Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Aug 1988
Accuracy of the clinical diagnosis of vascular dementia: a prospective clinical and post-mortem neuropathological study.
Brains from a prospective study of demented patients were investigated post mortem. Of the 27 patients with clinical diagnosis of vascular dementia, 23 showed multiple cerebral infarcts but senile plaques and neurofibrillary tangles were absent or in insignificant numbers. This gives an accuracy of 85%, a figure higher than previously documented.
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J. Neurol. Neurosurg. Psychiatr. · May 1988
Case ReportsHarlequin syndrome: the sudden onset of unilateral flushing and sweating.
Facial flushing and sweating were investigated in five patients who complained of the sudden onset of unilateral facial flushing in hot weather or when exercising vigorously. One patient probably suffered a brainstem infarct at the time that the unilateral flush was first noticed, and was left with a subtle Horner's syndrome on the side opposite to the flush. The other four had no other neurological symptoms and no ocular signs of Horner's syndrome. ⋯ The complaint of unilateral flushing and sweating was abolished in one patient by ipsilateral stellate ganglionectomy. The unilateral facial flushing and sweating induced by heat in all five patients was thus a normal or excessive response by an intact sympathetic pathway, the other side failing to respond because of a sympathetic deficit. The onset in the four cases of peripheral origin followed strenuous exertion, which suggested that an anterior radicular artery may have become occluded at the third thoracic segment during torsion of the thoracic spine.
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J. Neurol. Neurosurg. Psychiatr. · May 1988
Case ReportsThe clinical spectrum of ocular bobbing and ocular dipping.
The term "ocular bobbing" defines a distinctive class of abnormal spontaneous vertical eye movements which occur in a variety of clinicopathological settings. Four cardinal forms, which correspond to the predicted permutations of the two characteristic clinical variables, initial vertical excursion and phasic velocity, have now been described. ⋯ The four pathological forms share several basic phenomenological features but exhibit clinical and aetiological diversity and significant differences in prognosis. An analysis of the clinical spectrum of disorders subsumed under the general heading of "ocular bobbing" is presented.
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J. Neurol. Neurosurg. Psychiatr. · Apr 1988
Clinical Trial Controlled Clinical TrialPain intensity measurements in patients with acute pain receiving afferent stimulation.
Six different pain rating scales, including a "pain relief scale", were compared in 80 patients suffering acute orofacial pain. Pain intensity measurements were made before and after a 30 min period of afferent stimulation (TENS/vibration and placebo). ⋯ The verbal rating scale did not perform well. The pain relief scale and the numerical rating scale are interesting alternatives to the established visual analogue scale.