Romanian journal of neurology and psychiatry = Revue roumaine de neurologie et psychiatrie最新文献

Anticardiolipin antibodies (ACL-A) are acquired antiphospholipid antibodies characteristically found in patients with systemic lupus erythematosus or related autoimmune diseases. Several reports have shown that there may be an association between ACL-A and various neurological disorders, in particular cerebral ischemia. Using a micropin enzyme linked immunosorbent assay we measured the levels of ACL-A in the sera of 225 unselected patients with various neurological disorders. The prevalence of ACL-A in the whole group was 4.0% (9/225). However, the prevalence in patients with ischemic cerebrovascular disorders was 9.1% (5/55). With one exception (thrombocytopenia was found more often in ACL-A-positive cases) there was no difference with respect to the prevalence of risk factors for stroke and associated diseases between ACL-A-positive and ACL-A-negative patients with TIA/stroke. High titers of ACL-A were also found in a few patients with epilepsy (n = 2), migraine (n = 1), and intracranial meningioma (n = 1). In patients with ischemic cerebrovascular disorders search for ACL-A may help to identify patients with a possibly higher risk of thrombosis.

The effect of antihypertensive therapy withdrawal in acute ischaemic stroke patients was assessed in order to establish possible correlations between blood pressure values and the modified Rankin Scale (mRS) outcome. One hundred and twelve consecutive patients with acute ischaemic stroke and hypertension were treated with relatively similar regimen. Seventy-two hours following the onset of stroke, systolic blood pressure decreased to < or = 180 mmHg in 110 patients. Antihypertensive therapy was randomly discontinued in 59 patients. Clinical outcome and mortality were compared in patients with and without antihypertensive therapy withdrawal, no statistically significant differences (p > 0.05) between the two groups being found. Statistically significant positive correlations (p < 0.05) between mRS outcome and the decrease of systolic and diastolic blood pressure values were in patients treated with anticoagulant and antihypertensive therapy. Statistically significant negative correlations (p < 0.05) between mRS outcome and low levels of diastolic blood pressure were noted in patients who discontinued antihypertensive therapy. Our findings emphasize the need to associate antihypertensive and anticoagulant therapy in acute ischaemic stroke patients with hypertension. Spontaneous decrease of diastolic blood pressure values showed poor outcome. The management of hypertension associated with acute ischaemic stroke should be reconsidered.

A polygraphic study on resistance to habituation of the somatic, autonomic and EEG components of the orienting reaction elicited by a repetitive auditory stimulus was performed in 66 epileptics with therapy-resistant partial seizures (TRPS) and in 135 matched subjects in two control groups. The study showed a significantly higher resistance to habituation of the orienting reaction in epileptics with TRPS vs. the normal subjects of the control group I. A significantly higher resistance to habituation was also noted vs. the epileptics with therapy-controlled partial seizures of control group II. The correlational analysis of data showed that the severity of these habituation disturbances in epileptics with TRPS depended on the patients' age, type of electroclinical seizures, pretrial seizure frequency, type of resting EEG, administered treatment (no. of administered antiepileptic drugs/patient), daily dose, as well as on the serum level of these drugs. The multivariate regression analysis showed that the most significant predictive variables for the habituation disturbances were the pretrial seizure frequency, type of electroclinical seizures, daily dose of administered antiepileptic drugs and their serum level. The data also evidenced that the antiepileptic treatment improves the interictal habituation disturbances, the effect being more marked as the treatment was more sustained. The above-mentioned habituation changes in epileptics with TRPS should be ascribed to some disturbances in nervous excitability.

Four patients with severe muscle cramps were reported. In two of them the electrical signs of neuromyotonia were demonstrated. All the patients had undergone gastrectomy and all were immoderate consumers of alcohol. The neuromuscular disorder was reversible in all the patients.

Melodic Intonation Therapy is a well-known method exploring the verbal encoding of aphasics but within this study, it was used to investigate the verbal decoding (the auditory comprehension). Two separate groups, 240 cases each, were investigated, the former with MIT and the latter with other therapy methods. Each group included three subgroups according to the three frequent types of aphasia (Wernicke, Broca and Anomia). The method of semantic fields was associated to treat the second group since it is usually used in the treatment of aphasics with auditory decoding disturbances. All patients were tested twice, before and after therapy.

Sixty-four muscle biopsies obtained from patients with Duchenne muscular dystrophy, limb-girdle dystrophy, congenital muscular dystrophy, or who referred for diagnosis were examined with histochemical methods for dystrophin staining with antidystrophin antibodies. Six atypical cases in whom the dystrophin expression was inconsistent with both clinical and morphopathological pattern were selected: one case of Duchenne muscular dystrophy in whom dystrophin was partially represented, one case referred for investigation in whom dystrophin was absent, despite the lack of clinico-morphological signs supporting the diagnosis of Duchenne disease, two cases of congenital muscular dystrophy in whom dystrophin was absent and one patient with the same diagnosis in whom dystrophin was present, but quantitatively reduced. A patient with limb-girdle muscle dystrophy, in whom immunohistochemical investigation was necessary for the diagnosis is also reported. In conclusion, the immunohistochemical investigation using antidystrophin labelled antibodies of muscle biopsies obtained from patients with various types of muscular dystrophy is mandatory.

The study analysed the profile of psychomotor retardation in depression by clinically and psychometrically assessing its motor, speech and cognitive components. Psychomotor performance level of a group of 100 moderately depressed patients was significantly lower than that of controls on most psychometric tests. The interrelations among the variables evaluating various aspects of the depressive psychomotor retardation were examined and factor analyses were performed. Clinical ratings of motor, speech and mental retardation were strongly intercorrelated and a general factor emerged. When psychometric evaluations of depressive psychomotor retardation were factor analysed only separate factors characterizing cognitive and motor slowing were identified. Few and weak correlations were recorded between clinical and psychometric evaluations of depressive psychomotor retardation. Factors responsible for psychomotor slowing in depression were discussed.