Journal of Neurology, Neurosurgery and Psychiatry articles from September 2002

Journal of Neurology, Neurosurgery and Psychiatry archives from September 2002

Herpes simplex virus encephalitis still has an unacceptably high mortality. (Encephalitis).(Editorial)
September 1, 2002... Herpes simplex virus (HSV) is a human herpesvirus that causes HSV encephalitis (HSE), which is the commonest fatal sporadic encephalitis in humans. (1 2) About 90% of all HSE cases in adults and children are due to HSV-l, while HSV-2 is...

Impact of early intervention on outcome following mild head injury in adults: Written information is valuable to injured patients. (Mild Head Injury).(Brief Article)
September 1, 2002... In this issue, the paper "Impact of early intervention upon outcome following mild head injury in adults" by Pons-ford and colleagues (pp 330-2)' describes a valuable study addressing an important current issue in public health. The authors...

Multiple sclerosis in Malta in 1999: Examination of the low incidence of multiple sclerosis in Malta. (Multiple Sclerosis).(Brief Article)
September 1, 2002... The paper by Dean et al (1) (this issue pp 256-60) is not just one of countless papers on the prevalence of multiple sclerosis that have been published over the last 70 years. For several reasons it deserves special attention. The...

The effects of deep brain stimulation and levodopa on postural sway in subjects with Parkinson's disease: Deep brain stimulation reduces postural instability in Parkinson's disease. (Parkinson's Disease).(Brief Article)
September 1, 2002... Postural instability, leading to falls, is a common feature of neurodegenerative parkinsonian syndromes, often associated with injury and hospital admission. In a recent prospective study of falls in 109 patients with Parkinson's disease, 68%...

Functional weakness and sensory disturbance. (Physical Signs).
September 1, 2002... In the diagnosis of functional weakness and sensory disturbance, positive physical signs are as important as absence of signs of disease. Motor signs, particularly Hoover's sign, are more reliable than sensory signs, but none should be used...

A randomised placebo controlled exploratory study of vitamin B-12, lofepramine, and L-phenylalanine (the "Cari Loder regime") in the treatment of multiple sclerosis. (Paper).
September 1, 2002... Objective: To determine whether combination therapy with lofepramine, L-phenylalanine, and intramuscular vitamin B-12 (the "Cari Loder regime") reduces disability in patients with multiple sclerosis. Methods: A placebo controlled, double...

Home based management in multiple sclerosis: Results of a randomised controlled trial. (Paper).
September 1, 2002... Background: Home based medical care is a popular alternative to standard hospital care but there is uncertainty about its cost-effectiveness. Objectives: To compare the effectiveness and the costs of multidisciplinary home based core in...

Multiple sclerosis in Malta in 1999: an update. (Paper).
September 1, 2002... Objectives: To ascertain the prevalence of multiple sclerosis (MS) in the islands of Malta and compare it with a previous study undertaken 21 years earlier, when a remarkably low prevalence was found. Method: Deaths with MS on the death...

Genetic variability in the insulin signalling pathway may contribute to the risk of late onset Alzheimer's disease. (Paper).
September 1, 2002... Objective: To test the hypothesis that polymorphic variation in insulin signalling genes may underlie the shared risk of dysfunctional insulin signalling and late onset Alzheimer's disease (AD). The p85[alpha] subunit of phosphatidyl inositol...

Effects of deep brain stimulation and levodopa on postural sway in Parkinson's disease. (Paper).
September 1, 2002... Objective: To quantify postural sway in subjects with Parkinson's disease and elderly controls, and determine the effects of Parkinson's disease, deep brain stimulation, levodopa, and their interactions on postural control during quiet...

Dual channel deep brain stimulation system (Kinetra) for Parkinson's disease and essential tremor: a prospective multicentre open label clinical study. (Paper).
September 1, 2002... Objectives: To evaluate the safety and efficacy of a new dual channel stimulator (Kinetra) in patients with severe Parkinson's disease (PD) or essential tremor (ET). Methods: 111 patients with PD and 18 with ET were studied. Leads were...

Long term psychosocial outcomes after mild head injury in early childhood. (Paper).
September 1, 2002... Objectives: The question of whether any adverse cognitive or psychosocial outcomes occur after mild head injury in early childhood has evoked considerable controversy. This study examined mild head injury before age 10 and potential...

Semiquantitative analysis of corpus callosum injury using magnetic resonance imaging indicates clinical severity in patients with diffuse axonal injury. (Paper).
September 1, 2002... Objective: To evaluate the hypothesis that the extent of corpus callosum injury indicates the depth of shearing lesions in the central brain structure and therefore relates to the clinical severity of diffuse axonal injury. Methods: A...

Concurrent arterial aneurysms in brain arteriovenous malformations with haemorrhagic presentation. (Paper).
September 1, 2002... Objective: To assess the effect of concurrent arterial aneurysms on the risk of incident haemorrhage from brain arteriovenous malformations (AVMs). Methods: In a cross sectional study, 463 consecutive, prospectively enrolled patients...

