Benign symmetric lipomatosis (Launois-Bensaude syndrome). A rare cause of muscular weakness.

A 76-year-old female patient is presented who suffered from muscular weakness in arms and legs. She was obese and had a symmetric accumulation of fatty tissue with a bumpy structure at both arms which gave the patient a pseudoathletic appearance. Fatty tissue accumulations were present at both shoulders, arms, at both thighs, at the back and the abdomen. She suffered from benign symmetric lipomatosis (BSL), also called Launois-Bensaude syndrome (LBS), which is a rare disorder of unknown origin and poorly understood pathophysiology. It is believed to be a disease of disturbed lipogenesis induced by catecholamines. The syndrome is often associated with features of metabolic syndrome such as diabetes mellitus, hyperuricemia, hyperlipidemia and hypertension and is associated with polyneuropathy which is an integral part of the disease. Therapeutic options are pharmacological treatment with salbutamol and surgical procedures such as lipectomy or liposuction.

Retroperitoneal schwannoma presenting as an adrenal tumor.

A retroperitoneal tumor in the region of the adrenal gland was diagnosed in a 56-year-old woman. The patient had been suffering from a dull abdominal pain for nearly four weeks before consulting her family physician. Ultrasound, CT and MRI scans revealed a giant tumor of the right adrenal gland. Endocrine activity could not be demonstrated. The size of the tumor was suggestive of an adrenal carcinoma. The patient was referred for adrenalectomy and complete exstirpation of the retroperitoneal mass. The histological examination revealed characteristical findings of a benign schwannoma.

[EEG findings following cerebral surgery]. / EEG-Befunde nach Grosshirntumor-Operationen.

Departing from the well-known influences exerted on the picture of the cerebral potential by an intracranial space-occupying process, the persisting pathological EEG findings with proved absence of recidivity have been determined in this study. These investigations were based on the postoperative EEG leads of 204 patients with cerebral operations with a determination of the persisting focal disturbances, the general changes and the signs of an increased tendency to attacks and, with respect to possible consequences, a correlation with the morphological criteria-position and size of defect of the cerebral parenchyma, the extent of the cerebral ventricles, the histological dignity-being carried out.

[Neuro-ophthalmologic findings following cerebral tumor excision in relation to topography and morphology]. / Neuroophthalmologische Befunde nach Grosshirntumorexstirpation in Abhängigkeit von Topographie und Morphologie.

The secured significance of position and extent of a cerebral tumour as well as its biological dignity with respect to the kind and frequency of the neuro-ophthalmological findings was the starting point of these investigations. In this retrospective study the findings of visual acuity, visual field and papillae of 204 patients operated on the cerebrum were determined and the significance of the morphological factors (position and size of the defect of the cerebral parenchyma, extent of the cerebral ventricles, degree of the cortical atrophy, influence of dignity) for the persisting ophthalmological deficiency phenomena was pointed out.

[Neuropsychiatric-psychological findings in patients with hypophyseal adenoma following trans-sphenoidal surgery]. / Neuropsychiatrisch-psychologische Befunde bei transsphenoidal operierten Hypophysenadenom-Patienten.

Investigations carried out by Schuster, Bleuler, Fischer et al. pointed out the importance of the endocrine functions with respect to the psychopathological phenomena. On the basis of 98 catamnestically observed pituitary patients operated on transphenoidally observed pituitary patients operated on transphenoidally at our hospital in the years 1978 to 1987 we wanted to obtain the pre- and postoperative psychic findings by clinical-explorative and neuropsychological investigations and point out the importance of these disturbances.

[Neuropsychiatric-ophthalmologic and radiologic findings in sphenoid wing meningioma]. / Neuropsychiatrisch-ophthalmologische und radiologische Befunde beim Keilbeinflügel-Meningeom.

On the basis of 90 catamnestically pursued disease courses of surgically treated sphenoid bone wing meningioma of the years 1970 to 1987 the validity of the clinical-neuropsychiatric and neuro-ophthalmological examinations as well as the information value of the native X-ray pictures were ascertained. The aim of the work was to point out the possibility and necessity of an early clinical diagnosis by an intensified observation of the neuro-ophthalmological and neuro-psychiatric primary symptoms.

[Transverse syndrome in aneurysmal bone cyst]. / Querschnittssyndrom bei aneurysmatischer Knochenzyste.

