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Editorial. Encourages authors to submit manuscripts on issues on the clinical care, medical research, and health care policy on aging.

Calls for papers on alternative neurology.

Calls for authors to submit manuscripts relating to pain management. Publication of theme issues on the topic in November 2003 by the 'Journal of the American Medical Association' (JAMA) and several 'Archives' journals; Suggested topics; Contact information.

In 1825, Jean-Baptiste Bouillaud read a paper at the Royal Academy of Medicine in Paris supporting Franz Gall's theory of a relation between speech and the frontal lobes. Bouillaud argued that if the frontal lobes are crucial to speech, 2 conditions must be satisfied: when the frontal lobes are affected, speech must also be affected; conversely, when the frontal lobes are spared, speech is also spared. Following these principles, he tested and argued in support of Gall's theory by analyzing the data from 2 neuropathological casebooks (Lallemand, 1820-1823; Rostan, 1820 and 1823). We now know that Bouillaud was wrong, since the crucial dichotomy is between the left and right hemispheres and not between the anterior and posterior areas. What is interesting is that the actual data refute Bouillaud's conclusion. We replicated his experiment by reanalyzing the 147 clinical cases described by Lallemand. There were, of course, some cases with frontal lesions and speech disorders; other cases, however, had speech disorders with lesions outside the frontal lobes, and still others had frontal lesions without speech disorders. Although Bouillaud did not notice it, as we expected, almost all patients with speech disorders had a left hemisphere lesion. [ABSTRACT FROM AUTHOR]

In 1861, Prosper Ménière presented a paper before the French Academy of Medicine in which he described a series of patients with episodic vertigo and hearing loss. He also mentioned the postmortem examination of a young girl who experienced vertigo after a hemorrhage into the inner ear. Prior to that time, vertigo was thought to be a cerebral symptom similar to epileptic seizures. Ménière pointed out that vertigo frequently had a benign course and that common treatments, such as bleeding, often did more harm than good. He was not attempting to define a disease or syndrome but rather to emphasize that vertigo could originate from damage to the inner ear. Confusion regarding the clinical and pathologic features of Ménière disease persisted well into the 20th century. [ABSTRACT FROM AUTHOR]

New criteria for the diagnosis of multiple sclerosis (MS) were published as the result of an internationally formed committee. To increase the specificity of diagnosis and to minimize the number of false diagnoses, the committee recommended the use of both clinical and paraclinical criteria, the latter involving information obtained from magnetic resonance imaging, evoked potentials, and cerebrospinal fluid (CSF) analysis. Although rigorous magnetic resonance imaging requirements were provided, the “new criteria paper” fell short in terms of guidelines as to how the CSF analysis should be performed and simply equated the IgG index with isoelectric focusing, without any justification. The spectrum of parameters analyzed and methods for CSF analysis differ worldwide and often yield variable results in terms of sensitivity, specificity, accuracy, and reliability, with no decided “optimal” CSF test for the diagnosis of MS. To address this question specifically, an international panel of experts in MS and CSF diagnostic techniques was convened and the result was this article, representing a consensus of all the participants. These recommendations for establishing a standard for the evaluation of CSF in patients suspected of having MS should greatly complement the new criteria in ensuring that a correct diagnosis of MS is being made. [ABSTRACT FROM AUTHOR]

