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Infrarot-reflexpupillographisch wurden bei 101 gesunden Probanden die physiologischen Zeitwerte (Latenz-, Kontraktions-, Wiedererweiterungs-, Gesamtreflexzeit) des direkten phasischen Pupillenlichtreflexes bei 4 verschiedenen Reizintensitaten an beiden Augen bestimmt. Durch die statistische Auswertung der Zeitwerte von uber 4000 Pupillogrammen in Form einer Mittelwertberechnung mit Standardabweichung und mittels einer dreidimensionalen Varianzanalyse ergaben sich folgende Ergebnisse: Die Anwendungsmoglichkeit der Methode fur die klinisch-neurologische Untersuchung wird diskutiert.

Among 586 surgically treated tumors of the pituitary gland 72 cases (12.3%) of spontaneous necrosis of the tumor were found. However only in 10 cases (1.7%) were there clues of an additional rupture of the tumor with signs of meningeal reaction in the CSF. Cases with a relatively benign clinical course and signs of regression are more frequent than generally assumed. Spontaneous necrosis with and without rupture is much more frequent in endocrinologically inactive tumors (including prolactinomas) as opposed to STH- and ACTH-cell adenomas. Analyzing the patient material the clinical symptomatology and the differential diagnosis of spontaneous necrosis of the tumor with and without rupture are discussed.

Four cases of mild botulinus type B intoxication are reported with the clinical neurophysiological studies. Electromyographically tetanic stimulation of the N. ulnaris initially led to tetanic potentiation of the muscle action potential. After an interval without any symptoms tetanic reduction became apparent between the fourth and seventh week of the illness. The electroneurographic finding was normal during the observation period of three months. Infrared reflex pupillographic studies revealed that the cholinergic autonomous synapses were disturbed for a period much longer than the symptoms clinically established. The speed at which the pupillographic findings returned to normal varied considerably according to the patient. Electroencephalographic results indicated generalized groups of slow high amplitude waves in three of the four cases during the period of observation. The pathophysiology of botulinus intoxication is discussed with a consideration of the literature and the results of this study.

A report given of a 32-year-old female patient who exhibited a unilateral, paradoxical pupillary reaction to light, but was obviously healthy in all other respects. All of the neuroophthalmological findings, including the infrared reflex-pupillographic results registered, are indicated and discussed in detail in the report. An analysis of the findings leads to the conclusion that this disturbance has a central, prenuclear location. Apart from a stenosis at the junction of the arteria vertebralis, which was determined angiographically, further examination did not reveal any pathological findings.

In the evaluation of chiasmal syndromes the efficiency of VER analysis could be enhanced by separate stimulation of the temporal and nasal half of the visual field. The report is based on data of 27 patients with compressive chiasmal lesions. VER findings have been correlated with the visual fields meticulously plotted with a Tuebingen perimeter and/or an Octopus computer perimeter. Alterations in both parameters have been graded in three groups. The degree of alteration correlated fairly well for both test procedures. Not only was a reduction of VER amplitude observed for the affected hemifield, but a latency delay as well. A discrete damage in the nasal hemifield may be detected even earlier by means of VER half field analysis than by conventional subjective perimetry.

Infrared pupillography was used to determine physiological time parameters of the direct phasic light reflex in 101 normal subjects. These parameters include latency, contraction and redilatation times as well as total reaction time, measured in response to 4 different light stimulus intensities. A total of more than 4000 pupillary stimulations in these subjects was analyzed statistically. The study of these time parameters included determination of the mean, the standard deviation and three dimensional analysis of variance, with the following results: 1. The physiological time parameters are bilaterally symmetrical. 2. The most stable parameters with least variability in an individual subject were latency and contraction time. The redilatation time, however, showed marked intra-individual variability. 3. Variance analysis revealed a high degree of correlation among the different parameters to light stimuli of varying intensity. 4. There was a highly significant prolongation of latency and of contraction time with increasing age. 5. No sex dependent effect on physiological time parameters was found. In addition, no interaction among light stimulus intensity, age and sex could be detected. Possible applications of the method for clinical neurological examination are discussed.

A report given of a 32-year-old female patient who exhibited a unilateral paradoxical pupillary reaction to light, but was obviously healthy in all other respects. All of the neuroophthalmological findings, including the infrared reflex-pupillographic results registered, are indicated and discussed in detail in the report. An analysis of the findings leads to the conclusion that this disturbance has a central, prenuclear location. Apart from a stenosis at the junction of the arteria vertebralis, which was determined angiographically, further examination did not reveal any pathological findings.

Pupillary hippus was observed and recorded in a man of 44 years, who had epileptic seizures, chronic alcoholism with liver disease and Primidon intoxication, during a period of unconsciousness of 24 h. During this time the simultaneous records of the EEG and pupillogram over a long period of time revealed that the basic EEG rhythm and hippus had the same frequency. Both recordings were temporarily in phase, time-locked, and could be blocked by painful and acoustic stimuli. The etiology and interpretation of hippus are discussed.