Clinical Neuroscience

[The role of neurolytic obturator nerve block to relieve pain due to cancer and osteoarthritis (in English language)]


JULY 22, 2009

Clinical Neuroscience - 2009;62(07-08)

[Neurolytic obturator nerve block have been performed successfully to relieve pain due to osteolytic metastases of pelvic bone since 1981 in our Pain Clinic. The analgesic effect of one block lasts from three to four months and can be repeated as required. Following the block the patient can go home one hour later. In 2008 we started to perform the neurolytic obturator nerve block to relieve pain due to degenerative osteoarthritis of hip joint. It is a good choice for those patients, who are not enough fit to be operated, or during the waiting time of hip replacement surgery.]



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[Pompe’s disease - Part I - Pathogenesis and clinical features]


[Pompe’s disease is an ultra-orphan disease caused by the deficiency of lysosomal alpha-glucosidase. At present, it is the only inherited muscle disorder, which can be treated by replacement of the enzyme. According to the natural course, early infantile and late childhood-juvenile-adult cases are known. Respiratory insufficiency, cardiomyopathy, and muscle hypotonia are cardinal symptoms/signs in infantile Pompe’s disease, while cardiomyopathy is absent in adult-onset cases. CK levels are always elevated in the sera of infantile patients. Hip-girdle dystrophy and orthopnoe should alert suspicion in adult patients. Diagnosis is established by decreased activity of the enzyme or mutational analysis. Muscle biopsy can be misleading in adult cases due to absence of glycogen in the examined specimen. In this review, we also discuss our experiences obtained by the treatment of three patients.]

Clinical Neuroscience

[In memoriam György Fényes (1924-1998)]

EMED Alexander

Clinical Neuroscience

[Removal of multiple thoracic dumbbell tumours through combined hemi-semi laminectomy and minimal invasive paraspinal approach]

PAPP Zoltán

[One third of the primary spinal tumours are neurinomas. These tumours most often located intraduralyextramedullary, but 15-25 percent of the cases, the tumour extends to the paraspinal region through the neuroforamina. Spinal manifestation of Schwann-cell tumours, usually neurofibromas, can be seen in neurofibromatosis. 31 years old female patient, suffering from NF1 was operated on with a Th 3-6 and Th 10-11 dumbbell tumours. At the first step the tumour mass, located in the spinal canal, was resected through a partial hemilaminectomy. At the second operation the extraspinal tumour was resected through a minimal invasive paraspinal approach. The author present the combined use of minimal invasive spine surgical technics and discuss the benefits and disadvantages of these approaches, compared to the standard surgical procedures.]

Clinical Neuroscience

[Factors affecting the development of chronic hydrocephalus following subarachnoid hemorrhage]


[Hydrocephalus is a common complication of aneurysmal subarachnoid hemorrhage. Numerous studies have dealt so far with the triggering cause of the chronic cerebrospinal fluid (CSF) absorptional and circulatory disorders. Despite the fact that these studies gave several different explanations, most of them agreed on the fact that the obstruction of CSF pathway has a crucial role in the development of the clinical feature. By examing three years’ clinical cases they the authors were trying to find out which are the factors that influence the development of the late hydrocephalus which succeeds the subarachnoid hemorrhage; moreover to find out if the incidence of the latter may be decreased by a continuous drainage of CSF which advances its purification. One hundred and seventy-one patients (one hundred and twenty-seven females) were treated by aneurysmal SAH at Department of Neurosurgery, University of Szeged between 2002 and 2005. The following parameters were recorded: gender, clinical state, risk factors (smoking, consuming alcohol and hypertension), the method and the time of surgical treatment as well as CSF drainage. The studies have shown that the risk of incidence of chronic hydrocephalus’s incidence were higher in men and in case of severe clinical state with severe SAH. The disturbed CSF circulation and/or absorption were positively correlated with consuming alcohol and hypertension, while smoking did not affect it. The rate of the incidence of chronic hydrocephalus among our patients was lower (5.8%) compared to the results of other studies (7-40%) suggests that disturbance of CSF circulation and/or absorption may be avoided in the majority of cases by continuous external ventricular or lumbar CSF drainage, which is applied routinly.]

Clinical Neuroscience

[High resolution sonography for the examination of peripheral nerves in vascular neuropathy]


[High-frequency sonography is a new method for the imaging of the peripheral nerves. In vasculitic neuropathy, pain or axonopathy can often prevent the lesion to be localized during electrophysiological examinations. There are only few informations in the literature about the ability of the sonography for localizing lesions in vasculitic neuropathy. High-frequency sonography helped in our two cases of mononeuritis multiplex and two cases of distal-symmetric polyneuropathy to put the diagnosis of a vasculitic neuropathy and was able to detect focal morphologic lesions which could not be identified electrophysiologically due to the axonopathy.]

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