Platelet monoamine oxidase B activity and vitamin B12 in dementia.

The activity of platelet monoamine oxidase B (MAO-B) was highly correlated with the severity of dementia in 39 patients suffering from probable dementia of the Alzheimer type and in 18 age-matched controls. There was no association between a low vitamin B12 level and high MAO-B activity in our sample of patients, who are living in a geriatric hospital where the balanced nutrition of inpatients is controlled by diet assistants.

Migraine attacks. Alleviation by an inhibitor of prostaglandin synthesis and action.

Twenty-six patients with migraine attacks were treated for 3 to 16 months with flufenamic acid (125 mg four to six times per attack), an inhibitor of prostaglandin synthesis and action. In 25 patients the drug afforded symptomatic relief in 195 of 200 treated attacks. Side effects observed were mild dyspepsia (eight patients) and severe upper gastrointestinal symptoms (two patients). None of the eight patients treated with placebo reported any relief (20 attacks). The "common" antimigraine drugs afforded symptomatic relief in 12 of the patients, partial relief in seven, and no relief in seven. Treatment with flufenamic acid was based on the hypothesis that prostaglandins are involved in migraine attack and that the drug relieves migraine by inhibition of the vasoactivity of prostaglandins.

Myoclonic attacks induced by L-dopa and bromocryptin in Parkinson patients: a sleep EEG study.

Six patients with Parkinson's disease developed nocturnal myoclonic attacks after prolongued treatment with L-Dopa which were electroencephalographically recorded. These symptoms persisted after treatment with 2 bromo-alpha-ergocryptin (Bromocryptin), a dopamine receptor agonist, which was substituted for L-Dopa. Bromocryptin is known to have no pre- or postsynaptic effect on serotonin metabolism. It is proposed that these myoclonic phenomena are the expression of the hypersensitivity of denervated catecholamine receptors in the brainstem to the stimulation of L-Dopa and Bromocryptin. This thesis differs with previous suggestions that serotonin plays a major role in the genesis of myoclonic seizures in Parkinsonian patients treated with L-Dopa.

Weight loss in patients treated long-term with levodopa. Metabolic aspects.

Seven aged Parkinsonian patients treated with levodopa (average dose 3-4 g daily for 1-3 years), showed a considerable weight loss. They were compared to two control groups of elderly and young volunteers after levodopa stimulation and after oral glucose tolerance tests. It was found that after levodopa administration the plasma free fatty acids, glucose, growth hormone and cortisol were significantly higher in the Parkinsonian group than in the young control group and only slightly higher than in the aged control group. It was also found that the serum insulin was significantly higher in Parkinsonian patients than in the aged control group. We think that the metabolic disturbances found in Parkinsonian patients are not solely due to levodopa administration but may be due to ageing processes. We suggest that weight loss in the older Parkinsonian patients treated over long periods with high doses of levodopa, is due to the enhancement of the lipolytic activity of the ageing fat cells caused by high levels of circulating insulin.

Dopamine-beta-hydroxylase (DBH) in idiopathic torsion dystonia (ITD).

Dopamine-beta-hydroxylase (DBH) has been reported to be elevated in the serum of patients with idiopathic torsion dystonia. We have examined the levels in jewish patients suffering from that disease and found levels comparable to those of age-and sex-matched controls.

Sinistrad mirror writing and reading after brain concussion in a bi-systemic (oriento-occidental) polyglot.

The problem of mirror writing and reading is discussed in the light of a clinical case, where this disturbance appeared after an apparently minor head injury. Mirror writing and reading in this polyglot individual affected only the sinistrad (Hebrew) writing and reading system, leaving the dextrad (Latin) system unimpaired. This disturbance appeared together with dyscalculia, left-right disorientation and slight temporal confusion, suggestive of parieto-occipital lobe pathology. The clinical picture also showed apparently "conversional" traits, such as are sometimes seen in incomplete parietal lobe syndromes. The relevant literature is reviewed and patho-physiological mechanisms of mirror reversal are discussed.

Long-term effects of L-deprenyl in chronic levodopa treated parkinsonian patients.

In a previous communication the results of a three months clinical trial with the co-administration of the Beta-type Monoamineoxydase (MAO)-inhibitor L-deprenyl in long-term levodopa treated Parkinsonian patients were reported. In view of the favourable effects observed in this study, as well as in others, L-deprenyl was continued in this patient group and given to other patients, found suitable, for periods of four years and more. In the 29 patients reported here, special attention was addressed to fluctuating manifestations of chronic levodopa therapy. Apart from a considerable subjective improvement, L-deprenyl effected an objective improvement in the overall disability score as well as an appreciable reduction of "on-off" phenomena in the great majority of the patients. Dyskinesias appeared in 4 of the patients and increased mildly in another ten. Untoward effects of L-deprenyl were not serious, mostly transitory, and none was prohibitive. In 13 of the 29 patients (44.83%) the levodopa dose could be reduced by 26.5% +/- 0.46, while in two patients it was raised from 250 mgm to 462.5 mgm daily. The present and previous clinical studies show that L-deprenyl is a valuable adjunctive agent for the long-term levodopa treated parkinsonian patient.

Hepatolenticular degeneration (Wilson's disease) and pregnancy. A review and report of a case.

This article presents a case report of Wilson's disease in pregnancy and a review of this entity during gestation. Biochemical and pathological data are reviewed and current treatment is discussed. Pertinent questions of interest to the obstetrician are indicated with reference to Wilson's disease.

Disorders of verbal expression in parkinsonism.

The present study shows that rigor is one of the main causative factors in the parkinsonian speech disorder, whereas tremor ordinarily can only play a minor role. The Fast Fourier Analysis of the frequency spectra demonstrated in parkinsonian speech frequency regions that are energy-deficient and also that the entire frequency spectrum is restricted to a range of 100 to 400 Hz, including the deficient regions, as against the 100- to 700-Hz range in the controls. These analytical findings seem to underline the important role played by the laryngeal and breathing dysfunctions in the parkinsonian voice and speech production.