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This Month in Archives of Neurology
August 1999

This Month in Archives of Neurology

Arch Neurol. 1999;56(8):910-911. doi:10.1001/archneur.56.8.910

Botulinum Toxin and the Autonomic Nervous System

Naumann and colleagues review the merits and demerits of botulinum toxin in treating disorders of the autonomic nervous system. Problems with excessive sweating, bladder control, and gastrointestinal motility are discussed. This is a new and developing area of neurotherapeutics that will be of increasing interest.Article

Magnetic Resonance Spectroscopy

Rudkin and Arnold present a state-of-the-art scientific review of the information provided by magnetic resonance spectroscopy to evaluate the metabolic state associated with epilepsy, multiple sclerosis, brain tumors, HIV-1–associated neurological disorders, cerebrovascular disease, and neurodegenerative disorders. One envisions online magnetic resonance spectroscopy in the neurosurgical intensive care unit as a useful adjunct in patient management.Article

Automatic and Posturing Behaviors in Temporal Lobe Epilepsy

In a careful study, Dupont et al outline the association of ipsilateral motor automatisms and contralateral dystonic posturing in different types of temporal lobe epilepsy. Their findings explain these complex behaviors in useful neurophysiological terms.Article

Interferon-γ and Myasthenia Gravis

Data are presented by Bongioanni and colleagues for a persistent activation of the immune system in patients with myasthenia gravis. They report that reduced cell surface interferon-γ receptors seem to be related to enhanced T-lymphocyte immune function.Article

Genetic Spastic Paraplegias

Coutinho and colleagues describe their experience in Portugal with autosomal recessive inherited spastic paraplegias and find a heterogeneous group of diseases. They report that a given phenotype has different genotypes and that a given genotype is found to have several phenotypes. Again, the genotype settles the issue.Article

Magnetic Resonance Imaging in Creutzfeldt-Jakob Disease

Na and colleagues in Korea describe focal abnormalities on diffusion-weighted images in patients with probable Creutzfeldt-Jakob disease. Correlations with abnormal metabolism or perfusion on positron emission tomography and single photon emission computed tomography are also described. Their observations extend previous studies and suggest a diagnostic imaging approach to this class of prion diseases.Article

Apolipoprotein E ϵ4 Allele in Late-Onset Dementia

Barber et al studied the apolipoprotein E ϵ4 allele and temporal lobe atrophy or white matter lesions as measured by magnetic resonance imaging in Alzheimer disease, vascular dementia, and dementia of Lewy body type. They find that although the presence of the apolipoprotein E ϵ4 allele may modify the risk for acquiring Alzheimer disease, it does not influence subsequent pathological processes.Article

Strokes in Children

Bonduel and colleagues studied a series of children who presented with a variety of risk factors for thrombosis. A variety of prethrombotic disorders were found in 30% of their patients. They stress the importance of performing a complete hemostatic evaluation on all children with arterial ischemic stroke and sinovenous thrombosis.Article

Seasonal Optic Neuritis

Jin and colleagues report optic neuritis in Sweden occurring in an uneven frequency across seasons, with the highest incidence in spring and the lowest in winter. The various factors and issues involved are discussed in this important epidemiological study.Article

Imaging Midbrain Dystonia

Patients with unilateral symptomatic poststroke dystonia with a well-defined midbrain lesion were studied using stereotaxic magnetic resonance analysis and positron emission tomography with fluorodopa F 18. The findings indicate that dopaminergic dysfunction plays an important role in the occurrence and severity of midbrain dystonia and tremor. This is an elegant clinical, anatomical, and imaging study conducted by Vidailhet et al. Article

Treating Dementia With Antihypertensive Medication

Guo and colleagues present convincing data that the use of diuretics protects against dementia in the elderly population studied. It is of considerable interest that patients with baseline dementia who were not taking diuretics had a 2-fold faster rate of decline in their score on the Mini-Mental State Examination than those taking diuretics. More attention needs to be paid to this important clinical observation. Article

Stimulating Parkinson Disease

Ceballos-Baumann et al report that subthalamic nucleus stimulation reduces the movement-related impairment of frontal motor associations and the inappropriate motor cortex resting activity in patients with Parkinson disease as quantitated further by positron emission tomography. The neurophysiological rationale for this therapy is clarified in this elegant study.Article