Document 6596533

.*3tKT COLLEGE
A Journal of Neurology
1967
Volume 90
Part IV
Defective Autonomic Control of Blood Vessels in Idiopathic Orthostatic Hypotension. Roger Bannister, Leslie Ardill and Peter Fentem
..
..
The Circle of Willis—the Incidence of Developmental Abnormalities in Normal
and Infarcted Brains. S. K. Battacharji, E. C. Hutchinson and A. J.
McCall
Intracerebral Microaneurysms and Small Cerebrovascular Lesions. F. M. Cole
and Peter Yates
Cerebral Effects of Rewanning following Prolonged Hypothermia: Significance
for the Management of Severe Cranio-cerebral Injury and Acute Pyrexia.
Maurice Bloch
A Pharmacological Investigation of Cerebro-spinal Fluid from Patients with
Migraine. Margaret Barrie and Alison Jowett
..
..
..
..
Experimental Porphyria and its Relationship to the Human Disease. T.
Lehoczky, J. Sos, L. Selmeci and Margit Halasy ..
..
..
..
Clinical, Biochemical and Histopathological Findings in a Family with Muscular
Dystrophy. L. J. Hurwitz, Nina A. J. Carson, Ingrid V. Allen, T. F.
Fannin, J. A. Lyttle and D. W. Neill
Nemaline Myopathy: Report of a Fatal Case, with Histochemical and Electron
Microscopic Studies. S. A. Shafiq, Victor Dubowitz, Hart de C. Peterson
and A. T. Milhorat
The Brain in Multiple Neurofibromatosis (von Recklinghausen's Disease): a
Suggested Neuropathological Basis for the Associated Mental Defect.
N. Paul Rosman and John Pearce ..
..
..
..
..
..
"Infantile Hydranencephaly"—a Report of Five Cases of Infarction of both
Cerebral Hemispheres in Infancy. Richard Lindenberg and Phillip D.
Swanson
Ataxia and other Neurological Disorders as Sequels of Severe Hypoglycaemia in
Childhood. T. T. S. Ingram, G. D. Stark and Ivy Blackburn ..
..
Progressive Multifocal Leukoencephalopathy: Electron Microscope Study of
Four Cases. M. A. Woodhouse, A. D. Dayan, J. Burston, I. Caldwell,
J. Hume Adams, D. Melcher and H. Urich ..
..
..
..
..
Geographical Considerations in Multiple Sclerosis. Uri Leibowitz, David
Sharon and Milton Alter
Spinal Segmental and Long-loop Reflexes on Spinal Motoneurone Excitability
in Spasticity and Rigidity. C.-B. Yap
The Effect of Undernutrition and Subsequent Rehabilitation on the Growth
and Composition of the Central Nervous System of the Rat. J. W. T.
Dickerson and Ann L. Walmsley
..
..
..
..
..
..
Notices of Recent Publications
..
..
..
..
..
..
..
Index
725
747
759
769
785
795
799
817
829
839
851
863
871
887
897
907
915
MACMILLAN (JOURNALS) LTD, LITTLE ESSEX STREET, LONDON, W.C.2
Advertisements
EDITOR IN CHIEF
Dr. Denis Williams, C.B.E.
EDITORIAL BOARD
Prof. John Cumings
Dr. Bryan Matthews
Prof. Brodie Hughes
Dr. Peter Nathan
Prof. William McMenemey
Prof. Charles Phillips, F.R.S.
ADVISERS
Dr. D. E. Broadbent
Prof. Roger Gilliatt
Dr. R. T. C. Pratt
Prof. David Whitteridge,
F.R.S.
Dr. J. W. D. Bull
Dr. Ronald Henson
Dr. J. D. Spillane
Prof. John Cavanagh
Mr. Valentine Logue
Prof. P. D. Wall
Prof. Oliver Zangwill
SECRETARY AND TREASURER
Dr. Samuel Nevin
All Editorial Communications, Typescripts and books for review to be addressed to The Editor of
Brain, The National Hospital, Queen Square, W.C. 1.
