithmetic; and (3) mathematical geniuses, such as the elder Bidder. These are endowed with exceptional abilities, and their knowledge of pure mathematics is profound.

Clinical Neuroscience

Thorium granulomas in the brain

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Thorotrast was used in 1936 and 1937 to demonstrate the lesions of prefrontal lobotomy. Four patients came to autopsy after 10-22 years, and in each, one or more thorium granulomas were found. These masses ranged from 6 X 8 mm to 8X12 mm in size, were composed of hyaline material enclosed by a thick capsule of mixed connective and glia tissue, and surrounded in part by large phagocytes filled with thorium dioxide particles. Dense connective tissue developed in sulci where thorotrast escaped into the subarachnoid spaces, and marked gliosis with desquamation of the ependyma occurred when it entered the ventricles. The phagocytes in the cases with longer survival often showed vacant cavities where the nuclei should have been. Neurons in the vicinity showed no obvious lesions. The material was described as containing "a very strong thorium source.” It is believed that the alpha particles given off by the thorium are responsible for the formation of the granulomas and, after many years, for the death of the phagocytes. Thorium can safely be used in the brain only for the demonstration of cysts and abscesses which can then be completely removed. A case of such employment was described by Lehoczky in 1939.

Clinical Neuroscience

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L'observation que nous rapportons tire son intêret de la révélation extrêmement tardive (75 ans) d'un angiome de la moelle de type capillaire, resté jusque là cliniquement muet. Elle illustre la longue latence possible des mal formations vasculaires de la moelle, et elle montre qu'il faut toujours penser à cette étiologie devant une affection médullaire dont la cause nous échappe.

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Clinical Neuroscience

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