Ocular flutter and truncal ataxia may be associated with enterovirus infection.

We report on three patients who presented a rare, uniform clinical syndrome consisting of ocular flutter and truncal ataxia. In all patients the symptoms followed an upper respiratory infection and resolved without sequelae within a few weeks. Previous reports have emphasized the apparent relationship of this entity to infectious disease, but the infectious agent remained uncertain.

Stable xenon CT in patients with chronic cerebrovascular disease.

Xenon-enhanced CT (XeCT) is a method of measuring regional cerebral blood flow (rCBF). Although it is used for acute and perioperative assessment the ability of XeCT to show hypoperfused areas in vivo, as compared with morphological imaging modalities other than noncontrast CT, is not defined. Correlation with MRI helps to define the smallest detectable hypoperfused area.

Quantification of motor deficit in Parkinson's disease with a motor performance test series.

It was the purpose of the present study to quantify the expected motor deficit in parkinsonian patients with the computer assisted Motor Performance Test Series (MPS), version 05.87 by Schuhfried (1987) and to examine which of the motor test variables found correlate at a significance level of p less than 0.01 with items of "motor examination" recorded at neurological examination and "activities of daily living" of the Unified Parkinson's Disease Rating Scale (UPDRS), version 3.

Impairment of motor planning in patients with Parkinson's disease: evidence from ideomotor apraxia testing.

Compared with a group of age matched controls, patients with Parkinson's disease scored significantly lower in testing for ideomotor apraxia. Imitation of movement sequences was affected more severely than performance of single movements. The degree of impairment was not related to severity of motor disability, but correlated strongly with the results of tests that measured visuospatial and visuoperceptive abilities.

[Depression and Parkinson syndrome].

Depressive mood is frequently associated with Parkinson's syndrome, but it may also occur as a precursor of this disease. As regards the subtypes of Parkinson's disease, the frequency of depressive states is significantly higher in the type dominated by akinesia and rigidity than in the type dominated by tremor. On the basis of biochemical changes, certain aspects of the depression can be successfully treated by substitution therapy: L-dopa medication may increase the reduced dopamine values in the striatum, thereby improving drive.

[Contribution of cerebral angiography to the prognosis of juvenile stroke].

46 patients (aged 13 to 40 years) suffering from ischaemic cerebrovascular disease were investigated by means of complete 4-vessel angiography. 40 of these patients were re-examined after a mean follow-up period of 57 months. The aim of the study was to investigate possible connections between the angiographic data and the clinical condition some years later.

[Long-term prognosis of patients with juvenile infarct. Catamnestic results].

Seventy patients suffering from ischemic cerebrovascular disease had had their first attack before the age of 40 years. Of these patients 57 were re-examined 84 months (mean) after the initial event. Within 48 months, 22 of 51 patients (43.

[Cerebral metastases as the first clinical manifestation of cancer].

A review of the case histories over the 10-year period 1969 to 1978 revealed 80 patients with cerebral metastases. Group 1 comprised 41 patients (43.9% carcinoma of the breast, 12.

Spinal cavernous haemangioma (intradural-extramedullary) underlying repeated subarachnoid haemorrhage.

Within a period of 13 months a 24-year-old male student experienced four attacks of subarachnoid haemorrhage. An intradural-extramedullary haemangioma at the level of the second thoracic segment was found to be the cause of the repeated bleeding.

[Lactate acidosis in the cerebrospinal fluid as a prognostic parameter of malacic cerebral insult (author's transl)].

The concentrations of lactate and pyruvate were determined in 111 CSF and blood samples. The CSF and blood chemistry of 43 patients with a lateralized ischaemic cerebral insult was compared with that of a control group of 18 patients. The first tests were carried out within 24 to 48 hours and 50 follow-up determinations were undertaken in the cerebral insult group.

[The Steel Richardson Olszewski-syndrome. A report on 3 further cases (author's transl)].

In this report we are describing 3 further cases of progressive supranuclear palsy, all displaying the typical clinical features (first described by Steele, Richardson and Olszewski, 1964): Ophthalmoplegia (affecting chiefly vertical gaze), pseudobulbar palsy, dysarthria, dystonic rigidity of the neck and upper trunk and dementia. Clinical symptoms started between 49 and 51 years of age with slow progression during 2 to 4 years. One patient died 2 years after the first clinical symptoms began.

Inflammatory demyelinating polyradiculitis in a patient with multiple sclerosis.

A case of multiple sclerosis (MS) occurred in which there were recent demyelinated plaques in the CNS, and inflammatory demyelination and remyelination in the peripheral (Schwann cell) portions of the spinal roots. The lesions in the peripheral nervous system (PNS) were characterized by inflammation, primary segmental demyelination, myelin stripping, the occurrence of lipid debris-containing macrophages in the endoneurium, and remyelination. To our knowledge, this is the first description of simultaneous acute inflammatory demyelination in the CNS and PNS in MS.

[Arteritis in cerebral inflammatory diseases. Diagnostic value of angiography (author's transl)].

Cerebral angiography may sometimes show up inflammatory changes in the brain arteries in cases of tuberculous and acute purulent bacterial meningitis. The arteries at the base of the brain are predominantly affected, in some cases together with peripheral branches. Normal angiograms or non-specific alterations may be expected in patients suffering from non-purulent meningitis and encephalitis.

[The cerebral angiogram in cases of stroke in youth (author's transl)].

Sixty-seven patients (ages: 11-40 years) suffering from ischemic cerebral circulatory disturbances were investigated clinically and angiographically. In 34 cases, transient ischemic attacks or reversible ischemic neurological defects were diagnosed; 33 patients suffered from completed strokes. In most cases the completed stroke took place without previous transient ischemic attacks.

[Cerebral angiography in collagen disease and arteritis of different aetiology (author's transl)].

The cerebral angiograms of 11 patients suffering from collagen disease are presented. Panarteriitis nodosa was diagnosed in 4 cases, Lupus erythematodes in 2 cases. With 5 patients immunovasculitis with cerebral affection was found, which was, however, not to be classified in detail.

[Acid-base equilibrium in the cerebrospinal fluid in diseases of the central nervous parenchyma].

A number of case studies reveal and dynamic changes of the acid-base balance in the blood and cerebrospinal fluid, such as the increasing decompensation of the metabolic lactate acidosis in the cerebrospinal fluid in lethal cases or the gradual regression in patients who were cured. Individual metabolic cerebrospinal parameters are correlated with the disturbance of consciousness. The cerebrospinal fluid parameters of patients with clouded consiciousness constitute prognostically critical values: lactate 3.

[Acute intermittent porphyria. A case report and family study].

The course of acute intermittent porphyria is described in a patient who died during an acute exacerbation of the disease. An analysis of the urinary porphyrin precursors (delta-aminolaevulinic acid and porphobilinogen), the determination of toal porphyrin excretion and the separation of haem precursors in the urine according to the number of carboxylic groups demonstrate different degrees of biochemical severity in the individual consanuinious members of this patient's family. The detection of latent carriers is of particular importance since the avoidance of porphyrogenic substances is the most important prophylactic measure to be undertaken in all latent clinical cases.

[Organic dementia as a first symptom of infantile Huntington's chorea (author's transl)].

A loss of intellectual capacity at the age of 10 was the first symptom in a case of infantile Huntington's chorea. Subsequently a rigid hypokinetic syndrome occurred only at the age of 20. The dementia syndrome was confirmed in psychological tests.