Clinical Neuroscience

[The issue of myelitis necroticans]

JUBA Adolf1, PÉTERFAI János1

MARCH 05, 1951

Clinical Neuroscience - 1951;4(01)

[The authors have reviewed two recent cases of myelitis necroticans, addressing questions of pathogenesis and aetiology and whether it is a distinct disease. It is concluded that the clinical presentation is variable and that the newer cases rarely agree completely with the original description. Histopathologically, necrosis of certain sections of the spinal cord is present in all cases, but, unlike in Foix and Alajouanine, it does not extend to the central part of the spinal cord and may also start higher up outside the lumbar sections. In many cases, the extra- and intraspinal vascular flow originally described is absent or modified and less marked. The vascular flow cannot be considered to play a primary role in the pathogenesis, but is a phenomenon parallel to the destruction of the spinal cord parenchyma. In the pathology, the infectious-inflammatory nature, given the absence of true tissue inflammation even in acute cases, cannot be confirmed and the spinal cord involvement is probably the result of various toxic agents. Thus, from a pathological point of view, it is not possible to speak of a single disease and the name "necrotising myelopathy" is justified instead of "myelitis necroticans".]

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  1. Gyulai Állami Kórház Elme-Idegosztálya

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[In a 29-year-old male patient, hyperhidrosis of the scalp and neck had persisted for 9 years in response to various stimuli, but most markedly to joint impulses. The hyperhidrosis was temporarily relieved by blockade with novocaine of the ggl. cervivale sup. and then surgically removed. This observation demonstrates that the efferent pathway of gustatory hyperhidrosis can be eliminated by sympathectomy, which is important evidence to refute the dual innervation hypothesis of sweat glands. ]

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