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The aim of this study was to investigate why capnographs malfunction at high altitude, in order to suggest ways of improving instrument reliability. Four machines were decompressed to simulated high altitude and measurements taken. The study showed that the reduced air density at altitude has effects upon the pump, causing difficulty in entraining gas, and that high altitude has additional effects upon calibration of the instruments. [ABSTRACT FROM AUTHOR]

The case histories of two patients who developed an anterior interosseous nerve palsy apparently as a result of an external pressure injury are reported. Both patients recovered fully without surgical exploration, one 19 months and the other nine months after the onset. It is stressed that complete recovery may occur spontaneously. [ABSTRACT FROM AUTHOR]

The electroencephalogram in three patients with Jakob-Creutzfeldt disease showed two separate abnormalities—namely, progressive background suppression and periodic generalized synchronous triphasic sharp wave complexes which evolve to a uniform morphology and periodicity. The abnormalities, when found in the EEG of a patient in middle-age with a dementing illness, should not be confused with other periodic electroencephalographic phenomena. Since the neuropathological abnormalities of Jakob-Creutzfeldt disease are non-specific, the electroencephalogram is essential for the recognition of this disorder, although serial recordings may be necessary to establish the diagnosis. Modification of the electroencephalographic abnormalities occurs with afferent stimuli and with methylphenidate or diazepam, suggesting that the phenomenon of background suppression is independent of the presence of the periodic complexes. Modification of clinical activity with methylphenidate suggests that some degree of reversibility of function exists in this inexorably fatal disorder. Further detailed studies of the electroencephalogram in cases of Jakob-Creutzfeldt disease are indicated. [ABSTRACT FROM PUBLISHER]

Peripheral neuropathy and optic neuritis occurring in alcoholics are sometimes due to the toxic effects of disulfiram rather than to alcohol. Unless this is considered in the management of such patients it is likely that administration of the drug will be continued. In the past there have been reports of 16 cases of peripheral neuropathy and six cases of optic neuritis, possibly caused in this way; these reports are reviewed and a further six cases are described. The effects of disulfiram on the nervous system are briefly discussed. [ABSTRACT FROM AUTHOR]

Two patients with a serologically-proved infection with (MP) developed cranial nerve pareses which cleared spontaneously within 1 month of the onset. The sixth and seventh cranial nerves were the most severely affected. It is suggested that the signs were due to a mild brainstem encephalitis associated with the MP infection. The benign course of the syndrome is emphasized. The neurological complications of MP infection may be commoner than has been generally supposed. [ABSTRACT FROM PUBLISHER]

An abstract of the article "Tau Tubulin Kinase 2, Implicated by Tau Phosphorylation, Contains Mutations That Segregate with Spinocerebellar Ataxia Type II," is presented.

Sir William Osler, physician in Montreal, in Pennsylvania, at Johns Hopkins and in England, promoted clinical medicine and its interpretation through clinical and pathological observation. He was a keen bibliophile and medical historian. He taught at the bedside and wrote a textbook that was a standard work in his time and for several decades after he died. As a generalist he practised the emerging speciality of neurology and knew many of the early clinicians in that field. The neurology of his time and his contributions to the subject are explored here., Competing Interests: Declaration of conflicting interestsThe author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

John Goodsir, conservator and professor of anatomy at the University of Edinburgh, suffered an unidentified illness described by experts after his death as tabes. The features that led to this diagnosis, the understanding of tabes at that time and its relationship in some cases to syphilis, are discussed. It is concluded that the most likely diagnoses are subacute combined degeneration of the cord as a result of malnutrition or tabes dorsalis resulting from earlier syphilis. The presence of 'lightning pains' leans towards the latter diagnosis but evidence for a means of acquisition of syphilis is lacking. The disadvantages of retrospective diagnosis are discussed.

The human face reflects a person's character and emotions, both in health and disease. Charles Bell, published in 1806 Essays on the Anatomy of Expression in Painting in which he stressed the importance of understanding anatomy when studying art. He concluded that emotions were revealed in facial expression and that these expressions were only to be found in humans, not in lower animals. Charles Darwin in 1872 published The Expression of the Emotions in Man and Animals , where he acknowledged Bell's contribution to facial expression especially the role of the nervous system, but questioned Bell's conclusion, that animals were incapable of showing emotions through facial expression. Darwin reasoned that human facial expressions reflected emotions, some from our primeval state, some from habit but most were universal and controlled by an involuntary nervous system, described by Bell, and now known as the parasympathetic system. This paper explores Bell's contribution to the understanding of facial expression. We conclude that his understanding of neuroanatomy along with his artistic ability enhanced our comprehension of human facial expressions, although his theological interpretation of the reason for facial expressions and emotions needs to be seen more in the context of nineteenth century Natural Theology.

Sir Charles Bell, a 19th century surgeon, anatomist and artist, was heavily influenced by the religious practice of Natural Theology, a belief which implied that the world is created by an Intelligent Designer. In the 18th century, William Paley, later Rector of Bishop Wearmouth, wrote the seminal book about Natural Theology. Charles Bell who practised in London and Edinburgh used his artistic skills to underline his teaching of anatomy and surgery. Later, Bell wrote one of the eight Bridgewater Treatises on the Hand. Bell went on to illustrate the final edition of Paley's Natural Theology in which he demonstrated that proof of Design were to be found in the animal frame, reflecting his earlier work on art and human structure. It is concluded that Charles Bell and William Paley's ideals were in harmony with each other, holding the same belief about Creation. This paper argues that Bell's understanding and devotion to Natural Theology allowed him to accurately explain function, realism and expression in the human body, all revealing the direct influence of the Divine Creator.

The First World War of 1914-1918 produced a wealth of disability and death and much has been written of this catastrophe for mankind. Prose is prolific and much poetry has been written too, some of it discussed here; it consists of works by healthcare workers and also about the effects of the war upon those who fought and those who were left behind. Some of the work is by neurologists and some deals with the neurological disorders of those who fought., (© 2013 Elsevier B.V. All rights reserved.)

John Bell, brother-surgeon of Charles Bell, was, like Charles, an outstanding surgeon and a good artist. John was one of the few who illustrated his work with their own drawings in the days before audiovisual aids were available and without the benefit of reliable drawing aids, photography and computer-aided design. Charles, on the other hand, was the better artist and illustrated much of the normal anatomy of the nervous system. Each brother undertook extensive surgery of men who had been wounded in war; John Bell left us his engravings from the textbooks, more numerous perhaps than Charles, but Charles left us a series of oil paintings and watercolours in addition to the illustrations in his textbooks., (© 2013 Elsevier B.V. All rights reserved.)