All Communications concerning subscriptions, or the supply of copies of the Journal, to be sent
to the Publishers, Messrs. MACMILLAN (JOURNALS) LTD., Little Essex Street, W.C.2.
Directions to Authors with regard to the Preparation of Papers for Publication.
PAPERS must be typewritten on one side of the paper only and double-spaced, and should
not be carbon copies. The typescript should be carefully revised before submission to the Editor.
Insertions and written corrections in the proofs should be avoided as far as possible, and when
made should be legible.
BIBLIOGRAPHICAL REFERENCES should be listed in duplicate at the end of the paper in
alphabetical order, and not numbered. In the case of a Journal, the author's name, date of
publication in brackets, are followed by the name of the Journal (abbreviated according to the
World List of Scientific Periodicals), the volume number and the first and last page number of
the paper quoted, both in Arabic numerals. In the case of a book: Author's name, date of
publication in brackets, title of book, place of publication, and the publisher's name.
Works by the same author should be given in chronological order, and if there be more than
one in a year, they are marked a, b, c, &c. when an author's name recurs a short line is used.
In the Text numbered references are not used, but the author's name is followed by the date
(in brackets) of the publication cited.
ILLUSTRATIONS should be line drawings where possible, and must be in Indian ink on white
paper or Bristol boards. Drawings should be about twice the size of the reproduction, and
thus lines must be thick enough to show up after reduction. Lettering is best left to the engraver,
but should be written in legibly in pencil. All illustrations should be on separate sheets, should be
numbered in order and bear the author's name. Legends, also, should be on separate pieces of
paper and numbered in order.
Half-tone reproductions should be kept to a minimum; good photographs are essential. Authors
are asked to contribute to their cost.
We refer intending authors to the Journal of Physiology's "Suggestions to Authors," price 2s.
post-free from Cambridge University Press, Box 92, 200 Euston Road, London, N.W.I.
Authors are supplied free of charge with 50 copies of each paper reprinted in the form in which
the paper stands in the page of Brain. If further reprints are desired, authors are responsible
for ordering these direct from Messrs. STAPLES PRINTERS LIMITED, Bridgwater Road, London,
E.I5, at the time they receive the galley proofs. If wrapper, title and renumbering of pages are
desired, authors must specify the same when ordering.
Price 20s. net.
Subscription 84s. net
Entered u Second Class Matter, April 24, 1929, at the Pott Office at Boston, Mass., under the Act of March 3,1197
(Sec. 397, P.L. and R.).
Printed in Great Britain.
vt ••
•fv
Management of the manic phase of a manic-depressive illness*
'He was surprisingly unresentful about his stay in the
'secure' ward. So long as he had plenty of paper and
pencils, he was happy re-planning the world and would
rush up to any visitor anxious to expound his latest
theories. He admitted to hallucinations of sound and
sometimes acted under their instructions — once when he
hit a nurse . . . The threat of physical exhaustion and
unpredictable violence made it vital to control the illness
with speed, and intramuscular 'Stelazine' was given eighthourly starting with a dose of 4 mg. as he was a big man,
and then adjusting the dose between 1 mg. and 3 mg.
according to his state. Within 48 hours he was taking
nourishment normally and catching up on sleep.'
'Oral medication with 'Stelazine' 10 mg. twice a day, plus
an anti-Parkinsonism drug, was then given. Though
major problems of nursing soon passed, he remained
grandiose and without insight for several weeks, and
absconding was feared. E.C.T. was even considered, but
proved unnecessary. Frequent reassuring visits of his wife
helped, and awareness as to how abnormally he had
behaved slowly dawned on him.'
'After two weeks in a convalescent villa and a couple of
successful weekends at home, he was discharged on a
daily maintenance regimen of one 15 mg. 'Stelazine
Spansule' Capsule at night.'
* Excerpts from a case narrative prepared by a consultant psychiatrist,
based on actual patient records. Certain minor details have been changed
to protect individuals.
in psychiatry many symptoms respond to
the major tranquillizer with the invaluable alerting action
Now available as 'Spansule' Capsules 10 mg. and 15 mg.: also Tablets 5 mg., Concentrate in 114 ml. (4 fl. oz.) bottles containing
10 mg. 'Stelazine' per ml., and Ampoules 1 mg./ml. Literature giving full prescribing information available o n request.
