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Four patients are described who sustained comparatively minor peripheral injury, the affected area soon becoming the site of segmental dystonia. The movement disorder developed as the symptoms from the injury subsided, and except for the recent trauma, no cause for the dystonia was apparent; litigation was not an issue for any patient. It is suggested that on rare occasions peripheral trauma results in the development of dystonia. Since injury never involved the head, the role of the spinal dopaminergic system and the relevance of pain from the injury are discussed in considering possible underlying mechanisms. [ABSTRACT FROM AUTHOR]

In 48 patients with chronic migraine and muscle tension headaches, a comparison was made between a prophylactic course of acupuncture and of medical treatment. It was intended that all patients should have 3 months with both forms of treatment, but 19 were unwilling to change from one form of prophylaxis to the other. Twenty-four of 41 patients improved on acupuncture, the improvement being very marked in nine; nine of 36 patients improved on medical treatment, the improvement being marked in three. Of the 29 patients who changed from one form of treatment to the other, a larger proportion preferred acupuncture to medical treatment. A beneficial response to acupuncture was more likely when the patient had local tender muscular points. The presence of depressive features did not preclude satisfactory treatment with acupuncture. No major side effects were encountered with acupuncture. [ABSTRACT FROM AUTHOR]

In this report are described seven patients assessed clinically and neuropsychologically in whom mirror movements affecting predominantly the hands occurred as a congenital disorder. These mirror movements, representing a specific type of abnormal synkinesia, may arise as a hereditary condition, in the presence of a recognisable underlying neurological abnormality, and sporadically, and the seven patients provide more or less satisfactory examples of each of these three groups. Despite the apparent uniformity of the disorder, the heterogeneity and variability may be marked, examples in some of our patients including the pronounced increase in tone that developed with arm movement, and the capacity for modulation of the associated movement by alteration of neck position and bio-feedback. Various possible mechanisms are considered; these include impaired cerebral inhibition of unwanted movements, and functioning of abnormal motor pathways. Emphasis has been placed on the putative role of the direct, crossed corticomotoneurone pathways and on the unilateral and bilateral cerebral events that precede movement. [ABSTRACT FROM AUTHOR]

Cerebral damage which renders the preferred arm useless may lead patients to use their non-preferred arm for everyday tasks including writing. In these circumstances, mirror writing and other mirror movements may occur. The present study on 10 formerly right-handed patients was carried out to determine whether similar phenomena occurred when serious damage to the right arm itself had occurred, cerebral function remaining intact or any damage being coincidental and non-focal. The patients were asked to describe the events that had occurred when they started using their left hand, to carry out a number of writing tests, and to undertake two graphic tasks to assess directional motor preferences. Seven patients had executed mirror reversal of letters, and eight had experienced mirror phenomena when carrying out everyday tasks with their left hand; brief case histories are cited. No patient exhibited mirror writing on formal testing, and there was no evidence of alteration in the expected preference of direction in which graphic tasks were undertaken. The practical and theoretical implications of these observations are discussed. [ABSTRACT FROM AUTHOR]

Guanethidine was infused by the regional intravenous technique into upper and lower limbs of patients with painful hyperpathic states, due to peripheral or central lesions. The relief of pain and hyperpathia occurred within 20 minutes of infusion and lasted between three and 128 hours; in a few patients, the relief has lasted for months. Great reduction in skin conductance and vasodilatation occurred, there being marked variation in the time of onset and duration of these effects. In some cases there was marked pilo-erection. Guanethidine given in this way did not completely block the sympathetic control of digital blood-vessels. There were no effects on sensibility of normally innervated regions. [ABSTRACT FROM AUTHOR]

Six cases are described of muscle weakness and wasting of scapuloperoneal distribution with an onset in early adult or middle life and a relatively benign progression. One case also showed mild facial weakness. Four cases were probably sporadic but in two, a mother and daughter, autosomal dominant inheritance was likely. Electromyographic studies demonstrated myopathic features in all, and this was confirmed by muscle biopsy in five. Electrocardiographic abnormalities were present in three cases, but their significance is uncertain. It is considered that adult onset scapuloperoneal myopathy constitutes a clinically distinct condition. [ABSTRACT FROM AUTHOR]

