[Fredy Quadfasel (1902-1981) : Neuropsychiatrist, politically persecuted NS opponent and his impact in American exile]. / Fredy Quadfasel (1902-1981) : Neuropsychiater, politisch verfolgter NS­Gegner und sein Wirken im US­amerikanischen Exil.

The physician and psychologist Dr. Fredy Quadfasel, born in East Prussia, was trained in neuropsychiatry by Kurt Goldstein in Frankfurt/Main and by Karl Bonhoeffer at the Charité in Berlin. After he was detained by the Gestapo due to political opposition, he was probably denounced for offending the so-called Malicious Practices Act (Heimtückegesetz) from March 1933, and imprisoned for 2-3 months. In 1934/35 he emigrated to the USA via England and Canada, where he initially ran a neuropsychiatry office in New York. Very soon he was able to take on an academic post and became an instructor in neurology. After medical military service in 1944-1947 at the Cushing General Hospital in Framingham near Boston, he was appointed head of the neurological department. Later he moved on to the Boston Veterans Administration Hospital. His academic positions included being an instructor in neurology at Harvard Medical School and associate professor at the Boston University School of Medicine. He had a considerable impact on neurology, especially on the locally emerging discipline of neuropsychology represented by Harold Goodglass and Norman Geschwind. Despite a lack of personal records of Quadfasel, a chequered reconstruction of his life and work was possible due to many archival documents with which it was possible to trace the career of a highly esteemed neurologist in Germany and the USA.

[Arthur Simons on tonic neck reflexes in persons with hemiplegia. From the years 1916 to 1919]. / Arthur Simons über tonische Halsreflexe beim Hemiplegiker. Aus den Jahren 1916 bis 1919.

Tonic neck reflexes described in 1921 by Magnus and deKlejn in animals and men were studied in hemiplegic patients who were mainly victims of WWI by Arthur Simons, a neurologist in Berlin and coworker of Hermann Oppenheim. The effect of the asymmetric neck reflexes after head rotation was restricted to the paralyzed side: tonus (spasms) of extension and adduction during mid-position of the head or head version to the paralyzed side; flexion tonus and abduction during head version to the non-paralyzed side; and flexion tonus (spasms) of the paralyzed limbs during flexion of the head and extension spasms by head extension. More than this, hemiplegic "Mitbewegungen" or associated reactions (Walshe) were observed. They are elicited by conscious innervations of the unaffected side, e.g. by fist closure, and are increased or varied by head rotation, the tonic neck reflexes. They occurred in 25%. A film with Arthur Simons as examiner from the years 1916-1919 shows these nearly forgotten phenomena. Their everyday significance was already stressed in 1920, long before the rules of antispastic positions were defined by Bobath.

[Hans Schliack (1919 - 2008): a personal and professional appraisal]. / Hans Schliack (1919 - 2008): Eine persönliche und wissenschaftliche Würdigung.

Hans Schliack (1919 -2008) was one of the prominent post war neurologists who acted successfully for the emancipation of clinical neurology in the former western part of Berlin and Germany. His scientific work was destined to the theory of segments (dermatomes, myotomes, zones of Head, initially with Karl Hansen in Lübeck), sweat disturbances in neurological disorders and peripheral nerve lesions. The latter issue led - in cooperation with Marco Mumenthaler - to the textbook, which held its leading standard since its first edition in 1965. Schliack's founding editorship of the purely neurological journal "Aktuelle Neurologie" since 1974, his author- and editorship of neurological textbooks and his teaching of numerous coworkers in Berlin and Hannover stress his outstanding role over nearly five decades.

Founding years of clinical neurology in Berlin until 1933.

During the so-called "Gründerjhare" or "founding years" in Berlin it became necessary to build new hospitals because of the rapid growth of population. As a result, several infirmaries, asylums for the insane and institutions for epileptics were build between 1877 and 1912. The new building of the University of Neuropsychiatric Clinic ("Nervenklinik") of the Charité was opened in 1905 according to plans made by Friedrich Jolly (1844-1904), the physician who named myasthenia gravis pseudoparalytica. A "Neurological Central Station", under the direction of Oskar and Cecil Vogt, in existence since 1898, was a research center dedicated more to morphology. There the study of the structure of the cerebral cortex by Korbinian Brodmann (1868-1925) and research into basal ganglia diseases by the Vogts began. The Kaiser-Wilhelm Institute for Cerebral Research, which moved into a new building in 1931, also had its origin here. Hermann Oppenheim (1858-1919) promoted independent clinical neurology, as did his younger contemporary, Max Lewandowsky (1876-1918), who was already advising physician for neurology at the Berlin-Friedrichshain Hospital. Hug Liepmann (1863-1925), the creator of apraxia theory, worked at the asylums for the insane in Dalldorf (Berlin-Wittenau) and Berlin-Herzberge. In 1911, the first neurological unit was established in the large hospital in Berlin-Buch under the direction of Otto Maas. Not until after World War I were further neurological hospital units founded, under the direction of Paul Schuster (1867-1940), Kurt Goldstein (1878-1965), Kurt Löwenstein (died in 1953) and Friedrich Heinrich Lewy (1885-1950). These Jewish physicians, as well as C.E. Benda and Otto Maas, had to leave their posts in 1933 and emigrate. The clinical institutions and scientific achievements of these pioneers of independent clinical neurology will be presented up to the point of its violent dissolution.

[Agoraphobia and "psychogenic"-attributed gait disorder as symptoms of "stiff-man" syndrome]. / Agoraphobie und "psychogen" anmutende Gangstörung als Symptome eines "stiff-man"-Syndroms (SMS).

