Jamaica ginger paralysis. Forty-seven-year follow-up.

In 1930, thousands of Americans were poisoned by an illicit extract of Jamaica ginger ("jake") used to circumvent the Prohibition laws. A neurotoxic organophosphate compound, triorthocresyl phosphate (TOCP), had been used as an adulterant. The earliest reports were of peripheral neuritis, but later it was evident that an upper motor neuron syndrome had supervened. This TOCP poisoning apparently involved various cell groups and tracts in the spinal cord; the lesions was not peripheral at all. We interviewed 11 survivors of the illness residing in eastern Tennessee. Four were carefully examined. The principal findings showed the spasticity and abnormal reflexes of an upper motor neuron syndrome. One patient had mild disease, despite typical findings, and had lived a normal life.

Flexor and extensor postures in sedative drug-induced coma.

Flexor and extensor postural reflexes are most commonly seen in coma after structural brain lesions, but may also occur in metabolic coma. We report 10 patients who exhibited flexor or extensor posturing as an early and transient feature of coma resulting from sedative drug ingestion. In comatose patients with normal pupillary reactivity but no ocular movements, these postural responses suggest sedative drug overdose.

Some 9-hydroxycannabinoid-like compounds. Synthesis and evaluation of analgesic and behavioral properties.

A series of 9-hydroxylated cannabinoid-like compounds was prepared and tested for analgesic properties in mice and behavioral properties in dogs. Although the prototype compound, 9-nor-9-hydroxyhexahydrocannabinol, has potent antinociceptive activity in laboratory animals, the new analogues were relatively inactive. All of the compounds produced an alteration of behavior in unanesthetized dogs. Two of the compounds produced cannabinoid-like effects and the other two produced general CNS depression.

Modulation of brain development by morphine: effects on central motor systems and behavior.

Morphine administration to neonatal rats on days 1-7 after birth produced long-term changes in behavior and brain function. The pups were smaller than saline-treated littermates and showed retarded motor development. As adults, the morphine-treated rats had impaired motor coordination, altered gait, and altered patterns of activity in an open field. Several brain regions of the adult rats, including motor areas, had decreased metabolic activity as measured by the 2-deoxy-glucose technique, suggesting decreased functional activity in these areas. These results may be relevant to findings that children exposed in utero to narcotics tend to have impaired motor development.

Electrophysiological investigation of IDPN neuropathy--initial studies.

beta,beta'-iminodipropionitrile (IDPN) causes giant axon swellings in proximal internodes of spinal motor axons and in stem processes of dorsal root ganglia neurons. The electrophysiological consequences of the swellings were investigated in cats given IDPN (50 mg/kg i.p.) weekly for 0 (control), 1 (7 days), 2 (14 days), or 5 (35 days) weeks; some additional animals were studied 15 (50 days) or 65 (100 days) days following the fifth injection. Extracellular recordings of the spinal monosynaptic reflex revealed amplitudes of efferent responses to be equally reduced at 35, 50 and 100 days. Single stimulation of dorsal roots, or soleus or medial gastrocnemius afferents often evoked doublet efferent responses which arose intraspinally. Similar repetitive responses were observed in dorsal root (afferent) input upon single stimulation of peripheral nerves. Latencies to monosynaptic responses became progressively prolonged over 100 days; spinal cord contribution to the increased latencies was maximal by 35 days. Conduction velocities in single soleus and medial gastrocnemius axons declined to 70 and 64% of normal by 50 days and to 56 and 50% of normal by 100 days respectively. Maximal recurrent inhibition was reduced 42-49% by 35 days and quantitatively similar at 50 and 100 days. Intracellular recordings from spinal motoneurons revealed that, at 35 days, action potentials could be elicited by orthodromic but not by antidromic stimulation in 14% of cells tested. This was taken as evidence of block of impulse conduction by the intervening axonal swelling upon antidromic stimulation. The possibility of abnormal electrical interactions between swollen and demyelinated intraparenchymal axons was tested by determining the number of ventral root fibers via which antidromic stimulation would elicit an action potential in the same motoneuron perikaryon. Electrical crosstalk, never seen in normal animals, varied in incidence during the evolution of the neuropathy (7-35 days), reaching a maximum of 30% at 14 days. Many motoneuron action potentials were remarkably similar to those observed in chromatolytic motoneurons, exhibiting, among other features, decreased SD thresholds and IS conduction times, reduced amplitudes and durations of afterhyperpolarization, delayed depolarizations and an enhanced propensity to fire repetitively upon single stimulation. There was no morphological evidence of chromatolysis in the motoneurons. The concept of "functional axotomy" is introduced to accommodate these findings and discussed in terms of altered dendritic excitability. Not all motoneuron types are equally compromised in the neuropathy.(ABSTRACT TRUNCATED AT 400 WORDS)

