Fortschritte der Neurologie, Psychiatrie, und ihrer Grenzgebiete最新文献

Predisposing factors and concomitant diseases were examined in cluster headache patients. A positive or negative correlation to a particular disease, e.g. gastrointestinal ulcerative disease, could not be showen. Factors indicating a genetic predisposition could also not be found. In the Freiburg Personality Inventory cluster and migraine patients had an essentially normal profile; however, both groups evidenced a tendency towards psychosomatic reactions.

In the case of seizures which are difficult to diagnose, the demonstration of epilepsy-typical graphoelements in the EEG confirms the suspected presence of an epilepsy. Activation methods are employed, since epilepsy-typical potentials may be even absent in established cerebral convulsibility in the routine wake EEG. The purpose of these method is the activation of epilepsy-typical potentials in patients, whereas the activation should not be so strong that those potentials may also be activated in healthy persons - since they can be provoked by a sufficiently strong stimulation in any individual. Hyperventilation, photostimulation, sleep, sleep deprivation and, in addition, drug provocation with Bemergrid, have proved most effective in routine diagnostic procedures; the diagnostic significance of the latter is still most problematic. - The various activation methods show a variably marked effect in the different types of seizures.

The article reports on a case which appeared as though two tunnel syndromes were present simultaneously, namely, the cubital and the carpal tunnel syndromes. Thorough electrophysiological examination revealed, however, that this simulated pattern was due to the presence of an anastomosis after Martin-Gruber. Three months after surgery the patient was free from symptoms. Intraoperative neurography had established the compression and its resolution. Anastomosis of Riche-Canieu was an additional, secondary finding.

During 5 years we have registered mortality in 1239 chronic hospitalized psychiatric patients (609 men and 630 women) aged between 40-70 years in 6 German hospitals. We examined this patients on incidence of cardial riskfactors. The death rates were compared to the others of BRD. In this connection we found out an intensified mortality in all age groups of psychiatric patients as against to BRD average. The mortality of respiratory system diseases surpassed death rates of BRD many times better. Also psychiatric patients died by cardiovascular diseases more than expected. The death rates from ischaemic heart diseases in men were approximately twice as much than at BRD statistic. Patients who died in arteriosclerotic diseases had more often riskfactors than the other deceased. The great number of sudden and unexpected deaths was remarkable.

The problem of suicide is linked not only with psychiatric and psychological aspects, but also with sociological, ethical and legal, philosophical and theological problems. Significantly results of suicide research are represented by the psychoanalytic aspects of suicide as a conflict of aggression and narcissistic crisis, as well as by the description of the "presuicidal syndrome" (Ringel) and the structural analysis of the suicidal event. Today, suicidal syndromes are strikingly frequent among adolescents, the aged, drug addicts, dipsomaniacs and alcohol and other addicts in general as well as among psychotic patients. It is often particularly difficult to assess suicidality. Quite frequently the suicidal patient taxes the therapist's resources to a very high degree. Prevention of suicide must be considered as an important psychiatric and social challenge; the goal should be to correct the inner attitude of the person concerned and to influence and change the conditioning factors of the social environment. All preventive measures can be considered meaningful and justified only if they are directed not only at the preservation of life but also at the quality of the life led by the persons considered as suicide risks.