We report on two patients with truncal rigidity and agoraphobia. The fear of crossing open places had been judged as psychogenic in both cases. The detection of positive GAD-antibodies led to our final diagnosis. Treatment with liquorphoresis and clonazepam or diazepam alone resulted in a prompt amelioration of the rigidity and, to a lesser extent, of the agoraphobia as well. The stiff-man syndrome has neurological and psychological aspects and shows one more facet of the syndrome of agoraphobia first described by Westphal.

[Supranuclear, bilateral and distal-symmetric arm paralysis in central cervical spinal cord trauma]. / Supranukleäre, bilaterale und distal-symmetrische Armlähmung beim zentralen Halsmarktrauma.

A case of central spinal cord trauma following hyperextension of the cervical spine and with the finding on MRT of lesions at the level of C 2/3 to C 4/5 disks is reported. A supranuclear paralysis of the lower segments with complete paralysis of the hands and a transient atrophy of the intrinsic hand muscles could be demonstrated. In this connection we refer to the original clinical descriptions of O. Foerster, which have almost been forgotten in the mean time.

[Colloid cysts of the 3d ventricle: problems of early intravital diagnosis]. / Kolloidzysten des 3. Ventrikels: Probleme der frühzeitigen intravitalen Diagnose.

Basing on two own cases with acute signs of increased obstructive intracranial pressure the problem of early diagnosis of colloid cysts of the third ventricle is discussed with special reference to case reports in the literature. In the absence of typical clinical signs and symptoms, there are acute and chronic constellations of signs and symptoms that point to a suspicion of an obstruction of liquor flow by a colloid cyst. It is explained which importance CT and MR assume in the diagnosis of these benign tumours that present a very varied neurological pattern. Special reference is made to the presentation of neuroradiological differential diagnoses and the application of specific examination methods, such as tomography in very thin layers and allowing some time to elapse after contrast medium administration has been effected.

[Electroneurography in the carpal tunnel syndrome--selective antidromic sensory and orthodromic measurement of the median nerve in the wrist-palm segment with surface electrodes]. / Elektroneurographie beim Karpaltunnel-Syndrom--Selektive antidromsensible und orthodrome Messung des Nervus medianus im Segment Handgelenk-Palma mit Oberflächenelektroden.

In addition to standard electroneurographic parameters of the median nerve the antidromic sensory and orthodromic conduction velocity in the wrist-palm segment were recorded with surface electrodes. Statistics with stepwise discriminant analysis were based on the data of 102 hands from normal persons and 54 hands from patients with carpal tunnel syndrome. The most sensitive parameter in diagnosis of the mild carpal tunnel syndrome is the antidromic sensory conduction velocity in the wrist-palm segment.

Changes in intracranial pressure associated with delayed cerebral radionecrosis.

Continuous recording of intracranial pressure (ICP) from one lateral ventricle in a case of histologically proven delayed temporal radionecrosis due to previous irradiation of the pituitary gland for the treatment of an adiposity of the Cushing type has revealed the occurrence of B-waves and ramplike waves despite the absence of raised intracranial pressure. Ventriculo-atrial shunting failed to relieve the severe psychic symptomatology, which was due to direct tissue damage. These observations indicate that B-waves may have a neurogenic origin.

[Effect of anesthesia and surgery on the postoperative course in multiple sclerosis]. / Einfluss von Narkose und Operation auf den postoperativen Verlauf der Multiplen Sklerose.

Multiple sclerosis is the most frequently occurring neurologic disease in our area. The common opinion is that a stress situation such as a surgical procedure or general anaesthesia may lead to an amelioration of this disease. No really convincing evidence exists to support this opinion. The observation of the postoperative course of two patients, who underwent a total of three surgical procedures under general anaesthesia suggests a short-lived temporary deterioration of their symptoms. An amelioration of the disease however was not observed.

[The difference between delayed radiation-necroses of the cerebral hemispheres and midline: its bearing in radiation therapy (author's transl)]. / Der Unterschied zwischen zerebralen Hemisphären- und Mittellinien-Strahlenspätnekrosen und seine Bedeutung für die Strahlentherapie.

Delayed cerebral necroses after irradiation are to be divided into hemispheric and midline lesions, as they differ from each other in sesveral aspects. Apart from the symptoms, they are differing in the duration of latency, in the course and prognosis, and also with regard to morphology. Though there is no doubt that radiation tolerance of cerebral midline structures is relatively limited, on biological grounds, evidence of a difference between the tolerated doses could not be given from the existent inhomogeneous radiation data, with the help of the NSD-concept. Radiation planning for the region of the head, nevertheless, carefully should avoid in every case to involve the structures of the cerebral midline.

Dose effect relationships in cervical and thoracic radiation myelopathies.

The course and prognosis of radiation myelopathies are determined by 3 factors; the segmental (vertical) location of the lesion, the extent of the transverse syndrome (complete or incomplete) and the radiation dose. The median spinal dose in cervical radiation myelopathies with fatal outcome was higher than in survivals with an incomplete transverse syndrome. In thoracic radiation myelopathies a dose difference between complete and incomplete transverse syndromes could be found as well. Incomplete transverse syndromes as submaximum radiation injuries are more suitable for the determination of the spinal tolerance dose than complete transverse syndromes. The lowest threshold could be stated for cases following high-volume irradiation of the lymphatic system.

[Propranolol for prophylaxis of migraine (author's transl)]. / Propranolol in der Migräneprophylaxe. Eine Doppelblindstudie.

The prophylactic effectiveness of propranolol (80 to 120 mg per day) in 18 migraine patients was compared with a placebo group of 19 migraine patients in a double blind study without cross over for a treatment period of six and twelve weeks. A statistically significant difference in effect could not be ascertained. The results and methodological assumptions of the double blind studies with cross over already under consideration in the literature are discussed.