A.M.A. Archives of Neurology & Psychiatry

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ISSN : 0096-6886
Published by: American Medical Association (AMA) (10.1001)
Total articles ≅ 756
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Charles E. Wells
A.M.A. Archives of Neurology & Psychiatry, Volume 81, pp 667-677; https://doi.org/10.1001/archneurpsyc.1959.02340180001001

With the knowledge that anticoagulant drugs were effective in significantly reducing the incidence of cerebral embolic phenomena1,2and the evidence that in animals anticoagulants might increase the severity of experimental hemorrhagic infarcts,3-5the study of cerebral embolic phenomena in man has taken on new importance. This paper examines three aspects of cerebral embolism in man—the usual clinical course, the prognostic signs of significance, and the effects of anticoagulation upon the clinical outcome. I. The Natural History The present study is an effort to delineate the clinical features and course of cerebral embolic phenomena. In previous pathological studies6,7the natural history of those episodes ending in death has been considered, but this hardly gives a verisimilitude of the usual clinical course. The records of 185 patients with a diagnosis of cerebral embolism admitted to the New York Hospital over the past 18 years were critically assayed. In 82
A. R. McINTYRE, A. L. Bennett, J. S. Brodkey
A.M.A. Archives of Neurology & Psychiatry, Volume 81, pp 678-683; https://doi.org/10.1001/archneurpsyc.1959.02340180012002

The presence of fibrillation in the muscles of the Bar Harbor strain of dystrophic mice has previously been reported from this laboratory.1We have observed that the electromyogram from dystrophic mice of this strain is strikingly similar to that recorded from muscles of patients suffering from dystrophia myotonica. The muscles of such patients and animals are hyperirritable, and the records obtained by the insertion of a concentric needle electrode reveal the presence of short motor volleys of high frequency against a background of electrical activity characteristic of denervated muscle. In order to demonstrate the presence of fibrillation, free of the superimposed activity from innervated structures, it was decided to study the electrical activity of muscles in dystrophic mice and patients in whom the motor nerves were blocked. The identification of characteristics common to both the dystrophy in this strain of mice and a particular form of dystrophy in man
C. E. C. Wells, W. R. L. James, A. D. Evans
A.M.A. Archives of Neurology & Psychiatry, Volume 81, pp 699-705; https://doi.org/10.1001/archneurpsyc.1959.02340180033005

Although the major complication of the 1957 pandemic of influenza was pneumonia, cases of neurological disorder were reported to accompany or to follow the initial respiratory infection. The brunt of the insult was borne at any level of the nervous system, giving rise to a varying combination of clinical symptoms and signs. One of these was the Guillain-Barré syndrome. Despite the occurrence of fatal cases and the opportunity for pathological study, this syndrome remains a clinical concept, although, since its first description in 1916,16the ambit of its diagnostic use has been greatly extended, particularly in the literature of Scandinavia, America, and the British Commonwealth. By the outbreak of World War II, Guillain14himself had accepted several varieties of the syndrome, and in his most recent communication15(1953) he allotted 3 of his series of 19 cases to a sixth variety, which had been described nearly 20
Eben Alexander, Courtland H. Davis, Nancy C. Kester
A.M.A. Archives of Neurology & Psychiatry, Volume 81, pp 684-692; https://doi.org/10.1001/archneurpsyc.1959.02340180018003

The proper management of intracranial arterial aneurysms has been the object of considerable controversy. In an effort to evaluate various methods of treatment, we have compared the results of these methods in 115 patients treated under similar conditions by the same surgeons. Before the evolution of modern neurosurgical techniques, intracranial aneurysms were curiosities, usually discovered at autopsy. In 1923 Symonds'1presentation of the criteria for the diagnosis of a ruptured intracranial aneurysm gave impetus to further study of this subject. Richardson and Hyland,2Walsh and King,3Dandy,4and numerous others have contributed much to the increasing frequency of diagnosis and successful treatment of aneurysms. Recently a more complete study by Hamby5has brought the entire subject into focus with a survey of the previous publications and an analysis of his own material. The mortality rate of ruptured intracranial aneurysms is known to be high, ranging
E Alexander, C H Davis, N C Kester
A.M.A. Archives of Neurology & Psychiatry, Volume 81

