[Successful corticoid treatment of lumbosacral plexus neuropathy in heroin abuse. Clinical aspects, electrophysiology, therapy and follow-up].

A 33 year old heroin addict developed a lumbosacral plexopathy which clinically and electrophysiologically resembled an "idiopathic lumbosacral plexus neuropathy". He complained of severe neuralgic pain, marked paresis, and distinct sensory loss in the right leg. The plexopathy was accompanied by rhabdomyolysis.

[Chronic neuropathy of the suprascapular nerve in high performance athletes].

The clinical and electrophysiological examination of 36 top-level volleyball players showed a suprascapular neuropathy in 28% of the subjects. The most commonly observed clinical symptom was a focal severe atrophy of the m. infraspinatus, combined with loss of strength of the arm in abduction and external rotation.

[Iterative dysarthria in Parkinson disease].

Iterative dysarthria is a speech disorder which bears some resemblance to stuttering. It is commonly found in Parkinson's disease but has so far received little attention to. We report the case of a 67 year old female parkinsonian patient with a severe dysarthria of the iterative type.

Complex repetitive discharges in the iliopsoas muscle.

A prospective electromyographic investigation of lower limb muscles in patients with different neurogenic disorders showed that complex repetitive discharges (CRD) were observed predominantly and often only in the iliopsoas muscle. Analysis of the EMG findings in acute and chronic lesions shows that CRD are a feature of a chronic proximal motor axon lesion. Furthermore, the frequently focal occurrence of CRD in the iliopsoas muscle in clinically distal diabetic polyneuropathies suggests that this muscle and its nerves represent a locus minoris resistentiae.

Transcranial Doppler ultrasonography of carotid-basilar collateral circulation in subclavian steal.

The combination of a carotid-basilar and a vertebro-vertebral collateral circulation was verified directly in a patient with a complete subclavian steal by means of transcranial Doppler ultrasonography. The patient showed permanently reversed blood flow in the basilar artery. The subclavian steal influenced the hemodynamics of the circle of Willis at rest and during functional tests of the collaterally supplied arm.

[Form of manifestations and course of brachial plexus lesions following medial sternotomy].

A prospective study is reported of the prevalence, the clinical picture and the course of plexus brachialis lesions following median sternotomy during heart operations. The study comprises 1,585 patients. In 22 patients (1.

[Thoraco-abdominal manifestation of diabetic neuropathy].

The differential diagnostic importance of the thoraco-abdominal manifestation of diabetic neuropathy, with special reference to the neurophysiological findings is underlined. The cases of six patients are described who suffered from severe, burning pain of varying location (area of the lower thoracic aperture, lower abdomen, scapulae, back). In all six patients pathological spontaneous activity of different location and intensity could be found bilaterally in the paravertebral muscles.

Analysis of muscle responses elicited by transcranial stimulation of the cortico-spinal system in man.

Anodal stimulation of the central area of the scalp can produce visible twitches of various contralateral muscles. In a number of recent reports the technique of transcranial motor stimulation in man has been used to demonstrate abnormal evoked muscle responses in various diseases affecting descending motor pathways. The present paper deals with the systematic study of physiological influences and wave forms of these motor responses in normal subjects.

The coexistence of bradykinesia and chorea in Huntington's disease and its implications for theories of basal ganglia control of movement.

Investigation of motor function in a group of 17 patients with Huntington's disease reveals that, in addition to the chorea that many patients exhibit, defects in voluntary motor performance also are evident. Fast simple wrist flexion movements to 15 degrees or 60 degrees were slower, and individual movements showed greater variability than seen in normal subjects. This bradykinesia was most pronounced in those patients who were akinetic and rigid, but also was seen in those with chorea alone; bradykinesia was independent of the drug treatment that the patients were receiving (and was therefore not due to drug-induced parkinsonism).

[Analysis of residues of organochlorine compounds in plant drugs. 3. Identification of residues of polychlorobiphenyl compounds by comparison of gas chromatography on packed and capillary columns and GCMS coupling].

The identification of residues of polychlorinated biphenyls in a test sample of Flores Chamomillae could be achieved by the retention behavior at gas chromatographic analyses on packed and capillary columns compared with reference standard Clophen A 60, respectively as well as well by capillary GC/MS using single ion monitoring of substance-characteristic ion mass.

Transcranial magnetic stimulation of the human brain: responses in muscles supplied by cranial nerves.

The present investigation demonstrates that time-varying magnetic fields induced over the skull elicit distinct types of responses in muscles supplied by the cranial nerves both on the ipsilateral and the contralateral side. When the center of the copper coil was positioned 4 cm lateral to the vertex on a line from the vertex to the external auditory meatus, bilateral responses in the masseter, orbicularis oculi, mentalis, and sternocleidomastoideus muscles with a delay of about 10 to 14 ms after the stimulus occurred. Similar to the transcranially evoked muscle responses in hand muscles, the responses in the cranial muscles can be influenced in latency and amplitude by background excitation.

Evaluation of intracranial pressure from transcranial Doppler studies in cerebral disease.

