Clinical Neuroscience

JANUARY 30, 2021

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


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

FEBRUARY 10, 1953

[Clinical data for permeability of the blood-ventricular barrier]


[The authors used Amsler and Huber's electrical zero point method to investigate the permeability of the blood-retinal fluid barrier to fluorescein in 150 cases (iritis, glaucoma, hypertension, diabetes mellitus, chorioretinitis, myxoedema, heterochromia iridis, Horner's syndrome, contusio bulbi, retinal haemorrhages, allergic eye diseases, multiple sclerosis, ggl. ciliare, ggl. stellatum novocain blockade). Glaucoma infl. chron. and gl. simplex, normal permeability was found. In acute attacks, there was no significant increase in permeability, but after the attack, blood-vascular barrier permeability was significantly increased. In cases of contusio bulbi, Horner's syndrome, ggl.ciliare, ggl. stellatum novocain blockade, permeability increased only if ocular tension decreased at the same time, suggesting the possibility of so-called secretory blockade (apparent increase in permeability according to Goldmann.) In cases of retinitis hypertonica, anaemia with a significant increase in permeability was often observed. In cases of anaemia perniciosa, permeability was also increased (anoxic phenomenon). After local administration of pilocarpine, histamine, adrenaline and after i.v. injection of hydase, no difference in permeability was found. ]

Clinical Neuroscience

MAY 09, 1953

[Prevention and treatment of amentiformis images resulting from stacked electroshock treatment]


[During cumulative electroconvulsive therapy, amentiform restlessness may occur before and after the stupor phase; in individuals with signs of mild hyperthyroidism, with usually very marked sympathicotonic signs. The clinical observations outlined above suggest that the reduction in the body's mobilisable fluid, partly due to the increase in sympathicotonia and prolonged, intense capillary permeability following ES treatment, is a significant factor in its induction. The immediate resolution of confusion by i.v. administration of ergotamine tartrate or its hydrated derivative (DHE45), and the sustained sedation by combined injections of Sevenal+ergotamine tartrate have been shown to be effective. Prophylactic, regularly monitored tea drinking during treatment can reduce complications and, with immediate combined sedation in the presence of a mentiform condition, corrigorate fluid dysfunction and completely eliminate mortality. ]

Clinical Neuroscience

NOVEMBER 20, 1953

[On the treatment and origin of acute life-threatening mental disorders (so-called acute fatal catatonia)]

NAGY Tibor

[1. Acute life-threatening insanity can be cured by early and cumulative electroshock treatment. 2. The syndrome can be understood as a cluster of symptoms of cortico-cerebrospinal-pituitary-adrenal dysfunction, which may be triggered by psychic, somatic and toxic effects. 3. Instead of the various names used in the literature - delirium acutum, amentia, catatonia perniciosa, azotaemic insanity, acute toxic psychosis, etc. - a more comprehensive name seems justified.]

Clinical Neuroscience

NOVEMBER 20, 1953

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


[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]


[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.]