Dermal microdialysis provides evidence for hypersensitivity to noradrenaline in patients with familial dysautonomia. (Paper).
September 1, 2002... Objectives: To use the technique of dermal microdialysis to examine sensitivity of skin vessels to noradrenaline (NA) in patients with familial dysautonomia (FD) and in healthy controls. Methods: In 14 patients with FD and 12 healthy...

Thomas Laycock (1812-1876). (Historical Note).(Brief Article)
September 1, 2002... Among medical historians, Thomas Laycock (1) is best known for his determining influence on the young Hugh-lings Jackson. Laycock's interests were the nervous system and psychology. (2 3) Thomas Laycock was the son of a Wesleyan minister....

Six novel connexin32 (GJB 1) mutations in X-linked Charcot-Marie-Tooth disease. (Short Report).
September 1, 2002... X-linked Charcot-Marie-Tooth disease (CMTX) is a ciinicaliy heterogeneous hereditary motor and sensory neuropathy with X-linked transmission. Common clinical manifestations of CMTX, as in other forms of Charcot-Marie-Tooth disease (CMT),...

Characteristics of patients with persistent severe disability and medically unexplained neurological symptoms: A pilot study. (Short Report).
September 1, 2002... This study audited 25 patients (21 female) from Oxfordshire who had been referred to either the liaison psychiatry or the neurological disability service between 1992 and 1998, reported a Barthel activities of daily living index score < 20 or...

Typical features of cerebellar ataxic gait. (Short Report).
September 1, 2002... Background: Although gait disturbance is one of the most pronounced and disabling symptoms in cerebellar disease (CD), quantitative studies on this topic are rare. Objectives: To characterise the typical clinical features of cerebellar...

Relation between walking speed and muscle strength is affected by somatosensory loss in multiple sclerosis. (Short Report).
September 1, 2002... Objective: To evaluate the correlation between gait speed and strength in multiple sclerosis (MS) with particular regard to patients presenting with proprioceptive loss. Methods: Gait evaluation and isokinetic testing of muscular...

Cecile Vogt (1875-1962). (Neurological Stamp).
September 1, 2002... Cecile Vogt was French and her husband Oskar Vogt (1870-1959) half Danish and half German. She married Oskar in 1899 in Berlin. The Vogts crusaded for a brain institute and finally the Kaiser Wilhelm Institute fur Hirnfirschung was created...

Age related shift in the primary sites of involvement in cervical spondylotic myelopathy from lower to upper levels. (Short Report).
September 1, 2002... Ascending axonal volleys were analysed after epidural stimulation at multiple sites along the cervical cord to localise the site of the lesion precisely in cervical spondylotic myelopathy. The intraoperative recordings uncovered a single site...

Hemiageusia resulting from a cavernous haemangioma in the brain stem. (Neurological Picture).(Brief Article)
September 1, 2002... AA 34 year old man without any history of neurological diseases noted a sudden loss of taste on the right half of his tongue. At the same time he complained of a mild headache and an impaired coordination of the right hand, which resolved...

Expression of chemokines in cerebrospinal fluid and serum of patients with chronic inflammatory demyelinating polyneuropathy. (Short Report).
September 1, 2002... Chemokines are likely to contribute to the pathogenesis of chronic inflammatory demyelinating polyneuropathy (CIDP), as evidenced by data from experimental autoimmune neuritis. The [alpha] and [beta] chemokines in the cerebrospinal fluid...

Tubular aggregate myopathy with abnormal pupils and skeletal deformities. (Short Report).
September 1, 2002... A patient is described with a novel syndrome characterised by progressive muscular weakness, contractures, pupillary muscle dysfunction, and skeletal deformity. The main myopathological feature was an abundance of tubular aggregates in both...

The legacy of vigabatrin in a regional epilepsy clinic. (Short Report).
September 1, 2002... Objectives: To review all patients who had received vigabatrin at the Walton Centre to determine the incidence of visual field defect, seizure outcome if vigabatrin had been stopped, and adherence to guidelines on the use of vigabatrin in...

Impact of early intervention on outcome following mild head injury in adults. (Short Report).
September 1, 2002... Background: The impact of mild head injury is variable and determinants of outcome remain poorly understood. Results of previous intervention studies have been mixed. Objectives: To evaluate the impact on outcome of the provision of...

Quantitative cardiovascular autonomic function study in Fisher syndrome. (Short Report).
September 1, 2002... Quantitative cardiovascular autonomic function tests were performed longitudinally in nine patients with Fisher syndrome (FS). Parasympathetic autonomic function was evaluated by the Valsalva ratio and RR interval variation during rest and...

Cerebral Whipple's disease with a stroke-like presentation and cerebrovascular pathology. (Short Report).
September 1, 2002... Although neurological, symptoms are common in Whipple's disease, patients rarely have a purely neurological presentation and involvement restricted to the central nervous system is uncommon. A 39 year old woman presented with a...

