Casuistic contribution to the differential diagnosis of the myoclonic syndrome]

Involuntary muscle twitches, which are accompanied by a more or less pronounced effect of motion and which may last for several hours, are a common guiding symptom of a number of neurological syndromes. This paper reports the case of a 24-year-old male who had been suffering since his sixth year from episodic muscular spasms accompanied by attacks of petit mal. These are regarded as representing a myoclonic-epileptic syndrome. In this connection, a distinction has to be made, by differential diagnosis, between the "true" myoclonic syndrome which is characterized by the absence of complications due to attacks of grand mal or petit mal, Kojewnikoff's epilepsy, and the myoclonic-epileptic dementia form of syndrome.     

Systems measures of word use and differential diagnosis

This paper presents findings on the power of two systems measures of word use to discriminate four patient groups. The first is the slope of accumulated entropy or complexity of the sample (known to be logarithmic over time). The other is the average Poisson rate for the use of new words (known to be a Poisson process). The four groups consisted of cancer, depressed, paranoid, and somatization patients. The two word measures discriminate the first three groups from the fourth. There is evidence that larger samples will identify a similar discriminator for each of the first three groups from one another. The results are discussed in terms of how these methods may offer fresh insight into the relationship between language use and psychopathology.     

Facioscapulohumeral neuromuscular syndromes--problems of differential and early diagnosis and genetic counseling

Among 20 kinships affected by facioscapulohumeral and scapulohumeroperoneal neuromuscular syndromes 6 probands with autosomal dominant transmission and 5 obviously sporadic cases revealed myopathic changes on biopsy and were classified to have facioscapulohumer (operone)al muscle dystrophies. 5 autosomal dominant cases and one sporadic case with neurogenic muscle changes and 3 other non-dystrophic phenocopies emphasize the necessity of muscle biopsy for nosological assignment. Definite correlations between mode of inheritance, clinical and morphological findings could not be found. Pathological ultrasound and EMG findings in parents and children of seemingly sporadic cases suggest to assume autosomal dominant inheritance with incomplete penterance in such cases.     

Clinical and cisternographic differential diagnosis between presenile dementia and Hakim syndrome

The authors compared with regard clinical and the radionuclide cisternography examination 27 patients with Hakim-Syndrome and 11 with Alzheimer-Disease. In all cases, dementia was a stable symptom. Patients with Hakim-Syndrome have an early gait disturbance, ataxia and epileptic seizures. Only in case of patients with Alzheimer-Disease we found aphasia, apraxia and psychotic disorders. 24 hours after the injection radionuclide cisternography showed ventricular retention and absence of parasagital accumulation only in patients with Hakim-Syndrome. Lighter changes (mixed cisternographic pattern) were found in patients with Alzheimer-Disease as well.     

Incidence and diagnosis of lumbosacral pouch diverticula]

The myelograms of ninety-nine patients with an ischias symptomatology were analyzed. In fifteen of the subjects there were found lumbosacral radicular pouch diverticula which, after elimination of other nosogenic factors, were considered chiefly responsible for the clinical and neurological pictures observed in six cases. The pathological and anatomical, clinical and radiographic results described by the authors represent a disease picture which is little known and, hence, not generally included in the differential diagnosis of ischialgia, but which has been found to yield to neurosurgical treatment in selected cases.     

Personality diagnosis of school-age children]

This paper discusses some selected methodical and metric problems of psychological personality diagnosis in both childhood and the period of youth. In additon to discussing a number of important questions concerning psychometric methods, the author deals with problems associated with personality diagnosis, sociometric methods, and fictitious situational tests, analyzing them by reference to data reported in the literature.     

Some suggestions on epileptic psychoses, their differential diagnosis and therapy

From a present point of view, some clinical suggestions are put forward concerning the symptomatology, differential diagnostics, and therapy of psychotic states in epileptic patients (twilight states, states of emotional deterioration and epileptic psychoses proper).     

Prognosis of the rehabilitation of psychiatric patients by Leonhard's differential diagnosis

There is a report on rehabilitation results of chronic patients after 10-years-follow-up in a psychiatric community hospital. Indication for therapy, prognosis and main fields of treatment are differently dependent on variable diseases according to the diagnostic classification given by Leonhard. Where as illness duration and professional basis don't correlate with favourable rehabilitation results additional accentuated behaviour and unfavourable social situations in interhuman relations render the rehabilitative therapy more difficult. Future research into that direction might be a basis for more effective therapeutic action.     

Issues to consider in the differential diagnosis of normal childhood nonfluencies and stuttering

Historically more attention has been focused on the adult stutterer than on the young stutterer. This article discusses three key issues in the differential diagnosis of normal childhood nonfluencies and childhood stuttering. The three issues are (1) whether early childhood disfluencies are heterogeneous or homogeneous phenomena, (2) whether the relationship between normal childhood nonfluencies and early stuttering is continuous or dichotomous, and (3) whether normal nonfluencies and stuttering differ quantitatively or qualitatively. Theoretical research as well as clinical implications of these issues are discussed.     

Cerebrospinal fluid diagnosis of multiple sclerosis]

Starting from the knowledge accumulated with respect to the etiopathogenesis and the components of immunoreaction a minimal to maximal program by steps has been developed for the cerebrospinal fluid (CSF) in multiple sclerosis (MS). It is based on fundamental methods (I), special supplementary methods (II), and relatively specific immunological methods (III). For MS five possible conditions of the CSF could be determined from alterations of cells and variations in protein: a (1) typically complete and (2.) typically incomplete immunoreactive encephalomyelitic (encephalitic) syndrome, a (3.) nonspecific CSF-syndrome of low degree and less typical character (in the sense of an acute or subacute irritation syndrome) an (4.) atypical syndrome of a considerable degree, and a (5.) normal condition of the cerebrospinal fluid. The significance of immunoreactive cerebrospinal fluid syndromes to the diagnostic criteria of multiple sclerosis as well as further relatively disease-specific methods (such as the MEM test and MSF assay) of determining cellular immunity, are discussed.