The ecological interview: A first step in out-patient child behavior therapy

The importance of interview information in child behavior is therapy discussed with particular reference to ecological information. An illustration of three pre-interview checklist is provided. The ecological interview is described is detail and its function in the construction of behaviourtherapy programs is discussed. A case study is presented to illustrate features of the interview.     

Cephalic tetanus: demonstration of a dual lesion.

A clinical and electrophysiological study of 15 cases of cephalic tetanus is reported. This condition is a form of local tetanus which commonly follows an injury to the face or head. It is characterised by muscle paralysis which is maximal close to the site of injury, while spasm is evident at mroe distant sites. As muscle paralysis improves with time it is succeeded by spasm. It is argued that paralysis is due to high local concentrations of toxin in the brainstem while lesser concentrations cause spasm by abolishing inhibition. Electrophysiological studies indicate that paralysis is of lower motor neurone type with denervation potentials, hyperirritability, loss of motor units, and marginally increased distal latencies being the features recorded.     

Cross-correlation analysis of multi-unit EMG recordings in man

This paper discusses the measurement of synchrony between 2 multi-unit EMG recordings. The suitability of a number of previously described indices of synchrony is reviewed. A new index of synchronisation is proposed. This index is independent of the number of units contributing to the correlogram but is dependent upon their firing frequency and upon the bin width of the correlogram. The autospectral density function calculated from each multi-unit record is used to estimate motor unit firing rates. The relationship between the frequency of firing and the chosen index of synchronisation is reciprocal such that if the firing rate is doubled, the index is halved. This may be explained if the proportion of events that is synchronized remains constant and is independent of the firing rate. It is argued that this in turn indicates that the proportion of common and non-common sources driving the neurons also remains unchanged in these experiments. In these circumstances, and to take into account changes in unit firing that may be present in different recordings, it is convenient to normalize an experimentally determined index E/M at a frequency f to some standard frequency f_s. The problem of superimposition of spikes that occurs as the contraction strength is increased is discussed.     

La vasodilatation a-t-elle un rôle dans la migraine ? Oui

The role of vasodilatation in migraine pathophysiology is still debated with three hypotheses. The first is that vasodilatation of meningeal or intracranial arteries are the primary cause of pain. The second is that vasodilatation is secondary to neuronal activation, but can sustain or increase pain through sensitized perivascular nociceptors. The third is that vasodilatation is an epiphenomenon neither sufficient nor necessary for pain. We review in this part the arguments in favor of the old hypothesis that vasodilation is the primary cause of pain. Finally we show that there is a mild vasodilation during the attacks provoked by CGRP infusion.     

Rem sleep behavior disorder: potential relationship to post-traumatic stress disorder.

Rapid eye movement sleep behavior disorder (RBD) is a parasomnia in which there is enactment, often violent, of dream mentation. Although this syndrome is sometimes associated with neurologic disorders, psychiatric comorbidity is not typical. The authors present a unique series of veterans with RBD. A high incidence of comorbidity with post-traumatic stress disorder is noted. The literature on RBD is reviewed, and the coexistence of RBD and post-traumatic stress disorder is reasoned. The authors suggest that it is possible that similar neuropathologic processes are responsible for both conditions, at times in the same patient.     

Levodopa treatment of presenile dementia

In Parkinson's disease as well as presenile dementia there is a dopamine deficit in the basal ganglia. Extrapyramidal symptoms are common in presenile dementia, and dementia is a common trait in Parkinsonism. It is reasonable to suggest a partial common etiology and pathophysiology, and the logical consequence is an investigation of levodopa substitution in presenile dementia. Unitil now very few reports of such studies have been published. The investigations have been uncontrolled or carried out on small or inhomogeneous materials. This investigation is triple-blind, clinically controlled, and the material is very homogeneous. After 6 months' levodopa treatment no significant effect is shown either on a broad spectrum of psychiatric items or in cognitive functioning. This negative result is discussed. The probability of a specific Parkinson dementia is mentioned and the significance of the modifying effect of an imbalance in other transmitter systems is emphasized.     

Lingual myoclonus. Case report and review

Myoclonus of the tongue is described for the first time as an isolated phenomenon and is related to the palatal-branchial myoclonus syndrome. Literature on the subject is reviewed. In the case which is presented the lingual myoclonus is seen to disappear, which is not the characteristic behavior of the palatal myoclonus syndrome. Since myoclonus of the tongue or palate is felt to represent a release of the primitive mechanism for integration of oral-pharyngeal movement from suprasegmental modulation, a sequence of events is proposed to explain the clinical findings on the basis of a discreet brain stem contusion at the upper medullary level.     

Inherited AT-III deficiency: fast and slow inactivation of thrombin and factor Xa

A family with inherited AT-III deficiency is presented. This variant is unlike those formerly described, as the plasma concentration is high, the thrombin inhibition with heparin is slow, and factor Xa inhibition is decreased.     