Richard D. Hahn, Bruce Webster, George Weickhardt, Evan Thomas, William Timberlake, Harry Solomon, John H. Stokes, Joseph Earle Moore, Albert Heyman, George Gammon, et al.
A.M.A. Archives of Neurology & Psychiatry, Volume 81, pp 557-590; https://doi.org/10.1001/archneurpsyc.1959.02340170023003

Introduction This paper is a cooperative report of the clinical, spinal fluid, and serologic findings in a group of 1,086 patients with general paresis (dementia paralytica) treated with penicillin with or without fever therapy at eight different hospitals. A detailed account of the formation and function of this cooperative clinical study has been given previously as an introduction to the presentation of the group experience in treatment of asymptomatic central nervous system syphilis.1 Shortly after the effectiveness of penicillin in the treatment of early syphilis was reported, various investigators began to study the efficacy of this new antibiotic in the treatment of central nervous system syphilis. These investigations were supported in part by grants from the Office of Scientific Research and Development, the National Institutes of Health, and the Division of Venereal Disease, U. S. Public Health Service. The findings of the individual investigators have provided much of the
N. Q. Brill, Evelyn Crumpton, Samuel Eiduson, H. M. Grayson, L. I. Hellman, R. A. Richards
A.M.A. Archives of Neurology & Psychiatry, Volume 81, pp 627-635; https://doi.org/10.1001/archneurpsyc.1959.02340170093010

Electroconvulsive therapy is a complex treatment which involves at least three factors: (1) introduction of a quantity of electrical current into the brain; (2) rapidly induced loss of consciousness, and (3) motor convulsion. It is the aim of this study to determine experimentally the extent to which each of these components contributes to the therapeutic effectiveness of the over-all treatment. Although ECT is extensively used in the treatment of the mentally ill, it has never been firmly established whether it is the electrical current itself, or the motor convulsion, or the resulting unconsciousness which is the major therapeutic factor of the treatment; or whether the entire treatment complex is necessary. The literature abounds in statistical and case reports comparing various forms of shock treatment, but few controlled studies have been done, especially with regard to the specific aim of this investigation (i. e., to determine the therapeutic efficacy of certain
H. Azima
A.M.A. Archives of Neurology & Psychiatry, Volume 81, pp 658-664; https://doi.org/10.1001/archneurpsyc.1959.02340170124014

Since the introduction of phrenotropic drugs in psychiatry, the major syndromes influenced by them have been those associated with excitation, elation, agitation, and, sometimes, anxiety. There has been, as yet, no satisfactory means for chemical control of depressive states. Amphetamines, effective in mild depression, have a transitory unpredictable effect and are also habitforming. Iproniazid (Marsilid), one of the few promising antidepressants, may produce undesirable side-effects, and death, though rare, has followed its use.1While surveying different substances in this area, it was noted that Kuhn, in Switzerland,2had observed favorable results with an iminodibenzyl compound in 30 depressed patients. A preliminary trial with this substance3confirmed Kuhn's opinion. Concomitantly, Lehmann et al.4reached the same conclusions. The present study was undertaken to observe more fully the effects of this substance (imipramine), which appeared to be a potent antidepressant and also to investigate the changes in psychodynamic
Darab K. Dastur
A.M.A. Archives of Neurology & Psychiatry, Volume 81, pp 601-614; https://doi.org/10.1001/archneurpsyc.1959.02340170067007

I "The fact is decisive that the morbid anatomy [of dementia precox] has disclosed not simple inadequacy of the nervous constitution but destructive morbid processes as the background of the clinical picture." This remark of Kraepelin's1immediately reveals the pronounced neuropathological bias with which schizophrenia was received during the early years of this century. This position on the part of the psychiatrists of the day was, however, not untenable, as Alzheimer2had by then reported severe changes in the cerebral cortex, with disorganization of the ganglion cells and extensive glial reactions. He described not only swollen nuclei and shrunken neurons, with a frequent falling out of groups of cells, but also proliferative fibrous gliosis and pigmentary changes. He concluded that these changes were responsible for the disturbance in cortical function of these patients. It is worth noting that most of these histopathological descriptions applied to brains of catatonic
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