[Polypragmasy in chronic tension headache?]. / Polypragmasie beim Spannungskopfschmerz?

The various forms of treatment (drugs as well as non-drug therapy) of patients suffering from tension type headache are presented. Analgesics and non-steroidal antirheumatics are used in the management of episodic tension type headache, as well as acute exacerbation of chronic tension type headache. In view of the presumably multifactorial pathogenesis, a multidimensional therapeutic approach is required in patients with chronic tension type headache. Antidepressive drugs (thymoleptics) are usually prescribed as basic therapy. Additional implementation of non-drug therapeutic measures tailored to individual symptomatology is advisable, such as EMG biofeedback, other relaxation techniques, massage, physiotherapy and--in selected cases--psychotherapy or acupuncture.

[Calcium channel blockers in therapy of neurologic diseases]. / Kalziumkanalblocker in der Therapie neurologischer Krankheitsbilder.

The clinical use of calcium antagonists (Ca-antagonists) in neurological diseases focuses on 2 main therapeutic fields: (a) For the therapy of migraine flunarizine is the first choice therapy and nimodipine is a second line treatment. With verapamil cluster headache can be treated successfully, flunarizine shows less impressive clinical efficacy. The therapy with flunarizine may be restricted due to the incidence of extrapyramidal disturbances and depressions as known side effects. (b) The therapy of clinical conditions after subarachnoidal bleeding with nimodipine is well established. In the therapy of acute cerebral ischemia the therapeutic efficacy of nimodipine administered orally is not therapeutically proved until now; the intravenous administration of nimodipine offers the risk of acute hypotensive reactions. At present the usefulness of the administration of ca-antagonists in the so-called cerebrovascular insufficiency or dementia and various others cerebral disorders with vertigo could not be demonstrated.

Thalamic ischemia in transient global amnesia: a SPECT study.

We performed 99mTc-HMPAO SPECT in a patient during transient global amnesia and twice thereafter. SPECT during the attack showed a significant diminution of regional blood flow in the left thalamus and a less marked diminution in the right thalamus. Quantitative evaluation of global 99mTc-HMPAO uptake indicated a diffuse depression of cerebral blood flow. At follow-up to 40 days after the attack, global uptake and thalamic flow indices normalized, but there was a persistent reduction of left frontal flow values.

[Report on the results achieved over the past 10 years in the neuro-orthopaedic out-patient department (author's transl)]. / Erfahrungsbericht über 10 Jahre Neuro-Orthopädische Ambulanz.

A short abstract of the pathophysiology of pain and its conduction is followed by a discussion of the importance of neurological-orthopaedic cooperation for the diagnosis and the treatment of pain syndromes arising from the locomotor apparatus. The examination of the spine from the functional, i.e. segmental point of view is pointed out. The main reflex answer of the spine to irritation is the restriction of movement or hypermobility. Therefore, neuro-orthopaedic reflex treatment consists of so-called "test treatment" by means of manipulation to overcome the restriction of movement or by local curative anaesthesia, or by a combination of both methods. The results over the past decade of treatment in 1008 patients suffering from various pain syndromes are presented and differentiated.

[Treatment of Spastic Gait Disorders Using an "Electro-Gait-Stimulator ("Schrittstimulator") (author's transl)]. / Zur Elektrobehandlung der spastischen Gangstörung mit einem "Schrittstimulator"

A short historical outline of electric treatment of spasticity is given. A specially developed management with a "gait-stimulator" is described. Four muscles of each lower extremity being mainly engaged in walk were electrically stimulated in the physiological sequences according to the normal gait. The used electric impulses were of a duration of 0,25 msec and an intensity up to 700 V. Using such a "gain-stimulator" in spastic-paraparetic patients a reduced spasticity has been achieved. Positive effect of this treatment has been mostly pronounced, when the programming of impulses was adjusted to the end of the expected physiological contraction of the corresponding muscles. Physiological and pathological data of the "Silent period" is proposed to be mostly involved. The application of impulses in physiological sequences seems to reactivate normal reflex - mechanisms which are disturbed by supraspinal laesion. The results indicate that the electric impulses activates muscle-sensory - organs and that impulses on these organs produce a pace-making function on the spinal cord, which lessens spasticity.

[Long-term EEG investigations at the withdrawal of young polytoxicomanic addicts]. / EEG-Untersuchungen im Längsschnitt bei der Entwöhnung von jugendlichen Polytoxikomanen

Serial EEG examinations (an average of three recordings in 14 weeks) are reported from adolescent inpatients (19 in number) who had been weaned of multiple drug abuse of an average duration of 2 years. At first examination seven had a normal EEG, 11 had a moderately abnormal EEG, and one had a markedly abnormal one. At final examination 13 had a normal EEG, five had a moderately abnormal EEG and three had definitely abnormal EEG's. The majority of the patients showed a decrease (significant at the 5% level), others an increase in EEG abnormalities. The relationship between the EEG changes in the course of the series on the one hand and the previous drug abuses is discussed.