[Generalized muscle weakness mimicking periodic paralysis in a patient with toluene abuse].

A 23-year-old Japanese man was admitted to our hospital because of acute generalized muscle weakness and frequent vomiting. He had been diagnosed as having hypokalemic periodic paralysis, since he had recurrent episodes of transient generalized muscle weakness with a hypokalemia. Laboratory studies have revealed a severe hypokalemic hyperchloremic metabolic acidosis, elevated serum levels of creatine phosphokinase and ammonia. The urinary level of the hippuric acid, a metabolic product of toluene, was found to be extremely high, suggesting that he had been exposed to toluene. With intravenous supplement of potasium, his muscle strength improved. Chronic exposure to toluene induces various neurological disorders, such as encephalopathy, cerebellar and pyramidal signs, peripheral neuropathy. In addition, it should be kept in mind that hypokalemic muscle weakness can be induced by the renal tubular acidosis resulting from chronic toluene exposure, and that it is by no means easy to distinguish hypokalemic periodic paralysis if it occurs recurrently.

[The frontal assessment battery at bed side(FAB) in patients with Parkinson's disease].

It is by no means easy to assess the frontal lobe function precisely in patients with neurological disorders. Recently, Dubois et al. (2000) reported a new bedside cognitive and behavioral battery for evaluating frontal lobe function. To evaluate the clinical efficacy of this frontal assessment battery at bedside (FAB), we performed both FAB and Hasegawa's dementia scale (HDS), a Japanese version of convenient clinical scaling of dementia resembling the Mini-Mental State Examination, in patients with Parkinson's disease (PD) and age-matched controls. The FAB global score was significantly lower in the PD patients compared to the controls. On the other hand, there was no significant difference in the scores of HDS between the PD patients and controls. In the PD patients, there was no correlation between the FAB scores and their age or duration of the illness. The FAB is likely to be useful and convenient battery for assessing frontal lobe function at bedside in the PD patients.