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PubMed1978

Neurological disorders and pregnancy.

Certain neurological disorders are particularly liable to occur during pregnancy or may be profoundly influenced by it. Moreover, neurological disorders may influence the management of otherwise uncomplicated obstetric cases. Despite the practical importance of this subject, however, little attention has been devoted to it in the literature. Moreover, those papers that have been published are widely disseminated and so are not easily accessible to the many practicing physicians who may be confronted with a clinical problem of this sort. In this communication, a succinct account is provided of the interrelationship between noneclamptic pregnancy and maternal neurological disorders, with emphasis being placed on aspects that are of practical significance in a clinical context. The treatment of neurological disorders that are likely to pose a problem during pregnancy is discussed, and the manner in which these disorders may influence obstetric management is reviewed.

Abnormalities, Drug-Induced↗

PubMed1975

[Folate deficiency and neurologic disorders].

Estimation of serum folate was carried out in 74 patients with various neurological disorders. Levels less than normal were detected in 63 of them, with mainly peripheral neuritis, cerebellar syndromes and/or psychological disorders. The role of certain etiological factors was demonstrated, e.g. alcoholism, malnutrition, diarrhea, anti-epileptic treatment. Links between these neurological disorders and the folate deficiency remain to be demonstrated. In at least 8 cases, treatment with folic acid seems to have had a favourable influence on the course of these disorders.

Adolescent↗

PubMed1979

[Slowed saccades in various neurological disorders].

4 patients suffering from different neurological disorders are presented, exhibiting a striking slowing down of all saccades. According to their clinical features the problem of slow saccades of supranuclear origin is discussed, to elucidate the question whether these eye movements are saccadic at all. Electro-oculographic traces served to distinguish these particular eye movements, and a computer calculated duration, velocity and acceleration of these saccades, to identify their saccadic nature. 1 patient with Wernicke syndrome showed a remarkable improvement of saccadic velocity following thiamine administration. The findings are reconciled with known saccadic behavior, and a model of the pathophysiological mechanism is cast. The adaptability of the system nearly back to normal in the case of Wernicke syndrome is stressed.

Aged↗

PubMed2026

Short-term psychodynamic psychotherapy for functional neurological disorder: A pilot randomized controlled trial.

BACKGROUND: Evidence-based psychotherapeutic treatments for Functional Neurological Disorder (FND) remain limited. This pilot trial evaluated the preliminary efficacy of Short-term Psychodynamic Psychotherapy (STPP) plus Standard Medical Care (SMC) compared with SMC alone in reducing FND symptom frequency. METHODS: Adults with FND were randomized (1:1) to receive either SMC alone or 12 weekly sessions of STPP plus SMC. The primary outcome was symptom frequency (days with symptoms in the last 4 weeks) assessed at the end of treatment (3 months) and at 6-month follow-up. Secondary outcomes included treatment response (≥50% reduction in symptom frequency) and scores on the Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), and World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). RESULTS: Of 91 randomized patients (mean age 38.2 years, 75.8% female), 81.3% completed follow-up. Intention-to-treat analysis using Linear Mixed Models showed that STPP plus SMC significantly reduced symptom frequency compared with SMC alone (estimated mean difference -5.72 [95% CI -8.68 to -2.77]; Cohen's d = 0.77; p < 0.001).Treatment response was achieved by 65.8% in the intervention group versus 16.7% in controls (OR 8.21 [95% CI 2.79-24.19]; p < 0.001; NNT 2.0).Significant improvements were also observed for depression (HAM-D: estimated mean difference -10.80; d = 1.45), anxiety (HAM-A: -7.94; d = 1.06), and disability (WHODAS 2.0: -5.77; d = 0.74), all p < 0.001. CONCLUSIONS: STPP was associated with clinically meaningful improvements in FND symptom frequency and all secondary outcomes, with large effect sizes and high treatment response rates. These findings support the preliminary efficacy of STPP for FND and justify larger, multicenter confirmatory trials.

Humans↗

PubMed1975

Neurologic disorders following surgery for peptic ulcer disease.