Neurological presentation of Fabry's disease in a 52 year old man. (Lesson of the Month).
September 1, 2002... Fabry's disease is an X linked inborn error of metabolism due to deficient activity of the lysosomal enzyme [alpha] galactosidase A. Previously unrecognised Fabry's disease presenting in a 52 year old man being investigated for progressive...

Letters.
September 1, 2002... An unusual case of Behcet's disease presenting with bilateral internal carotid artery occlusion Behcet's disease (BD) is a multisystemic recurrent inflammatory disorder, which is originally described as a triad of oral and genital...

Correspondence. (Post Script).
September 1, 2002... Mexiletine on segmental hyperhidrosis Ishibashi et al (1) reported the excellent efficacy of mexiletine for the treatment of segmental hyperhidrosis in two patients (who had syringomyelia and cavernous haemangioma of the spinal cord,...

Neurochemistry of Consciousness: Neurotransmitters in Mind.
September 1, 2002... Edited by Elaine Perry, Heather Ashton, and Allan Yaung (Pp 346, EUR65.00). Published by John Benjamins Publishing Company, Amsterdam, 2002. ISBN 90-272-5156-8 Consciousness is a portmanteau word, full of rich and different meanings:...

Risk Control and Quality Management in Neurosurgery.
September 1, 2002... Edited by H-J Steiger and E Uhl (Pp 227, EUR 108.000). Published by Springer Verlag Wien, Wien, 2001. ISBN 3-211-83678-0 This is an interesting and timely publication. The book contains a compilation of material presented at an...

Primary Progressive Multiple Sclerosis.
September 1, 2002... Edited by M Filippi and G Comi (Pp 128, EUR47.95). Published by Springer, Milan, 2002. ISBN 88-470-0167-6 The field of multiple sclerosis (MS) is awash with literature on every aspect of the disease ranging from epidemiology and genetics...

Multiple Sclerosis: A Guide For the Newly Diagnosed, 2nd edn.
September 1, 2002... By N J Holland, T J Murray, and S C Reingold (Pp 160, us$21.95). Published by Demos Medical Publishing Inc, New York, 2002. ISBN 1-888799-60-9 This book is an invaluable guide for patients with multiple sclerosis (MS), as well as their...

Disordered Mind and Brain: The Neural Basis of Mental Symptoms.
September 1, 2002... By Peter F Liddle (Pp 320, [pounds sterling]40.00). Published by Gaskell, London, 2001. ISBN 1-901242-65-X The premise of this book is that the key to understanding the neural basis of the major mental disorders is an understanding of the...

Corrections.
September 1, 2002... Rosso SM, van Swieten JC, Roks G, et al. Apoliproprotein E4 in the temporal variant of frontotemporal dementia. J Neurol Neurosurg Psychiatry 2002;72:820. Due to the style used in house for listing authors' affiliations in the Letters...

Neurosurgery and the neurologist.
September 1, 2002... When Thomas Willis (1621-1675) first used the term" neurology" in Cerebri Anatome to mean knowledge of the cranial, spinal, and autonomic nerves, he did not specify whether practitioners should be physicians or surgeons. The physicians won...

Acute head injury for the neurologist.
September 1, 2002... Trauma is the leading cause of death in the first four decades of life, with head injury being implicated in at least half the number of cases. In the UK, 1500 per 100 000 of the population (total one million) attend accident and emergency...

Head injury for neurologists.
September 1, 2002... Trauma is the leading cause of death and long term disablement in young persons. Head injury accounts for about 30% of traumatic deaths and a higher proportion of long term disablement. Historically the emphasis of reviews on head injury has...

Hydrocephalus and shunts: what the neurologist should know.
September 1, 2002... The second most common reason for being sued for negligence in neurosurgery is a problem related to hydrocephalus management (the first being spinal surgery!). However, the good news is that the overall standard of care for patients with...

Raised intracranial pressure.
September 1, 2002... Raised intracranial pressure (ICP) is a common problem in neurosurgical and neurological practice. It can arise as a consequence of intracranial mass lesions, disorders of cerebrospinal fluid (CSF) circulation, and more diffuse intracranial...

Subarachnoid haemorrhage and intracranial aneurysms: what neurologists need to know.
September 1, 2002... The incidence of stroke caused by subarachnoid haemorrhage (SAH) remains constant, with intracranial aneurysm rupture causing SAH in up to 5000 patients in the UK per annum. Although this represents less than 5% of all strokes, recognition is...

Surgical disorders of the cervical spine: presentation and management of common disorders.
September 1, 2002... "This man needs to see a Doctor!" So wrote an exasperated neurologist after reviewing a patient on the neurosurgical ward. Unfortunately this comment still springs to mind when one considers the clinical management of some cervical spine...

Surgical disorders of the thoracic and lumbar spine: a guide for neurologists.
September 1, 2002... Degenerative and pathological disorders of the thoracolumbar spine may present with symptoms which warrant further evaluation by a neurologist. This article aims to provide an overview of the typical presentation and standard management of...