Swiss Archives of Neurology, Psychiatry and Psychotherapy

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Open AccessBook Review

H. J. Deuber, F. Keller, A. Schwarz, Hrsg.: Nierenfunktion und Arzneimittel. Therapie, Kinetik, Wirkung, Toxizität

by EMH Swiss Medical Publishers Ltd.

Swiss Arch. Neurol. Psychiatry Psychother. 2002, 153(7), 338; https://doi.org/10.4414/sanp.2002.01312 - 1 Jan 2002

Viewed by 72

Abstract

Mit ihrem Buch Nierenfunktion und Arzneimittel möchten die Autoren,die überwiegend an süddeutschen Kliniken tätig sind, sowohl nephrologische Fachärzte als auch anderweitig praktizierende Ärzte ansprechen [...] Full article

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Open AccessBook Review

Hilmar Prange, Andreas Bitsch, Hrsg.: Infektionserkrankungen des Zentralnervensystems. Pathogenese, Diagnose und Therapie

by EMH Swiss Medical Publishers Ltd.

Swiss Arch. Neurol. Psychiatry Psychother. 2002, 153(7), 337; https://doi.org/10.4414/sanp.2002.01311 - 1 Jan 2002

Abstract

Die Infektionen des Nervensystems werden nur selten von Neurologen beschrieben, daher schliesst dieses Buch eine wichtige Lücke auf dem Gebiet der Neuroinfektiologie im deutschsprachigen Raum [...] Full article

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Open AccessBook Review

A. Hartmann, W.-D. Heiss, Hrsg.: Der Schlaganfall. Pathogenese, Klinik, Diagnostik und Therapie akuter zerebrovaskulärer Erkrankungen

by EMH Swiss Medical Publishers Ltd.

Swiss Arch. Neurol. Psychiatry Psychother. 2002, 153(7), 337; https://doi.org/10.4414/sanp.2002.01310 - 1 Jan 2002

Abstract

Das vorliegende Lehrbuch befasst sich mit sämtlichen Aspekten des Schlaganfalles und wurde von Grund auf für den deutschen Sprachraum konzipiert [...] Full article

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Open AccessBook Review

H. C. Diener, V. Limmroth: Neurologie für Praktiker

by EMH Swiss Medical Publishers Ltd.

Swiss Arch. Neurol. Psychiatry Psychother. 2002, 153(7), 337-338; https://doi.org/10.4414/sanp.2002.01309 - 1 Jan 2002

Abstract

Die Autoren haben ein interessantes Neurologielehrbuch geschrieben, welches sich in erster Linie an Hausärzte, an Allgemeinmediziner oder hausärztlich tätige Internisten richtet. Neurologie für Praktiker ist ein gut verständlich geschriebenes Lehrbuch, das sich an der Häufigkeit neurologischer Symptome und Krankheitsbilder orientiert [...] Full article

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Open AccessAbstract

6. Jahrestagung der Zerebrovaskulären Arbeitsgruppe der Schweiz 6^e Réunion du Groupe suisse de travail pour les maladies cérébrovasculaires

by EMH Swiss Medical Publishers Ltd.

Swiss Arch. Neurol. Psychiatry Psychother. 2002, 153(7), 326-335; https://doi.org/10.4414/sanp.2002.01306 - 1 Jan 2002

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Abstract

Hypersomnia, defined as excessive sleepiness or sleep-like behaviour, can reflect insufficient arousal (de-arousal) following disruption of the ascending reticular activating formation, increased production of sleep, or both. The frequency and clinical characteristics of post-stroke hypersomnia are poorly known [...] Full article

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Open AccessReview

50 years of peripheral nerve surgery: a neurologist’s view

by Marco Mumenthaler

Swiss Arch. Neurol. Psychiatry Psychother. 2002, 153(7), 321-324; https://doi.org/10.4414/sanp.2002.01304 - 1 Jan 2002

Cited by 1 | Viewed by 86

Abstract

When the author started his training as a neurologist exactly 50 years ago, the only diagnostic tools used were clinical examination and testing of excitability of peripheral nerves and muscles by electrical square waves impulses. The EMG was introduced to Switzerland in 1953. [...] Read more.

When the author started his training as a neurologist exactly 50 years ago, the only diagnostic tools used were clinical examination and testing of excitability of peripheral nerves and muscles by electrical square waves impulses. The EMG was introduced to Switzerland in 1953. In the early fifties of the last century the carpal tunnel syndrome was redetected and became clinically important. Then a real boom of entrapment syndromes began and also became somewhat exaggerated. Lesions of peripheral nerves were repaired 50 years ago by every general surgeon and suture under tension was too frequently applied. Finally interponates were used. It had to be shown that only autotransplantates were really successful. The technique of peripheral nerve surgery got more and more sophisticated and more and more specialists were trained.The widespread use of the microscope started. Nowadays the peripheral nerve surgeon is by himself an excellent specialist, not only in the treatment but also in the diagnosis of peripheral nerve lesions. Full article

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Open AccessArticle

Aetiologies, clinical and vascular findings in symptomatic and asymptomatic carotid artery occlusion

by Th. Baumann, A. J. Steck and Ph. Lyrer

Swiss Arch. Neurol. Psychiatry Psychother. 2002, 153(7), 316-320; https://doi.org/10.4414/sanp.2002.01303 - 1 Jan 2002

Cited by 1 | Viewed by 78

Abstract

Carotid artery occlusion (CAO) is an important finding in stroke with different aetiologies. It most often occurs at the carotid bifurcation, less often at the intracranial portion of the internal carotid artery and rarely at the common carotid artery. Clinical presentations range from [...] Read more.