SMITH KLINE A N D FRENCH LABORATORIES LTD W E L W Y N GARDEN CITY, HERTFORDSHIRE
'Stelazioe' (brand or trifluoperazioe dihydrochloride) and 'Hpausule' are trade marlu. BZ: PA 128
mmm
"...and well
have you right
in next to no time"
(a rapid response is
characteristic
with
'Concordin'-10)
'All 56 patients who improved on
protriptyline did so within the first
2 weeks and 23 of them (41 per cent)
showed initial improvement during
the first 7 days. None of the 54
improved imipramine cases showed
initial improvement by the end of the
first week; 27 (50 per cent) showed
it during the second week, 26 (48.1
per cent), during the third week and
1 patient (1.9 per cent) required 3
weeks. This was observed uniformly
in all the diagnostic categories.'
From a paper presented at the
IVth World Congress of Psychiatry,
Madrid. September 5-11. 1966.
'A particularly notable feature was
the rapid onset of action following
the administration of protriptyline.
In 30 of the 47 patients in whose
clinical condition lack of drive
predominated, a distinct
improvement was observed during
the first three days. By the end of
the fifth day of treatment, eight
other patients reported an
improvement, and only in 9 of the
47 patients did it take longer to
affect the lack of drive favourably.'
Med.Klin.A 966,61,1876 (25 Nov)
CONCORDIN-10
Protriptyline hydrochloride
a powerful antidepressant
Rapid improvement
Response is often seen within a week
the patient improves early in treatment,
doctor-patient rapport is enhanced.
Highly effective
Frequently successful even when
patients fail to benefit from other
antidepressants.
Versatile
Suitable for both in-patients and
out-patients; dosage is simple and
'Concordin' is usually well tolerated.
Essentially free from sedative
activity
Since drowsiness is rare, normal
daily activities can be performed —
an important consideration when
prescribing for out-patients.
No dietary restrictions
Not a monoamine oxidase inhibitor
—the patient can enjoy full freedom
in choice of food.
Suitable for use with many other
agents
Can be used concurrently with other
psychotherapeutic agents, such as
tranquillisers and amitriptyline, if desired
(but not with monoamine oxidase
inhibitors).
Can be used concurrently with ECT
Usually reduces the number of shock
treatments necessary for the patient.
Note: 'Concordin' is available as
'Concordin'-10. containing 10 mg
protriptyline hydrochloride. and also as
'Concordin'-5 containing 5 mg
protriptyline hydrochloride. In moderate
to severe depression, 'Concordin'-10 is
generally the more appropriate dosage
form. It is therefore important to specify
'Concordin'-10 when this is required.
Detailed information is available to
physicians on request.
Merck Sharp & Dohme Limited
Hoddesdon, Hertfordshire
Telephone, Hoddesdon 67123
Advertisements
VI
ANNUAL REVIEW OF
PSYCHOLOGY
Volume 18
February 1967
Editors: P. R. Farnsworth, O. McNemar,
Q. McNemar
Contents:
606 pages
Perception, D. E. Johannsen
Visual Sensitivity, F. A. Mote
Comparative Psychology and Ethology, / . P. Scott
Developmental Psychology, H. W. Stevenson
Educational Psychology, R. C. Anderson
Projcctive Methodologies, S. Fisher
Personnel Selection, R. M. Guion
Test Theory, / . A. Keats
Value: Behavioral Decision Theory, G. M. Becker
and C. G. McClintock
Group Dynamics, H. B. Gerard and N. Miller
Psychotherapy, D. H. Ford and H. B. Urban
Classification of the Behaviour Disorders, /. Zubin
Audition, J. J. Zwislocki
Organizational Psychology, R. P. Quinn and R. L.
Kahn
Personality, G. S. Klein, H. L. Barr, and D. L.
