[Pain and pain perception]. / Schmerz und Schmerzerleben.

Pain is both sensual perception and sense of touch, and it leads to emotional change of health, which has an effect back to a pain perception. Experience of pain is modified by intern and extern influences, and it can appear very multiformly in the chronicity. A part of these factors are described.

[Generalized nocifensor reflexes--II. A modified reflex pattern caused by functional disorders of the thalamus]. / Generalisierte nozifensive Reflexe--II. Modifizierte Reflexmuster durch Thalamusfunktionsstörungen.

In the past, clinically relevant diagnostic procedures using nocifensive reflexes have been restricted mainly to ascertaining the functional status of the efferent or afferent portion of the reflex arc. The method described here, which evoked global nocifensive reflexes, permits differentiated conclusions to be drawn regarding possible supraspinal influences on nocifension. The reflex patterns yielded by the procedure can provide information regarding the functional status of the formatio reticularis, which is subject to modulatory influences of the pallidostriatum and thalamus. The results show that specific, pathohistologically confirmed lesions of the thalamus de-inhibit the formatio reticularis for motor reticulospinal activity and that this is reflected in the nocifensive pattern. Thus, the nocifensive reflex on the contralateral side to the thalamic process is stronger and has a shorter latent time than that on the clinically healthy side. This phenomenon has so far been confirmed on all patients with an impaired thalamus function.

[Current diagnosis of impotence]. / Aktuelle Impotenzdiagnostik.

In recent years the true incidence of impotence due to organic diseases in comparison with psychogenic disorders could be verified. New diagnostic tools as penile Doppler ultrasonography, PBI estimation, NPT measurement, invasive SKIT's, neurophysiological methods, selective phalloarteriography, artificial erection and dynamic cavernosography are introduced and are the guide to therapeutic approach.

[Generalized nocifensive reflexes. I. Methodologic bases]. / Generalisierte nozifensive Reflexe--I. Methodische Grundlagen.

Normal protective and defence reflexes show that the nocifensive system is intact. Nocifensive reflexes can be modified by various brainstem disturbances, and in the case of lesions the symptoms may appear in the afferent or efferent section of the reflex arc. The purpose of our study was to find a method for evoked generalized nocifensive reflexes so that inferences regarding the course of the reflex could be drawn from a reflex pattern obtained from the latent periods of various lead regions during nocifensive stimulation. The stimulus is provided by a painful train of electrical pulses applied to a superficial nerve (N. medianus, N. fibularis). As a rule, the leads are connected symmetrically to the flexors of the upper and lower extremities. The results shown, as expected, that nocifensive reactions fulfill the conditions of a conditioned reflex with increasing habituation and sensitization. The reflex arc passes through the formatio reticularis, and it is here in particular that cerebral influences can have a modulatory effect. These conclusions are based on the length of the latent times, which are longer than those associated with spinal reflexes, but shorter than the reaction times shown by the voluntary innervation. Moreover, the reflex patterns observed for the upper and lower extremities are identical for different stimulation sites, so the reflex circuit must be supraspinal. Since, in addition, the reflex pattern associated with acoustic stimulation is similar to that of an electrically evoked reflex, the formatio reticularis can be considered a nocifensive centre.

[Pathophysiologic observations of facial neuralgia]. / Pathophysiologische Betrachtungen zur Gesichtsneuralgie.

The different etiology and pathogenesis of face-neuralgiae requires a spezific therapy of the respective illness. New aspects are formed in the last years in the so-called idiopathic neuralgia. She has good chances with the therapy through the Jannetta-operation. The evident mechanical lesion by compression, the ephaptic genesis and the special pain-characterization with trigger-attacks not support the "idiopathic". This is called "ictal neuralgia". The paper attempts pathophysiological to explain the specific pain. It shows aspects to the trigger mechanism, to the intensity of the pain and to the ictal pain-characterization.

[Dorsolateral thalamic infarct syndrome with therapeutically modifiable pain crises]. / Ein dorsolaterales Thalamus-Infarkt-Syndrom mit therapeutisch beeinflussbaren Schmerzkrisen.

The Controlateral Pain Flexor Reflex (CPFR) is demonstrated by a case study of a thalamic syndrome with a typical thalamic hand, thalamic foot, and thalamic pain crisis. Mechanical triggering by a painful irritation on the healthy hand side leads to a stronger motoric-nocifensic reflex response of the contralateral extremities. On the other hand the healthy person would develop an ipsilateral nocifensic response only. In the case reported here, the electrically evoked CPFR led to the same result, and simultaneously caused disappearance of the thalamic pain, since this kind of management represents therapeutical approach via the endorphin system. In respect of the pathophysiological basis of the thalamic modified nocifensic reflex response, we are inclined to believe that painful stimulation evokes an accentuated flexor reaction if the thalamic-controlled influences are omitted by a lesion of the specific nuclei.

[Determination of supraspinal modification of reflex excitation]. / Studie zur Erfassung der supraspinalen Beeinflussung der Reflexerregbarkeit.

On the basis of some examples is demonstrated, that by the aid of a defined pain stimulus of the N. medianus a generalized shockreaction occurs, which is modified by supraspinal influences. Using segmental electroneurographic recording from the autochthonous dorsal musculature--in notice of sensitivation and habituation--could be found a measure for the supraspinal reflex excitation.

[Polyneuropathy syndrome in old age]. / Polyneuropathie-Syndrome im Alter.

On the basis of the findings in a total of 27 patients aged between 59 and 74 years and three patients aged between 44 and 52 years, etiopathogenetic problems of polyneuropathies in older patients are discussed. For this the results of the neurological-clinical and thies in older patienta are discussed. For this, the results of the neurological-clinical and instrumental diagnostic examinations are evaluated and differentiated in the form of a factor analysis and the question of a vascular factor is dealt with under various aspects.

[The problem of polyneuropathy in methaqualone medication]. / Zur Problematik einer Polyneuropathie bei Methaqualon-Medikation.

Thirteen years after the introduction of methaqualone into therapy, investigators (namely, Finke, Spiegelberg, and Suchenwirth), by reference to individual cases, pointed out the possible development of polyneuropathies. This has not so far been confirmed despite worldwide use of the drug. Experiments on rats, which were conducted by the present authors, show a statistically significant decrease in maximum motor conduction speed, which is believed to be functional disorder. Clinical symptoms or nervous structural variations in the sense of polyneuropathy could not be observed.