Status of perfusion scintigraphy in the diagnostic strategy in cerebrovascular disorders and space-occupying lesions

The results of an evaluation of the perfusion scintigraphy findings of 350 hospitalised neurological patients and 55 more strictly selected neurosurgical patients with cerebrovascular complaints, revealed an accuraty of 83%, a sensitivity of 89%, and a specificity of 83%. The selection of the patients had no influence on the results as a whole. Compared with contrast-medium angiography, incorrect diagnosis must be expected in 17% of the cases. This includes erroneous negative findings in 10% of the cases. Grounds for misinterpretations are suggested, and the biological and methodological limitations of the method are set forth.     

Psychopathologic symptoms in torticollis spasmodicus

The paper presents the results of detailed diagnosis of 51 patients with torticollis spasmodicus. A discussion of the results would seem to indicate the possibility of there being one group with prior neuroses, one group compulsive in nature, and one group whose diminished performance arises from the condition of the brain. Reliable diagnosis is only possible when both mental and physical parameters have been taken into consideration.     

Incontinentia pigmenti as the leading symptom

It is reported on four girls aged 8 to 20 with Incontinentia pigmenti (Ip) The ectodermal dysplasia was associated with oligophrenia, therapy resistant epilepsy with severe psychorganic syndromes and dementia, Lennox syndrome, lability of emotion with severe disorders of social adaptations, spasticity, hypo- and areflexia, hemiathetosis, choreiform unrest, pathological EEG findings, including spike-potentials; relations to cleidocranial dysostosis, dysraphia, Poland's, Greig's and Chotzen's syndrome were found. Ip means unfavourable prognosis and progression of neuropsychiatric disorders.     

Principles of computer-assisted classification in psychiatry

The use of computer based diagnostic decision and artificial intelligence are discussed in relation to the problems of validity and reliability of psychiatric diagnoses. The authors suggest a definition of a computer aided classificator as an existent decision system for an automatically analysis of findings.     

On the technique of analysis of the superego--an introduction

As a result of Freud's ambiguity (and that of later analysts) regarding the nature of the superego and how to treat it in clinical practice, it has taken many years and many theoreticians to move from Freud's predilection to use it for purposes of "suggestion" in overcoming resistance, toward the concept of the superego as part of the ego's hierarchically mobilized defensive activities in the analytical process. Although much ambiguity persists, an attempt is made here to reduce it so that analytical technique may move forward to allow the superego to be analyzed as an unconscious conflict solution.     

A view of aggression in phobic states

This article attempts to apply a theory of aggression as motivation to overcome obstacles to the understanding of phobic states and their formation. The role of aggression in the genesis of phobic conditions is discussed, and the traditional analytic view of aggression as instinctual drive is contrasted with a motivational approach. The motivational view offers the advantage of a clearer understanding of the stimulus contexts, representational connections, and both real and imaginary object connections that are lacking in the more traditional understanding of aggression as a biological drive.     

Adolf Strümpell and the issue of "traumatic neurosis"

By his introduction of the term "psychisches Trauma", Strümpell exerted an influence on Oppenheims concept of traumatic neurosis. What he termed "Begehrensvorstellungen", too, had an important part to play in the ensuing discussion on the origin of traumatic neuroses. That the two sides in dispute nonetheless appealed to the authority of the internist and neurologist Strümpell in matters of expert opinion, is an indication of his discernment in these problematic open questions.