Clinical Neuroscience

[Treatment of anaesthetic poisoning with beta-beta-methyl-ethyl glutarimide (Megimide) ]

PATAKFALVI Albert1, DUS Vince2

MAY 01, 1960

Clinical Neuroscience - 1960;13(05)

[Authors report on the treatment of 13 patients with Megimide, mostly severe, some purely barbiturate, some combination intoxication. Megimide has the advantages of rapid onset of action, avoidance of side effects with careful dosing, and a very high therapeutic range of action. In our case, no toxic symptoms were observed with 1800 ml. ]


  1. Pécsi Orbostudományi Egyetem I. sz. Belklinika és Idegklinika
  2. Pécsi Orvostduományi Egyetem I- sz. Belklinika és Idegklinika



Further articles in this publication

Clinical Neuroscience

[Brainstem reflexes associated with temporal tumour]


[We report a case of brainstem syndrome associated with a right temporal tumour, partly as a reflex rhythm and partly of localisational significance.]

Clinical Neuroscience

[Experiences and conclusions from using Hirepin]


[My experience with Hirepin in 22 patients and the conclusions I have drawn from it are summarised below: 1. the potential for parkinsonoid symptoms caused by Hibernal and Rausedyl to occur is increased when the two drugs are used together, which is otherwise desirable, and sometimes inhibits further effective treatment. 2. The use of Hirepin, while retaining the psychopharmacological benefits of Hibernal 4- Rausedyl, virtually eliminates the occurrence of parkinsonoid symptoms. 3. Hirepin has produced psychiatric improvement above the level of Hibernal 4- Rausedyl that causes parkinsonoid symptoms without the above symptoms, so parkinsonoid symptoms are not a necessary concomitant of psychiatric improvement, but are a necessary indicator of the individually effective level of medication.]

Clinical Neuroscience

[Lessons learned from 200 Andaxin treatments]

KARDOS György, SIMKÓ Alfréd

[In half a year (first half of 1959) 200 patients were treated with Andaxin. Our experience has shown that Andaxin has an excellent effect in abnormal experiential reactions, especially when the premorbid personality does not show abnormal, "psychopathic" features; in the latter case it has a more favourable effect than Hibernal (chlorpromazine) and Rausedyl (rauwolfia), an important factor being that the side-effects are fewer and considerably milder. Another important aspect in outpatient psychiatry is that the drug is non-toxic, practically harmless and not suicidal. In schizophrenic patients, chlorpromazines are more effective, but combination with Andaxin seems preferable when the clinical picture (mainly defect syndromes) is dominated by anxious or hostile irritability, or when a parkinsonoid syndrome or akathisia-like obsessive-compulsive hyperkinesia has developed. Andaxin can be a useful adjunct to the treatment of chronic alcoholics, cerebro sclerotic patients and parkinsonism. It is likely to be most effectively used in combination with Tofranil for depression and with chlorpromazine for manic states. Side effects are few and harmless. These include "adynamia" at the start of treatment, mild allergic reactions in about 5% of cases and, finally, three cases of "loss of tone" which are not well understood.]

Clinical Neuroscience

[Operated intracerebral haemorrhages]

HARASZTI Erzsébet, HULLAY József

[In addition to a brief review of the literature on intracerebral haemorrhages and their surgical management, we described the clinical and surgical management of 12 cases. The clinical picture is characterized by acute onset and bloody or xantochromic cerebrospinal fluid, the development of nodal symptoms and progressive intracranial pressure increase, which may be pathognomic for apoplexy in the case of advanced age and hypertension, otherwise most often for haemorrhage from cerebral haemorrhage, the latter especially when paroxysmal phenomena are present before the acute onset. The cause of bleeding in our cases was, according to the literature, hypertension, angioma, aneurysm, trauma and unknown cause. The surgical solution consisted of aspiration of the haemorrhage or excision of the hemorrhage from the capsule and, where possible, resolution of the occult lesion. Of 12 patients, none were lost after surgery and the outcome was satisfactory in 11 cases. Our conclusion on the question of surgery for non-hypertensive haemorrhages is the same as the general principles, but for hypertensive haemorrhages it avoids any generalised constraint on the choice of time. ]

All articles in the issue

Related contents

Clinical Neuroscience

Fluoxetine use is associated with improved survival of patients with COVID-19 pneumonia: A retrospective case-control study

NÉMETH Klára Zsófia, SZÛCS Anna , VITRAI József , JUHÁSZ Dóra , NÉMETH Pál János , HOLLÓ András

