A report is presented on a patient with Wernicke's encephalopathy secondary to hyperemesis gravidarum. The 25-year-old female presented 11 weeks into pregnancy with prolonged vomiting. Neurological examination 8 weeks later demonstrated obtunded sensations, nystagmus and ataxia of gait. MR imaging revealed bilateral lesions in the mediodorsal nuclei of thalami, in the hypothalamus and in the periaqueductal gray matter (1). The neurological signs and the MRI findings pointed to a diagnosis of Wernicke's encephalopathy. The patient was treated with intramuscular vitamin B1 followed by oral thiamine until the end of pregnancy. The subsequent course of the pregnancy was uncomplicated, and resulted in the delivery of a healthy 2970 g male infant. A review of the literature published during the last 30 years revealed an additional 20 cases of Wernicke's encephalopathy induced by hyperemesis gravidarum. Only half of these pregnancies resulted in the birth of a normal infant.

Objective: The aim of this study was to determine the prevalence of multiple sclerosis (MS) in the population of Csongrád County, Hungary (400,128 inhabitants) and to determine the functional status (based on the Expanded Disability Status Scale; EDSS) of the patients according to the clinical forms of the disease. Methods: The diagnosis was established with the aid of the Poser diagnostic criteria, and the degree of physical disability was determined using the Kurtzke EDSS. Results: In Csongrád County, the prevalence of MS is 62/100,000. The distribution of patients according to the clinical forms of MS was as follows: 15% had the benign form, 54% had relapsing-remitting MS, 20% had secondary chronic progressive MS and 11% had the primary chronic progressive form of MS. Sixty percent of relapsing-remitting MS patients had an EDSS score of 0–4 points and 33% had an EDSS score of 4.5–6.5 points. Conclusion: The distribution of patients according to the clinical forms of the disease in this representative population is comparable to results in other regions of the world.

During a period of 2 years, the number of diagnosed patients has almost doubled. The disease can be recognized in an early stage with a minimal neurological deficit. The development of the diagnostics necessitates re-examinations with modern diagnostic procedures. During the last 3 years, the general practitioner system has been reorganized, and the working relationships between the clinic and family doctors have developed considerably. A comparison of the present findings with those in other countries with a similar climate revealed very similar prevalence data.

Introduction ‐ Inflammatory processes are suspected in the pathomechanism of Alzheimer's dementia (AD) but the serum and cerebrospinal fluid (CSF) levels of inflammatory cytokines are not yet determined in the different forms of the disorder. Subjects and methods ‐ Interleukin‐6 (IL‐6) levels were examined in the sera and CSF of patients with mild‐moderate and severe stage of late onset sporadic type of AD and in the sera of demented Down syndrome (DS) probands with similar stages of AD and compared with data of age‐matched healthy controls.Results ‐ Normal serum IL‐6 levels were found in the mild‐moderate stage, but significantly increased levels were found in the severe stage of both dementia groups. The CSF concentrations remained within the normal range in all groups. Positive correlations between the serum IL‐6 levels and age and the severity of the disease were present. Conclusion ‐ These findings suggest a disease stage dependent general activation of the immune system both in sporadic AD and in DS with AD.

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Abstract. The effects of desglycinamide9-arginine8-vasopressin (DG-AVP) on memory processes have been studied in patients with central diabetes insipidus (DI) and in non-diabetic control patients. Acute im injection of DG-AVP improved some aspects of short-term memory. Subchronic intranasal administration of DG-AVP facilitated short-term memory more consistently and in addition improved long-term memory. DG-AVP increased the attention, but only in the non-diabetic subjects. The effects of DG-AVP on memory processes persisted after discontinuation of treatment. DG-AVP did not affect the parameters for water and electrolyte metabolism, blood pressure and pulse rate neither in DI nor in the control patients. Thus, the memory effects of DG-AVP are probably mediated by a direct action on the central nervous system.

Bilateral temporo-parietal hypoperfusion and decreased glucose metabolism are characteristic in vivo findings in Alzheimer's disease (AD). Lactate is a metabolic vasodilator and is known to induce increased cerebral blood flow in healthy adults. The present study addresses the issue whether sodium lactate infusion affects functional state and resulting electroencephalographic patterns of AD patients. Twelve late-onset sporadic AD probands participated in this self-control study. The relative power and synchronization likelihood (SL) values of the electroencephalographic samples were calculated and compared off-line before and after sodium lactate infusion (0.5 M, 5 ml/kg body weight). Based on the reactivity to sodium lactate the scalp could be divided into three parts; no significant changes were seen in the seriously damaged (P3-P4) areas. The moderately affected regions in the close neighborhood showed a paradoxic inactivation with electroencephalographic slowing, a likely consequence of the metabolic-like steal effect of the near-normal areas outside. These results indicate a diminished vascular and/or metabolic reserve capacity to sodium lactate challenge in AD and confirm the formerly described electroencephalographic abnormalities.

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