Background: Several case reports of the onset or exacerbation of multiple sclerosis or other demyelinating conditions shortly after vaccination have suggested that vaccines may increase the risk of demyelinating diseases. Objective: To evaluate the association between vaccination and onset of multiple sclerosis or optic neuritis. Design: Case-control study involving cases of multiple sclerosis or optic neuritis among adults 18 to 49 years of age. Data on vaccinations and other risk factors were obtained from computerized and paper medical records and from telephone interviews. Setting: Three health maintenance organizations. Participants: Four hundred forty case subjects and 950 control subjects matched on health maintenance organization, sex, and date of birth. Interventions: None. Main Outcome Measures: Onset of first symptoms of demyelinating disease at any time after vaccination and during specified intervals after vaccination (<1 year, 1-5 years, and >5 years). Results: Cases and controls had similar vaccination histories. The odds ratios (95% confidence intervals), adjusted for potential confounding variables, of the associations between ever having been vaccinated and risk of demyelinating disease (multiple sclerosis and optic neuritis combined) were 0.9 (0.6-1.5) for hepatitis B vaccine; 0.6 (0.4-0.8) for tetanus vaccination; 0.8 (0.6-1.2) for influenza vaccine; 0.8 (0.5-1.5) for measles, mumps, rubella vaccine; 0.9 (0.5-1.4) for measles vaccine; and 0.7 (0.4-1.0) for rubella vaccine. The results were similar when multiple sclerosis and optic neuritis were analyzed separately. There was no increased risk according to timing of vaccination. Conclusion: Vaccination against hepatitis B, influenza, tetanus, measles, or rubella is not associated with an increased risk of multiple sclerosis or optic neuritis. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the rate of brain atrophy calculated from serial magnetic resonance imaging (MRI) registration as a surrogate marker of disease progression for use in clinical trials in Alzheimer disease (AD). Methods: Eighteen patients with mild to moderate AD and 18 age-matched normal controls underwent 2 MRI brain scans separated by a 12-month interval. Each individual's later scan was registered to their first scan, and the volume of cerebral tissue loss calculated directly from the registered and subtracted MRI scan pairs. The mean and SD of the rate of brain volume changes were used to estimate the sample sizes that would be needed in a clinical trial with a drug anticipated to modify disease progression by varying degrees. Comparable sample size estimates were performed with data for other methods of monitoring rates of brain atrophy, extracted from published papers. Results: The mean (SD) rate of brain atrophy for the patients with AD was 2.37% (1.11%) per year, while in the control group it was 0.41% (0.47%) per year. Based on these figures, to have 90% power to detect a drug effect equivalent to a 20% reduction in the rate of atrophy, 207 patients would be needed in each treatment arm. This assumes a 1-year placebo-controlled trial with a 10% patient dropout rate, and that 10% of scan pairs are unusable. Conclusion: Registration of serial MRI volume images provides a powerful method of quantification of brain atrophy that can be used to monitor progression of AD in clinical trials. [ABSTRACT FROM AUTHOR]

Background: In the 1840s Brown-Séquard described the motor and sensory effects of sectioning half of the spinal cord. Penetrating injuries can cause Brown-Séquard or, more frequently, Brown-Séquard–plus syndromes. Objective: To report the case of a 25-year-old man who developed left-sided Brown-Séquard syndrome at the C8 level and left-sided Horner syndrome plus urinary retention and bilateral extensor responses following a stab wound in the right side of the neck. Results: Magnetic resonance imaging demonstrated a low cervical lesion and somatosensory evoked potentials confirmed the clinical finding of left-side dorsal column disturbance. At follow-up, the patient's mobility and bladder function had returned to normal. Conclusion: This patient recovered well after a penetrating neck injury that disturbed function in more than half the lower cervical spinal cord (Brown-Séquard–plus syndrome). [ABSTRACT FROM AUTHOR]

The article presents a medical case study on Uncal Herniation. Many cases of intracranial tumor of long lenght, it was found postmortal that the posterior deficient part of the cerebellum had been pushed down and backwards to the foramen magnum. The medulla itself caudally displaced the 2 structures with a forming cone-shaped plug tightly filling up the foramen magnum.

The article presents an index to the vol.61 of the journal "Archives of Neurology." The editor of the journal is Roger N. Rosenberg and members present in the editorial board include James I. Ausman, Louis R. Caplan, Mahlon R. DeLong, James A. Ferrendelli, John H. Growdon. Some of the authors who contributed their papers in the journal are D. Aarsland, K. Anderson, T. Larsen, A. Lolk, F. Baas, Y. Baba, R. Bakshi, R.L. Barbano, D.N. Herrmann, S. Hart-Gouleau, J. Pannella- Vaughan, P.A. Lodewick, R.H. Dworkin.

In the second half of the 19th century, new scientific concepts of the etiology and nature of epilepsy emerged that challenged metaphysical view's on epilepsy held since antiquity.[sup1] In 1910, Gottfried Benn (1886-1956), who would become a well-known German poet, was a medical student at the famous Charite Hospital of Friedrich Wilhelm University (Berlin, Germany). He offered a contemporary perspective on the dramatic evolution of epilepsy theory in his brief report, "A Contribution to the History of Psychiatry."[sup2] A year later, Benn's study on "The Etiology of Pubertal Epilepsy"[sup3] received the gold medal from the medical faculty of the university. Both publications are briefly reviewed here. The purpose of this article is to provide a brief glimpse of European ideas on epilepsy at the beginning of the 20th century as seen through the eyes of Gottfried Benn, a German poet-physician who became particularly interested in pubertal epilepsy. It was during this period that epilepsy began to he seen as a neurologic rather than a psychiatric disorder. [ABSTRACT FROM AUTHOR]

Discusses the application of microarrays to neurological disease. Background on modern microarray-based functional genomics; Microarray-based genomic applications under development; Analytical approaches to gene expression analysis using a cancer classification model.