Wolitzky
Other medical REVIEWS of interest:
• MEDICINE, Vol. 18 (May 1967)
• BIOCHEMISTRY, Vol. 36 (July 1967)
• MICROBIOLOGY, Vol. 21 (October 1967)
• GENETICS, Vol. 1 (October 1967)
For complete information on the topics, authors,
and prices of the various publications of Annual
Reviews, Inc., a nonprofit corporation, please
write for a free copy of our 1968 Prospectus.
REPRINTS of all articles published in the Annual
Review of Psychology from Vol. 12 may now be
purchased at a uniform price of 8.95 each. A
descriptive REPRINT BROCHURE, in which the
reprints are listed both by author and by subject, is
available on request.
Publisher:
ANNUAL REVIEW OF
PHYSIOLOGY
Volume 29
March 1967
Editors: V. E. Hall, A. C. Giese, R. R. Sonncnschein
Contents:
652 pages
Prefatory Chapter, M. Kleiber
Transport Through Biological Membranes, E. Heinz
Growth and Differentiation, R. M. Gaze
Comparative Physiology: Metabolism, / . Awapara
and J. W. Simpson
Respiration, L. Bernstein
Gastric Juice and Secretion: Physiology and
Variations in Disease, G. E. Farrar, Jr., and
R. J. Bower
Comparative Physiology: Invertebrate Excretory
Organs, L. B. Kirschner
Lymphatics and Lymphoid Tissues, L. Allen
Systemic Circulation, A. A. Rovick and W. C.
Randall
Heart, fV. Schaper
The Adenohypophysis and Its Hypothalamic
Control, R. Guillemin
Parathyroid Hormone, C. D. Arnaud, Jr., A. M.
Tenenhouse, and H. Rasmussen
Reproduction, R. V. Short
The Nervous System at the Cellular Level, A. R.
Martin and J. L. VeaJe
Central Nervous System: Afferent Mechanisms and
Perception, P. O. Bishop
Hearing, /. Schwartzkopff
Visual Processes in the Limulus Eye, M. L. Wolbarsht and S. S. Yeandle
Higher Functions of the Central Nervous System,
A. M. Laursen
Central Nervous System: Motor Mechanisms,
E. Eldred and J. Buchwald
All volumes are clotlibound, with subject, author and
cumulative indexes.
PRICE each: $8.50 postpaid (U.S.A.)
$9.00 postpaid (elsewhere)
Student rates available on current volumes. Detailed
information sent on request.
ANNUAL REVIEWS, INC.
4J39 El Camino Way, Palo Alto, California 94306, U.S.A.
What clinicians
say about
ORBENIN i
inicians have frequently testified to the success of Orbenin in the treatment of Gram-positive
fections. World Medical Literature now contains over 400 references to Orbenin.
leumonia •
Lung Abscess •
Tonsillitis •
Pharyngitis •
Acute bronchitis
ipticaemia
)ils •
Carbuncles •
>teomyelitis •
Infected dermatoses
Osteitis
>st-operative wound infections •
Burns •
Skin graft protection
:ute endocarditis
aphylococcal enterocolitis •
Staphylococcal urinary tract infections •
)sage
iu/ts 500mg (2 capsules) four times daily.
i0mg (1 vial) by intramuscular injection, four
les daily.
lildren Under 2 years—quarter adult dose.
10 years—half adult dose.
iditional information is available on request.
Staphylococcal meningitis
Contra-indications
Orbenin should not be given to patients with a
penicillin allergy or administered by subconjunctival
injection.
Side-effects
As with other penicillins.
Orbenin (Regd) (cioxaciiim sodium BP) is a product of British research at
Beecham Research Laboratories
originators of the new penicillins.
Brentford, England,
Advertisements
via
(1RITIJH
POSTORADUATE
MEDICAL
FEDERATION—UNIVBRtlTY
OF
LONDON)
INSTITUTE OF NEUROLOGY
(QUEEN SQVARE, LONDON, W.C.I)
ASSOCIATED
W I T H THE N A T I O N A L U O I P I T A L , Q U E E N I Q U A R B ,
H O S P I T A L FOR N E R V O U S D I S E A S E S , H A I D A V A L B .
A N D THE
The Institute provides postgraduate training in the various departments of Neurology.
