Clinical Neuroscience

[The current state of family care for people with mental illness]

SAMU István1, BERTHOLD Magdolna1, SARKADI Ádám1, ANTAL Ilona1

DECEMBER 01, 1965

Clinical Neuroscience - 1965;18(12)

[It analyses the situation of the Balassagyarmat Hospital's tapeworm plant, in view of the changed conditions following the establishment of the production cooperatives. It concludes that the tentacle continues to be beneficial from the point of view of the patient's subjective attitude, therapy and patient retention. The objective conditions for its operation have tended to improve in recent times. It is also possible to employ patients who have failed in an occupational therapy institution. The environment and the occupation have led to a significant improvement in the condition of patients, especially when using modern, active treatments. The tentacle is inexpensive and could solve a significant part of our psychiatric bed occupancy problem. However, this function is hampered by scarce financial support - despite the objective endowment. ]

AFFILIATIONS

  1. Balassagyarmati Városi Tanács Kórháza Férfi Ideg- és Psychiatriai Osztálya

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Further articles in this publication

Clinical Neuroscience

[Data on the development of depersonalisation syndrome]

TAKÁCS László, VARGA Lajos

[The authors describe three patients in whom different factors were involved in the development of d. The first patient with d. experience was still on the track of neurosis. The second patient was integrated by defense mechanisms and protected himself for seven years from the harms of his environment, but a situational change - i.e. plus stress - decomposed him, delusions appeared and the pathology developed into paranoid psychosis. In the third patient, who grew up in an unusually difficult environment, a sudden insecurity of existence led to the onset of d. phenomena introduced by neurasthenia, and then, without delusions, he escaped into an autistic world in which his d. experiences dissolved, and only contact with the real world brought them back again. Authors have outlined through these three d. cases that regressive phenomena in psychopathological processes can sometimes stagnate for years at different stages depending on the situation. The individual can protect and reinforce his or her shaky psychic equilibrium for a time by means of a wide variety of defense mechanisms, often bizarre, as pathological switches. However, with the onset of new stresses, the tension of consciousness may diminish, thus deepening the regression, and in these new pathological connections, in the increasing regression and dissociation phenomena, psychosis can no longer be avoided. ]

Clinical Neuroscience

[About synkinesis]

PÁLVÖLGYI Richard

[The author describes the physiological and abnormal synkinesis of the limb and trunk muscles, after subdividing synkinesis into the areas of supply to the brain nerves. He describes a synkinesis triggered by the lateral movement of the tongue in one half of the platysma. He discusses synkinesis associated with stuttering and describes a case in which synkinesis was also detected in the right musc. biceps brachii prior to stuttering. Finally, he describes a case during recovery from emiparesis, synkinesis in the lower limb, associated with movement of the same side of the upper limb, which resolved after ten days. ]

Clinical Neuroscience

[Glioma optici nervi]

HAITS Géza, IRTÓ István

[The authors present a case of optic nerve glioma diagnosed by X-ray examination after a schematic literature review. They emphasize the importance of slice examination among the diagnostic radiographic procedures and point out the effectiveness of complex therapy, surgery and postoperative radiotherapy. ]

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[LAM 30: 1990–2020. Facing the mirror: Three decades of LAM, the Hungarian medicine and health care system]

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Clinical Neuroscience

Electrophysiological investigation for autonomic dysfunction in patients with myasthenia gravis: A prospective study

NALBANTOGLU Mecbure, AKALIN Ali Mehmet, GUNDUZ Aysegul, KIZILTAN Meral

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.

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

[The Comprehensive Aphasia Test in Hungarian]

ZAKARIÁS Lilla, RÓZSA Sándor, LUKÁCS Ágnes

[In this paper we present the Comprehensive Aphasia Test-Hungarian (CAT-H; Zakariás and Lukács, in preparation), an assessment tool newly adapted to Hungarian, currently under standardisation. The test is suitable for the assessment of an acquired language disorder, post-stroke aphasia. The aims of this paper are to present 1) the main characteristics of the test, its areas of application, and the process of the Hungarian adaptation and standardisation, 2) the first results from a sample of Hungarian people with aphasia and healthy controls. Ninety-nine people with aphasia, mostly with unilateral, left hemisphere stroke, and 19 neurologically intact control participants were administered the CAT-H. In addition, we developed a questionnaire assessing demographic and clinical information. The CAT-H consists of two parts, a Cognitive Screening Test and a Language Test. People with aphasia performed significantly worse than the control group in all language and almost all cognitive subtests of the CAT-H. Consistent with our expectations, the control group performed close to ceiling in all subtests, whereas people with aphasia exhibited great individual variability both in the language and the cognitive subtests. In addition, we found that age, time post-onset, and type of stroke were associated with cognitive and linguistic abilities measured by the CAT-H. Our results and our experiences clearly show that the CAT-H provides a comprehensive profile of a person’s impaired and intact language abilities and can be used to monitor language recovery as well as to screen for basic cognitive deficits in aphasia. We hope that the CAT-H will be a unique resource for rehabilitation professionals and aphasia researchers in aphasia assessment and diagnostics in Hungary. ]

Clinical Neuroscience

[What happens to vertiginous population after emission from the Emergency Department?]

MAIHOUB Stefani, MOLNÁR András, CSIKÓS András, KANIZSAI Péter, TAMÁS László, SZIRMAI Ágnes

[Background – Dizziness is one of the most frequent complaints when a patient is searching for medical care and resolution. This can be a problematic presentation in the emergency department, both from a diagnostic and a management standpoint. Purpose – The aim of our study is to clarify what happens to patients after leaving the emergency department. Methods – 879 patients were examined at the Semmel­weis University Emergency Department with vertigo and dizziness. We sent a questionnaire to these patients and we had 308 completed papers back (110 male, 198 female patients, mean age 61.8 ± 12.31 SD), which we further analyzed. Results – Based on the emergency department diagnosis we had the following results: central vestibular lesion (n = 71), dizziness or giddiness (n = 64) and BPPV (n = 51) were among the most frequent diagnosis. Clarification of the final post-examination diagnosis took several days (28.8%), and weeks (24.2%). It was also noticed that 24.02% of this population never received a proper diagnosis. Among the population only 80 patients (25.8%) got proper diagnosis of their complaints, which was supported by qualitative statistical analysis (Cohen Kappa test) result (κ = 0.560). Discussion – The correlation between our emergency department diagnosis and final diagnosis given to patients is low, a phenomenon that is also observable in other countries. Therefore, patient follow-up is an important issue, including the importance of neurotology and possibly neurological examination. Conclusion – Emergency diagnosis of vertigo is a great challenge, but despite of difficulties the targeted and quick case history and exact examination can evaluate the central or peripheral cause of the balance disorder. Therefore, to prevent declination of the quality of life the importance of further investigation is high.]