Schweizer Archiv fur Neurologie, Neurochirurgie und Psychiatrie = Archives suisses de neurologie, neurochirurgie et de psychiatrie最新文献

The authors describe the clinical and laboratory results relative to 7 cases of Ophthalmoplegia Plus, with special reference to the histochemical, ultra-structural and CFS findings and to the data obtained by Computerized Tomography (CT) of the brain. The CSF was altered in all the examined patients: 3 out of 7 presented an abnormal albumin quotient, 1 patient had an increased IgG Index; the isoelectrofocusing of the CSF proteins, carried out in 6 out of 7 cases, showed an abnormal protein content referred to gamma trace in 3 cases, oligoclonal bands in the CSF in one case, a double Tau fraction in one case, a damaged blood-brain barrier in 5 cases. The CT-performed in 6 out of 7 cases-revealed in one patient a diffuse hypodensity of the periventricular white matter, without signs of atrophy; 2 cases showed a mild atrophy of the posterior fossa involving the cerebellar hemispheres and vermis in one case, the vermis and the brain stem in the other one; no patient revealed signs of cortical or ventricular atrophy. The boundaries of the Ophthalmoplegia Plus are here discussed on the ground of the results obtained by the employment of the various research methods.

Structure, frequency, conditions and specificity of epileptic personality change have been estimated in very different ways. Psychological tests and statistical checks have been rare. The Rorschach-test claims to have the only tradition. 140 chronic epileptic patients without dementia were all investigated by psychiatrists and psychological tests. A specific epilepsy-syndrome could not be demonstrated, but nevertheless test-criteria of the organic psychosyndrome. They confirm and complete the psychological finding.

From the spectrum of research contributed by the social sciences, the present article highlights some recent studies concerning the role of social factors and the interaction of social and biological factors in the etiology of schizophrenia. Open questions prevail over the settled questions.

For schizophrenic patients, memory and desire are not bodily experiences. Mnemonic traces can be mobilized only at the cost of acute psychotic disintegration of the Self. This paper emphasizes the importance of understanding the Ego structure, the narcissistic economy and psychotic defenses (denial, splitting) as a psychosomatic the organization. Indeed, during somatic illness we observe a reintegration of the body as the hinge between emotional and symbolic aspects of subjective experience. The author suggests that the psychosomatic viewpoint is particularly useful in understanding the clinical evolution of schizophrenia, in psychotherapeutic management of transference and in the elaboration of psychiatric care policies for such patients.

We studied and compared 120 cases with an infarction in the superficial area of the middle cerebral artery (MCA) or the posterior cerebral artery (PCA). Among the patients with an infarction of the MCA area, 8% had a capsular involvement and 3% a delayed contralateral sylvian infarction. Among the patients with an infarction of the PCA area, 35% had a thalamo-mesencephalic involvement and 23% a delayed contralateral occipital infarction. Thus, multifocal infarction was significantly more frequent in the PCA area than in the MCA area. No particular vascular risk factor could explain this difference, which may be related to general constitutional factors, such as the type of collateral supply or the vascular anatomy itself. In the PCA area only, we found a significant association between the severity of risk factors and occurrence of multifocal infarction.

At the University Psychiatric Clinic in Basle, 14 primary brain tumours were diagnosed in a patient population of 12,530 in the course of 10 years. The rate of primary brain tumours in hospitalized psychiatric patients is thus one in 1,000. Primary brain tumours occurred 20 times more frequently in psychiatric patients than in a normal population, in whom the rate is one in 20,000. The classic brain tumour triad frequently occurs late and is found in less than 50% of patients. In 50 to 60 percent, brain tumour is associated with mental changes, mainly confusional states and psychoorganic syndrome. There is no typical pathopsychology of brain tumours, and that is why the possibility must always be ruled out. On the basis of these remarks, concrete recommendations are made for daily practice.

On the basis of the literature and of his own research concerning the long-term-evolution and the vocational rehabilitation of schizophrenics, the author shows that social factors play an important role in the long-term-evolution of schizophrenia. Of particular importance is the influence of the therapeutic setting, of overtaxing "life-events", of the family atmosphere, of the institutional infrastructure, of the expectations of the social environment, and of several socio-economic and cultural factors. Biological and psychosocial influences can be combined into a multiconditional model of schizophrenia in three phases, in which the vulnerability- und information-processing-hypothesis are central. This model leads to interesting consequences for the prevention and the therapy of schizophrenia.

This is a report of the individual psychotherapy of a schizophrenic woman who has been cured after years of treatment. The report deals mainly with psychodynamic problems such as resistance and negativism. It shows that only a common view of such phenomena, which includes the therapist as well as the patient and establishes a symmetry of experience, can lead to those processes of identification and counter-identification which ultimatively are helpful to both the patient and his therapist.

A case of Herpes Simplex Virus Encephalitis (HSVE) with clinical Korsakoff's syndrome was studied with conventional and electron microscopy, and with the immunoperoxydase (PAP) technique. Eleven additional cases of HSVE were studied retrospectively with the same technique. All eleven cases were positive for HSVE-antigens. In nine cases where an electron microscopic study was performed, the presence of viral particles was confirmed. The advantages of this technique for both rapid diagnosis on brain biopsy material and for retrospective studies are discussed.