Increased level of tonic sympathetic arousal in high-vs. low-alexithymic cervical dystonia patients

The purpose of this study was to assess whether alexithymia is a risk factor for autonomic dysregulation in cervical dystonia (spasmodic torticollis, ST). Alexithymia was assessed by an authorized German version of the TAS-20. In a first step, we recruited 10 ST-patients with high alexithymia scores (> 62; M = 69.2, SD = 3.0) and compared them with 10 ST-patients with low alexithymia scores (< 35; M = 28.7, SD = 4.3) on physiological and subjective responses to a cognitive and an emotional laboratory stressor. High-alexithymic ST-patients generally showed increased levels of autonomic arousal (higher SCL, more NS.SCF and lower T; 0.016 /= 57 vs. low 相似文献   

Ophthalmoplegie,Ataxie, Areflexie (Fisher-Syndrom)

Zusammenfassung Es werden fünf Fälle eines in der Literatur gewöhnlich nach M. Fisher benannten und im deutschen Sprachraum bislang noch nicht beschriebenen Syndroms dargestellt und in ihrer Ätiologie, klinischen Symptomatik und nosologischen Zuordnung diskutiert.Die Hauptmerkmale des klinischen Verlaufs (1. vorangehender Infekt, 2. Paraesthesien in den Händen, 3. cerebelläre Ataxie, 4. Doppelbilder, 5. komplette externe Ophthalmoplegie, 6. kurzfristig träge Pupillenreaktionen, 7. Areflexie, 8. minimale oder ganz fehlende Sensibilitätsstörungen und Paresen, 9. vollständig erhaltendes Bewußtsein, 10. cyto-albuminäre Dissoziation im Liquor, 11. Rückbildung ohne spezifische Therapie) entsprechen in allen Einzelheiten den bisherigen Beschreibungen. Virologiseh konnte in zwei Fällen ein cytopathischer Effekt auf Affennierenzellen nachgewiesen und bislang über drei Passagen fortgeführt werden. Die Untersuchungen sind noch nicht abgeschlossen.Die auffallende und sehr gleichförmig verlaufende Symptomatik des Syndroms wird als atypische Polyradiculitis (Guillain-Barrésches Syndrom) mit bevorzugter Beteiligung des Hirnstammes aufgefaßt. Dadurch erklärt sich auch das in der ausführlich diskutierten Literatur umstrittene Problem der cerebellären Ataxie als Folge eines Befalls cerebellärer Bahnen im Hirnstamm.     

Outcome after conservative treatment of Perthes' disease in children

Background. This article presents outcomes after conservative treatment of Perthes' disease according to Staheli's algorithm. Material and methods. We analyzed 38 children (30 boys and 8 girls), ranging in age from 2.5 to 10 years, who were treated in the period 1995-2003 using a homogeneous conservative method. Treatment consisted in the application of exercises to increase or maintain a full range of movement, swimming pool exercises, load release on the limb (crutches), and indirect traction. Clinical and radiological examinations were used to assess the outcome, and the results of this method were compared to the outcomes described in the literature. Results. In all subjects, after an average 3.8-year observation period, we observed reconstruction of the femoral head and a good functional outcome, regardless of age. Conclusions. Treatment of Perthes' disease by using crutches to relieve limb load, and by applying kinesitherapy and traction, allows for good results, comparable to those achieved with other conservative methods. The most decisive factors for treatment outcome are the child's age at onset and the degree of advancement of the changes.     

Chronisch subdurales Hämatom bei einem Patienten mit Verdacht auf Prodromalstadium einer Schizophrenie

A patient showing "prodromal symptoms" of suspected psychosis was referred to our clinic specialized in early recognition of schizophrenia where an MRI brain scan showed a chronic subdural hemorrhage. Based on this case, it will be shown that organic brain disease, in addition to incipient schizophrenia, needs to be considered in patients with marked personality changes, social withdrawal, aggressiveness, and suspiciousness. Diagnosis of the first episode and prodromal stage of schizophrenia should include-apart from the case history as well as the psychopathological and physiological findings-certain obligatory medical examinations (EEG, cCT, or MRI) in order to identify possible organic causes and avoid misdiagnoses.