Aripiprazole for the Treatment of Inappropriate Sexual Behavior: Case Report of an Alzheimer's Disease Patient Known as Heterosexual with Recently Shifted Sexual Orientation to Same Gender.

Although inappropriate sexual behavior in dementia is not common, it can be extremely troublesome for healthcare professionals and caregivers as well as patients themselves. There is paucity of data in the literature for the management of these behaviors, but the limited available data suggest efficiency of some commonly used treatment modalities. Herein, we present a 74-year old Alzheimer's disease (AD) patient, known to be heterosexual throughout her past life, presenting with a recent display of same-sex inappropriate sexual behavior six years after the initial diagnosis of her disease. This new clinical picture of hypersexuality responded well to aripiprazole and her symptoms gradually diminished and eventually disappeared after onset of medication. This report also constitutes the first reported case of an AD patient in the published literature presenting with hypersexuality of shifted sexual orientation during the course of the disease.

Unregistered subtracted CT angiography for the visualization of intracranial arteries at or near the skull base: preliminary experience.

PURPOSE: Restrictions with computed tomography angiography (CTA) regarding the visualization of arteries near the skull base are well known. Today, the gold standard for overcoming this is the matched mask bone elimination method. Worldwide use of this method is limited since it requires advanced imaging physics and software. A more simple method was introduced recently that avoided motion artifacts significantly by restraining the patient's head with a vacuum-type head holder. The purpose of this study was to investigate the feasibility of using unregistered subtracted CTA without such head-holding methods. MATERIALS AND METHODS: Of the 42 patients that underwent subtracted CTA, 39 were recruited for this study. Two patients were excluded due to agitation during examination and one due to artifacts of an embolized aneurysm. All the examinations were performed in an 8-channel multidetector CT suite. After performing a non-contrast low-dose CT examination, CTA was carried out using the same scan planes as on the scout images. Images were transferred to a workstation and subtraction was performed. Hard-copy images through identical locations were reviewed by 2 observers, a radiologist and a clinician (neurologist), and visualization of the internal carotid artery and posterior artery systems were scored. Data were analyzed using the Wilcoxon signed-rank test. RESULTS: Significant statistical differences, in favor of subtracted images, were noted in both observers' scores, both for the internal carotid artery and posterior system arteries. The differences in the clinician's scores were more prominent than that of radiologist's. CONCLUSION: These results are promising for the expanded use of the subtraction method, especially in radiology departments that lack the staff and equipment for registered methods.

Red cell superoxide dismutase activity in sporadic amyotrophic lateral sclerosis.

Specific biologic markers are not available for definitive diagnosis and monitoring of disease progression in sporadic amyotrophic lateral sclerosis (SALS). Oxidative stress plays a role in ALS pathogenesis. The purpose of this study was to determine the association between Cu/Zn superoxide dismutase (SOD1) activity, diagnosis and prognosis. The present study included 25 SALS patients (SALS group; age 51+/-12 years) and 10 healthy subjects (age 45+/-5 years) as a control group. Patients were divided into groups representing four levels of diagnostic certainty of ALS in accordance with the El Escorial Revisited criteria. The disease state was determined using the modified ALS health state scale of Riviere et al. (Arch Neurol 1998:55;526-8). Red-cell SOD1 activity was determined by spectrophotometry. SOD1 activity in red cells was compared statistically with diagnostic criteria and disease state. Red cell SOD1 activity was high in all SALS patients, but there was no significant association between enzyme activity and diagnostic criteria and disease state. In this preliminary study, we did not find any correlation between SOD1 activity level and diagnosis or prognosis. Measured SOD1 activity sometimes supports ALS diagnosis, but it is neither a specific nor a prognostic factor.

Myoclonus relieved by carbamazepine in subacute sclerosing panencephalitis.

A 20-year-old woman with subacute sclerosing panencephalitis, bedridden because of dystonic posturing and very frequent myoclonic involuntary movements, improved dramatically with carbamazepine. The favorable effect of the carbamazepine on myoclonus was demonstrated by discontinuing and reintroducing carbamazepine, and videoing the consequent reappearance and disappearance of the myoclonus. [Published with video sequences].