Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Jul 1998
Dopamine transporter imaging with [123I]-beta-CIT demonstrates presynaptic nigrostriatal dopaminergic damage in Wilson's disease.
The most common neurological manifestations in Wilson's disease are parkinsonism and dystonia. These are assumed to be due to striatal injury, which has been repeatedly demonstrated by pathology and CT or MRI. The substantia nigra has not been shown to be damaged in pathological studies. However, there have been clinical and imaging studies suggesting presynaptic nigrostriatal injury. (1r)-2Beta-carbomethoxy-3beta-(4-iodophenyl)tropane (beta-CIT) is a specific ligand that binds to the dopamine transporter (DAT), and can examine the integrity of dopaminergic nerve terminals. Evidence for presynaptic nigrostriatal dopaminergic damage in Wilson's disease was searched for using [123I]-beta-CIT SPECT. ⋯ There was severe loss of the DAT in the striatum suggesting significant damage in presynaptic nigrostriatal dopaminergic nerve terminals. Therefore, a presynaptic lesion may contribute to neurological manifestations in Wilson's disease.
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J. Neurol. Neurosurg. Psychiatr. · Jul 1998
Shunt surgery in poor grade patients with tuberculous meningitis and hydrocephalus: effects of response to external ventricular drainage and other variables on long term outcome.
Thirty two poor grade patients (grade 3, 20 patients and grade 4, 12 patients) with tuberculous meningitis and hydrocephalus were prospectively studied to evaluate the response to external ventricular drainage in predicting outcome after shunt surgery. All grade 3 patients underwent a shunt procedure irrespective of their response to external ventricular drainage, and an attempt was made to correlate the immediate response to external ventricular drainage to their long term outcome. Patients in grade 4 underwent shunt surgery only if there was clinical improvement by at least one grade after external ventricular drainage. ⋯ The rest of the variables studied (age, duration of illness, duration of altered sensorium, CSF cell count, and CSF protein concentrations) had no effect on long term outcome. All patients in grade 3 should be given the benefit of shunt surgery without a trial of external ventricular drainage. However, patients in grade 4 should undergo an external ventricular drainage in view of the high mortality in this group.
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J. Neurol. Neurosurg. Psychiatr. · Jul 1998
Biography Historical ArticleFerdinand Jakob Heinrich von Müller (1825-96).
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J. Neurol. Neurosurg. Psychiatr. · May 1998
Comparative StudyCLOX: an executive clock drawing task.
To describe a clock drawing task (CLOX) designed to elicit executive impairment and discriminate it from non-executive constructional failure. ⋯ The CLOX is an internally consistent measure that is easy to administer and displays good inter-rater reliability. It is strongly associated with cognitive test scores. The pattern of CLOX failures may discriminate clinical dementia subgroups.