The Out-Patient Practice is open at 10 o'clock at QUEEN SQUARJE every day (except
Saturday). A fee of 5 gns. per month is charged for attending the Out-patient Department
only.
The In-Patient Practice at Queen Square and Maida Vale is open at 10 a.m. and a limited
number of clinic clerks are appointed at both Hospitals. Fees: three months, £62 10 0;
six months, £125.
Whole-time courses of instruction are given during the Autumn, Winter and Summer terms.
Besides this, teaching in the various neurological disciplines goes on throughout the year
together with clinical demonstrations every Wednesday and Saturday morning as advertised
in the medical journals.
Applications should be made to the Dean at the Institute, JAMES BULL.
LATEST LIVINGSTONE BOOKS
GUIDE TO PSYCHIATRY
MYRE SIM
Second Edition, 890 pages, 1270 references, 60s.
TUTORS AND THEIR STUDENTS
MYRE SIM
76 pages, 5s.
COMPREHENSIVE TEXTBOOK OF PSYCHIATRY
A. M. FREEDMAN and H. I. KAPLAN
1,692 pages, 400 Illustrations, £9 18s.
THE DEVELOPMENT OF THE INFANT AND
YOUNG CHILD: NORMAL AND ABNORMAL
R. S. ILUNGWORTH
Third Edition, 396 pages, 160 Illustrations, 37s. 6d.
CHILDBEARING. It* Social and Psychological
Factors
S. A. RICHARDSON and A. F. GUTTMACHER
352 pages, 3 Illustrations, 63s.
PROCEEDINGS OF THE SECOND SYMPOSIUM
ON CATECHOLAMINES
G. H. ACHE SON
804 pages, 100 Illustrations, £6.
THE EEG IN CLINICAL PRACTICE
J. P. LAIDLAW and J. B. STANTON
128 pages, 147 Illustrations, 40s.
EXERCISES IN NEUROLOGICAL DIAGNOSIS
J. H. TYRER and J. M. SUTHERLAND
274 pages, 48 Illustrations, 42s.
RADIOLOGY IN NEURO-OPHTHALMOLOGY
G. LOMBARD!
300 pages, 165 Illustrations, £5 6s.
AN INTRODUCTION TO DIAGNOSTIC
NEUROLOGY
S. RENFREW
Vol. I, Second Edition, 204 pages, 52 Illustrations, 12s. 6d.
Vol. II, 232 pages, 18 illustrations, 12s. 6d.
Vol. Ill, 210 pages, 12s. 6d.
POSTOPERATIVE COMPLICATIONS IN
NEUROSURGICAL PRACTICE
Recognition, Prevention and Management
N. H. HORWITZ and J. V. RIZZOLI
400 pages, 25 Illustrations, £7.
MYCOSES OF THE CENTRAL NERVOUS SYSTEM
B. F. FETTER, G. K. KUNTWORTH and W. S. HENDRY
300 pages, 163 Illustrations, £5 2s.
THE NEUROGENIC BLADDER
S. BOYARSKY
300 pages, 125 Illustrations, £5 16s.
THE ESSENTIALS OF NEUROANATOMY
G. A. G. MITCHELL, O.B.E., TJ3.
112 pages, 82 Illustrations, 15s.
Further dttailt sent on request
E. <fi S. LIVINGSTONE
LTD., 15-16-17 TEVIOT PLACE,
EDINBURGH
Advertisements
IX
EPILEPSY
CAN LIMIT
OPPORTUNITY
ZARONTIN
EPANUTIN
CELONTIN
enable the epileptic to play a useful part in the community
in petit ma/
... ZARONTIN* (ethosuximide, Parke-Davis)
in grand ma/
and temporal
lobe epilepsy ... EPANUTIN* (phenytoin sodium B.P. Parke-Davis)
in temporal
lobe epilepsy
and petit mat...
CELONTIN* (methsuximide, Parke-Davis)
Detailed information on Zarontin, Epanutin and Celontin is available on request
PARKE DAVIS
HOUNSLOW • LONDON • TELEPHONE: 01 570 2361
* Trade mark
(ODI!)