Carotid artery occlusion (CAO) is an important finding in stroke with different aetiologies. It most often occurs at the carotid bifurcation, less often at the intracranial portion of the internal carotid artery and rarely at the common carotid artery. Clinical presentations range from asymptomatic cases to severe neurological deficits or death. Cerebrovascular events in carotid artery occlusion have been attributed to either thromboembolic and/or haemodynamic mechanisms. The sensitivity and specificity of newer Duplex ultrasound techniques were found to be high for the detection of carotid artery occlusion in case studies as well as in a metaanalytic review. In this retrospective study of 174 consecutive patients with either symptomatic (SCAO) or asymptomatic carotid artery occlusion (ACAO) detected by neurosonological methods, the clinical characteristics and findings of diagnostic tests are summarised. The vast majority of patients in the ACAO group was examined because of a cerebrovascular event not related to the occluded carotid artery. Clinical data included sex, age, vascular risk factors, medication, site of occlusion, stroke syndrome according to the Oxford Community Stroke Project, result of digital subtraction angiography (DSA) in selected cases, presumed aetiology after diagnostic work-up and outcome. Carotid artery occlusion was symptomatic in 67% and asymptomatic in 31%.The high proportion of asymptomatic carotid artery occlusions contributed to a relatively good outcome of carotid artery occlusion, leaving 69% with no or only slight disability (Rankin scale 0–2). In patients with proximal carotid artery occlusion who had undergone digital subtraction angiography the rate of near occlusions was 14%. Atherosclerosis was the most common cause of carotid artery occlusion (78%), followed by dissection (5%) and emboli from infracarotideal structures (2%). In 14% no aetiology could be identified after complete diagnostic work-up. Comparisons made between the symptomatic and asymptomatic group mainly revealed different aetiologies. Patients with asymptomatic carotid artery occlusion usually had atherosclerosis, while in symptomatic carotid artery occlusion further aetiologies like dissection and embolism were observed. Symptomatic carotid artery occlusion did not differ from asymptomatic carotid artery occlusion regarding collateral pathways, contralateral high-grade stenosis, vascular risk factors or demographic data. The result that patients with asymptomatic carotid artery occlusion were more often on treatment with oral anticoagulants could not be explained by an overrepresentation of patients with atrial fibrillation. This unexpected finding needs to be confirmed by further studies. The relatively high rate of near occlusions missed by neurovascular ultrasound may be due to the condition that angiography was only performed in doubtful cases. Nevertheless, the fact that the rate was still over 5% if patients without angiography were included raises the question whether the rate of false-positive carotid artery occlusion ultrasound findings might be higher than previously reported. Full article

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Open AccessReview

Psychopharmakotherapie und Psychotherapie in der Kinder- und Jugendpsychiatrie unter Berücksichtigung neurobiologischer Aspekte

by Barbara Steck

Swiss Arch. Neurol. Psychiatry Psychother. 2002, 153(7), 308-315; https://doi.org/10.4414/sanp.2002.01305 - 1 Jan 2002

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Abstract

Child and adolescent psychopharmacological treatment is much more than writing prescriptions, even if psychopharmacological interventions in various psychiatric diseases of children and adolescents have been helpful to reduce psychological suffering and improve quality of life. Psychopharmacological treatment for children and adolescents has to [...] Read more.