The neurologic status of 2,000 veterans who had had surgery for peptic ulcer between 1952 and 1957 was evaluated. In 1970, a total of 156 of these men were examined, 97 of whom had procedures that disrupted the normal continuity of the upper gastrointestinal tract. Twenty-one had neurologic disorders, including 17 patients with peripheral neuropathies. Procedures bypassing the ampulla of Vater were performed in 15 of these. The only detected factor associated with neurologic manifestations was weight loss since surgery. A mortality study of the total population revealed 865 patients had died by the end of 1973. There were seven deaths attributed to neurologic causes, one in a patient with amyotrophic lateral sclerosis and one in another with spinal paralysis. All seven were among the 70% of the deceased who had had surgery that disrupted the continuity of the upper gastrointestinal tract. Thus, we conclude that the type of surgery influenced the likelihood of neurologic complications, but at least for motor neuron disease, the increased risk was not appreciable.

Adult↗

PubMedDate not supplied

[Neurological disorders in sickle-cell disease (author's transl)].

Neurological disorders may be, specially in children, the first and dramatic troubles giving notice of the hematological disease. These disorders, listed according to their frequency are: cerebral vascular thrombosis, epilepsy, bacterial meningitis, meningism, cerebral thrombo-phlebitis, disorders of cranial nerves, hydrocephalus related to a pachy meningitis. One must be cautious with transfusions. Paraclinical neurological tests have no specificity.

Anemia, Sickle Cell↗

PubMed2026

Integrative chemical genetics platform identifies condensate modulators linked to neurological disorders.

Dysregulation of biomolecular condensates is implicated across multiple neurological disorders. However, approaches to systematically identify their modulators remain limited. Here, we expand the utility of MLF2 as a versatile condensate biomarker and develop CondenScreen, an integrated high-content screening and bioinformatics pipeline enabling identification of condensate modulators across chemical and genetic space. Screening 1760 bioactive compounds in a cellular DYT1 dystonia model, we validate the platform for condensate-targeted drug discovery, identifying drugs that prevent the accumulation of the MLF2 reporter into nuclear envelope condensates. In parallel, a genome-wide CRISPR/Cas9 screen correlates nuclear condensate abundance with genes implicated in microcephaly and over eight additional neurodevelopmental disorders. Machine learning and confocal imaging resolve distinct condensate phenotypes, with RNF26 deletion provoking nuclear envelope condensates that phenocopy hallmarks of torsin deficiency. Our study provides a scalable platform for identifying modulators of condensates and establishes a correlative connection between nuclear condensate accumulation and genes implicated in neurodevelopmental disorders.

Humans↗

PubMed1979

Identification of specific neurological disorders using double discrimination scales derived from the standardized Luria neuropsychological battery.

The Standardized Luria-Nebraska Neuropsychological Battery has been validated in a number of studies and has shown its effectiveness in making basic neuropsychological discriminations. A major advantage of this battery, compared to other test batteries, is its structure. The test consists of 269 separate items, each of which is designed to measure a different neuropsychological skill. As a result, these items can be combined in a number of ways to form scales aimed at specific neurological processes. It is the purpose of the present study to investigate whether or not the Luria Battery can be successful in discriminating specific neurological disorders by the development of what is termed "double discrimination scales." Using this process, two scales are established to diagnose any given neurological process. The first represents items in which the patients with a specific disorder do worse than a general neurological control group while the second scale represents items in which the patients with a neurological disorder do better than the general neurological control group. For a patient to be diagnosed as having a given process, the patient must score in the proper range on both scales. This method was applied to a sample of 24 multiple sclerosis patients who were compared with 74 patients diagnosed as normal, 106 psychiatric patients, and 101 brain damaged patients. Using the double discrimination procedure, the accuracy of identification of 100% was achieved in all groups. The study supported the usefulness of the double discrimination approach with the Standardized Luria Neuropsychological Battery and opens up the possibilities for scales to be developed for a wide variety of diseases in specific lateralized disorders.

Adult↗

PubMed1977

Relapsing neurological disorder associated with rubella virus infection in two sisters.

A disseminated relapsing neurological disorder presented simultaneously in two sisters. Encephalitic features were present in one case. The illness was associated with a significant increase in rubella specific IgM in both sisters. Despite the absence of a rubella rash, this increase would be compatible with a recent infection by the rubella virus as a basis for the illness, and the persistent elevation, with active antigenic stimulation. It is suggested that both patients might represent the clinical manifestations of perivenous demyelination caused by the rubella virus, which, in view of the relapsing nature of the illness, has progressed to plaque formation.

Adolescent↗

PubMed2026

Diagnostic communication in functional neurological disorder: A systematic review and meta-analysis of patient acceptance and clinical outcomes.