Focuses on the history of printmaking and its influence on the development of the neurological sciences. Spread of the accepted cell doctrine through printed works during the 15th century; Ability afforded by printed works to conduct independent anatomical observations that could be compared with contemporary paradigms; Use of copperplate engraving to improve image representation.

Highlights the contributions of Doctor Harvey Cushing to neurosurgery and the understanding of medulloblastoma or cerebellar primitive neuroectodermal tumor. Classification of brain tumors; Characteristics of cerebellar medulloblastoma; Surgical treatment of medulloblastoma; Introduction of the use of postoperative radiotherapy in the treatment of medulloblastoma.

In the first half of the 19th century, European physicians, including Marshall Hall, Bernardus Brach, and Moritz Romberg, described loss of postural control in darkness by patients with severely compromised proprioception. Late 19th-century neurologists developed instruments to measure and record postural sway in patients with neurologic disease. Principal American contributors were the neurologist Silas Weir Mitchell from Philadelphia, Pa, and his trainees Morris Lewis and Guy Hinsdale. The efforts of these neurologists anticipated later physiologic studies and ultimately the development of computerized dynamic platform posturography. [ABSTRACT FROM AUTHOR]

Discusses the history of amyotrophic lateral sclerosis (ALS). Contribution of Jean-Martin Charcot to the study of ALS; Details on how ALS got its name; Other contributors to the history of ALS.

The dynamometer came into general use by neurologists in the late 19th century. Various dynamometers were developed and adopted by neurologists at that time to measure muscle strength, in keeping with the general trend of adopting instrumentation to distinguish our specialty and aid observation and diagnosis. Many dynamometers were adaptations of the French Mathieu dynamometer, which was initially promoted by American neurologist William Hammond. Another variation, the Mathieu dynamograph, used to graphically record measurements made with a dynamometer, was also initially studied, used, and promoted by Hammond. The high cost of the dynamograph and the lack of demonstrated clinical utility contributed to its limited dissemination. The history of the dynamometer and the dynamograph illustrate both the practical difficulties associated with developing a new instrument, and the numerous modifications that such an instrument goes through, some of which have little to do with practical application. [ABSTRACT FROM AUTHOR]

Lists individuals who provide scientific reviews of papers submitted to the "Archives of Neurology" journal. Bassel W. Abou-Khalil; Gary M. Abrams; Oded Abramsky; Harold P. Adams; Yves Agid; Mark Agostini; J. Eric Ahlskog; Martin L. Albert.

The article presents information about papers that appear in the December 2004 issue of the journal "Archives of Neurology." The paper "Mechanisms of Stroke Recovery," by Ward and Cohen describe the development of new, noninvasive and innovative techniques to study how the brain responds to focal injury and possible strategies to enhance the response to injury. The paper "Mirror Writing, Left-handedness and Leftward Scripts," by S chott and Schott describe a high prevalence of left-handed mirror writing among those whose native languages are traditionally written in a leftward direction, including Chinese, Japanese and Hebrew.

The article presents a list of various editors and the editorial board of the periodical "Archives of Neurology," who contributed scientifically excellent reviews of the papers to various issues to American Medical Association. The reviews prepared by these editors serve a vital function making sure that only the best clinical and basic research, reviews, and comments are finally published. The board includes Martin L. Albert, Andrea Alessio, Richard Bhidayasir, Tom Bird, Marc Chamberlain, Gary Rosenberg, Gary Schellenberg, and Harry Vinters.

Lists reviewers of papers on basic and clinical neurological research published in the periodical 'Archives of Neurology.'

Presents the case of a middle-aged woman diagnosed with scleroderma by positive antricentromere antibodies, Raynaud phenomenon and acral skin changes. Findings in the computed tomographic scan of the head; Observation of small artery disease in cases of scleroderma.

Editorial. Focuses on a policy governing the publication of biomedical research. Requirements for authors when submitting manuscripts for publication; Purpose of full disclosure of financial interests by authors; Impact of the policy to academic freedom.

Lists reviewers of clinical and basic research papers published in the journal 'Archives.'

Discusses several issues in the diagnosis of non-epileptic seizures. Background on epilepsy as a neurological disorder; Development of center of excellence for the care of patients with epilepsy; Consideration of the subject of non-epileptic seizures called hysteroepilepsy.

Comments on a study which examined the impact of cerebrovascular diseases on the cognitive performance of patients with Alzheimer disease, published in the 'Archives of Neurology.' Results of a study on similar topic; Issues surrounding the conclusions of the study.

