Bulletin of the Los Angeles neurological societies最新文献

We performed electromyography on the vastus lateralis muscle in 36 normal subjects and in 18 patients with inflammatory myopathy using a specially constructed dual electrode. This permitted simultaneous recording of a motor unit from a single fiber (SF) and standard sized electrode surface. We then correlated parameters of the SF potential (jitter, blocking, fiber density and duration) and the motor unit potential (MUP) (number of phases, duration) for different sites within the same individual. The mean values for the above parameters were correlated between individuals, and the group means were compared for the control and the inflammatory myopathy group.

Volumetric comparisons of the caudate nucleus of different mammals including rat, rabbit, cat, zebra, deer, antelope, bull, horse, dolphin (Stenella graffmani) and human are presented. A linear regression coefficient is obtained with its corresponding correlation coefficient. The results indicate that there is not a close correlation between the size of the caudate nucleus and the brain weight of the different animals studied when the caudate of the horse is included. When it is omitted there is a close correspondence. The caudate nucleus of the horse is extremely large in relation to its brain weight. The possible meaning of this fact is discussed. Measurement of different brain structures is of interest, both from the purely descriptive aspect and because it can suggest phylogenetic relations as well as explanation of functional differences in different animal species (1, 2).

Some practical neurological ideas concerning the nature of mind are presented to assist clinicians in appreciating the fact that brain physiology first creates and then serves the mind--the highest of the hierarchical functions of the nervous system. The qualities of the mind are shaped and modulated by life experience and many disturbed responses can be tempered by a knowledgeable approach. To gain a holistic concept of the functioning nervous system one must recognize and accept that all manifestations of behavior, including those termed psychological, are the product of physiological processes.

A retrospective study of 55 patients with Meniere's disease suggested a subgrouping based on presentation of auditory symptoms. Patients were defined as "definite" (documented fluctuating hearing loss and episodic vertigo), "probable" (history of fluctuating hearing loss and episodic vertigo) and "possible" (history of fluctuating tinnitus and episodic vertigo). An in-depth discussion of the natural history, audiometric and vestibular findings is presented.

The Amnionic Band Syndrome is a not uncommon disorder of the fetus which may result in cerebral malformations that mimic anencephaly. It is important to distinguish these two entities because of differences in pathogenesis and risk of recurrence. A preliminary stillborn female of 29 weeks gestation with multiple anomalies, including cerebral-placental fusion, cranial agenesis, cleft lip, syndactyly and ectopic liver is presented. These malformations are typical of the Amnionic Band Syndrome, an entity which has not been described in the neurologic literature.

An opportunity to investigate the role of anti-acetylcholine receptor antibody (anti-AcH R-antibody) in neonatal myasthenia gravis was presented when an infant was born to a symptomatic myasthenic mother who elected to breast feed the child. Pyridostigmine bromide determinations in plasma and breast milk were made by quantitative gas liquid chromatography. Anti-AcH R-antibody was assayed by an immunoprecipitation method. Simultaneous maternal blood and milk samples did not suggest concentration of pyridostigmine bromide in milk or significant transfer of medication through demand breast feeding. Weakness was not noted in the neonate in spite of high levels of anti-AcH R-antibody demonstrated in her blood. Presence of a markedly elevated anti-AcH R-antibody in a pregnant patient symptomatic with myasthenia gravis does not necessarily predict a clinically affected offspring, nor does the elevated antibody in the infant, presumably acquired transplacentally, necessarily result in clinical symptomatology in the newborn period.

This review discusses the classification, pathophysiologic mechanisms, clinical presentation, diagnostic evaluation, and management of spinal cord arteriovenous malformations. Our series of 21 patients with spinal cord AVM's is briefly discussed. The clinical presentation of these relatively rare lesions is varied, and diagnosis and treatment are often delayed. The majority of these lesions can be excised using microsurgical techniques. The key to successful management is early diagnosis and microsurgical removal before severe compromise of spinal cord function occurs.

One hundred patients with suspected cerebrovascular disease were studied, using Doppler imaging techniques (Dop-Scan), as described by Spencer in 1974. Using a continuous wave Doppler probe, derived images of the carotid vessels and their tributaries were constructed. Twenty-nine of these patients had angiographic studies. A close correlation between Doppler imaging and angiography was found. Although the imaging of the bifurcations does provide useful clinical information compatible to information obtained at angiography, it is necessary to supplement this by analyzing the Doppler signals generated at defined segments of the circulation. Some of the pitfalls of Doppler diagnosis of extracranial vascular disease have been avoided by the dual techniques of imaging and analyzing the Doppler signals directly over the neck vessels. Doppler imaging techniques allow safe, inexpensive, noninvasive studies which are reproducible and reliable. The techniques are easily adaptable to office and hospital practice and have the distinct advantage of saving some patients from angiographic investigation.