OBJECTIVES: Diagnostic disclosure is a key therapeutic moment in Functional Neurological Disorder (FND). This systematic review aimed to evaluate quantitative evidence on diagnostic acceptance, understanding, satisfaction, symptom outcomes, and healthcare utilisation following diagnostic disclosure in FND, and to conduct a meta-analysis of diagnostic acceptance. METHODS: Systematic searches of PubMed, Scopus, PsycINFO, and Web of Science identified quantitative studies in adults with FND. Screening followed predefined inclusion criteria. Data were extracted using a structured template and risk of bias was assessed using the Newcastle-Ottawa Scale. A random-effects meta-analysis of proportions was conducted using the Freeman-Tukey transformation. RESULTS: Fifteen studies were included, four of which contributed to the meta-analysis (n = 481). Reported diagnostic acceptance rates ranged from 38.7% to 90%, although the timing and method of assessment varied across studies. Pooled acceptance was 0.68 (95% CI 0.44-0.88), with substantial heterogeneity. Structured or reinforced communication was frequently associated with improved understanding and satisfaction, although its superiority for diagnostic acceptance was not established. In some studies, diagnostic acceptance was associated with more favourable clinical outcomes, although findings were inconsistent. Some studies reported reductions in healthcare utilisation or costs following satisfactory diagnostic explanation, whereas others found no sustained overall reduction. CONCLUSIONS: Diagnostic communication in FND is associated with differences in acceptance, understanding, and downstream clinical and healthcare outcomes. Approximately two-thirds of patients were reported as accepting the diagnosis following disclosure, although the timing and method of assessment varied substantially across studies. Empathic and evidence-informed communication may enhance understanding and engagement, although its effects on healthcare use and recovery remain uncertain. PRACTICE IMPLICATIONS: Diagnostic disclosure should be delivered clearly, empathically, and with reinforcement over time. Written information, reputable educational resources, and opportunities for follow-up clarification may support patient understanding and engagement, although stronger comparative evidence is needed.

Humans↗

PubMed1977

Computerized axial tomography in neurologic disorders of children.

Computerized axial tomography offers major advantages over air encephalography and angiography for studies of neurologic disorders in children. The low morbidity and the ease of the procedure permit the accurate diagnosis of intracranial pathology in situations where more invasive procedures would not be undertaken. The techniques of the procedure and its uses and limitations are emphasized in a number of neurologic problems of children.

Anesthesia↗

PubMed1979

Adenylate kinase activity and glutathione concentration of cerebrospinal fluid in different neurological disorders.

Adenylate kinase activity and glutathione concentration were measured in cerebrospinal fluid (CSF) of 64 consecutive patients admitted for various neurological disorders. These two analyses were performed in addition to conventional examination of the CSF. Neurological symptoms most probably connected in some cases with no and in others with only subtle changes in the central nervous system were linked to no or only moderate activities of adenylate kinase together with no glutathione. 1 patient with meningioma had no adenylate kinase activity at all while 3 patients with malignant brain tumours showed clear activities similar to 3 patients with well established diagnoses of multiple sclerosis. On the contrary, glutathione was absent in CSF of the patients with brain tumours and multiple sclerosis. Various cerebrovascular diseases involving larger areas of the brain tissue resulted in clear adenylate kinase activities in CSF either alone as in 11 of the patients with cerebral infarction or in combination with the appearance of also glutathione as in the remaining 7 patients with cerebral infarction as well as in the 14 patients studied with hemorrhages of the brain.

Adenylate Kinase↗

PubMed1976

Neurological disorders in the elderly at home.

Eight hundred and eight subjects participated in three surveys of random samples of people aged 65 years or more living in their own homes. Neurological history and examination showed the prevalence of completed stroke to be 73 per 1000. Eighty-seven subjects per 1000 gave a history of transient cerebral ischaemic attacks. These prevalence rates were unaffected by age or sex. Senile dementia was diagnosed in 24 subjects per 1000 under 75 years and 109 per 1000 over that age. The prevalence of dementia of all types was 43 per 1000 under, and 140 per 1000, over 75 years of age. Parkinsonism was diagnosed in 16 subjects per 1000, and essential tremor in 17 per 1000. The prevalence of epilepsy was four subject per 1000. Other neurological disorders were diagnosed in 36 subjects, and a similar number had neurological abnormalities to which a definite diagnosis could not be given.

