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.     

Structural differentiation of psychological performances in epilepsy patients

Investigating the specific of psychic performance disorders in epileptics structural aspects in addition to quantitative performance differences are considerable. We compared psychometrically obtained performance structures of epileptic children and adults and of parallelised healthy control persons. It became evident, that the performance differentiation hypothesis is to corroborate also in epileptic patients. The psychic performance structure of epileptics is characterized by a lower differentiation level of the basis functions underlining the performances. Our factor analytic investigations emphasize the importance of deceleration of psychic/psychomotoric speed in epileptics as primary basic disorder.     

Intrathecal methotrexate--overdosing in pediatric lymphoblastic leukemia

Intrathecal methotrexate-overdosage in the meningosis therapy leads to CNS damages dependent on dose. It was given a own case report and a literature review with clinical symptoms and the therapy in this complication. Neuropathologic findings included demyelinisation und necrosis of the white matter.     

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.     

Psychometric detection of depressive mood conditions

An investigation into the diagnostic value of psychometric methods for the diagnosis of depressive states involved five psychometric questionnaires, one concentration test procedure, and one problem-solving approach to register cognitive processes. The data obtained for 80 depressive patients of varied aetiology were compared with those of sample of 80 neurotics without depressive aberration. Even univariate comparisons revealed statistically significant differences between the two samples. Multivariate methods (factor analysis, discriminative analysis) yielded more differentiated information. The "Scale for depression depth measurements" was found to be of particular diagnostic relevance; it was standardized for the time being.