Introduces a series of articles on neurology.

Presents the case of a young adult female with type I complex regional pain syndrome (CRPS). History of the patient's illness; Results of a cerebrospinal fluid analysis; Signs and symptoms of type I CRPS.

Presents a case report on an elderly man with D é j é rine syndrome, a neurological manifestation caused by selective dysfunction of the paramedian region of the medulla oblongata. Results of physical examination; Outcome of the computed tomographic scan and left vertebral angiogram; Analysis and discussion.

Objective: To learn if oral steroid treatment can alter the signs of primary progressive aphasia (PPA). Many patients with PPA have had a vasectomy and there is a possible link between vasectomy and autoimmune diseases. If PPA is, at least in part, an autoimmune disease, patients might improve with immunosuppressant treatment. Design: Case report. Setting: Cognitive and memory clinic. Patient: A 68-year-old right-handed man with a 2.5-year history of progressive speech impairment who had a vasectomy 25 years prior. Results: Examination revealed that he had a nonfluent aphasia with intact repetition and comprehension. Before and during oral prednisone treatment, he was assessed for speech fluency, naming, and episodic and working memory. All assessments except episodic memory showed a dramatic improvement. On reassessment 1 month after discontinuing treatment, the patient's performance on cognitive testing had regressed toward baseline. Conclusions: Although this patient's improvement with steroid treatment provides support for the postulate that PPA might be a treatable autoimmune disease, future placebo-controlled trials are needed before conclusions can be drawn. [ABSTRACT FROM AUTHOR]

Objective: To report the very early magnetic resonance imaging features of eclampsia. Design: Case report. Setting: Inpatient neurology service. Patient: A 35-year-old woman who developed late postpartum eclampsia with cerebral edema, caudate hemorrhage, and ischemic strokes. Main Outcome Measure: Very early magnetic resonance imaging features. Results: Magnetic resonance imaging with gadolinium showed posterior sulcal hyperintensity and leptomeningeal enhancement preceding the development of posterior reversible encephalopathy syndrome, hemorrhage, and ischemic strokes by days. Conclusion: Magnetic resonance imaging with gadolinium shows early characteristic findings that precede the more classic clinical presentation of eclampsia. [ABSTRACT FROM AUTHOR]

Provides an overview of the articles published in the journal "Archives of Neurology." Therapeutics for progressive multiple sclerosis; Prediction of the immunotherapeutic response in Alzheimer disease; Association between central obesity and the aging brain.

Background: Cerebellar lesions revealed by abnormal signals on magnetic resonance images are extremely rare in acquired hepatocerebral degeneration (AHCD). Objective: To report a case of AHCD with prominent cerebellar findings both clinically and radiologically. Design and Setting: Case report and tertiary-care hospital. Patient: A 46-year-old man complained of progressive speech difficulties of 5 months' duration. Two years earlier, he had been diagnosed as having cirrhosis of the liver caused by alcoholism and hepatitis B virus infection. Results: The patient had progressive ataxic dysarthria and limb and gait ataxia as manifestations of AHCD. Magnetic resonance imaging of the brain revealed distinctive symmetrical T2 high-signal intensities in the bilateral cerebellar hemispheres and brachium pontis, which were consistent with his neurologic deficits. Simultaneously, high T1 signals in the bilateral pallidum and ventral midbrain were noted, which are typical manifestations of AHCD. Follow-up magnetic resonance imaging 3 months later showed the same cerebellar signs and abnormal signals. Conclusions: The cerebellar cortex and middle cerebellar peduncle are considered highly vulnerable structures to metabolic insults in liver disease. Findings from our patient suggest that dominant cerebellar deficits with compatible T2 high-signal lesions are another type of clinical manifestation in AHCD. [ABSTRACT FROM AUTHOR]

Background: Isolated superior rectus palsy due to a contralateral midbrain lesion has not been reported. Case Description: A 71-year-old woman suddenly developed diplopia. Examination showed that she had isolated superior rectus paresis. Magnetic resonance imaging showed a tiny infarct at the area of the oculomotor nucleus on the contralateral side. Conclusion: Isolated superior rectus palsy may be caused by a contralateral midbrain lesion that selectively involves crossing superior rectus nerve fibers. [ABSTRACT FROM AUTHOR]

Introduces a series of articles about neurology, published in the May 2002 issue of the 'Archives of Neurology.'

Discusses several medical facts about brain abscess. Mortality rates; Pathogenesis; Treatment.

Presents the table of contents for the March 2004 issue of "Archives."