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Testing language abilities is common in the context of migration. It has been observed that approximately 6.2 million adults in Germany are low literate and that approximately 47% of this group doe...

Despite its asexual reproduction, garlic (Allium sativum L.) exhibits wide diversity for morphological and agronomic characters due to accumulation of mutations. Sixteen agro-morphological characters were evaluated to assess patterns of variation among landraces and their relationship with geographical regions. There were high levels of diversity within the germplasm. Differences in germplasm were predominantly due to genotype. Biologically significant correlation coefficients were observed among characters, indicating the stability of these relationships in garlic. Results indicated that the ability to produce scapes and plant weight should be considered in future garlic germplasm evaluation. Based on cluster analysis, there was a relationship between genetic divergence and geographical origins; genotypes from the same or nearby locations were in the same cluster. Genotypes GI-14 and GI-15 from Isfahan and Markazi provinces, respectively, had the ability to flower and were bolting types. Variation observ...

Spasticity is a complex disorder that causes significant disability in affected patients. We here present long-term results of botulinum toxin type A (BoNT-A) treatment in spasticity of various etiologies in the upper and lower limbs.We evaluated long-term results of BoNT-A treatment with Dysport and Botox for up to 12 years in 137 patients with spasticity of various etiologies. The focus was laid on efficacy, dosage, safety and side effects over time in a retrospective analysis of the database of our movement disorder clinic.The mean clinical benefit, latency and duration of response were comparable for both products. Side effects were generally mild and comparable for the two products. We found a significant negative correlation between time from onset of spasticity to start of BoNT-A treatment and degree of improvement after treatment.Our data confirm the safety and efficacy of BoNT-A treatment of spasticity of different etiologies over a long period of time. Furthermore, the data imply that BoNT-A treatment should be started early after appearance of spasticity to obtain better treatment response.

Objectives: Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disorder, characterized by a selective progressive degeneration of the motor system. Electromyography is essential for the diagnosis of ALS. The measurement of motor conduction of peripheral nerves is of major importance to recognize other possible causes of progressive muscle wasting. However, there are also pathologic changes in nerve conduction studies in ALS patients. Methods: In this study we analysed the values of distal motor latency (DML), compound muscle action potential (CMAP) and motor nerve conduction velocity (MNCV) in 95 patients with definite ALS. Results: We found slight slowing of MNCV and moderate to strong reduction of CMAP and a prolongation of DML. We found no significant correlation between MNCV and CMAP. Discussion: The main finding of the present work was the negative correlation between DML and CMAP. It is interpreted as a very distal axonal damage as the main reason for prolongation of DML in AL...

It can be difficult to detect upper motor neuron (UMN) involvement in early amyotrophic lateral sclerosis (ALS). The present study tested the usefulness of mirror movements (MMs), i.e., contralateral coactivation of hand muscles, as a UMN sign in ALS. Thirty-seven patients with possible, probable or definite ALS and 19 patients with suspected ALS without clinical signs of UMN involvement, 21 disease controls and 15 healthy volunteers were included. MMs were studied clinically, electromyographically and by transcranial magnetic stimulation (TMS), looking for ipsilateral motor evoked potentials (IMEPs). MMs were observed clinically in 15 ALS patients (27%) and electromyographically in 28 (50%). IMEPs in the abductor pollicis brevis muscle following TMS were recorded in 34 (61%) of all ALS patients and in nine (47%) out of 19 patients with suspected ALS, but not in healthy controls. Central motor conduction times were prolonged in 15 ALS patients (27%). It is concluded that MMs, especially if studied by EMG and TMS (IMEPs) can essentially improve detection of UMN involvement, especially in early stages of ALS.

We report on a case of polymicrogyria with benign childhood epilepsy and amyotrophic lateral sclerosis (ALS). While performing dexterity tasks with either hand, strong unsustained mirror movements of the unintended hand were observed. The patient was seen over a period of three years and, as often seen in ALS, there was a moderate progress of the motor neuron disease affecting the upper and lower motor neuron in an asymmetrical manner. In addition, more rapidly progressive bulbar symptoms could be observed by the clinical and neurophysiological examination. MRI revealed polymicrogyria of the right frontal lobe with irregular bumpy inner and outer surface and abnormally thick and smooth cortex, dysplastic insular cortex and asymmetrically widened Sylvial fissure. No signs of atrophy, especially of the motorcortex and corticospinal tract were observed. The corpus callosum was completely developed and of normal size. We hypothesize an enrolment of the dysplastic right frontal lobe pathophysiology of the observed mirror movements.

We retrospectively screened a large cohort of 554 ALS patients with regard to documented nerve compression syndromes and identified 23 patients, mostly with carpal tunnel syndrome. Patients could be subdivided into three groups. Group A comprised 13 patients in whom nerve compression was apparently confused with early ALS signs. Group B consisted of six patients diagnosed with carpal tunnel syndrome who had experienced improvement after surgery years before they eventually developed ALS. Group C consisted of four patients who, after diagnosis of ALS, additionally developed a nerve compression syndrome. Altogether, the frequency of true nerve compression syndromes in our ALS cohort (1.8%) was no higher than in the general population (0.3-10.8%). In group A, the initial confusion with a nerve compression syndrome led to a slight though not significant delay (15.2 vs. 12.9 months; p = 0.32) of the diagnosis of ALS. Survival was no different between group A and the cohort. It can also be concluded that the misdiagnoses could have been avoided by thorough electrophysiological examination using a standardized protocol.