Advertisements
BRAIN RESEARCH
International Multidisciplinary Journal devoted to
Fundamental Research in the Brain Sciences
Forthcoming articles:
The evolution of the primate brain: Some aspects of quantitative relations (R. L. Holloway, Jr.,
New York, N.Y., U.S.A.)
Central nervous system-thyroid interrelationsships (D. H. Ford, Brooklyn, N.Y., U.S.A.)
Telencephalo-diencephalic aspects of sleep mechanisms (P. L. Parmeggiani, Bologna, Italy)
Biochemical-physiological correlations in studies of the y-aminobutyric acid system (E. Roberts,
K. Kuriyama, Duarte, Calif., U.S.A.)
Functional organization of group I activated neurones in the cuneate nucleus of the cat (I. Rosen,
Lund, Sweden)
Unresponsive cells in cerebral cortex (J. S. Kelly, K. Krnjevi6, C. K. W. Yim, Montreal, Que.,
Canada)
Hyperpolarizing increase in membrane conductance in hippocampal neurons (D. P. Purpura,
S. Prelevic, M. Santini, New York, N.Y., U.S.A.)
Heart rate changes following selective deprivation of rapid eye movement (REM) sleep (V. Karadzic,
W. C. Dement, Palo Alto, Calif., U.S.A.)
Habituation of the flexor reflex in spinal rats, and in rats with frontal cortex lesions followed by spinal
transection (J. P. Griffin, J. A. Pearson, London, Great Britain)
Shivering and panting during sleep (P. L. Parmeggiani, C. Rabini, Bologna, Italy)
Effect of hallucinogenic anticholinergic agents on D-amphetamine toxicity for aggregated mice
(C. D. Proctor, L. G. Ashley, J. L. Potts, B. A. Denefield, Nashville, Tenn., U.S.A.)
Effects of bilateral eye enucleation upon single-unit activity of the lateral geniculate body in free
behaving cats (H. Sakakura, K. Iwama, Osaka, Japan)
Acetylcholine release from the cerebral cortex: its role in cortical arousal (J. W. Phillis, Clayton,
Victoria, Australia)
lntracellular recording from cat spinal interneurons during acute asphyxiation (A. Niechaj, A. Van
Harreveld, Pasadena, Calif., U.S.A.)
Publication and Subscriptions
Brain Research is published monthly. During 1968 5 volumes are scheduled to appear. Subscription
price for 1968: £36 Os. Od., Dfl. 360.00 or USS100.00 plus postage 24s., Dfl. 12.00 or USS3.35.
Subscriptions should be sent to:
ELSEVIER PUBLISHING COMPANY
335, JAN V A N GALENSTRAAT, P.O. BOX 211, AMSTERDAM, THE NETHERLANDS
Meningitis-the role of
PENBRITIN
'Ampicillin appears to be an excellent drug for the treatment of acute meningitis due to
D. pneumoniae, N. meningitidis, and H. influenzae in children.'1
Bactericidal. Highly active against the common meningeal pathogens, Penbritin
kills, rather than merely inhibits bacteria.
Adequate Concentrations. T/M Penbritin crosses the blood-brain barrier
when
the meninges are inflamed, producing adequate concentrations in the C.S.F.1
Effective. Two controlled comparisons confirm that intravenous and intramuscular Penbritin is not only as effective as other conventional therapy, but has
distinct advantages:
CONTROLLED TRIAL 1963-1965
CONTROLLED TRIAL 1964-1965
Treatment Groups: 192 patients were assigned to
the Penbritin group, 261 to the control group who
were treated with the conventional penicillin G/
chloramphenicol regime.
Treatment Groups: 28 patients were assigned to
the Penbritin group; 25 matched patients to the control group who were treated initially with penicillin G,
chloramphenicol and sulphadiazine, discontinuing
the unnecessary antibiotics later.
Results of treatment: 79.2% of the Penbritin
patients were discharged from hospital with no
apparent defect, compared with 77.5% in the control
group.
Authors' conclusions: 'the advantages of a single
drug, and the absence of significant toxicity suggest
that this agent (Penbritin) be considered as the drug
of choice for the initial treatment of meningitis in
patients more than 2 months of age.'2
Results of treatment: 61 % of the Penbritin group
responded satisfactorily, compared with 48% in the
control group.
