[Six months treatment of restless legs syndrome with levodopa/benserazide in domiciliary practice]. / Therapie des Restless-Legs-Syndroms. Anwendungsbeobachtung mit Levodopa/Benserazid in der niedergelassenen Praxis uber sechs Monate.

Restless legs syndrome is a common neurological condition with 2-10% prevalence in the general population. Patients suffer from uncomfortable or unpleasant sensations in legs or arms and motor restlessness with a compelling desire to move the extremities. The symptoms worsen at rest with at least temporary relief by activity but also later in the day and in the evening. Dopaminergic drugs are considered to be the first choice in therapy, however, only levodopa/benserazide is approved until now. In this six months observational study, eighty patients with diagnosed RLS were treated with levodopa/ benserazide. The RLS symptoms improved in 90%, 77.5% of the patients continued with the treatment after the end of the study. Levodopa/Benserazide proved to be efficacious independently of severity of RLS and was well tolerated in long-term therapy.

Adaptive mechanisms of saccadic system in diagnostic use.

The possibilities of diagnostic use of saccades are given in pathological eye movements as well as in adaptive mechanisms. They are used to offset the degradation of oculomotor performance resulting from interference along the chain of neural conducting, in neuromuscular transmission and in muscle function. Pharmacological effects can be used to increase the influence of disorders or to detect adaptive mechanisms. During the pharmacological therapy with carbamazepine or diphenylhydantoin, adaptive processes can be measured.

[Saccadic eye movements: methodologic aspects and possibilities of clinical use]. / Die sakkadischen Augenbewegungen: methodische Aspekte und Möglichkeiten der klinischen Anwendung.

Saccades are fast eye movements that occur when the eye makes a refixation movement. Initially clinically relevant physiological and anatomical data are given. The two most frequently used oculographic methods are presented briefly. For clinical use it is particularly important that ocular motor disorders and effects of various drugs are compensated partially by plastic adaptation of central mechanisms. The main diagnostic fields are disorders of brain stem, cerebellum or peripheral oculomotor apparatus. Examination of horizontal and vertical saccades is a useful help in diagnosis of subclinical ocular motor disorders in encephalomyelitis disseminata.

[The oculomotor system--simulation of physiologic and pathologic horizontal saccadic eye movements]. / Das okulomotorische System--Simulation von physiologischen und pathologischen horizontalen sakkadischen Augenbewegungen.

Horizontal saccadic eye movements were analyzed by way of the input- and output-functions of the oculomotor system. On the basis of the parameters of the model, it was possible to simulate both physiological and pathological saccades. In this paper we present the results of simulation experiments that were performed to study the influence of various ocular motor disorders. The parameters of the model proved a useful diagnostic aid.

[Saccadic eye movements in the diagnosis of disseminated encephalomyelitis]. / Die sakkadischen Augenbewegungen in der Diagnostik der Enzephalomyelitis disseminata.

Saccadic eye movements were examined in 40 healthy subjects and 30 patients suffering from multiple sclerosis and the effective predictors for diagnosis were determined by discriminant analyses. Saccades indicated a higher diagnostic relevance compared with brainstem auditory evoked potentials and visual evoked potentials.

[Clinical, electromyography and pathologic-anatomic studies in myopathy--a contribution to rational diagnostic strategy]. / Klinische, elektromyographische und pathologisch-anatomische Untersuchungen bei Myopathien--ein Beitrag zur rationellen Diagnosestrategie.

A total of 189 patients underwent clinical, electromyographical and patho-anatomical examination (by muscle biopsy). 102 of the patients suffered from myopathy, 45 patients from neurogenic muscle diseases. 31 patients were suffering from chronic renal insufficiency and 11 patients from chronic alcoholism. The statistic elaboration of the findings was done by the multivariate analysis of variance (MANOVA) and discriminant analysis, in order to determine the diagnostic value of single parameters of investigation and to demonstrate diagnostically effective parameter combinations for diagnosing myopathies. Employing the discriminant function for the differentiation of myopathies and neurogenic muscle diseases yielded in patients with chronic renal insufficiency predominantly (30 cases) references to a neurogenic lesion of the proximal muscles and in the patients with chronic alcoholism relatively often (6 cases) references to a myogenic lesion of the proximal muscles.

[Electrophysiologic and histomorphological studies on the nervus ischiadicus of rats. I. The uninjured nerves]. / Elektrophysiologische und histomorphologische Untersuchungen am Nervus ischiadicus der Ratte. I. Untersuchungen des ungeschädigten Nerven.

We report in the model described above on measurements of striking features of the normal sciatic nerve of adult male Wistarrats (250-300 g). Electrophysiological parameters were measured by means of an Electromyoneurograph (needle stimulation). The calculation of the maximum motor nerve conduction velocity results in a mean value of 59.6 ms-1. The mean compound action potentials of the foot muscle are 9.2 mV (proximal stimulated) and 10.1 mV (distal stimulated). Counting out 10011 nerve fibres in Light Microscoping Findings for histological studies we got a nearly Normal distribution of the fibre diameters with a mean fibre diameter of 7.09 microns. The corresponding density of nerve fibres is 8700.4 mm-2. The calculated percentage of neural tissue, related to the surrounding connective tissue is about 36.32%.

