Intrathecal interferon in subacute sclerosing panencephalitisMaimone, D.; Grimaldi, L. M. E.; Incorpora, G.; Biondi, R.; Sofia, V.; Mancuso, G. Russo; Siciliano, L.; Ruscica, M.; Pavone, L.
doi: 10.1111/j.1600-0404.1988.tb03639.xpmid: 3227800
ABSTRACT‐ Three patients at Stage II of subacute sclerosing panencephalitis (SSPE) were treated with semipurified alpha‐interferon (IFN) using different combinations of intrathecal and intravenous routes: 1 × 106 IU of alpha‐IFN were given every other day up to a total of 15 × 106 IU. Transient improvement of neurological symptoms and electroencephalogram were noted in all 3, while cognitive function slightly improved in 2 of them. Clinical benefits gradually disappeared 2 to 6 months after cessation of IFN. Intrathecal antibody production did not change substantially, but CSF Leu 3a/Leu 2a ratio appeared to increase. No significant side effects were observed, except for a mild meningeal inflammatory reaction after each intrathecal administration of IFN.
Syndrome of deltoid and/or gluteal fibrotic contracture: an injection myopathyChen, S. S.; Chien, C. H.; Yu, H. S.
doi: 10.1111/j.1600-0404.1988.tb03640.xpmid: 3227801
ABSTRACT‐ One hundred and fifteen cases of injection myopathy with deltoid and/or gluteal fibrotic contracture were studied, almost all of whom had definite histories of repeated intragluteal or intradeltoid injections. One third had siblings affected by the same fibro‐muscular disorders manifestated by focal muscle atrophy and limitation of adduction and flexion of the shoulder or hip. Electromyography disclosed myopathic changes of the fibrotic muscles. Muscle biopsy showed marked perimysial and endomysial fibrosis with non‐specific degeneration, regenerative changes and, in some cases, partial denervation signs. Under the electron microscope, endomysial and perimysial collagen fibrils lost their normal unimodal diameter distribution and showed a rather broad spectral distribution of diameters suggesting a defective control of collagen formation in this disease entity. Repeated injection injuries and myotoxicity resulting in multifocal myositis are the first trigger of this fibrotic syndrome, and abnormal control of collagen formation could be another important pathogenic factor.
CNS‐borreliosis selectively affecting central motor neuronsFredrikson, S.; Link, H.
doi: 10.1111/j.1600-0404.1988.tb03642.xpmid: 3227803
ABSTRACT‐ A patient is described having Borrelia burgdorferi spirochetal infection clinically affecting central motor neurons selectively and without any sensory impairment. Diagnosis was based on elevated B. burgdorferi IgG antibody titers in cerebrospinal fluid (CSF) and titer normalization at clinical recovery. This occurred promptly and was complete after penicillin treatment despite 14 months of progressive central nervous system (CNS) dysfunction, favouring the hypothesis of the presence of the organism within the CNS. CSF findings characteristic of neuroborreliosis were registered, including parallel occurrence of mononuclear plecytosis, severe blood‐brain barrier damage and marked CSF IgM index elevation of prolonged duration. Some earlier reports of CNS manifestations related to B. burgdorferi are reviewed.
Cognitive evoked potential (P 300 ): a metric for cerebral concussionPratap‐Chand, R.; Sinniah, Malliga; Salem, F. A.
doi: 10.1111/j.1600-0404.1988.tb03643.xpmid: 3227804
ABSTRACT‐ Cognitive impairment has been reported to occur in minor head injury (concussion). The value of the P300 evoked potential as a measure of cerebral concussion was studied in 20 patients with minor head injury and compared with the data from 20 normal subjects. Significant abnormalities of the P300 latency and amplitude were noted in these patients in the post‐concussion period. The abnormalities improved completely on repeat testing. The correlation of the P300 to other parameters of head injury is discussed. The P300 constitutes a simple laboratory test that is a sensitive measure of cerebral dysfunction in concussive head injuries.
Alpha‐naphthyl‐acetate‐esterase activity in cerebrospinal fluid cellsReuck, J.; Vanderdonckt, P.
doi: 10.1111/j.1600-0404.1988.tb03644.xpmid: 3265833
ABSTRACT‐ Mono‐histiocytes and T‐lymphocytes were assessed by the cytochemi‐cal alpha‐naphthyl‐acetate‐esterase (ANAE) stain in 50 CSF samples of patients with various neurological diseases. The ANAE‐activity of lymphocytes was decreased in multiple sclerosis and subacute sclerosing panencephalitis, while the activity of mono‐histiocytes was increased in the group of infarctions and bacterial and viral infections of the central nervous system. In bacterial meningitis and viral meningo‐encephalo‐radiculitis the number of ANAE‐positive lymphocytes increased after treatment and clinical improvement. ANAE staining appears to be a useful additional tool in CSF cytology in these conditions.
The course of epilepsy during pregnancy: a study of 78 casesGjerde, I. O.; Strandjord, R. E.; Ulstein, M.
doi: 10.1111/j.1600-0404.1988.tb03646.xpmid: 3147566
ABSTRACT‐ We have compared frequency and severity of epileptic seizures during pregnancy with the 9 months prior to pregnancy in 66 patients with a total of 78 pregnancies. Data on total number of seizures and major seizures are analysed separately. No statistically significant differences between frequency before and during pregnancy were found. Cases with seizures before pregnancy tended to have seizures during pregnancy, but there was no association between occurrence of seizures prior to pregnancy and increased frequency during pregnancy. There was no evidence that seizures became more severe during pregnancy. No relationship was found between type of epilepsy and change in seizure frequency during pregnancy. The data suggest that our therapeutic interventions may have influenced seizure frequency in at most a minority of cases. Serum concentrations of the anti‐epileptic drugs were monitored regularly during pregnancy. Only data on patients on constant drug dosages and, therefore, presumedly with the mildest seizure disorders were analysed. In the majority of cases there was a decrease in drug levels during pregnancy. Most cases tolerated this decrease without an increase in seizure frequency. On the other hand, most cases with increased frequency also had decreased drug levels.
Chorea and lupus anticoagulant: a case reportØkseter, K.; Sirnes, K.
doi: 10.1111/j.1600-0404.1988.tb03647.xpmid: 3147567
ABSTRACT‐ A 16‐year‐old girl was hospitalized apparently with Sydenham's chorea. Laboratory investigations failed to reveal any sign of preceding streptococcal infection. However, lupus anticoagulant was demonstrated in plasma. Complete remission followed combined therapy with corticosteroid and anticoagulant drugs. Since the treatment of chorea in systemic lupus erythematosus associated with lupus anticoagulant is completely different from that of Sydenham's chorea, the case illustrates the importance of a thorough laboratory investigation.