Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Apr 1978
Case ReportsSpinal cord necrosis after intrathecal injection of methylene blue.
A 59 year old man had 6 ml of unbuffered methylene blue injected into the lumbar theca in an attempt to localise the source of cerebrospinal fluid rhinorrhoea. After injection of the dye he became shocked, and within the next few days he developed a mild paraparesis which subsequently progressed to a total paraplegia. The distribution of the spinal cord damage found at necropsy, eight and a half years after injection of the dye, is described and its relationship to the clinical picture discussed.
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J. Neurol. Neurosurg. Psychiatr. · Mar 1978
Comparative StudyPatterns of performance in amnesic subjects.
Patients with Korsakoff's syndrome, dementia, alcoholism, right and left temporal lobectomy, and normal subjects were compared on verbal learning and picture recognition memory tasks. Alcoholics and right lobectomy patients were similar on all measures, but the other groups had a characteristic pattern, particularly on hit and false positive rates in picture recognition.
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A method, multiple point stimulation, has been reported to isolate 5-20 single hypothenar or thenar motor units for investigation. This method is attractive for testing neuromuscular transmission because the required stimulus intensities are much less than for supramaximal nerve stimulation, and movement artefact is less of a problem. ⋯ In healthy motor units, increases in the surface peak-to-peak voltage and corresponding reductions in the peak-to-peak duration occurred, the changes being maximum at the shorter stimulus intervals and accompanied by increased synchronisation of motor unit muscle fibre action potential discharges. The investigations of the responses for healthy single motor units to repetitive stimulation provide the basis for investigations of neuromuscular transmission at the level of the motor unit in diseases of neuromuscular transmission.
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J. Neurol. Neurosurg. Psychiatr. · Feb 1978
Case ReportsIntraspinal arachnoiditis and hydrocephalus after lumbar myelography using methylglucamine iocarmate.
A 35 year old woman developed a severe meningeal reaction after lumbar myelography using the water-soluble contrast medium methylglucamine iocarmate. Three months after myelography the findings were a transverse spinal cord syndrome corresponding to the middle thoracic segments resulting from well developed leptomeningeal adhesions. ⋯ After treatment with a ventriculoatrial shunt the patient is almost free of symptoms. A possible pathogenetic relationship between the contrast medium, the chronic leptomeningeal changes, and the symptoms of our patient is discussed on the basis of the literature.
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Spinal arachnoiditis is a rare condition. Eighty cases, diagnosed during a period when 7600 spinal contrast investigations were undertaken, have been reviewed. ⋯ This accounts for the persistence of radicular symptoms and the relatively low incidence of paraplegia when compared with earlier series. Surgery does not appear to have any role in the treatment.