Der Nervenarzt
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Early recognition of suicidal behavior is of extreme importance for avoidance of this cause of death. The risk of suicide attempts is particularly high in psychiatric illness, and among hospital in-patients especially in those with depression. Thus, the risk of suicide should be estimated in the first interview after admission to a psychiatric hospital. ⋯ They were more often single or divorced, and had fewer children of their own. Their psychopathology was characterized by a more strongly developed syndrome of depression, hostility and apathy. These findings point to a pattern of characteristics that are linked with suicidal behavior, which can be used to estimate the risk of suicide right at the beginning of a stay in hospital.
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In animal models of cerebral ischemia hypothermia has been shown to have a beneficial effect. Reduction of infarct size, fewer potentially neurotoxic metabolites, and a better neurological outcome were observed compared to sham-operated animals. ⋯ The first trials with hypothermia in patients with severe head injury have also shown beneficial results. However, studies on therapeutic hypothermia in the clinical management of acute stroke are not yet available.
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The transposition of the ulnar nerve has proved to be an effective therapy in ulnar neuritis at the elbow but has also many risks and technical problems. In contrast the simple decompression or release of the nerve within the cubital tunnel which was first described by Osborne and Feindel and Stratford is an operation which is free of complications and postoperative morbidity and can be performed in local anesthesia. According to the results of a former study of 139 cases and this follow-up study of further 523 cases the simple decompression proved to be an efficacious and almost entirely substitute for the more complicated and extensive procedure of volar transposition-not only for the "idiopathic" cubital tunnel syndrome but also for the "symptomatic" forms as tardy ulnar palsy, luxation of the ulnar nerve or other abnormalities i.e. epitrochleoanconeus muscle, ganglia, lipomas, bursitis. ⋯ Once muscle atrophy has developed the prognosis will be poor. This is also true for cases with concomitant polyneuropathy. Anterior transposition may be restricted to very few cases of extreme cubitus valgus.
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We report on the case of a 24 year old female patient, who, at first developed during 8 weeks of neuroleptic therapy parkinsonism and then, after improvement of psychopathology an acute rhabdomyolysis. Hyper-Ck-aemia up to 11,340 U/l was observed. Laboratory parameters normalized shortly after neuroleptics had been withdrawn and no further complications followed. Symptomatology is discussed with special reference to the possibility of an abortive malignant neuroleptic syndrome.