Pathological reflexes in presenile dementia--preliminary report.
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In 4 patients, trauma to the lumbosacral area produced abnormalities similar to those seen after resection of the nervi erigentes. Mechanisms of the resulting constipation and fecal incontinence for liquid stools included a prolonged transit time through the entire colon, a low rectal pressure, spasticity of the anal canal, and abnormal anal reflexes. Previous trauma to the lower spine must be considered in the differential diagnosis of chronic constipation.
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For the differentiation of neurotic disorders, the indices of pupilary reactions and hippus were studied. The study was performed with the aid of a pupillograph. A comparison of the pupillographic data in patients with borderline neurotic disorders of the 3 main groups (asthenic, obsessive-phobic and hysterical), demonstrated statistically significant differences in the control group and within the group with different forms of neurotic disorders. The quantitive and informative characteristics of the pupilary reactions and some regular tendencies in the characteristic of the hippus may help in the solution of one of the main problems of borderline psychiatry, an improved diagnosis.
In 41 patients with lateral amyotrophic sclerosis the tonic vibrational reflex (TVR) was examined. The H-reflex, the M-response, the stretch reflex, and the maximal spontaneous contraction before and during the Achilles tendon vibration were recorded simultaneously. A relationship between the TVR change and the disease form was revealed, and so was the different character of the change of the spinal reflexes in the presence of vibration. Mechanisms of the changes revealed are discussed with reference to the role of the gamma-system and the intraspinal inhibition in the origin of the motor disturbances characteristic of that disease.
The studies were carried out on patients with cerebral and spinal pathology (transient disturbances of cerebral circulation, post-traumatic epilepsy, cervical myelopathy with segmental disorders, etc.). Despite the absence of the clinical manifestations of the pyramid syndrome most patients showed diversely directed shifts of the amplitude of the soleus muscle H-reflex, absence of the depression of this response on high-frequency stimulation, presence of the H-potential in the foot muscles, and an increase of the amplitude of the H-reflex (withdrawn by needle electrodes) of the anterior tibial muscle. It has been concluded that of greater diagnostic value for revealing subclinical forms of the pyramid-extrapyramid insufficiency are electrophysiological findings characterizing the state of the spinal inhibition mechanisms, rather than tests characterizing the level of the motor neuron activity.
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