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Physiological studies have been made of extensor digitorum brevis muscles in 28 healthy subjects aged between 60 and 96. Within this elderly population there was evidence of muscle wasting and weakness. These changes were shown to result from a loss of functioning motor units. The surviving motor units were often enlarged and tended to have relatively slow twitches. In some subjects the maximum impulse conduction velocities were reduced in motor nerves; there was evidence that slowing of impulse conduction could be especially marked in distal regions of axons. The findings are considered to indicate the presence of motoneurone dysfunction in old age. [ABSTRACT FROM AUTHOR]

Isometric twitch contractions have been studied in extensor hallucis brevis muscles of 32 healthy male subjects aged between 3 and 25 years. The maximum twitch tensions were found to increase gradually with age and then to undergo marked enhancement at puberty. After puberty little further change occurred. In the youngest children examined the twitch contraction times were already within the adult range, though the half-relaxation times were prolonged. [ABSTRACT FROM AUTHOR]

Purpose: Although in the early stage of Creutzfeldt-Jakob disease most patients have obvious dementia, we found that the disease can be diagnosed in patients solely on the basis of a visual system disorder., Methods: We examined three patients who initially complained of a nonspecific, insidious visual disturbance., Results: The three patients were found to have Creutzfeldt-Jakob disease, confirmed by histopathologic analysis. Each patient had a homonymous hemianopsia on the first neuro-ophthalmologic examination. The initial neurologic, neuroimaging, and electrophysiologic examinations were not conclusive. The subsequent rapid deterioration in the neurologic status, including dementia and typical electroencephalographic changes, was suggestive of Creutzfeldt-Jakob disease., Conclusion: At onset of Creutzfeldt-Jakob disease, patients may have a homonymous hemianopsia despite normal results of magnetic resonance imaging of the brain and neurologic examination.

Eosinophilic meningitis is rare in Hodgkin's disease. Five previous cases have been reported. We describe an additional patient whose CSF showed an eosinophilic pleocytosis with Reed-Sternberg cells while in complete systemic remission from Hodgkin's disease. The patient responded to intrathecal administration of methotrexate given by Ommaya reservoir. Six months later, systemic relapse occurred, but the CSF remained normal. Eosinophilic meningitis is a treatable complication of Hodgkin's disease, and prolonged response is possible.

Neoplastic angioendotheliosis is a rare disorder characterized by progressive multifocal neurological deficit and dementia. The principal pathological findings are multiple infarcts in the brain and spinal cord and the microscopical demonstration of proliferated neoplastic cells, primarily within the lumens of arteries, arterioles, and capillaries. Vessels of the central nervous system are the most severely affected and appear to be the primary site of neoplastic proliferation. Systemic intravascular and focal extravascular proliferation can also be identified. The endothelial origin of the neoplastic cell with a gradation of changes from normal to neoplastic is demonstrated by the electron microscopical study of involved meningeal vessels. Our patient and those reported in the literature all demonstrate involvement of the central nervous system. In addition, an elevated cerebrospinal fluid protein level is present in all patients for whom that information is available, and fever and renal involvement are frequently present. Steroid therapy is generally ineffective. If the disease is suspected clinically, our studies suggest that meningeal biopsy is the diagnostic procedure of choice to help determine whether chemotherapy should be instituted.