Electrophysiological investigation of beta, beta'-iminodipropionitrile neurotoxicity: monosynaptic reflexes and recurrent inhibition.

beta-beta'-iminodipropionitrile (IDPN) neurotoxicity is morphologically characterized by the presence of giant axon swellings in the first proximal internodes of motor axons. The electrophysiological consequences of these proximal giant axon swellings on monosynaptic reflexes and recurrent inhibition were investigated along dorsal root-ventral root, medial gastrocnemius-ventral root and soleus-ventral root pathways of IDPN-intoxicated cats 35, 50 and 100 days following initial administration of the toxin (50 mg/kg/wk for 5 weeks). Monosynaptic reflex action potentials, normally relatively synchronous spike potentials, frequently appeared as doublet potentials which did not represent temporal fractionation of the spike potential. Latencies to the monosynaptic reflex action potentials were prolonged. Amplitudes of unconditioned monosynaptic reflex action potentials were significantly decreased at all time points, although there was a tendency for the amplitudes to recover with time. Post-tetanic potentiation was variously altered. Recurrent inhibition was reduced by 42-49% along monosynaptic reflex pathways. These results demonstrate that electrophysiological function in the spinal cord of IDPN-intoxicated cats is profoundly altered and the dysfunction partly results from the presence of the giant axon swellings.

Bilateral facial paralysis following ethylene glycol ingestion.

Bilateral facial weakness, diminished hearing and dysphagia developed in a patient with a large overdose of ethylene glycol. Our case and two others previously reported draw attention to the fact that cranial nerve dysfunction, especially bilateral facial palsy, may occur in addition to encephalopathy, coma and renal failure with ethylene glycol ingestion.

Intrauterine exposure to low levels of lead: the status of the neonate.

It has been suggested that lead (Pb) at low exposure levels is a behavioral teratogen. Blood lead (Pb-B) was measured in 185 samples of maternal blood and in 162 samples of cord blood drawn from members of a cohort of mother-infant pairs. Routine newborn assessments, an examination for minor anomalies, the Brazelton Neonatal Behavioral Assessment (NBAS), and part of the Graham/Rosenblith Behavioral Examination (G/R) were administered. Maternal and cord Pb-B correlated 0.80. In regression analyses, Apgar scores, birthweight, length, head circumference, neonatal anomalies, and seven behavioral scales were unrelated to either maternal or cord Pb-B. Three scales--the NBAS Abnormal Reflexes, the G/R Neurological Soft Sign, and the G/R Muscle Tonus Scales--were related minimally to either cord or maternal Pb-B. Because of the contrast in maternal and cord results, despite the high correlation of maternal and cord Pb-B, the data were reanalyzed for 132 cases with paired data. Only the Soft Sign Scale remained significant and that only for cord, but not maternal Pb-B. Regression analysis revealed a suppression with the Soft Sign Scale related to the variance of the cord Pb-B that was not common with maternal Pb-B. The possibility that the fetus under stress tends to accumulate Pb was considered.

