Psychiatrie, Neurologie, und medizinische Psychologie最新文献

Some remarks are made on the conception, etiopathogenesis, and diagnostics of psychoreactive disturbances. It is supposed that besides stress also other dynamisms and mechanisms of the personality are involved in their development. The first author introduces for own diagnostic purposes a three-dimensional classification, which contains the following items: 1. the situation and its importance, 2. the subject's profile, and 3. the means used and the kind of the subject's activity inclusive of the pathologic reactions.

With reference to features of two cases of grave traumatic temporal cerebral injury, where a "temporal psychosyndrome" as defined by Landolt was not ascertainable, the question is raised whether, apart from temporal-lobe epilepsy, such a syndrome really exists. Computed tomography offers an enhanced objective basis for an investigation embracing an extensive patient population.

Biotinidase deficiency is the primary biochemical defect in late-onset multiple carboxylase deficiency and an autosomal recessive disorder and characterized by seizures, ataxia, alopecia and skin rash. We describe a colorimetric semiquantitative method for screening for biotinidase activity from dried samples of whole blood spotted on filter papers. The administration of biotin to affected children can be a lifesaving procedure and can prevent irreversible neurologic damage.

A case of spontaneous spinal epidural hematoma is reported. The 56-year-old man was hospitalized with neck pain followed by right sided Brown-Sequard syndrome at the level of C5-6 with a light rectovesical insufficiency and cervical sympathetic symptomatology. CT scan revealed right sided extradural high density mass. Following emergency operation removing the epidural hematoma ensured good recovery from the illness. The spontaneous spinal epidural hematoma is rare emergency. The exact etiology is unknown. Etiology and pathophysiology of this unusual lesion are described.

The paper introduces a catalog of symptoms to promote in the field of endogenous psychoses differentiated diagnosis, at the same time constituting a prognosis. Symptoms should be more minutely differentiated than is customary in psychiatric questionnaires. Manic-depressive disorders and purely phasal psychoses are distinguished solely in the clinical evaluation. Thus benign cycloid psychoses can be distinguished from malignant unsystematic schizophrenia.

4 patients are reported having monoclonal gammopathies, who clinically exhibited a sensomotoric polyneuropathy being progressive during some years. The EMG showed axional failure and secondary demyelisation. In two of the patients an IgG-type multiple myeloma has been revealed, while in the other two ohnes an increase of abnormal IgM-mIg could be demonstrated. In all patients the liquor protein was found increased and the appropriate mIg has been found in the liquor. Immunohistochemically the appropriate immunoglobulins could be demonstrated on the peripheral nerve by means of immunofluorescence method. Electron microscopical studies of nerval biopsies supported the diagnosis of mIg-associated polyneuropathy. References to diagnostics and treatment of mIg-associated polyneuropathy are done.

By spectral EEG-mapping and EP-mapping, especially the topologic dimension of electrical brain activity can be evaluated for clinical use. On the other hand, this method allows the highest solution from all functional imaging procedures within the time dimension of brain activity. On the other hand, the ability of topological solution is limited. But the latter is probably better than hitherto assumed and surprisingly well at least regarding neonates. However, several methodological prerequisites described here must be fulfilled. From the pathophysiological point of view, the limits must be considered besides the diagnostic possibilities. Meanwhile, spectral EEG-mapping and EP-mapping are diagnostically used in all main fields of traditional EEG-analysis, like seizures and in the preadiagnostics of tumors a.o. Also in the diagnostics of cerebrovascular disease including transient ischemic attacks, the EEG-mapping and/or EP-mapping are useful within the total diagnostics. There is a similar situation in the diagnostics of degenerative brain disorders. But the significance of frequently described changes inpsychoses, partly also neuroses and other functional disorders is not clear. Altogether, this non-invasive, economically most favourable method for the functional imaging procedures in brain diagnostics is promising to extent the routine diagnostics also to a more precise manner.

The paper describes a case in which symptoms of dementia basing on a chronic psycho-organic syndrome together with congenital aqueduct stenosis were for years erroneously regarded as indicating psychosocial maldevelopment. Emphasis is laid on the need to consider the possibility of a process of dementia, even if maldevelopment of the personality only displays mild neurological symptoms.

This is a report, based on a one year's stay at the hospital of the Gondar College of Medical Sciences (PDR Ethiopia), on the usage of traditional therapeutic practices as described by patients of the neurologic-psychiatric department in their histories. More frequently than others, psychotic patients, patients suffering from headache, and patients complaining of fits had used traditional treatments before seeking medical help.

In tissue samples of 45 operated astrocytomas and of 45 meningiomas the fibrinolytic and proteolytic activity was determined by means of fibrin-agar-plate-method. In astrocytomas significant higher values of fibrinolysis were found than in the meningiomas. In the course of tumor cell necrosis or as a result of brain damage caused by the operation, proteins inducing fibrinolysis are liberated. In some cases they can lead to localized or generalized disturbances of haemostasis.