Fortschritte der Neurologie, Psychiatrie, und ihrer Grenzgebiete
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Paroxysmal symptoms of frequent recurrence and short duration occurring mostly unilaterally and without loss of consciousness have been described under a vast variety of headings. Brain stem origin of these symptoms was presumed. Electroencephalographic recordings usually did not show any paroxysmal discharges. 328 patients were found in the available literature including 9 patients of ours. ⋯ In one case cerebral atrophy was found. All types of seizures respond very well to antiepileptic drugs. The prognosis is favourable with the cryptogenic type and unfavourable with the symptomatic variety depending on the underlying disease.
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The literature dealing with radiation myelopathy is reviewed. The following points are to be noticed:radiation myelopathy is a rare complication in the radiation therapy of extraspinal tumors, nevertheless the number of case reports is increasing during the last years; probably this is due to the increasing use of high energy therapy. Already a cord dose of 1000 rad may be dangerous; with an increasing dose the risk of radiation myelopathy is increasing too. ⋯ Radiation lesions of the cervical spinal cord have been reported much more frequently than lesions of the dorsal spinal cord; lesions of the lumbal spinal cord are a very rare event. There exist different conceptions of the pathogenesis: opinions differ as to whether the effect is primarily on the connective tissue and blood vessels or on nerve cells and their axons or if the different tissues are injured simultaneously; moreover an autoimmuno-hypothesis is discussed. The clinical signs of radiation myelopathy can be grouped into two major syndromes: the transient radiation myelopathy and the delayed or chronic radiation myelopathy, which usually develops gradually with a subsequent chronic progressive course but in some cases may occur acutely after the latent period; the course is not always progressive but may be undulating and remissions have been reported in some rare cases...
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Fortschr Neurol Psychiatr Grenzgeb · May 1975
[On the so-called posttraumatic headache (author's transl)].
Following an introduction on the notion of posttraumatic headache and on the etiology and pathogenesis of headache occurring after head injuries, the author discusses in detail the clinical aspects of such pain. Especially, a description of headache that can be expected in different types of head injury and posttraumatic complication, is presented. The importance of differential diagnosis of cephalea originating in the vertebro-cervical region and of atraumatic headache occurring casually some time after a head injury, is stressed. ⋯ If psychoneurotic fixation of the accident sets in, psychiatric treatment should be commenced immediately as to prevent the establishment of irreversible neurotic symptoms. For the same reason, a pending procedure for recompensation should be settled as soon as possible. Observing the therapy explained, including guidance of patients, the prognosis of headache following head injuries proves on the whole to be very favourable.