The influence of electrostimulation on hexobarbital induced loss of righting reflex in rats.

Electrostimulation (ES) of slow (SF, 10 Hz) or fast (FF, 500 Hz) frequency decreases the sleeping time of rats anaesthetized by administration of acute doses of hexobarbital. When ES is applied via the ears, both SF and FF are equally efficient in reducing the loss of righting reflex (LRR), whereas if ES is applied peripherally via the paws, only FF decreases the acute narcosis time. Applied cranially, either continuous stimulation or administration of intermittent current (5 minutes on and off) were equally effective in reducing narcosis. A decreased period of 30 minutes' continuous stimulation will reduce sleeping time only if administered immediately after LRR. When restrained animals received ES for periods of up to 3 hours prior to administration of the barbiturate, the sleeping time of the stimulated and sham treated animals were not significantly different.

[Vestibular toxicity of gentamycin: value of the galvanic test (author's transl)]. / Toxicité vestibulaire de la gentamycine: intérêt de l'épreuve galvanique.

A total of 6 cases of bilateral vestibular areflexia due to Gentamycin are reported. Vestibular destruction was associated with deafness in only 3 of the patients. Two patients had no signs of renal insufficiency. Galvanic vestibular exploration showed complete and bilateral lack of excitability in 3 out of 4 cases, which could be due to the co-existence of nerve or nuclei lesions. In one case, galvanic excitability was within normal limits, and severe equilibrium problems presisted. The presence of an asymmetry on galvanic examination could be an unfavourable prognostic sign in vestibular toxicity due to Gentamycin.

[Psychomotor performance of persons chronically exposed to carbon disulfide. I]. / Sprawnosc psychomotoryczna osób narazonych na przewlekle dzialanie dwusiarczku wegla - czesc I.

The study was aimed at evaluating the psychomotor efficiency of those chronically exposed to CS2 and at selecting tests to be applied in CS2 poisonings diagnosis. The study covered 126 viscose industry workers occupationally exposed to CS2 and 126 controls matching those exposed as regards age, length of employment and educational background. The following tests and appliances were used in the study: Eye-hand coordination test, Turner test for independent movement of two hands, reactions time meter, one-plate and two-plate tapping, modified d'Heuyer's and Baille's tests. Significantly worse results were found in those exposed to CS2, as compared to controls. Particularly great difference were noted in result of reaction time measurement and Turner test for independent movement of two hands. Those tests may be used to diagnose CS2 adverse effects.

[Neurologic disorders in acute dichloroethane poisoning]. / Nevrologicheskie rasstroistva pri ostrom otravlenii dikhlorétanom.

The paper deals with a study of the nervous system in 121 patients with acute poisening with dichlorethane. Among the studied contingent there were 110 males and 11 females. According to the severity of the intoxication the patients were divided into 3 groups: mild--23 cases, moderate--11 cases, severe--87 cases. The following 6 neurological syndromes were distinguished: comatose, convulsive, atactic, extrapyramidal, psychotic and asthenic with vegetative-vascular insufficiency. Morphological studies detected the following: congestion plethora, vascular dystonia, microfoci hemorrhages, acute swelling of the nervous cells with signs of chromatolyses, shrunk cells, severe and ischemic change of the nervous cells. The treatment consisted in an accelerated elimination of dichlorethane from the organism and symptomatic therapy. The results of these studies demonstrated that in poisoning with dichlorethane there were diffuse, mainly dystrophic changes in the cells of the brain and spinal cord, which clinically may be expressed by symptoms of a lesion of many systems and may be qualified as toxic encephalomyelopathy.

[Ephedrine addiction]. / Efedronovaia narkomaniia.

Neurologic and psychopathologic disturbances were studied in patients with DL-ephedrine addiction. The patients were also subjected to echoencephalography. The authors identified the period of acute narcotic intoxication, the abstinence syndrome and the period of chronic intoxication. The recommendations on the treatment of the above patients are presented.