Long-term care and management of Wilson's disease in the GDR.

Diagnosis, long-term management and family investigations of Wilson's disease are provided by selected clinical institutions in the GDR. From 187 patients detected since 1949, 111 are alive. In spite of the principal effectiveness of penicillamine treatment, confirmed by the disappearance of most of the central nervous system symptoms and successful professional rehabilitation of many patients, insufficient therapeutic discipline, psychosocial disturbances and penicillamine side-effects forcing its substitution by zinc or triethylenetetramine dihydrochloride in 14 cases need our further attention.

[Effect of carbamazepine on the velocity of saccades]. / Der Einfluss von Karbamazepin auf die Sakkadengeschwindigkeit.

In 5 female patients suffering from focal epilepsies, the maximal velocity of saccades was determined before and during carbamazepinE therapy. A decrease in the velocity of saccades was followed by an increase at the same serum level.

[Diagnostic value of the H-reflex index in alcoholic polyneuropathy]. / Untersuchungen zur diagnostischen Wertigkeit des H-Reflex-Index bei alkoholischer Polyneuropathie.

We examined the H-reflex-index of triceps surae muscle (HI) and the motor nerve conduction velocity of the tibial nerve (mNLG) of 56 alcohol dependent patients. The results were compared with neurologic disorders, duration of the dependency and the type of alcoholism according to Jellinek. The HI showed significant more pathological changes than the mNLG.

[Spiroergometric studies in diseases of the muscles]. / Spiroergometrische Untersuchungen bei Erkrankungen der Muskulatur.

37 patients with muscle disease (23 myopathies and 14 neurogenic muscle diseases) were studied by spiroergometric investigations. The multivariate analysis of variance (MA-NOVA) and linear discriminant analyses indicated the diagnostic effectiveness of the maximal work capacity/maximal cardiac frequency ratio. The sensitivity was found to be 0.81 and the specificity was found to be 0.43.

[Ulnar sulcus syndrome--a contribution to course and prognosis]. / Das Sulcus-ulnaris- Syndrom--Ein Beitrag zu Verlauf und Prognose.

Of 1028 patients with 1138 peripheral nerve lesions, 142 suffered from an electrophysiologically proven SUS. At follow-up, 93 patients could be restudied. Spontaneous regressions were observed in patients below the age of 40 years and in case of a history under 6 months. So-called late pareses receded in no case without operative displacement of the ulnar nerve. However, if the etiology is unknown, the present results of investigation require reserve towards operative therapy.

[Diagnostic and therapeutic attempts in so-called progressive dialysis encephalopathy]. / Diagnostische und therapeutische Bemühungen bei der sogenannten progressiven Dialyseenzephalopathie.

57 patients from a chronic intermittent haemodialysis programme underwent 198 EEG examinations over a period of 5 years with follow-up. The results show that regular EEG examinations allow incipient dialysis encephalopathy to be recognized already at the pre-clinical stage. Whereas therapeutic measures always had no effect on the full clinical picture of dialysis encephalopathy and all patients died, in all but one case lengthening the dialysis time prevented the syndrome from reaching the clinical stage and in 6 cases EEG changes were reversed.

Carpal tunnel syndrome--course and prognosis.

In a retrospective study 157 patients with electrophysiologically proven carpal tunnel syndrome (CTS) were followed up. Of the 85 operatively treated patients, 86% showed clear improvement or cure, as did 32% of the patients not operated upon. Multivariate analysis of variance (MANOVA) and linear discriminant analyses indicated atrophy and length of history as effective predictors of clear improvement. The optimized discriminant point was ascertained in the receiver operator characteristics (ROC) curve. A predictive value of positive test of 0.89 was found for the course form "not cured" and a predictive value of negative test of 0.75 for the course form "cured" with a prevalence of one-third for the good course form. The prognosis was bad if atrophy occurred or the history exceeded 7 months. The determination of distal motor latency is indispensable for diagnosing CTS. For prognosis, however, length of history and clinical findings have been more helpful.

[Electrophysiology in distal median nerve compression syndrome--the so-called carpal tunnel syndrome]. / Elektrophysiologische Befunde beim distalen Kompressionssyndrom des N. medianus--sogenanntes Karpaltunnelsyndrom.

152 patients--110 women and 42 men--presenting a distal compression syndrome of the N. medianus, the so-called "carpal-canal syndrome" were examined electromyographically and electroneurographically on 198 hands. For avoiding a wrong diagnosis, the determination of the distal motor latency was carried out by means of concentric needle electrodes. Checkups could be carried out in 79 of the patients. Of these, 42 had in the meantime been subjected to an operation, 83 per cent of them with an improvement of the complaints. On the other hand, in 37 of the patients who had not been operated on, the complaints were unchanged or had increased. Only 27 per cent were free from complaints.