[The comparison of the effectiveness of treatment of multiple sclerosis relapse with high doses of methylprednisolone, alpha-24 corticotropin and cyclophosphamide]. / Porównanie skutecznosci leczenia rzutu stwardnienia rozsianego duzymi dawkami metyloprednizolonu, alpha-24 kortykotropina i cyklofosfamidem.

The effectiveness of treatment was compared in groups of patients with definite multiple sclerosis (MS) given respectively: methylprednisolone, alpha-24 corticotropine and cyclophosphamide combined with corticotropine. Clinical improvement was assessed by means of the expanded disability status scale (EDSS). The significant results were noted in patients treated with methylprednisolon and corticotropine combined with cyclophosphamide (1.5 in EDSS) for the first time, when compared to subsequent treatment. Within the patients in a more advanced stage of the disease, undergoing subsequent treatment, those given corticotropine displayed the best improvement (1.5 in EDSS), but without statistical significance. The authors suggest methylprednisolone or corticotropine combined with cyclophosphamide are the most effective immunosuppressive treatment in the initial phase of MS.

[Clinical-electrophysiological characteristics of Alzheimer's dementia and cerebrovascular dementia based on determination of cerebral refraction time]. / Kliniczno-elektrofizjologiczna charakterystyka otepienia alzheimerowskiego i naczyniopochodnego w oparciu o badanie czasu refrakcji mózgowej.

The aim of the study was an electrophysiologic assessment of cerebral refractory period in relation to chosen clinical parameters, EEG and CT in patients with dementia of various origin. The study included 30 patients (11 female, 19 male) aged 50-75: 15 with dementia of Alzheimer type (DAT) and 15 with vascular dementia (VD), and 15 age-matched healthy controls. Cerebral refractory period (CRP) was assessed by means of somatosensory evoked potentials with the use of paired stimulation with varying interstimulus interval, applied to the median nerve. Interstimulus interval, with which one somatosensory response was obtained to paired stimuli, was determined as absolute refractory period. CRP was significantly prolonged in demented patients, when compared to the control group, with no significant difference between groups with DAT and VD. CRP correlated negatively with age and positively with Mini Mental State Examination results, assessing the degree of mental deterioration. Prolonged CRP was noted in patients with vast lesions shown in CT. No relationship between CRP and EEG changes was found. CRP is a sensitive parameter, which may contribute to electrophysiological assessment of cerebral function.

[Autonomic nervous system disturbances in Parkinson's disease]. / Uszkodzenie ukladu autonomicznego w chorobie Parkinsona.

On the basis of neurophysiological tests we conclude that subclinical signs of dysautonomia appear in Parkinsonians. Various autonomic functions are not disturbed in the same degree. Examinations of cardiovascular system showed that functions connected with parasympathetic system were affected, while those connected with sympathetic part were not. Examinations of skin sympathetic reflexes displayed rather patchy, disseminated type of damage: only latencies of responses recorded from hands (but not from feet) were prolonged when compared to the control group.

[Evaluation of cardiovascular and sudomotor functions in Alzheimer's disease]. / Ocena czynnosci ukladu sercowo-naczyniowego i potowydzielniczego u chorych na chorobe Alzheimera.

The assessment of some aspects of cardiovascular and sudomotor system was performed in the group of patients with Alzheimer's disease. No one of patients complained of disturbances arising from these two parts of the vegetative system. The autonomic functions were evaluated by means of: clinical examination, heart rate variability tests at rest, measures of blood pressure and heart rate in supine and standing position and skin sympathetic response. At rest heart rate and its variability as well as blood pressure in the patients did not differ significantly from the results obtained in the healthy controls. On standing, changes in systolic blood pressure and heart rate were recorded in the controls, but not found in the patients. The majority of patients presented with abnormalities in skin sympathetic response: lack of response or prolongation of its latency. The results of motor and sensory nerve conduction studies excluded neuropathic changes in the patients. We conclude that autonomic disturbances accompanied Alzheimer's disease and were probably caused by damaged control mechanisms within the central vegetative system.

[Evaluation of sweating function, changes in heart function and postural blood pressure in patients with multiple sclerosis]. / Ocena czynnosci wydzielniczej potu, zmiennosci pracy serca i cisnienia tetniczego po pionizacji u chorych na stwardnienie rozsiane.

The aim of the study was electrophysiologic assessment of sudomotor function and some aspects of cardiovascular system function in patients with multiple sclerosis and an attempt of referring assessed variables to duration of the disease and EDSS score. The study included 24 patients with clinically definite, relapsing-remitting multiple sclerosis and 22 healthy, age-matched controls. Autonomic functions were evaluated by means of clinical examination, heart rate variability tests, measures of blood pressure in supine and standing position and skin sympathetic response examination. Clinical symptoms in patients with multiple sclerosis were scarce. Electrophysiologic tests showed no abnormalities in heart rate variability and blood pressure response to standing in studied group. The majority of patients presented with subclinical dysfunction of sudomotor system, indicated by an abnormal sympathetic skin response, which did not correlate with duration of the disease or EDSS score. Sympathetic skin response examination proved to be a sensitive indicator of autonomic disturbances in patients with multiple sclerosis.

[Neurological complications in patients with chronic renal failure]. / Powiklania neurologiczne u chorych z przewlekla niewydolnoscia nerek.

On the basis of current literature and their own experiences, the authors present the most common symptoms and syndromes of dysfunction of central and peripheral nervous system which appear in patients with chronic renal insufficiency. Current views on patomechanism of neural dysfunction due to renal failure in dialysed and non-dialysed patients are discussed.

[Diagnosis of blood flow disorders in the common carotid arteries by the ultrasonic Doppler method]. / Rozpoznawanie zaburzen przeplywu krwi w tetnicach szyjnych wspólnych metoda ultradzwiekowa oparta na zjawisku Dopplera.

The aim of this work was evaluation of the usefulness of the Doppler ultrasound method for detection of blood flow disturbances in carotid arteries. The investigations were done in 110 patients with symptoms of cerebral circulatory disorders. In 45 patients carotid arteriography was done. In 30 cases arterial reconstructive operations were performed. The curves of blood flow velocity in the common carotid arteries were recorded with a UDP-10 ultrasound blood flow detector. The obtained curves were subjected to morphological analysis and the mean momentary velocity of the systolic and diastolic flow wave was calculated. In 80% of cases with impaired patency of the carotid arteries demonstrated by angiography abnormal curves of blood flow velocity in the common carotid arteries were obtained. The method of ultrasound recording of blood flow velocity is non-invasive and safe and it is very useful for establishing indications to angiography and for postoperative control.