A case is reported of a 32 year old woman with a two year history suggestive of schizophrenia who presented in stupor. This proved to be due to hypercalcaemia with a concomitant high cerebrospinal fluid calcium concentration associated with previously unsuspected lymphosarcoma. Necropsy revealed no significant intracranial abnormality, and mechanisms that may have been involved in the production of the impaired consciousness are discussed. [ABSTRACT FROM AUTHOR]

Three cases of hypophosphataemic osteomalacia presenting in adult life, in which a myopathy was a prominent presenting feature, are described. In one, a nasopharyngeal haemangioma was also present. Possible mechanisms underlying the myopathy are discussed briefly. [ABSTRACT FROM AUTHOR]

An in vivo study of skeletal muscle paralysis induced by intravenous barium chloride has been made in curarized and non-curarized rats. The influence of potassium and calcium chlorides, propranolol, ouabain, and prior adrenalectomy on the paralysis has also been studied. Paralysis is found to be due to a direct effect on skeletal muscle, and to correlate well with the development of hypokalaemia. Possible mechanisms of action of barium are discussed, and attention is drawn to the similarity between barium poisoning and hypokalaemic familial periodic paralysis. [ABSTRACT FROM AUTHOR]

Two brothers are described who during their fourth decade presented with isolated down beat nystagmus and later developed a progressive cerebellar ataxia. The nature of this unusual oculomotor disorder and its rare occurrence in other inherited conditions are discussed. [ABSTRACT FROM PUBLISHER]

A family is described in which sometimes asymmetrical brachydactyly, with nail dysplasia of the involved fingers, has been transmitted through 6 generations affecting 6 males and 15 females. The thumbs and feet have been normal. This previously unreported condition is inherited as an autosomal disorder with full penetrance and variable expressivity, and causes only minor inconvenience. [ABSTRACT FROM PUBLISHER]

The experience of music is difficult to study objectively. Here we describe a detailed analysis of musical hallucinations developing after a probable brainstem stroke in an 83 year old musician who was able to describe and notate the hallucinations. The hallucinations comprised simple, repetitive melodic and rhythmic motifs that were combined apparently randomly without definite tonality, large-scale structure, or timbre. This observation is consistent with the proposal that musical hallucinations represent abnormal spontaneous activity in auditory cortical areas beyond the primary auditory cortex. This activity may generate novel musical motifs. [ABSTRACT FROM AUTHOR]

Discusses the nature of Marfan's syndrome and the norms of anthropometry. Renaissance studies of human proportion; Modern measurements of span and height; Doubts over the disproportion in Marfan's syndrome.

Skin pain alter PUVA therapy is a rare, but disabling disorder of unknown aetiology. We describe a patient with skin pain persisting for 12 months after PUVA therapy in whom impairment of axon reflex flare in affected, but not adjacent unaffected sites was demonstrated. [ABSTRACT FROM AUTHOR]

A patient with anorexia nervosa is reported whose presentation with foot drop was to a neurological department. Bilateral peroneal nerve palsies were subsequently demonstrated. The aetiology of these transient palsies is discussed. [ABSTRACT FROM PUBLISHER]

The concentration of digoxin in the cerebrospinal fluid (CSF) of ten patients receiving conventional oral doses of this cardiac glycoside has been measured by a radioimmunoassay technique. Digoxin was undetected in eight patients and barely detectable in two, suggesting the presence of a significant blood-CSF barrier for digoxin. The implication of these findings is discussed. [ABSTRACT FROM PUBLISHER]

Three patients are reported who developed slow and painless weakness and wasting of the muscles of one shoulder girdle, denervation in the affected muscles, and subsequent complete recovery. In two patients, an area of cutaneous sensory loss in the distribution of the circumflex nerve was detected. No underlying cause was found, and it is suggested that these features represent an unusual chronic and painless variant of idiopathic brachial plexus neuropathy. [ABSTRACT FROM AUTHOR]

A new syndrome was recently reported with the descriptive title of "painful legs and moving toes". The present paper describes five patients who developed this syndrome following minor trauma to the legs, which in three patients was attributable to surgery. Various mechanisms that may underlie this unusual combination of severe leg pain with involuntary movements of the toes are discussed, as is the role of previous injury. The possibility is considered that whilst the condition may be generated peripherally, a persistent abnormality of the central nervous system consequently develops. [ABSTRACT FROM AUTHOR]