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Background: Chronic inflammatory demyelinating polyneuropathy (CIDP) is a heterogeneous disorder and both clinical course and response to treatment vary widely. Because of the propensity for relapse, CIDP requires maintenance therapy after the initial response to treatment. There is no consensus regarding this in the published literature.Present Report: A patient with CIDP was treated with oral prednisolone and cyclophosphamide pulse therapy but required repeated plasma exchange and intravenous immunoglobulin (IVIg). Treatment with ciclosporin freed the patient from repeated IVIg administration. Therapeutic responses in 14 subsequent cases including three patients who showed improvement with ciclosporin are also presented along with an algorithm of the authors' suggested protocol for treatment.Conclusion: Ciclosporin should be considered for patients with intractable CIDP who require repeated IVIg. [ABSTRACT FROM AUTHOR]

Herpes simplex virus (HSV) is a rare, antecedent infectious agent in Guillain–Barré syndrome (GBS). We report a patient with overlapping GBS and Bickerstaff's brainstem encephalitis (BBE). The patient had a vesicular lesion on her nose. Antecedent HSV type 1 (HSV-1) infection was confirmed by isolation of the virus and detection of the presence of serum anti-HSV-1 IgM antibody during the acute phase. Her serum IgG had high anti-GQ1b antibody titer. External ophthalmoplegia has been noted in 2 of 4 reported cases of HSV-associated GBS. Herpetic brainstem encephalitis cases of poor prognosis are known, but only 2 cases of benign brainstem encephalitis secondary to HSV infection, in which there was acute ophthalmoplegia and clinical features consistent with those of BBE have been reported. [ABSTRACT FROM AUTHOR]

A letter to the editor about rhinolalia after diarrhea is presented.

Presents a letter to the editor regarding post-infectious acute ataxia and facial diplegia associated with anti-GD1a lgG antibody published in the 2004 issue of the "European Journal of Neurology."

A 59 year old man with prostatic carcinoma developed epidural compression of the cauda equina caused by bony expansion from a vertebral osteoblastic metastasis. For medical reasons he could not undergo radiation or surgery. Hormonal therapy alone relieved his low back pain and restored ambulation and urinary function. Postmyelography CT showed that the bony expansion from the vertebra had completely disappeared after treatment. This is the first report of remarkable improvement due to hormonal therapy alone. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate the efficiency of vaginoscopy and rectal palpation (palpable liquid in uterine horns) compared with hysteroscopy (presence of pus in the uterine lumen) for the diagnosis of clinical endometritis (CE), and hysteroscopy compared with endometrial cytology for the diagnosis of subclinical endometritis (SE) in postpartum dairy cows. Thirty Holstein cows between 20 and 35 days postpartum were examined for diagnosis of CE with a vaginal speculum, by rectal palpation, and by hysteroscopy; and examined for diagnosis of SE with hysteroscopy and endometrial cytology. Categorical data were analyzed with PROC CATMOD (SAS®, SAS Institute, Cary, NC, USA) and continuous data were analyzed with PROC GLM (SAS®, SAS Institute, Cary, NC, USA). Sensitivity, specificity, predicted value of a positive and negative result, and efficiency were calculated using Win Episcope®2.0 software (Clive, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK). Prevalence of CE diagnosed by vaginoscopy was 27%, by rectal palpation was 23%, and by hysteroscopy was 13%. When hysteroscopy, the only tool for direct examination of the endometrium, was used as the gold standard for diagnosis of CE, vaginoscopy had 100% sensitivity, 85% specificity, and 87% efficiency, and rectal palpation had 75% sensitivity, 85% specificity, and 83% efficiency. Prevalence of SE diagnosed by endometrial cytology was 35.3%. When endometrial cytology was used as the gold standard for diagnosis of SE, hysteroscopy had 11% sensitivity, 92% specificity, and 59% efficiency. In conclusion, vaginoscopy had higher sensitivity than, and similar specificity and efficiency to, rectal palpation for diagnosis of CE. Conversely, hysteroscopy, although having high specificity, had low sensitivity and efficiency for diagnosis of SE. Hysteroscopy proved to be efficient for diagnosis of CE but inefficient for diagnosis of SE. The authors gratefully acknowledge the support of the study by World of Medicine (WOM), Berlin, Germany, for providing all endoscopic equipment and the cooperation with the dairy farm in Brandenburg, Germany. Vanina Madoz visit to the Freie Universität Berlin was supported by a fellowship from the Deutscher Akademischer Austauschdienst, DAAD. [ABSTRACT FROM AUTHOR]