Age Factors↗

PubMed1977

Isoelectric focusing of CSF and serum proteins in neurological disorders combined with benign and malignant proliferations of reticulocytes, lymphocytes and plasmocytes.

The clinical data and the CSF and serum findings on isoelectric focusing (IEF) and electrophoresis were studied in nine patients with neurological disorders combined with proliferations of reticulocytes, lymphocytes or plasmocytes. Paraneoplastic neurological manifestations were considered in some of the subjects. CSF findings compatible with intrathecal synthesis of oligoclonal immunoglobulins were observed in two patients with lymphoreticular neoplasms. One of these had an IEF band spectrum differing from those found with multiple sclerosis (MS), while the other had changes indistingusihable from those with MS. On IEF the CSF and serum M components of the patients with plasma cell dyscrasias, as well as the serum M components of nine other patients with myelomatosis, exhibited considerable microheterogeneity with 3-18 abnormal bands. The isoelectric point (pI) of the individual bands was 5.8-9.2, mostly greater than 6.4; the band spectra exhibited pI ranges of 0.4-2.5 pH units, most frequently 0.4-1.2. The CSF findings, possible modified by the blood-CSF barrier, reflected the serum changes of plasma cell dyscrasias. The immunoglobulins produced in such disorders gave IEF band spectra differing from those of intrathecally produced immunoglobulins in MS.

Adult↗

PubMed1979

[Neurological disorders in endometriosis].

A long-term study of 324 females with endometriosis aged 20--52 years permitted to systematize some syndromes of neurological disorders, depending upon the localization and stage in the progress of endometriosis. In an active infiltrating extension of endometrioid heterotopy there prevail syndromes of peripheral nervous structure lesions. In the late period pseudoneurotic disorders are encountered. The main principles of treatment are discussed.

Adult↗

PubMed1978

[Neurological disorders and perhexiline maleate therapy. Clinical study of 10 cases. Neuropathological, pharmacocinetic and biochemical studies (author's transl)].

Ten new cases of perhexiline induced peripheral neuropathies are reported. The authors emphasize the possible association of other neurological disorders: cerebellar symptoms in one case, complex tremor in two other cases, marked decrease of photomotor reflexes in one case and disgeusia in another one. The pharmacocinetic study of 4 cases revealed the presence of a low metabolism of the drug in one of them. Polymorphous inclusions have been seen in Schwann cell and endothelial cell cytoplasm in the three patients with electron microscopic study of the nerves. The pathological study of one case showed the demyelination of spinal cord posterior columns. In another case, who died from hepatic coma, the biochemical study of cerebral lipids revealed the low values of cerebrosides and sulfatides in cerebellum and cerebral white matter.

Cerebellar Diseases↗

PubMed1977

The human platelet. A diagnostic and research tool for the study of biogenic amines in psychiatric and neurologic disorders.

Comparison of the properties of blood platelets and serotonergic synaptosomes suggests that the human platelet can serve as an appropriate model for the transport, metabolism, and release of serotonin (5-HT) by CNS serotonergic neurons. The study of blood 5-HT levels and platelet 5-HT pharmacodynamics in patients with a variety of psychiatric and neurologic disorders has generated interesting leads into possible abnormalities of CNS 5-HT neurons in these patients. This article reviews the experimental evidence, which uses the human platelet model to investigate neurotransmitter-related abnormalities in Down syndrome, mental retardation, infantile autism, hyperactivity syndromes (minimal brain dysfunction), schizophrenia, affective disorders, Duchenne muscular dystrophy, Parkinson disease, Huntington chorea, and migraine headaches.

Affective Symptoms↗

PubMed1977

Cerebrospinal fluid gamma-aminobutyric acid variations in neurological disorders.

Neuropathologically, Huntington's disease is characterized by a profound reduction in neuronal cells originating in the corpus striatum and globus pallidus. Since one of these cell types utilizes gamma-aminobutyric acid (GABA) as a neurotransmitter, it may be possible to differentially diagnose this disorder on the basis of the CSF content of this amino acid. In order to determine the validity of this hypothesis, cerebrospinal fluid GABA was analyzed, using a recently developed radioreceptor assay procedure and was found to be significantly reduced in patients diagnosed as having Huntington's disease and also lower in patients with Alzheimer's disease, though no difference was noted between Parkinson patients and control subjects. The results suggest that analysis of cerebrospinal fluid GABA may have diagnostic, and perhaps predictive, value in certain neurological disorders.

Adolescent↗