Child and adolescent psychopharmacological treatment is much more than writing prescriptions, even if psychopharmacological interventions in various psychiatric diseases of children and adolescents have been helpful to reduce psychological suffering and improve quality of life. Psychopharmacological treatment for children and adolescents has to consider specific implications: the evaluation of psychopharmacological agents indicated for various psychiatric disorders is still insufficient and remains difficult in the child and adolescent age group, the majority of the drugs on the market are legally not yet approved for children und adolescents, the long-term effects of the psychopharmacological therapy on the development of children and adolescents are for most of the drugs still not known. In children and adolescents with a serious psychiatric symptomatology, knowledge and application of different treatment methods are mandatory. In most cases of severe psychiatric disorders psychopharmacological therapy is necessary, yet cannot be applied as the only therapeutic intervention. Combination with psychotherapy is indicated. The following question has to be asked: which symptoms or disorders should be treated in order to improve the child’s relationship with its parents and to promote the child’s psychological development? The autonomy of the patient and his or her parents has always to be respected. It is the task of the child and adolescent psychiatrist to integrate knowledge of the mechanisms of pharmacological treatment and the underlying neurobiological processes, and at the same time to offer a significant relationship and a meaningful dialogue in order to meet the need of the ill child and its family. The article discusses psychobiological aspects of early influences in brain development according to various research data, as well as effects on memory and the regulation of the hypothalamicpituitary- adrenal axis. The differences of psychopharmacological treatment of psychiatric disorders in children and adolescents with respect to adult psychopharmacotherapy are described: the child’s symptomatology is closely related to its emotional, cognitive and psychosocial developmental process, as well as to the context in which the child is living.The differences in pharmacological efficacy in children are due to numerous factors such as differential expression of neurotransmitters and receptors in childhood.The importance of a therapeutic concept for each individual ill child and its family and the necessity to consider multiple factors are presented. The author deals with depressive syndromes and their treatment modalities in children and adolescents. Various interventions – psychopharmacology, different forms of psychotherapy – have shown their efficacy, demonstrating the complexity of the interactions of neurobiological processes and environmental influences, as well as the plasticity of neuronal structures and functions. Coping with a psychiatric but also a somatic disease shows a great individual variability and depends on a multitude of individual psychological resources as well as external circumstances such as parental or family support. Even if psychopharmacological treatment improves symptoms, dysfunctions or impairment due to the illness, it is the psychotherapeutic relationship which may help the child or the adolescent to deal better with personal suffering and understand what subjective meaning the disease has for her- or himself. Early pharmacological and psychotherapeutic intervention in children who were subjected to deleterious environmental influences may prevent neuro-developmental changes and reduce the risk of developing psychopathology. Full article

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Open AccessReview

Antibody Testing in Peripheral Neuropathies: A Critical Approach

by Adam Czaplinski and A. J. Steck

Swiss Arch. Neurol. Psychiatry Psychother. 2002, 153(7), 301-307; https://doi.org/10.4414/sanp.2002.01307 - 1 Jan 2002

Cited by 3 | Viewed by 136

Abstract

A number of autoantibodies that induce inflammation on autoimmune peripheral neuropathies have been described.We review the techniques to measure autoantibodies and assess the usefulness of antibody assays in acquired acute demyelinating neuropathies such as Guillain-Barré syndrome (GBS) and chronic acquired demyelinating neuropathies including [...] Read more.

A number of autoantibodies that induce inflammation on autoimmune peripheral neuropathies have been described.We review the techniques to measure autoantibodies and assess the usefulness of antibody assays in acquired acute demyelinating neuropathies such as Guillain-Barré syndrome (GBS) and chronic acquired demyelinating neuropathies including CIDP, multifocal motor neuropathy and MGUS neuropathy. In acute acquired demyelinating neuropathies associations of clinical characteristics and specific infections and the presence of anti-ganglioside antibodies have been found. Since diagnostic criteria have been available to subclassify Guillain-Barré syndrome in different clinical variants including clinical, electrophysiological, pathological and immunological findings, several varieties have been described: pure motor forms, sensory forms, primary axonal and primary demyelinating varieties. However, further studies are necessary to validate the usefulness of this subclassification with respect to treatment and prognosis.This is particularly important if subgrouping of GBS patients may lead to more individualised treatment. It has been suggested that for the IgG anti-GM1-positive subgroup of GBS patients, IVIg therapy may be the more efficacious treatment than plasmapheresis. The spectrum of chronic acquired demyelinating polyneuropathies cover different entities that have recently been categorised in three major groups: chronic inflammatory demyelinating polyneuropathy( CIDP),multifocal motor neuropathy(MMN) and MGUS neuropathy. Though the majority of CIDP patients respond well to immunotherapy, no constant autoantibody activity has been reported. In MMN serum antibodies, mostly IgM to the ganglioside GM1 or less frequently to asialo-GM1, GD1a or GM2 have been reported by ELISA in a variable proportion of MMN patients with a prevalence for anti-GM1 IgM in most large series, ranging from 30 to 60%.The reasons for these discrepant figures are still unclear but may be related to differences in the ELISA procedure or in the controls used to establish normal reference values. Antibodies to the myelin-associated glycoprotein (MAG) are detected in 50 to 60% of patients with neuropathy and immunoglobulin M (IgM) monoclonal gammopathy. Most patients have a slowly progressive, sensory or sensorimotor, demyelinating polyneuropathy. A causal relation between anti-MAG antibodies and neuropathy is supported because pathologic studies of sural nerve biopsies of patients with neuropathy and anti-MAG IgM monoclonal gammopathy show demyelination associated with IgM deposits on the affected myelin sheaths.We conclude that testing for serum autoantibodies should never be the first step in the work-up of peripheral neuropathy but an additional diagnostic measure after careful clinical and electrophysiological evaluation. High quality standards for a diagnostic antibody test should be applied. In our experience anti-MAG antibodies are a valuable marker that is relevant for diagnosis. Patients with chronic demyelinating polyneuropathies should be screened for anti-MAG antibodies. We test all our patients with lower motor neuron disease or motor neuropathies for anti- GM1 antibodies.We do not routinely test for anti- GM1 or related gangliosides in Guillain-Barré syndrome as the results have not yet a definite impact on the diagnosis or treatment regimen. Full article

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Swiss Arch. Neurol. Psychiatry Psychother., Volume 153, Issue 7 (01 2002) – 9 articles

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