Among the patients of the Hospital for Neurosurgery in Leipzig treated in the period from 1952 to 1986 66 per cent of 570 patients operated on because of spinal cord tumours showed a benign and 34 per cent a malignant nature of the tumours. The rate of primary bone tumours amounted to 6.5 per cent and that of secondary bone tumours was 5.8 per cent. The preoperative diagnostical and the differential-diagnostical as well as therapeutical problems were dealt with on the basis of the only case of an aneurysmal bone cyst.

[Effect of the position and size of the postoperative brain defect on psychological outcome]. / Der Einfluss von Lage und Grösse des postoperativen Hirndefektes auf die psychischen Eigenschaften.

Ascribing the origin of neurological and neuropsychological syndromes to certain cerebral areas is a well-known knowledge that has also been introduced in clinical practice. In spite of general acknowledgement of a multifactorial manner of the development of these psychic phenomena there are, however, with regard to the effects of the location and the size of the cerebral parenchymal defects, some diverging opinions with regard to these psychopathological phenomena. On the basis of clinical neuropsychiatric and neuropsychological examinations of 204 patients after extirpation of a cerebral tumour, the effects of the volume of the defects and its location as well as the cortical and subcortical atrophy on the psychic properties of performance and affective-emotional ranges were ascertained.

[Occupational and social integration of patients following cerebral cortex tumor operations]. / Die beruflich-soziale Integration von Patienten nach Grosshirntumoroperationen.

The aim of the surgeon to achieve complete health and well-being with full professional fitness cannot be reached in many cases or only partially. Since the postoperative psychophysical capacity of compensation and maximum stress is expressed in the form of the psychosocial integration in the professional and family life, we have tried to explain on the basis of 204 ketamnestically observed surgically treated patients wheter and in which way these sociological spheres are disturbed and what parameters disturb the invalidation behaviour. After clearing up these factors it was our concern to again point out the necessity of a complete rehabilitation under consideration of a multifactorial genesis of these psychic disturbances.

[Neuro-ophthalmologic findings in tumors of ventricles I-III]. / Neuroophthalmologische Befunde bei Prozessen der Ventrikel I-III.

The ophthalmological findings obtained in 254 patients with space occupying processes of the lateral and third ventricles are analysed. Visual disturbances (78%), defects of the visual field (69%), findings of the fundus of the eye (67%) and motility restrictions (24%) were identified. Only in eight per cent the findings of the eye-ground no particular findings were observed. As was expected, signs of cerebral compression were frequently found. Postoperative improvements were found in the choked papilla and motility restrictions were seen where as defects of the visual field and a decrease of the visual acuity were in most cases unchanged or had even increased.

[Results of treatment and rehabilitation in tumors of ventricles I-III]. / Ergebnisse der Nachbehandlung und Rehabilitation bei Prozessen der Ventrikel I-III.

Among 210 patients operated on because of processes of the ventricles I to III in the years 1953 to 1983 a continuous outpatient after-treatment was carried out in 64 patients. Departing from the histological findings and differentiation according to the results obtained after tumour extirpation or palliative interventions, the subjective complaints, the residual neurological symptoms as well as the possibilities and limits of occupational and social rehabilitation are discussed.

[Diagnostic value of epileptic seizures in cerebral gliomas]. / Diagnostischer Stellenwert von epileptischen Anfällen bei Grosshirngliomen.

On the basis of 346 glioma patients operated on in the years 1969-1983, the frequency of epileptic seizures and their importance for the diagnosis as well as the causes of the delay in clearing up the clinical picture were ascertained. Of the 226 patients with an astrocytoma, 51.5 per cent had one or several epileptic fits in the pre-operative period. For the 99 glioblastoma patients, the seizure rate was 33.7 per cent and for the 21 patients with an oligodendroglioma it was 69 per cent. Although in about 80 per cent of the cases epileptic fits were the first symptom of the disease, this important clinical sign led in only 30 per cent to a causal treatment. In another 20 per cent of the courses, the final clarification was initiated by an increase in the frequency of the fits or a change of the kind of the fit. In the remaining 50 per cent of the glioma patients it was only after the additional occurrence of neurological disturbance that the diagnosis could be verified and surgical treatment carried out.

[Postoperative treatment phases following the Cloward operation]. / Postoperative Behandlungsphasen nach Clowardscher Operation.

In this article, the experience gained in the postoperative treatment and care after ventral vertebral fusion (operation after Cloward) are presented. After a radicular or medullary decompression has been achieved by the surgical intervention, an individually adapted, symptom-centered physiotherapeutic exercise programme, a continuous observation of the neurological findings with roentgenological checking of the bony blocking process is carried out. The postoperatively established camp cravat is worn up to the roentgenologically verified incorporation of the dowel.