Revista de medicina interna, neurologie, psihiatrie, neurochirurgie, dermato-venerologie. Neurologie, psihiatrie, neurochirurgie最新文献

The authors have studied 30 patients with transient global amnesia aged between 49 and 76 years (median age of 63 years), without focal neurologic signs that have been followed for periods varying between 6 months and 10 years. Three of the patients had recurrent attacks of transient global amnesia, and another three had a stroke, although at some distance from the amnesia attack. Association was noted with certain risk factors including high blood pressure, and angiopathic changes of the eye fundus (in 50% of the patients), dyslipidemia (in 30%), diabetes (in 10%), and essential polyglobulia (in 7%). Coagulation studies including thrombelastograms were carried out in 22 patients, and demonstrated hypercoagulability in 50% of them. Changes in the arterial wall were noted in 85% of the 14 patients in whom carotid sphygmograms were recorded. The presence of these risk factors could explain the occurrence of cerebrovascular accidents in patients with transient global amnesia. Electroencephalograms performed immediately or a short time after the amnesia attack have evidenced in 18 patients rapid-type dysrhythmia, or diffuse theta waves, predominantly located in the deep layers of the left and right temporal areas. The EEG tracings were either flat or normal in the remaining 12 patients. Of the 30 patients presenting with global transient amnesia only two had migraine in antecedents, and another six had headache during the evolution of amnesia. The neurologic examination did not reveal any abnormality in 27 of the patients. Sequelar signs of neurological deficits were noted in the remaining three patients.(ABSTRACT TRUNCATED AT 250 WORDS)

The present study is an attempt to establish the death rate of alcoholic patients with their various psycho-organic complications. The study was done on cases of alcoholic patients hospitalized in our Clinic over the past three decades. Thus, if the mortality index in 46,591 psychic patients hospitalized between 1959 and 1988 was of 0.36%, in alcoholics (totalling 5,580 of all patients) the mortality index was of 1.97%. An analysis of these figures with the aid of the X-square method showed a p of less than 0.001, indicating a significant difference with a probability of over 99.90% between these two groups of patients.

The study of 15 cases of progressive cerebellar atrophies, and especially of the olivopontocerebellar atrophy, that was investigated both clinically and anatomically, has attempted to evidence particularities and correlations existing between these two types of atrophy. Olivopontocerebellar atrophy appears to be an abiotrophy of the cerebellum, considered to be spontaneous, sporadic, and sometimes with a hereditary familial background. It is a systemic disease, predominantly of the neocerebellum and involving the cerebellopedal system. It is at the opposite end of Holmes-type atrophies, and of the cerebello-olivary atrophies of the young (I. T. Niculescu, Th. Hornet, 1936) which mainly involve the paleocerebellum. The disease has a polymorphous symptomatology, it has a slow, progressive evolution with mostly cerebellar signs, with extrapyramidal phenomena and psychical disturbances due to lesions of the telencephalic pathways, and sometimes of the spinal, cerebellar and bulbar proprioceptive afferences, with spinal and bulbar involvement (Cezar Ionel, 1949, 1972).

The authors have treated 20 patients hospitalized for acute manic disorders with 450-750 micrograms of clonidine per day for a period of one month. The tolerance to the drug was excellent. A marked decrease in manic symptoms was noted in 65% of the patients after the first ten days of therapy. The response was rapid and was maintained for the entire duration of the study, and clonidine was efficient for all the symptoms of the manic syndrome. The supra-sedation effect was much lower than with neuroleptics, and clonidine could be considered to represent a practical progress in the acute therapy of manic patients. Clonidine, usually employed as an anti-hypertensive drug, is an alpha-2-adrenergic agonist. It is believed that this property decreases the neural transmission by noradrenaline by stimulating pre-synapsis inhibitor receptors.