We aimed to investigate the association between fluoxetine use and the survival of hospitalised coronavirus disease (COVID-19) pneumonia patients. This retrospective case-control study used data extracted from the medical records of adult patients hospitalised with moderate or severe COVID-19 pneumonia at the Uzsoki Teaching Hospital of the Semmelweis University in Budapest, Hungary between 17 March and 22 April 2021. As a part of standard medical treatment, patients received anti-COVID-19 therapies as favipiravir, remdesivir, baricitinib or a combination of these drugs; and 110 of them received 20 mg fluoxetine capsules once daily as an adjuvant medication. Multivariable logistic regression was used to evaluate the association between fluoxetine use and mortality. For excluding a fluoxetine-selection bias potentially influencing our results, we compared baseline prognostic markers in the two groups treated versus not treated with fluoxetine. Out of the 269 participants, 205 (76.2%) survived and 64 (23.8%) died between days 2 and 28 after hospitalisation. Greater age (OR [95% CI] 1.08 [1.05–1.11], p<0.001), radiographic severity based on chest X-ray (OR [95% CI] 2.03 [1.27–3.25], p=0.003) and higher score of shortened National Early Warning Score (sNEWS) (OR [95% CI] 1.20 [1.01-1.43], p=0.04) were associated with higher mortality. Fluoxetine use was associated with an important (70%) decrease of mortality (OR [95% CI] 0.33 [0.16–0.68], p=0.002) compared to the non-fluoxetine group. Age, gender, LDH, CRP, and D-dimer levels, sNEWS, Chest X-ray score did not show statistical difference between the fluoxetine and non-fluoxetine groups supporting the reliability of our finding. Provisional to confirmation in randomised controlled studies, fluoxetine may be a potent treatment increasing the survival for COVID-19 pneumonia.

Clinical Neuroscience

Cholinesterase inhibitors and memantine for the treatment of Alzheimer and non-Alzheimer dementias


In aging societies, the morbidity and mortality of dementia is increasing at a significant rate, thereby imposing burden on healthcare, economy and the society as well. Patients’ and caregivers’ quality of life and life expectancy are greatly determined by the early diagnosis and the initiation of available symptomatic treatments. Cholinesterase inhibitors and memantine have been the cornerstones of Alzheimer’s therapy for approximately two decades and over the years, more and more experience has been gained on their use in non-Alzheimer’s dementias too. The aim of our work was to provide a comprehensive summary about the use of cholinesterase inhibitors and memantine for the treatment of Alzheimer’s and non-Alzheimers’s dementias.

Clinical Neuroscience

Evaluation of the effectiveness of transforaminal epidural steroid injection in far lateral lumbar disc herniations

EVRAN Sevket, KATAR Salim

Far lateral lumbar disc herniations (FLDH) consist approximately 0.7-12% of all lumbar disc herniations. Compared to the more common central and paramedian lumbar disc herniations, they cause more severe and persistent radicular pain due to direct compression of the nerve root and dorsal root ganglion. In patients who do not respond to conservative treatments such as medical treatment and physical therapy, and have not developed neurological deficits, it is difficult to decide on surgical treatment because of the nerve root damage and spinal instability risk due to disruption of facet joint integrity. In this study, we aimed to evaluate the effect of transforaminal epidural steroid injection (TFESI) on the improvement of both pain control and functional capacity in patients with FLDH. A total of 37 patients who had radicular pain caused by far lateral disc herniation which is visible in their lumbar magnetic resonance imaging (MRI) scan, had no neurological deficit and did not respond to conservative treatment, were included the study. TFESI was applied to patients by preganglionic approach. Pre-treatment Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) scores of the patients were compared with the 3rd week, 3rd month and 6th month scores after the procedure. The mean initial VAS score was 8.63 ± 0.55, while it was 3.84 ± 1.66, 5.09 ± 0.85, 4.56 ± 1.66 at the 3rd week, 3rd month and 6th month controls, respectively. This decrease in the VAS score was found statistically significant (p = 0.001). ODI score with baseline mean value of 52.38 ± 6.84 was found to be 18.56 ± 4.95 at the 3rd week, 37.41 ± 14.1 at the 3rd month and 34.88 ± 14.33 at the 6th month. This downtrend of pa­tient’s ODI scores was found statistically significant (p = 0.001). This study has demonstrated that TFESI is an effective method for gaining increased functional capacity and pain control in the treatment of patients who are not suitable for surgical treatment with radicular complaints due to far lateral lumbar disc hernia.

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.

Lege Artis Medicinae

[Diagnosis and treatment of microvascular coronary heart disease. Specialities of conditions in Hungary]


[Invasive investigations show that in two-thirds of patients the myocardial ischaemia persists without obstructive coronary disease and any other heart conditions (INOCA). The underlying cause may be microvascular dysfunction (CMD) with consecutive microvascular coronary disease (MVD) and microvascular or epicardial vasospastic angina (MVA). The modern practice of clinical cardiology while using the developed non-invasive cardiac imaging permits exact measuring of the coronary flow with its characteristic indices. All of these improve the diagnosing of CMD-induced myocardial ischemia and provide opportunity to determine primary MVD cases. Since the recognition and treatment of MVD is significantly underrep­resented in the Hungarian medical care, the primary stable microvascular angina (MVA) is described in detail below with its modern invasive and non-invasive differential diagnosis and treatment, concerning especially its frequency provoked by high blood pressure and female coronary heart diseases. There are highlighted all recommended diagnostic procedures available under domestic conditions.]