Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Sep 1979
Case ReportsSpinal internuncial neurones in progressive encephalomyelitis with rigidity.
The clinical and pathological features of a fourth patient with progressive encephalomyelitis with rigidity are reported and compared with those previously described. It is suggested that the muscular rigidity, abnormal postures, painful muscular spasms, and myoclonus are a product of excessive and abnormal discharges of alpha motor neurones caused by their release from control by spinal internuncial neurones. ⋯ Experimental, clinical, and pathological evidence concerning spinal internuncial neurones is reviewed and found to conform to this theory. The pathogenesis of opsoclonus may be similar.
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J. Neurol. Neurosurg. Psychiatr. · Oct 1978
Case ReportsPainful legs and moving toes: evidence on the site of the lesion.
A condition of painful legs with moving toes was described in 1971. Further examples of this condition are now reported, showing lesions in the posterior root ganglion, cauda equina, nerve roots, or a peripheral nerve of the lower limb. It is concluded that this syndrome is caused by a lesion of the afferent fibres of the posterior nerve roots. It is likely that this lesion causes frequent spontaneous impulses in the posterior roots which activate local circuits of interneurones and motoneurones and result in co-ordinated movements involving local muscles.
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J. Neurol. Neurosurg. Psychiatr. · Oct 1978
Peripheral nerve biopsies in the diagnosis of leprosy in Aboriginal patients from the Northern Territory of Australia.
In the 12 years from 1964 to 1976, 171 peripheral nerve biopsies were taken from 81 Aboriginal patients in the Northern Territory of Australia, in whom a diagnosis of leprosy was either known or strongly suspected. Sixty-eight biopsy samples were from 19 patients known to have leprosy, and who were under assessment for nerve grafting, results of which have already been published. ⋯ Several patients with enlarged peripheral nerves, in whom the biopsy findings did not confine leprosy, remain under observation; their future investigation will include lymphocyte transformation tests and testing with refined lepromin, together with repeat nerve biopsy, where ethical and feasible. The clinical and epidemiological data suggest that a previous, and perhaps self-healing, form of leprosy may account for the neurological findings.
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J. Neurol. Neurosurg. Psychiatr. · Sep 1978
Case ReportsPrognostic significance of alpha frequency EEG rhythm in coma after cardiac arrest.
Sixty-five patients who remained in coma for more than 24 hours after resuscitation from cardiac arrest were divided into two groups according to their EEGs. Thirteen patients were found to have rhythm of alpha frequency while 52 had the usual EEG findings after cerebral anoxia. Three patients from the group with alpha frequency EEG rhythms regained full consciousness but showed severe sequelae. Our results suggest that the prognosis of comatose patients with EEG rhythm of alpha frequency is no poorer than that of other individuals who are comatose after cardiac arrest.
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J. Neurol. Neurosurg. Psychiatr. · Sep 1978
Electrical study of jaw and orbicularis oculi reflexes after trigeminal nerve surgery.
Trigeminal nerve ophthalmic and motor division function was assessed clinically and electrically in 32 patients who had undergone various surgical procedures for trigeminal neuralgia. Using known electrophysiological techniques, the orbicularis oculi and jaw reflexes were tested in all subjects. ⋯ However, jaw reflex abnormalities appeared in operated cases with no clinical or electromyographic evidence of masseter denervation. These results were unexpected, and imply that the proprioceptive fibres of the jaw reflex are mediated by a sensory and not a motor root as previously believed.