The extent to which estimations of intracranial pressure can be derived from intracranial flow patterns was studied. The blood flow velocity in the middle cerebral artery was recorded with the EME TC 2-64 transcranial Doppler (TCD) device in 26 patients suffering from various severe cerebral diseases. Simultaneously the mean intracranial pressure (ICP) was measured by means of an epidural device.

Successful treatment of tardive and spontaneous dyskinesias with corticosteroids.

Three patients, 2 with tardive dyskinesia and 1 with senile chorea, were successfully treated with corticosteroids during an observation period of up to 5 months. Permanent complete relief or pronounced improvement of the dyskinesias was observed at a dosage of 5 mg prednisolone/day. Possible interactions between the putatively hyperactive dopaminergic system and corticosteroids are discussed.

[Possibilities and limits of determining central motor conduction latencies in the human].

It was the aim of the present study to define the normal range of latencies to muscle compound action potentials of different muscles in the upper and lower extremity elicited by transcranial cortex stimulation (see Tab. 1). It was demonstrated that parameters, such as voluntary background innervation (see Fig.

[Postoperatively developing serratus paresis as a legal problem].

It is demonstrated in five exemplary cases that a neuralgic amyotrophy with particular involvement of the long thoracic nerve was the cause of a postoperative serratus paresis. In any case liability claims, it is essential for an expert's opinion on postoperative serratus paresis to differentiate this pathology from intraoperative injuries caused by pressure. Above all the interval between operation and the first manifestation of symptoms, as well as the development of distinct pain count against an intraoperative plexus lesion.

[Gas chromatographic determination of nitroglycerin in human plasma].

A selective and sensitive method for the determination of nitroglycerin in human plasma is described. The drug and 1,3-dinitrobenzene as internal standard were extracted from plasma with n-hexane followed by a concentration step. A further cleaning of extract is not necessary.

Intracranial flow patterns at increasing intracranial pressure.

In the course of a pilot study, changes in intracranial pressure were compared with the transcranial Doppler findings of the middle cerebral artery. The cases of five patients were discussed who developed dissociated brain death in spite of intensive therapeutic measures. The studies showed that changes of the intracranial pressure influenced the flow patterns considerably: at increasing intracranial pressure (decreasing cerebral perfusion pressure) a progressive reduction of the systolic and above all diastolic flow velocities and finally a pendular flow occurred.

Rapid micromethod for the analysis of mitotane and its metabolite in plasma by gas chromatography with electron-capture detection.

A rapid micromethod for 50-microliter samples is described for the analysis in plasma of mitotane (o,p'-DDD) and its metabolite (o,p'-DDE), using p,p'-DDD as internal standard. The compounds are extracted with heptane without sample pretreatment, and an aliquot is directly analysed by gas chromatography with electron-capture detection. Absolute recoveries for all three compounds were ca.

Modulation of the long-latency reflex to stretch by the supplementary motor area in humans.

Surface-recorded, electromyographic responses to 200-ms ramp stretches were studied in the wrist flexor muscles from both arms of a patient with clinical and radiographic evidence of infarction in the right supplementary motor area (SMA). They were compared with those from 8 age-matched control subjects. The latencies of the spinal component of the stretch reflex were slightly longer than normal in both arms of the patient (normal subjects: 28.

Disturbance of sequential movements in patients with Parkinson's disease.

The following sequences of two single movements were examined in 10 patients with Parkinson's disease and compared with the performance of 9 normal subjects of similar age. Isometric opposition of thumb and fingers to a force of 30 N ('squeeze'), followed by isotonic elbow flexion ('flex') through 15 degrees with the same arm. 'Squeeze' with the left hand followed by 'flex' with the right elbow.

Simple and complex movements off and on treatment in patients with Parkinson's disease.

The performance of a 15 degrees elbow flexion and a 30N hand squeeze was studied in nine normal subjects and in five patients with Parkinson's disease. The patients were studied when immobile after 12-18 hours withdrawal from antiparkinsonian drug therapy (OFF) and when more mobile after drugs (ON). Subjects performed each movement separately (simple movements) and both movements either simultaneously or sequentially (complex movements).

The Bereitschaftspotential, L-DOPA and Parkinson's disease.

Bereitschaftspotentials (BPs) prior to extension movements of the index finger were studied in normal subjects and in patients with Parkinson's disease. In both, BPs were studied before and after L-DOPA therapy; in addition, the normal subjects were studied after dopamine antagonists. In both patients and normal subjects, L-DOPA caused an increase in the amplitude of the early part of the BP and of the point of peak negativity, just prior to EMG onset (N1) but it did not cause an increase of the late lateralized part of the BP (NS' of Shibasaki); in normal subjects dopaminergic antagonists caused a decrease in the amplitude of the N1.

Associated postural adjustments in Parkinson's disease.

Postural activity in muscles of the back and legs associated with voluntary forward elevation of the arm at the shoulder with the subject standing was examined in 14 patients with Parkinson's disease and nine normal individuals. The time of onset of EMG activity in each of the postural muscles, relative to the onset of activity in the prime mover, was the same for both patient and normal groups and did not depend on load. The amplitude of the EMG bursts and their frequency of occurrence, was less in patients off drug treatment and immobile, than when mobile on therapy.