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Abnormal ocular movements were observed in a patient with myoclonic encephalopathy secondary to branchial carcinoma. Clinical, cinematographic, and oculographic studies demonstrated the presence of rapid, large amplitude, conjugated, horizontal movements which occurred in bursts. They had a tapered appearance and were triggered by fixing vision and jerking movements, while they were abolished by rest and closing the eyelids. These features are similar to those seen in macrosaccadic oscillations. Other types of oscillating ocular movements are discussed as well as the physiopathological features of this disorder.

A patient developed a neurological disorder at the age of 57 years and died 9 years later after progressive aggravation. The clinical picture was that of a unilateral, parietal, focal neurological syndrome for many years, finally becoming bilateral. The purely neurological nature of the condition, without signs of mental disturbance, should be emphasized. Pathological examination showed mainly unilateral circumscribed cortical atrophy in the parietal regions. Histological examination showed atrophic lesions typical of Pick's disease. This case provides suggestive evidence for the existence of purely parietal forms of Pick's disease.

The authors report a case of centropontine myelinosis associated with demyelinising lesions of the tectum mesencephali, the cerebellum, the central grey nuclei and the white matter of the hemispheres. This case is compared with similar observations already studied in the literature. From an aetiological standpoint, attention is drawn to the apparent causative role of diuretic therapy which had resulted in severe water and electrolyte disturbances.

The influence of phenobarbital on bile composition was studied in 13 patients with epilepsy, treated with the drug in doses ranging from 0.05 to 0.30 g per day during 4 months to 50 years. Fourteen normal subjects matched for age and sex acted as controls. Expressed as percent of total lipids, biliary cholesterol (9.2 +/- SD 2.7 in the controls, 9.0 +/- SD 2.5 in the treated patients), phospholipid (23.3 +/- SD 6.1 in the controls, 20.5 +/- SD 5.9 in the treated patients) and bile acid concentrations (67.5 +/- SD 8.1 in the controls, 70.4 +/- SD 7.4 in the treated patients) did not differ significantly in the two groups. When represented on triangular coordinates, bile from the treated patients was not separated from that of controls. These studies indicate that long-term phenobarbital administration in the doses used for the treatment of epilepsy does not modify biliary lipid composition and do not suggest that this drug may be useful in the treatment of cholesterol gallstones in man.

We have reviewed the aetiology, symptomatology, biology and clinical course of 61 cases of the Gayet-Wernicke encephalopathy. Our results do not differ fundamentally from those of Victor et al. (1971). Nevertheless, our study shows fewer oculomotor palsies in the acute stages, lower mortality and a lower incidence of residual anmesic syndromes. These results demonstrate the importance of early diagnosis and of starting the specific therapy in the initial stage of reversible biochemical lesions.

The comparative values of computerized tomography and radionuclide scan for the diagnosis of brain lesions were assessed on a series of 550 patients. A number of indications for each of these two methods have emerged from our results and from those found in the literature. The biases encountered in this type of study are discussed, and a "decision-making flow-chart" is proposed. The procedure of choice is computerized tomography in patients with suspected tumour or intracerebral haematoma, and radionuclide scan in those with suspected subdural haematoma or superficial cerebrovascular disease. The usefulness of clinical examination to determine precisely which of these two methods should be used cannot be overstressed.

The authors report the anatomical and clinical findings in a 65 year old patient with a lesion in the hypothalamus presenting mainly as disorders in heat and water regulation. Disorders in heat regulation dominated the clinical picture, in relation to a poikilothermia. Conservation of reactivity to pyrogenic bacteria is debatable. Inappropriate secretion of antidiuretic hormone (ISADH) by a direct effect on the supraoptico-hypophyseal aixs can account for the water and electrolyte disturbances. The anatomical lesions, due to hypothalamic changes, can be included in the circumscribed proliferative reticuloses of the CNS having a pseudo-inflammatory histological appearance.

The authors report a case of non-familial amyloid neuropathy in which there was sensory-motor neuropathy of the 4 limbs, multiple lesions in the cranial nerves, and large subcutaneous amyloid deposits. Biopsy samples showed the presence of amyloid deposits in the interstitial tissues, the vessel walls in the muscle hypodermis, and in the bone marrow. A light monoclonal lambda chain was present in the serum. Immunofluorescent studies of the biopsy specimens showed the presence of elective fluorescence with an anti-lambda immunoserum in the amyloid substance.

The author choroidal artery syndrome is a rare disorder associating, in its complete form, a hemiplegia, a hemianesthesia, and a homonymous lateral hemianopia. Four cases are reported in which the diagnosis was confirmed by a CT scan, which demonstrated a low density area in the posterior part of the posterior limb of the internal capsule, sparing the thalamus medially, and extending laterally to the apex of the pallidum thus corresponding to the area supplied by the anterior choroidal artery. The incomplete forms of this syndrome and clinicopathological correlations are discussed.