Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · May 2004
Randomized Controlled Trial Multicenter Study Clinical TrialMulticentre, randomised, double blind, placebo controlled, phase III study of weekly, low dose, subcutaneous interferon beta-1a in secondary progressive multiple sclerosis.
Interferon (IFN) beta has repeatedly shown benefit in multiple sclerosis (MS) in reducing the rate of relapse, the disease activity as shown with magnetic resonance imaging and, to some degree, the progression of disability; however, it is unknown how much the therapeutic response depends on the dose, the subgroup involved, and the disease stage. This multicentre, double blind, placebo controlled study explored the dose-response curve by examining the clinical benefit of low dose IFN beta-1a (Rebif), 22 micro g subcutaneously once weekly, in patients with secondary progressive MS. ⋯ This patient population was less clinically active than SPMS populations studied in other trials. Treatment with low dose, IFN beta-1a (Rebif) once weekly did not show any benefit in this study for either disability or relapse outcomes, including a subgroup with preceding relapses. These results add a point at one extreme of the dose-response spectrum of IFN beta therapy in MS, indicating that relapses in this phase may need treatment with higher doses than in the initial phases.
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J. Neurol. Neurosurg. Psychiatr. · May 2004
Randomized Controlled Trial Clinical TrialClozapine in drug induced psychosis in Parkinson's disease: a randomised, placebo controlled study with open follow up.
To compare the efficacy and safety of clozapine in drug induced psychosis in Parkinson's disease (PD). ⋯ Clozapine at a mean dose lower than 50 mg/day improves drug induced psychosis in PD without significant worsening of motor function, and the effect wears off once the treatment stops.
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J. Neurol. Neurosurg. Psychiatr. · May 2004
Electromagnetic function of polymicrogyric cortex in congenital bilateral perisylvian syndrome.
Congenital bilateral perisylvian syndrome (CBPS) is characterised by bilateral perisylvian polymicrogyria and suprabulbar paresis. Mild tetraparesis, cognitive impairment, and epilepsy are frequently associated. Sensory deficits are surprisingly rare, even though polymicrogyria often extends to auditory and sensorimotor cortex. ⋯ Plastic changes of sensory and motor cortex location suggest disturbed cortex organisation in CBPS patients. Because the polymicrogyric cortex of CBPS patients may embed normal functions in unexpected locations, functional mapping should be considered before brain surgery.
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J. Neurol. Neurosurg. Psychiatr. · May 2004
Case ReportsTreatment of anterior canal benign paroxysmal positional vertigo by a prolonged forced position procedure.
This report presents a therapeutic procedure for refractory benign paroxysmal positional vertigo (antBPPV) of the anterior canal. Two patients with refractory antBPPV were treated by a prolonged forced position procedure (PFPP). The technique is based on the assumption that the pathophysiological mechanism of antBPPV is similar to that generating posterior canal canalolithiasis. ⋯ The rationale for this therapy is that when the patient lies in the proposed forced position, the affected anterior canal is uppermost in an almost gravitationally vertical position. If the patient remains in this position for several hours, the floating particles lying in the non-ampullary arm of the canal can gradually slip out of the canal towards the vestibule due to gravity. We recommend trying PFPP when the side of lithiasis cannot be determined, in cases that are resistant to particle repositioning canal manoeuvres, and before considering canal plugging for refractory antBPPV.
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J. Neurol. Neurosurg. Psychiatr. · May 2004
Multicenter StudyThe seven minute screen: a neurocognitive screening test highly sensitive to various types of dementia.
The seven minute screen (7MS) is a compilation of the temporal orientation test, enhanced cued recall, clock drawing, and verbal fluency. It has been shown to be useful for detecting Alzheimer's disease in a population of patients with memory complaints. ⋯ The 7MS is a useful screening tool for discriminating patients with dementia from cognitively intact patients. This not only applies to Alzheimer's disease but also to other types of dementia. Specificity with respect to depression was lower for the 7MS than for the MMSE.