[Schizophreniform psychosis with polydipsia and electrolyte imbalance in multiple sclerosis]. / Schizophreniforme Psychose mit Polydipsie und Elektrolytentgleisung bei multipler Sklerose.

We present the case report of a young woman who suffered from schizophrenia-like psychosis leading to polydipsia and consequent water intoxication. Because of progressive somnolence and epileptic seizures therapy on the intensive care unit became necessary. Findings of MRI and cerebrospinal fluid were consistent with the diagnosis of chronic inflammatory disease of the central nervous system. As other possible causes could be excluded, multiple sclerosis seemed to be most probable. Simultaneous incidence of schizophrenia and multiple sclerosis and the differential diagnosis of central pontine myelinolysis following hyponatremia are discussed.

Intracranial electroencephalographic and evoked-potential recording from intravascular guide wires.

We describe a technique for recording electroencephalographic and evoked-potential information directly from the cerebral hemispheres and brain stem, via an endovascular approach. Recordings were performed with polytef-insulated guide wires in the course of interventional angiographies in 23 patients. All registrations were compared with simultaneous recordings from extracranial electrodes. This preliminary study raises the possibility that this technique may help to explore the electric activity of deep cerebral structures otherwise accessible only by stereotactic puncture or electrode insertion.

[Allergic vasculitis caused by Vigabatrin]. / Allergische Vaskulitis durch Vigabatrin.

A patient with focal epilepsy that was resistant to medical treatment received add-on therapy with vigabatrin. Six months after commencement of vigabatrin therapy, allergic vasculitis caused by vigabatrin was diagnosed. The patient displayed unilateral anterior ischaemic optic neuropathy with impairment of vision and concentric loss of visual field. The diagnosis was based on the lymphocyte transformation test and the clinical course. The allergic vasculitis was healed by cortisone therapy.

[Central pontine myelinolysis]. / Zentrale pontine Myelinolyse.

One week after relapsing a 44-year-old female alcoholic and drug addict developed a psycho-organic syndrome. Later she had swallowing and speech dysfunctions and became quadriplegic, the result of central pontine myelinolysis. The signs became most marked in the 5th week of illness and then gradually improved, but an independent existence became impossible. There were no electrolyte disorders. Computed tomography demonstrated the typical lesion (a hypodense focus in the pons, 1 cm in diameter) after the 3rd week, findings confirmed by magnetic resonance imaging. The acoustic evoked potentials were unremarkable. An abnormal eye-closure reflex suggested medulla oblongata damage. The diagnosis of central pontine myelinolysis is difficult because the typical brainstem lesions become demonstrable by various imaging techniques only after some delay.

[Ondine's curse with convulsive syncope. Clinical and Doppler ultrasound observations]. / Undines Fluch mit konvulsiver Synkope. Klinische und dopplersonographische Beobachtungen.

In a 31 years old woman with primary alveolar hypoventilation (Ondine's curse) and noctural seizures the arterial blood gases, EEG and blood flow velocity in the middle cerebral artery were measured before, during and after a phase of apnea terminated by a convulsive syncope. The blood flow velocity abruptly increased to the 2.5 fold of the initial value with the beginning of the convulsions, which is interpreted as a break down of the cerebral autoregulation.

[Neuro-borreliosis or intervertebral disk prolapse?]. / Neuroborreliose oder Bandscheibenvorfall?

Between September 1986 and November 1988, 17 patients were hospitalized and treated for neuro-borreliosis. Ten of them had been admitted with suspected lumbar or cervical root or compression syndrome. Only four patients recalled a tick bite, only three an erythema migrans. Uni- or bilateral facial paresis was a prominent feature in six patients. Three of 14 patients had no IgG antibodies against Borrelia, either in serum or cerebrospinal fluid at the initial examination, two had positive titres in serum only. Despite antibiotic treatment (usually 10 mega U penicillin three times daily) six patients had a recurrence by April, 1989, treated with penicillin again or with twice daily 100 mg doxycycline or 2 g ceftriaxon. In four of them a residual painful polyneuropathy remains.

[Comparison of the in vitro activity of ceftazidime: in culture, in serum and in combination with granulocytes]. / Vergleich der In-vitro-Aktivität von Ceftazidim: in Bouillon, Serum und in Kombination mit Granulozyten.

The bactericidal activity of ceftazidime against 5 serum resistant Staphylococcus epidermidis and 5 serum sensitive Pseudomonas aeruginosa strains was compared in Mueller-Hinton broth and normal human serum. Except for the first 4 hours incubation time ceftazidime was less active in serum as compared to broth against the serum resistant staphylococci at subinhibitory concentrations. Against the serum sensitive Pseudomonas aeruginosa strains the in vitro activity of ceftazidime in serum was significantly higher than in broth at all concentrations investigated. In vitro activity of ceftazidime was best in combination with leukocytes and serum against a Staphylococcus aureus and a Pseudomonas aeruginosa strain. Leukocytes in serum enhanced the bactericidal activity of ceftazidime against a Pseudomonas aeruginosa strain already at 1/4 MIC, which could only slightly be improved at 1 MIC, but not at 4 MIC.