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

The authors have investigated 19 cases of nontraumatic cerebrovascular accidents with a fatal outcome from a total of 1,627 consecutive nonselected forensic autopsies. Alcohol concentration in the blood was determined in 15 cases of which 60% (9 subjects) tested positive. The median age of the group with positive alcohol blood tests was 50.4 +/- 6.2 years. The median age of the group with negative results was 51.7 +/- 5.4 years. In the group with positive tests 4 were chronic consumers of alcohol. As compared with 1,773 determinations of blood alcohol done in the general casuistics of forensic medicine it appears that the incidence of alcohol concentrations under 1 g/thousand is greater in subjects that died with cerebrovascular accidents. In the group of subjects with alcohol concentrations in the blood between 1 and 2 g/thousand, and over, reflecting an advanced degree of inebriation, there are no significant differences between the two lots. In the authors cases the haemorrhagic forms of nontraumatic cerebrovascular accidents were predominant. Ischaemic lesions were found in only two cases.

The authors review the most updated information concerning the etiopathogenesis of nocturnal bruxism, stressing the co. destructive role of psychosomatic factors and of traumatogenic ones, of the type of premature dental contacts, and of occluding interferences, with evident direct implications in the buccal cavity and at a distance, giving rise to hypnic masticatory automatism, with painful hypercontraction of the masticatory muscles, and stress exerted on the temporomandibular articulations. On the basis of original studies of the interdisciplinary type (prosthetic gnathology and neurophysiology), with the aid of polygraphic investigations during sleep carried out in subjects with nocturnal bruxism it was possible to demonstrate that this oral parafunction may determine sleep disturbances at a central level which makes necessary a complex stomatologic and neuropsychiatric medical therapy.

The authors presents a series of patients with psychopathic conditions of dyscrinic and post-processive origin. In two cases the syndrome was associated to evolutive schizophrenia and an affective disease with potential handicapping risk. In another three cases there was gonadal insufficiency, spasmophilia and hypophyseal adenoma. The differential diagnosis is discussed, of psychopathoid conditions, in contrast with other psychopathies, and the value of modern means of diagnosis is stressed. A synopsis is also presented of the therapy currently employed, as well as considerations on the evolution and prognosis of psychopathoid conditions.

The author attempts to introduce several of the present data concerning the neurochemical basis of one of the most enigmatic neurological disturbances, the so-called "petit mal" epilepsy. The present material is based on some of the most recent studies of neurochemistry, and considerations are also made concerning the experimental modelling of "petit mal" epilepsy.

The special literature of the last two decades has mentioned repeatedly the occurrence of a "malignant neuroleptic syndrome", a severe, and not too rare complication of therapy with neuroleptic drugs. The authors make an analysis of 17 cases, and discuss the conditions of the development, the symptomatology and the treatment of the malignant neuroleptic syndrome. Due to the fact that the use of neuroleptics has been introduced in other fields of medicine the authors consider that information of physicians of all specialties with regard to this severe complication of neuroleptic therapy is useful.