Severity Of Neurological Symptoms Research Articles

Biochemical changes during graded brain ischemia in gerbils: Part 2. Regional evaluation of cerebral blood flow and brain metabolites

Regional changes of cerebral blood flow and biochemical substrates were assessed in the gerbil brain following different grades of cerebral ischemia. Ischemia was produced by occlusion of the right common carotid and left external carotid arteries. Gerbils were classified according to the severity of neurological symptoms as animals without, with mild and with severe neurological deficits. Brains were frozen in situ, sliced in 20-μm sections and processed for pictorial presentation of glucose and ATP, using bioluminescence techniques. Cerebral blood flow was determined in adjacent brain sections, using [ 14C]iodoantipyrine autoradiography. NADH fluorescence was recorded by illuminating the surface of the tissue block with ultraviolet light. Most animals without visible neurological symptoms exhibited reduced blood flow in circumscribed regions of cortex and basal ganglia of the right hemisphere without concomitant changes of biochemical substrates. In animals with mild neurological symptoms, blood flow in the right hemisphere was reduced, glucose and ATP decreased, and NADH fluorescence inhomogeneously enhanced. In animals with severe neurological symptoms blood flow was almost arrested in the right hemisphere and was distinctly reduced in the medial parts of the left hemisphere. The ischemic tissue was depleted from glucose and ATP, and exhibited bright NADH fluorescence. The severity of neurological symptoms, in consequence, correlated closely with both the degree and the size of biochemical lesions observed in the ischemic territory.

Ethambutol Neuropathy: Clinical and Electroneuromyographic Studies

Clinical features including changes in the peripheral nerve conduction were analzyed in 10 cases with ethambutol neuropathy. There were abnormalities in the visual field in seven and optic atrophy in five of 10 cases. Seven of 10 cases complained of numbness in the lower limbs. The age of onset and dose of ethambutol the patients continue to take after the occurrence of visual impairment were found to be important in determining the severity of neurological symptoms. A functional disturbance was more conspicuous in ethambutol neuropathy, particularly in the sensory system than in the motor system so far as the peripheral nerve conduction was serially examined. Some cases still had serious optic disturbances even about seven years after the onset of the disease and the presence of irreversible lesions was suspected.

Bony Anomalies with Neurological Symptoms in the Upper Cervical Region

The interesting cases of bony anomalies with various neurological symptoms in the upper cervical region were presented to discuss the relationship between the degree of bony anomalies and the severity of neurological symptoms.Case 1: acute complete quadriplegia due to atlantoaxial dislocation with os odontoideum.Case 2: Klippel-Feil syndrome with spondylotic myelopathy.Case 3: atlantooccipital assimilation with the severe symptoms of the brain stem and the upper cervical cord.Case 4: Arnold-Chiari malformation with remarkable cerebellar symptoms.Craniometry concerning the diagnosis of basilar impression was done on the x-ray films. All of the cases were accompanied with the various degree of basilar impression.In conclusion, the severity of neurological symptoms was in proportion to the degree of the narrowing of the foramen magnum and the cervical canal.

Spasmodic torticollis

Thirty-two patients, suffering from idiopathic spasmodic torticollis (ST) since 9 ± 8 years, participated. In addition to a rating of the neurological symptoms (posture, reduced motility, rigidity, tremor, spasmodic movements, neck pain) and a psychiatric exploration, as well as two questionnaires on personality variables (Minnesota Multiphasic Personality Inventory [MMPI]) and coping styles (Millon Behavioral Health Inventory) were investigated. A control group of patients with Parkinson's disease also filled out both questionnaires. Three patients had another neurological and two another psychiatric disease. MMPI scores, in particular hypochondriasis, depression and hysteria, were highly elevated in approximately 50% of the patients and correlated with the severity of neurological symptoms (i.e., pain). Patients with Parkinson's disease had similar abnormal personality profiles. This resemblance between both patient groups indicates that psychiatric symptoms in ST are nonspecific and represent the consequence of a chronic disabling disease. Since among ST patients no distinct patterns of symptoms, psychiatric or psychological variables were found, no clinically relevant subgroup could be identified.

Spasmodic torticollis: A psychogenic condition?

Thirty-two patients, suffering from idiopathic spasmodic torticollis (ST) since 9 ± 8 years, participated. In addition to a rating of the neurological symptoms (posture, reduced motility, rigidity, tremor, spasmodic movements, neck pain) and a psychiatric exploration, as well as two questionnaires on personality variables (Minnesota Multiphasic Personality Inventory [MMPI]) and coping styles (Millon Behavioral Health Inventory) were investigated. A control group of patients with Parkinson's disease also filled out both questionnaires. Three patients had another neurological and two another psychiatric disease. MMPI scores, in particular hypochondriasis, depression and hysteria, were highly elevated in approximately 50% of the patients and correlated with the severity of neurological symptoms (i.e., pain). Patients with Parkinson's disease had similar abnormal personality profiles. This resemblance between both patient groups indicates that psychiatric symptoms in ST are nonspecific and represent the consequence of a chronic disabling disease. Since among ST patients no distinct patterns of symptoms, psychiatric or psychological variables were found, no clinically relevant subgroup could be identified.