Thirty children were treated for near-drowning in the Children's Hospital, University of Helsinki during 1971--1976. The patients were divided into 3 groups according to the prognosis: group I included 13 children (43%) with a favourable prognosis, group II four children (13%) with a less favourable prognosis who developed severe sequelae, and group III 13 children with poor prognosis and in whom the subsequent outcome proved fatal. The surviving children underwent neurological, neurophysiological and psychological examination 6--58 months after the accident. The children in group I had slight neurological or psychological signs, some children presented a lowered intellectual functioning level. The children in group II were tetraplegic, unable to speak and had convulsions. The following factors were important in affecting prognosis: the longer the immersion time, the worse the prognosis. However, prognosis could still be favourable with an immersion-time of 11-20 min. Prognosis was bad if the first pH value was less than 7.00. The arterial oxygen pressure values measured during the treatment did not correlate with the prognosis but a low rectal temperature on admission was usually associated with a bad prognosis. The degree of EEG-disturbance had a prognostic value. However, the follow-up recording correlated better with the prognosis than the recordings during the first 24 hours, after which worsening of the EEG sometimes showed a progressive brain lesion.
On basis of 35 patients who have suffered from transient global amnesia the pathophysiological mechanisms of this syndrome are discussed. Our impression is that the primary cause of this syndrome is a transient ischemia of the hippocampus, an opinion common with most earlier authors. The possibility of a unilateral hippocampal disturbance resulting in transient global amnesia is discussed. We are inclined to regard the local hippocampal ischemia as arising from insufficiency of the anterior chorioidal artery and thus as a sequel of internal carotid insufficiency, which has earlier been proved to result from various rotatory, flexion, and extension movements of the neck.
SUMMARY Absence status and psychosis-like behaviour and continuous spike-and-wave EEG activity in two elderly women is reported. Once the correct diagnosis was made, the patients were successfully treated with sodium valproate. Differential diagnosis between absence status and psychotic syndromes is emphasised.
Patients with amyotrophic lateral sclerosis were treated with highdose intravenous infusion of human leukocyte interferon for six days. Neuropsychological examinations were carried out before, during and after the treatment. Marked reversible dysfunction was detected in immediate memory functions, coordination of hand movements, and drawing. Motor perseveration, micrographia, and slowing of behaviour were also observed. Changes appeared four to 12 days after start of treatment, with the peak on days six to eight. Recovery was almost complete by day 15. Intellectual ability, as measured by three WAIS subtests, praxis of hand movements, visuognostic functions, speech, reading, writing, and calculation remained essentially unaffected.
Abstract– 6 patients with amyotrophic lateral scleorsis were treated with intravenous infusion of 100–200 million IU per day of human leukocyte interferon. Side effects of treatment included fever, chills, malaise, nausea, marked leukopenia, mild anemia, and thrombocytopenia. Tiredness, confusion, papilledema, and overall signs of acute encephalitis were observed. Tendon reflexes and muscle force decreased. EEG activity was slowed, and evoked potentials showed significant slowing of conduction times. Neuro‐psychological tests revealed congitive dysfunction. The syndrome of inappropriate antidiuretic hormone secretion developed in all patients. All side effects were reversible with cessation of interferon treatment.
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