Diseases of the nervous system最新文献

It is hypothesized that alcoholics possess a perceptual-neurophysiological sensitivity which renders them vulnerable to the effects of information or stimulus overload: the resort to alcohol, therefore, may represent an adaptive attempt to restore physiologic homeostasis through the pharmacologic "dampening" properties of this drug. Twelve alcoholic subjects were assigned to three different levels of audio-visual sensory stimulation (no, medium, high) and three different doses of alcohol (placebo, low, high) according to a balanced incomplete block design. The results indicated trend level and significant interactions between alcohol and sensory level effects on craving intensity and systolic blood pressure, respectively, as well as a number of other intriguing findings. Should the findings of this pilot study be replicated, they will have important implications for the understanding of alcoholism.

There are presently no successful medical treatments available for most of the chronic dementias. For this reason it is most important to diagnose potentially reversible syndromes such as Normal Pressure Hydrocephalus and to determine if that patient is a candidate for neurosurgical treatment. A typical clinical case exemplifying the most common features of this syndrome is presented. This is followed by a discussion of the physiology, etiology, signs and symptoms, methods of diagnosis, and treatment of this illness. Material for this discussion was obtained from personal clinical experience and a review of the medical literature.

In a double-blind study of 58 acutely disturbed men and women brought to an emergency psychiatric unit, parenteral haloperidol was generally more useful than parenteral chlorpromazine in the control of disruptive signs and symptoms of psychosis. Half the patients (15/30) who received one injection of haloperidol 5 mg were calmed, cooperative and alert, and another fourth (8/30) were improved. By contrast, only 3 of 28 patients who received chlorpromazine were controlled successfully, and 11 of 28 were partly controlled. Covariant analysis of data from the Brief Psychiatric Rating Scale showed that haloperidol was superior (p less than .05) to chlorpromazine in five of the signs and symptoms evaluated, notably hostility and excitement. None of the statistical comparisons favored chlorpromazine. There were no adverse reactions in any of the patients. Results of this study and of work reported elsewhere indicate that haloperidol is the drug of choice for the control of disruptive symptoms and signs of psychosis in patients who require emergency treatment with an antipsychotic agent.

Forty-two patients with Parkinson's disease were given amantadine HC1 (Symmetrel) and placebo in an 18 week double-blind cross-over study to determine if amantadine provided additional benefit when combined with levodopa and carbidopa (Sinemet). Analysis of our results showed that amantadine effected a 92% improvement over baseline in symptom scores and a 95% improvement over baseline in activity impairment scores, compared with corresponding values of 4% and 18% for placebo. The difference between amantadine and placebo was statistically significant. Except for one case of mild livedo reticularis and two of blurred vision in the amantadine group, side effects were generally similar for amantadine and placebo in type and frequency. This study provides new evidence of the importance of combinations of antiparkinson drugs to achieve maximum therapeutic benefit.

This manuscript attempts to integrate certain biological aspects of schizophrenia with the clinical symptoms of this condition and the schizophrenic experience. Neurophysiological, biochemical, and dynamic aspects of schizophrenia involving reticular activating system, split brain studies, and the role of serotonin are discussed. The author feels that inability to selectively attend to a stimulus is the core defect in schizophrenia. Other related possibilities are alluded to.

Eleven temporal lobe epileptics, implanted with depth electrodes, 21 post-lobectomy epileptics, and 24 orthopedic controls were given a semantic differential test, which measured responses along 4 scales (evaluative, potency, activity, and danger) of 18 emotional and 1 non-emotional concepts. Results showed that post-lobectomy females thought of themselves as more dangerous than did orthopedic control females. Both post-lobectomy and implantation patients found the anger-hostility and fear-anxiety concepts less bad, potent, active, and dangerous than did the orthopedic controls. The post-lobectomy and implantation patients found the concept "sexual intercourse" and other non-sexual love-related concepts to be worse and more dangerous, but less potent and active than did the orthopedic controls.

A twelve year old black male sustained closed head trauma, following which he developed agitated hypomanic behavior. After failure to respond to several treatment modalities, he was begun on lithium carbonate for six months, at which time the medication was discontinued without recurrence of pathological behavior.