Der Nervenarzt
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Prolonged immobilization or physical inactivity has been shown to produce increased bone resorption due to enhanced osteoclastic activity and diminished bone formation. These skeletal changes are a typical complication in tetraplegic patients, who are at risk of developing hypocalcemia. Hypercalciuria is the most characteristic symptom. ⋯ The diagnosis could be established after malignant hypercalcemia, primary hyperparathyroidism, and other causes of hypercalcemia were excluded. Treatment with intravenous saline, furosemide, and calcitonin was not effective in lowering serum calcium. Treatment with pamidronate (Aredia) was successful and reduced the serum calcium to normal values.
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The present study examines episode characteristics in unipolar psychotic depression. From a sample of unipolar endogenous depressed inpatients, patients with a psychotic index episode (n = 19) were compared to nonpsychotic patients (n = 86) with regard to case history, characteristics of the inpatient episode, residual symptoms at discharge from hospital and course of illness up to seven months after discharge. ⋯ In the post-discharge short-term course of depression, these patients showed a more pronounced symptom homogeneity in the extreme ranges, which occurred by stable remissions or by prolonged symptomatology in need of treatment. These findings, together with the observation of higher stabilities of symptom scores in the psychotically depressed, emphasize the prognostic significance of symptomatology at discharge to the post-discharge episode course in these patients.
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Case Reports
[Relapsing paraneoplastic cerebellar syndrome and limbic encephalitis in a patient with breast cancer].
Paraneoplastic neurological syndromes are rare diseases that occur in relation to cancer. Supporting the hypothesis of an autoimmune mechanism, specific antineuronal antibodies have sometimes been detected. The current possibilities for treatment are limited. ⋯ It is possible that the impressive partial remission that occurred during the ensuing 6 months was not due to therapy. Although the patient was still bound to a wheelchair, discharge from hospital was possible because she was still able to perform daily tasks by herself. A recurrence of the cerebellar symptoms with mild alterations of mental status occurred 2 months later but again showed a good remission.