Authors' conclusions: Penbritin 'is as safe and
effective as conventional triple therapy, and in
addition hasthefollowing advantages: (1) simplicity of
administration, and (2) apparent freedom from hematologic and renal complications encountered with
chloramphenicol and sulphonamides respectively.'1
C h i l d r e n ' s D o s a g e . First 48 hours—150 mg./kg./day by 4-hourly intravenous injections or by continuous drip. From 3rd day onwards—100 mg./kg./day 4-hourly intramuscular injections. Intrathecal therapy
when necessary: infants and young children—5 mg. once daily. 10 years and above—10 mg. once daily.
These concentrations of Penbritin in the C.S.F. do not cause any local or cerebral irritation
A d u l t D o s a g e . 750 to 1000 mg. 4-6 hourly by intramuscular injection. Intrathecal therapy when necessary—10 to 40 mg. daily.
C o n t r a - i n d i c a t i o n : Penicillin allergy. S i d e - e f f e c t s : as with other penicillins.
References.
1. Journal of Paediatrics, (1966), 69,343.
2. Antimicrob. Agents & Chemother., (1965), p. 610.
Further information is available on request from the Company's Medical Department.
Penbritin (ampicillin B.P.) is a product of British research at
Beecham Research Laboratories Brentford, England
originators of the new penicillins.
xii
Advertisements
Pitman Medical
The Basal Ganglia and Posture
James Purdon Martin, MA, MD, FRCP (Lond)
In this book the author presents his clinical and pathological investigations into the
function of the Basal Ganglia. The guiding principle throughout the research was to
discover the functions which were lost or otherwise disturbed, in the conditions in
which the Basal Ganglia were known to be diseased.
The early chapters deal with the search for the deficiences of function in a group of
130 cases of post-encephalitic Parkinsonism. It was observed that the principal
'negative' or deficiency symptoms were attributable to the loss of postural reflexes; a
special study of the defects of locomotion demonstrated that they were due to faults of
postural controlling mechanisms, and a study of the patients' reactions to tilting
revealed still further postural defects. These chapters on 'negative' phenomena are
followed by studies of certain 'positive' symptoms of Basal Ganglia disease.
The conclusion is that the Basal Ganglia as a group are concerned with the reflex
control of posture, other than support of the body against gravity, and that
the globus pallidus is a major centre for postural reflexes. The text is particularly well
presented and is amplified by half-tone illustrations.
Contents
PART I The Basal Ganglia
Introduction
NEGATIVE PHENOMENA
Negative symptoms in basal ganglia disease (Post-encephalitic Parkinsonism)—Locomotion and the
Basal Ganglia—Tilting Reactions and Disorders of the Basal Ganglia—Negative Symptoms in
Idiopathic Parkinson's Disease—Loss of Postural Reflexes in Wilson's Disease—Loss of Postural
Reflexes in Huntington's Chorea—Anatomical Background to the Loss of Postural Reflexes
POSITIVE PHENOMENA
Hemichorea of Sudden Onset (Hemiballism)—The Caudate Nuclei and Locomotion—Curvature of the
Spine in Post-encephalitic Parkinsonism—Post-encephalitic Parkinsonism with Severe Rigidity—A
Note on Intention Tremor—Interpretation and Conclusions
PART II Posture and its Central Nervous Control
Posture and Postural Reflexes—Posture and Movement
Bibliography
Index
1st edition 1967 152 pages
146 illustrations
80s net
Pitman Medical Publishing Company Ltd
46 Charlotte Street, London, Wl
DEPRESSION:
a prison of the mind
Depression makes a dungeon of the
skull-an oubliette in which the
mind may languish through a
wearisome toll of eternities.
For many depressed patients,
'Aventyl' may be the key that
opens the door to the normal
world again. 'Aventyl' has a true
antidepressant action, with a
concomitant eftect on associated
anxiety when this is present. Its
action is rapid—most responding
patients improve within ten days.
