Ideggyogy Szemle
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A detailed information on the quantitative and qualitative features and the regional distribution of the current neurological services at the national level is necessary for the planning of health care provision for the future. We present the characteristics of the current neurological services analyzing the database of the National Health Insurance Fund for 2009. This database is exceptionally large and detailed compared to similar data sources in Europe. ⋯ The gross mean income of a 30-hour-per-week average neurological outpatient practice based on performance reports was 871 thousand HUF (about 4350 USD or 3160 EUR) per month. In recent years the neurological capacities significantly decreased and fragmented, do not correspond regionally to the number of population to be served, and their profitability does not cover the conditions of self sufficient operation. This analysis will help health care providers and decision makers to recognize and address the current problems and design the neurological health care system for the coming years.
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Case Reports
[Anti-NMDA-receptor encephalitis: description of the syndrome in connection with the first Hungarian patient].
In the majority of cases, anti-NMDA (N-methyl-D-aspartate) receptor encephalitis is a severe, but treatable disorder, therefore early diagnosis and adequate therapy are very important. It should be suspected in children and young women, who develop acute psychiatric symptoms and seizures. During the course of the disease severe encephalopathy, agitation, hallucinations, orofacial dyskinesias, prolonged cognitive disturbance, autonomic symptoms can be observed and akinetic mutism develops. ⋯ Elevated protein, pleiocytosis and oligoclonal bands can be present in the CSF Detection of NMDA-receptor antibodies in sera or CSF confirms diagnosis. We present the case of a 15-year-old girl, who fully recovered within two months after steroid treatment and repeated plasma exchange. Ovarian teratoma has not been detected.