Pain arising in the posterior arch of the atlas

Headache of cervical origin is by no means an adequate diagnosis. The exact mechanism has to be established for the case in question. A type of cervical headache which arises from the posteriorr arch of the atlas is described. The basic finding is tenderness of this structure on palpation; the technique of palpation is described. In a majority of cases movement restriction (blockage) between the occiput and the atlase is found. The headache as described by the patient is not characteristic, migrainous attacks being present in about one-third of the cases. A frequent feature is pain on retroflexion of the head. Treatment consists of manipulation of the blockage, and infiltration or needling of the posterior arch of the atlas if there is no blockage or if pain continues after the restoration of mobility. In the more complicated cases remedial exercise is indicated. Experience with 64 cases is described.     

Selective attention in an insect auditory neuron

Previous work (Pollack, 1986) showed that an identified auditory neuron of crickets, the omega neuron, selectively encodes the temporal structure of an ipsilateral sound stimulus when a contralateral stimulus is presented simultaneously, even though the contralateral stimulus is clearly encoded when it is presented alone. The present paper investigates the physiological basis for this selective response. The selectivity for the ipsilateral stimulus is a result of the apparent intensity difference of ipsi- and contralateral stimuli, which is imposed by auditory directionality; when simultaneous presentation of stimuli from the 2 sides is mimicked by presenting low- and high-intensity stimuli simultaneously from the ipsilateral side, the neuron responds selectively to the high-intensity stimulus, even though the low-intensity stimulus is effective when it is presented alone. The selective encoding of the more intense (= ipsilateral) stimulus is due to intensity-dependent inhibition, which is superimposed on the cell's excitatory response to sound. Because of the inhibition, the stimulus with lower intensity (i.e., the contralateral stimulus) is rendered subthreshold, while the stimulus with higher intensity (the ipsilateral stimulus) remains above threshold. Consequently, the temporal structure of the low-intensity stimulus is filtered out of the neuron's spike train. The source of the inhibition is not known. It is not a consequence of activation of the omega neuron. Its characteristics are not consistent with those of known inhibitory inputs to the omega neuron.     

Diagnostic aspects of anxiety disorders]

A concise review is presented of epidemiological, family- and genetic studies in anxiety disorders. Special emphasis is given to recent developments in the classification of anxiety disorders. The literature in which a more central role of panic attacks is suggested, is critically reviewed. Based upon the studies reviewed it is questionable whether the diagnosis agoraphobia without panic attacks is justified.     

Hypothesis testing in distributed source models for EEG and MEG data

Hypothesis testing in distributed source models for the electro- or magnetoencephalogram is generally performed for each voxel separately. Derived from the analysis of functional magnetic resonance imaging data, such a statistical parametric map (SPM) ignores the spatial smoothing in hypothesis testing with distributed source models. For example, when intending to test a single voxel, actually an entire region of voxels is tested simultaneously. Because there are more parameters than observations, typically constraints are employed to arrive at a solution which spatially smooths the solution. If ignored, it can be concluded from the hypothesis test that there is activity at some location where there is none. In addition, an SPM on distributed source models gives the illusion of very high resolution. As an alternative, a multivariate approach is suggested in which a region of interest is tested that is spatially smooth. In simulations with MEG and EEG it is shown that clear hypothesis testing in distributed source models is possible, provided that there is high correspondence between what is intended to be tested and what is actually tested. The approach is also illustrated by an application to data from an experiment measuring visual evoked fields when presenting checkerboard patterns.     

原发性脑室出血的病因、治疗与预后(附35例报告)

35例经CT证实的原发性脑室出血(PIVH)患者。病因是高血压、烟雾病、动静脉畸形、动脉瘤。PIVH分为三型:Ⅰ型室管膜下出血、Ⅱ型部分脑室出血、Ⅲ型全脑室出血。对Ⅰ型非手术治疗。对Ⅱ、Ⅲ型合并意识障碍手术治疗。多数病人生存下来(35例生存29例),但记忆力减退持续存在。     

Punishment — viewed as a dignified alternative

Punishment is clearly defined and re-examined as a treatment technique in a positive and not negative light. A treatment setting involving handicapped children is described and a system of punishment is outlined as an essential part of the regime. The objections to punishment are considered and, in conclusion, a philosophical basis is provided on which it is contended that punishment is a dignified alternative.     

Repair of giant occipital encephaloceles with microcephaly secondary to massive brain herniation

Giant occipital encephaloceles rarely contain large amounts of neural tissue that cannot be replaced in the abnormally small calvarium. Resection of neural elements is therefore often necessary in order to accomplish a closure. A technique is described wherein an extracranial compartment is prepared utilizing fine tantalum mesh to enclose the neural contents. The mesh is attached to the periphery of the skull defect providing a rigid extracranial compartment for the encephalocele. As intracranial pressure increases, the calvarium is forced to expand. The tantalum mesh is gradually imbricated into the calvarium by daily digital compression. If ventriculomegaly occurs, an interval ventriculoperitoneal shunt is placed. The encephalocele repair is reopened and the tantalum is surgically imbricated at that time. This allows for a satisfactory cosmetic result with preservation of all neural elements.