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Three non-schizophrenic individuals with drug-induced parkinsonism of a prolonged nature were presented. This is the first report of the occurrence of this extrapyramidal side effect in patients without a diagnosis of psychosis and demonstrates that neuroleptic-induced parkinsonism can occur in such individuals. The prolonged nature of the disability following withdrawal was unusual. Although such occurrences have been previously reported, no long-term study of the natural history of this syndrome has been reported. This study suggests that neuroleptic-induced parkinsonism can last at least 18 months and still disappear completely. This is possibly related to the long persistence of neuroleptic agents within the body.

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Bernard Brouwer (1881-1949), the first ordinary professor of neurology in the Netherlands and a man of prominent stature among continental neurologists, was invited to read lectures at several university clinics in the United States in 1926 and 1933. In this article, we describe Brouwer's impressions from these tours to obtain a view of US neurology in the 1920s and 1930s compared with the state of Dutch neurology. We studied Brouwer's reports of the lecture tours and pertinent materials obtained from several institutes in the United States where he lectured. Brouwer read the Herter Lectures at The Johns Hopkins University (Baltimore, Md) in April 1926 and subsequently visited several American cities. His second tour was by invitation from the Association for Research in Nervous and Mental Disease in New York, NY (1933), and he accepted invitations to visit New Haven, Conn; Boston, Mass; and Montreal, Quebec. According to Brouwer, neuroanatomy in the United States was studied on a wider experimental basis than in Europe. American colleagues, frequently working in teams, tended to have their theoretical-scientific work led by direct practical results. The scientific level among various universities ranged more widely than in the Netherlands, where the levels were homogeneous. In the United States, Brouwer encountered a general willingness to engage in scientific investigations, usually manifesting already in young students and residents, their inquisitive minds being stimulated early. His US colleagues had more assistants in the clinics and laboratories than those in the Netherlands. American neurologists were particularly interested in the anatomic and physiologic features of the meninges and cerebrospinal fluid circulation. American neurosurgeons were vastly advanced in neurosurgery.

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We measured methionine-enkephalin (MET) in platelets and platelet-poor-plasma of drug-free patients with classic migraine, common migraine or tension headache (TH). Migraineurs were studied both between and during attacks. TH patients were characterized by low platelet-MET and high plasma-MET levels, whereas migraine patients showed high platelet-MET and reduced plasma-MET levels. During migraine attacks both platelet and plasma-MET concentrations increased considerably. We suggest that determination of MET levels in platelets and plasma may be a useful marker to discriminate between TH and common migraine. The rise in MET during attacks may be directed against the ictal increase of serotonin.

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