The beneficial effect of 'Aventyl'
is not likely to be marred by
troublesome side-effects; the drug
is not a MAO inhibitor and exhibits
less anticholinergic activity than
other tricyclic antidepressants.
This simplifies management,
especially after the patient's
discharge from hospital.
'AVENTYL'
liberates
the depressed mind
\\veni\T inortriptylitu- as the hydrochloridc)
is presented as "l'ulvulcs' ol'25mi{.
lull proscribing information on request.
Jiu
From the series 'Carceri d'lnvenzione' (Imaginary
Prisons) by Piranesi. 1720-1778. The violence and
hopelessness of these works has led to the
speculation that Piranesi was a manic-depressive.
'Aventvl' is.i trade mark
ELI LILLY & COMPANY LIMITED
BASiNGSTOKE ENGLAND AVJ2. 05341
XIV
Advertisements
SPRINGERVERLAG
BERLIN-HEIDELBERG NEW YORK
Schiefer/Kazner
Klinische Echo-Encephalographie
In KQrze erscheint:
Von Prof. Dr. med. Wolfgang Schiefer und Dr. med. Ekkehard Kazner, Erlangen
Mit einer Einfuhrung in die akustischen GrundJagen von Dr. phil. Werner Guttner, Erlangen
Mit 174 Abbildiuigen
in 280 Einzeldarstellungen,
davon 2 farbige Operationsbilder
Etwa 230 Seiten 4°. 1967
Gebunden DM 68,—; US 8 17.00
• Bitte Prospekt
anfordem!
Die Ultraschalluntersuchung des Gehirns in Form der eindimensionalen Echo-Encephalographie hat in den letzten Jahren zunehmende
Bedeutung erlangt, da sie ohne GefShrdung des Patienten in kurzester Zeit Einblicke in die rilumlichen VerhSltnisse innerhalb der
Schadelkapsel zulSflt. In dieser Monographic werden zunachst die
physikalischen Voraussetzungen, soweit sie fur das Verstandnis des
Ultraschall-Echoimpulsverfahrens am Schadel erforderlich sind,
beschrieben. Nach ausfuhrlicher Erdrterung der Untersuchungstechnik, des normalen und des pathologischen Echo-Encephalogramms legen die Autoren an Hand von flber 9000 Einzeluntersuchungen bei 2747 Patienten den Wert der Methode eingehender
dar. Im speziellen Teil werden besonders die echo-encephalographischen Befunde bei supra- und infratentoriellen Hirntumoren,
cerebralen Massenblutungen, Enveichungen und beim kindlichen
Hydrocephalus demonstriert. Einen groBeren Raum nimmt die
Darstellung der Anwendung des Verfahrens beim SchSdel-Hirntrauma und seinen Komplikationen ein. Auf diesem Gebiet ist die
Methode bereits heute unentbehrlich geworden und hat zu einer
Verbessening der diagnostischen und damit auch der therapeutischen
Ergebnisse gefOhrt. AJle Kapitel sind durch 'eine ausfQhrliche
Kasuistik belegt, wobei die neuroradiologischen Befunde den Echogrammen gegeniibergestellt werden. Instruktive Abbildungen,
schematische Darstellungen sowie tabellarische Obersichten gestatten eine rasche Orientierung. Ein besonders ausfuhrliches Literaturverzeichnis bietet dem Leser die Mdglichkeit, sich auch in
Einzelfragen weiter einzuarbeiten. Das vorliegende Werk gibt erstmals einen Gesamtuberblick uber die klinische Anwendung der
eindimensionalen Echo-Encephalographie. AUe diagnostischen
Mbglichkeiten des Verfahrens sind erschopfend dargestellt. FOr
denjenigen, der sich mit der Echo-Encephalographie befaBt, ist
dieses Standardwerk nicht nur empfehlensw«rt, sondern unentbehrlich.
Interessenten: Neurologen, Neurochirurgen, Neurophysiologen, Radiologen, insbcsondere Neuroradiologen,
Chirurgen, insbesondere Unfallchirurgen, Kinderarzte, ferner
Internisten, Otologen, Ophthalmologen, Gutachter.