Adult-onset tic disorders.

We report on 8 patients with adult-onset motor tics and vocalisations. Three had compulsive tendencies in childhood and 3 had a family history of tics or obsessive-compulsive behaviour. In comparison with DSM-classified, younger-onset Gilles de la Tourette syndrome, adult-onset tic disorders are more often associated with severe symptoms, greater social morbidity, a potential trigger event, increased sensitivity, and poorer response to neuroleptic medication.

Autopsy practises for brain dissections and Rembrandt's anatomy lesson of Dr. Deyman.

Illustrations, previous to the 19th century, provide evidence that brain dissections were executed on an isolated head, contrary to Rembrandt's anatomy lesson of Dr. Deyman. This paradox seems to be explained by clever biased composition.

Artful imaging of the brain. From logo to metaphor, about Michelangelo and Kiefer.

Michelangelo has painted the fresco 'Creation of Adam' for the Sistine Chapel. Recently it was discovered that he had an outline of the brain concealed in Gods cloud. As a renaissance artist he was not supposed to believe that the brain is the seat of the soul.

Wilhelm von Hboldt and James Parkinson. An appraisal of observation and creativity.

Wilhelm von Humboldt (1767-1835) was an educational reformer, a statesman serving Frederick William III, King of Prussia and a philologist, who influenced the contemporary linguist Chomsky. Moreover von Humbolt was a prolific writer, he kept up a substantial correspondence with family and a circle of acquaintances. His letters also contain references to his physical fitness.

The black hole in Charley Toorop's "The three generations": a neuro-iconographic analysis and reconstruction.

The painting "The Three Generations" is considered one of the highlights in Charley Toorop's works. It essentially represents a self portrait of the artist herself, with John Rädeker's sculpture of her father Jan Toorop, and her son Edgar Fernhout. The completion of this painting took 9 years (1941-1950).

Unique myoclonic pattern in corticobasal degeneration.

We describe two similar patients with a clinical diagnosis of corticobasal ganglionic degeneration (CBGD). After a period of increased action tremor, both patients developed a fixed posture in the right arm with a slow rhythmic myoclonus, which appeared to be caused by trains of highly synchronized and stimulus sensitive myoclonic discharges. Resetting of the spontaneous myoclonic discharges by peripheral and central stimulation and a jerk-locked cortical potential were demonstrated in one case.

Quantitative determination of the dopamine agonist lisuride in plasma using high-performance liquid chromatography with fluorescence detection.

An HPLC method for the determination of lisuride hydrogen maleate in plasma is described. After addition of ergotamine tartrate as internal standard, plasma is extracted with diethyl ether. Following evaporation of the solvent and redissolving in methanol the extract is injected on a silica HPLC column and lisuride is monitored by fluorescence detection using an excitation wavelength of 322 nm and an emission wavelength of 405 nm.

Attenuation of haloperidol-induced catalepsy by noradrenaline and L-threo-DOPS.

In addition to impaired dopaminergic neurotransmission a dysfunctional noradrenergic system has been demonstrated in Parkinson's disease. L-threo-3,4-dihydroxyphenylserine (DOPS), a synthetic precursor of noradrenaline (NA), appears to be effective in the treatment of some akinetic symptoms in parkinsonian patients. In the present study the possible effect of DOPS was studied in rats, in which catalepsy was induced with haloperidol as a model for parkinsonian akinesia.

Parlodel SRO in Parkinson's disease: a double-blind randomized comparison of Parlodel standard and Parlodel SRO.

In this study, we compared in an intent-to-treat analysis the tolerance and efficacy of Parlodel SRO with its standard galenic formulation in 34 patients with Parkinson's disease who received optimal levodopa therapy. The results suggest that Parlodel SRO was equally efficacious as Parlodel standard, but Parlodel SRO is better tolerated.

[Physical symptoms of Parkinson's disease and the score on Beck's Depression Inventory].

In patients with Parkinson's disease high prevalence of depression has been estimated. This prevalence may be overestimated since the commonly used assessment of depressive complaints neglects the correspondence with physical symptoms of Parkinson's disease and psychosomatic symptoms in depression. To evaluate the effect of this contamination, we presented a frequently used questionnaire for assessing depressive complaints, Beck's Depression Inventory (BDI), to eight neurologists specialized in Parkinson's disease.

Catecholamine metabolism during additional administration of DL-threo-3,4-dihydroxyphenylserine to patients with Parkinson's disease.

DL-threo-3,4-dihydroxyphenylserine (DL-threo-DOPS) was administered during 10 days to 4 patients with longstanding Parkinson's disease in addition to their treatment with L-3,4-dihydroxyphenyl-L-alanine (L-DOPA)-carbidopa (Sinemet). All patients tended to improve in their symptoms freezing, all day life activity and mood. There were no improvements in rigidity, tremor, and akinesia (in general).

Meige syndrome: double-blind crossover study of sodium valproate.

A double-blind crossover study of sodium valproate and placebo was conducted in five patients with Meige syndrome. CSF neurotransmitter studies were performed at the end of each treatment period. GABA levels were not influenced by the administration of sodium valproate.

Tracing of dopamine receptors in hemiparkinsonism with positron emission tomography (PET).

In 13 hemiparkinson patients possible changes in dopamine receptors were investigated in vivo with PET, using [11C]methylspiperone as the receptor labeling ligand. Though in individual patients the specific binding of the tracer differed between both striata, no consistent difference was found. However, the specific binding in the striatum of patients with longterm dopaminergic medication was significantly higher than in non-medicated patients, and close to normal.

Bilateral ballism: a rare syndrome. Review of the literature and presentation of a case.

Ballism rarely occurs as a bilateral phenomenon and only 12 such cases have been reported so far in the literature. A further case is reported in the present paper. The definition of bilateral ballism is discussed, its movements described and the differences from chorea outlined.

Low-dose bromocriptine therapy in Parkinson's disease: double-blind, placebo-controlled study.

Twenty-one de novo parkinsonian patients in stage I to III of the Hoehn and Yahr scale completed a 6-month, double-blind, placebo-controlled study. Low-dose bromocriptine (15 mg daily) was effective. Rigidity improved more than tremor or bradykinesia.

A case of Gilles de la Tourette's syndrome with midbrain involvement.

In a 27-year-old patient with Gilles de la Tourette's syndrome a pineal tumor had been found 10 years previously and was apparently a coincidental finding. Minute calcifications were later detected around the third ventricle and the mesencephalic periaqueductal gray matter by high resolution computed tomography. It is argued that this observation may support Devinsky's speculations that midbrain involvement has pathological significance for the Gilles de la Tourette syndrome.

Axial apraxia in Parkinson's disease.

Attention is drawn to certain disorders of posture and movement such as kneeling, turning around in the recumbent position, arising and walking which form a separate group of motor disabilities in Parkinson patients. Levodopa therapy is far less effective for these axial motor abnormalities than for hypokinesia, tremor, rigidity and manual dexterity. Inappropriate function of the axial musculature leads to debilitating situations.

Spasmodic torticollis: treatment with Tizanidine.

A randomized double-blind cross-over study was performed to compare the efficacy of Tizanidine to that of placebo in the treatment of spasmodic torticollis. No evidence was found that Tizanidine was effective in 10 patients with spasmodic torticollis who received Tizanidine during 6 weeks, up to a dose of 12 mg a day.