Specialities

Gastroenterology

Clinical Neuroscience

JANUARY 30, 2021

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

DECEMBER 31, 1954

[Comparative histopathological study of polyneuritis of different aetiology]

HABERLAND Katalin

[1. the author reviewed 14 cases of poly-neuritis of different aetiology and searched for a correlation between the quality and localisation of histological lesions and the aetiological factor. 2 Histopathological examination of all sections of the surrounding nervous system except terminal neuropathways was performed from three main aspects: a) quality of histological lesion - inflammation or degeneration, b) localization of the pathological process, c) axonal lesion and axonal retrograde cell changes. 3. 7 cases showed severe degeneration of the parenchyma of the surrounding nervous system with axonal cell changes. The site of the degeneration was the peripheral nerve (distal typus degeneration). In these cases, arsenic, achylia gastrica, hypovitaminosis, anaemia were aetiological factors. 4. 6 cases had generalized serous inflammation of the peripheral nervous system in the foreground of the histological picture, associated with degeneration of the medullary sheath and axodilatation without retrograde cellular changes. In contrast to the previous group, the degeneration was most severe in the dural sheath and in the root (proximal tympanic degeneration). The author, in agreement with Scheinker and Sántha, seeks an explanation for the proxymal radicular marrow degeneration in that the swollen root is strangulated in the dural sheath. In these cases, an allergic reaction (after influenza, pneumonia, tonsillitis, ulcus molle, gastritis) is postulated as the aetiological factor. The last case corresponds to polyganglinitis, in which a viral origin is likely. 5. Histopathological examination of the cases shows that the aetiological factors which primarily cause the metabolic abnormalities of the nervous system are those which cause a distal-type parenchymal degenerative process of the surrounding nervous system. As a consequence of an allergic reaction or infection, a radicular interstitial inflammatory process develops. 6 To distinguish between these two processes, the author, following Lewy and Wechsler, considers it appropriate to call the first group of cases 'polyneuropathy' and the latter 'polyganglioradiculitis' (as explained in the text), on the basis of the localisation of the degenerative lesions.]

Clinical Neuroscience

DECEMBER 31, 1954

[Central nervous system and RES. I. Nervous system regulation of liver RES]

CSABA György, RAPPAY György

[Our experiments were carried out on 80 healthy white rats, males and females. The aim of our experiments was to determine the neuromuscular influence and regulation of reticuloendathelium. The experimental methodology used was the stabilized Törő-Velősy procedure. By surgically and pharmacologically performing the experiments with subcortical agents, we found that: 1. RES (hepatic RES) is under the regulation of the central nervous system. 2. Sympathetic excitation increases and parasympathetic excitation decreases RES activity.]

Clinical Neuroscience

NOVEMBER 20, 1953

[The u. n. treatment of acute fatal catatonia electrospasm]

VARGHA Miklós, KOVÁCS Béla

[Attempts have been made to deconstruct the nosolgical entity of schizophrenia from several angles. A detailed differentiation on the basis of psychopathology may be useful in order to find a closer link between the diverse biochemical, pathophysiological, morphological sub-scores and the psychopathological picture. Morphological lesions (Miskolczy, Hechst (Horányi), Josephy, Fünfgeld), as Miskolczy emphasises, only provide a consistent picture in certain forms of schizophrenia. The relative intactness of the cerebral areas (Stief, Hechst (Horányi)) is in contrast to some of the clinical symptoms, so that we can say that morphological lesions, whether of the brain or liver (Gaupp), etc., have not been able to prove the unity of schizophrenia or to clarify the affiliation of the different forms. Biochemical and pathophysiological research is at the stage of data collection, as Riebelling, in his most recent summary paper, has pointed out.]

Clinical Neuroscience

NOVEMBER 20, 1953

[Data on the pathomechanism of ventricular diverticulus formation]

SOÓS Imre, MOHÁCSI Ildikó

[A case of a lateral ventricular diverticulum herniating into the cisterna ambiens and a case of multiple intracerebral ventricular diverticulosis were described. Cisterna ambiens diverticulum may form in adulthood on rigid hydrocephalus cerebrum, although it has also been described in children. It is essentially an infratentorial herniation of the retrosplenial gyrus in a slowly developing brain pressure gradient. A large differential between supratentorial and infratentorial pressures is a favourable condition for its development. It can be diagnosed in vivo only by ventriculography. It is to be distinguished from arachnoid cysts of the cisterna ambiens, which do not converge with the ventricular system and have no parenchyma or ependyma in their walls. Intracerebral diverticula may originate anywhere in the ventricular system of the juvenile hydrocephalus brain. The pathomechanism of their origin is due to the readiness of the severely oedematous parenchyma to infiltrate and secondary collapse into the ventricular system. (Weber and da Rugna: dissezierende intracerebrale Divertikel) The involvement of the dilated third ventricle in the cisternae is not a true diverticulum, but is notoriously common in hydrocephalus. The clinical significance of diverticulum formation is that it is a self-healing activity that eliminates obstruction to cerebrospinal fluid circulation and provides a route for the surgical resolution of occlusive hydrocephalus.]