[Peripheral facial paralysis as the first symptom of unknown metastatic primary tumor]. / Die periphere Fazialisparese als Erstsymptom bei unbekanntem metastasierendem Primärtumor.

The spread of metastases to the brain and the leptomeninges is usually a terminal event in patients with known malignancies. We report on two patients, in whom the diagnosis of a diffusely metastasizing carcinoma was considerably delayed by the initial symptom of a peripheral facial nerve paralysis. The clinical, neuroradiologic and cerebrospinal fluid findings are discussed. A malignant neoplasm with diffuse or focal metastasis to the leptomeninges is a rare cause of peripheral facial paralysis of unclear genesis. The necessity of a lumbar puncture plus magnetic resonance imaging of the brain to enable an early diagnosis is emphasized.

[Indications for the use of chlormethiazole ]. / Indikationen für den Einsatz von Clomethiazol.

Clomethiazol (Distraneurin) has decisively improved our therapeutic possibilities in delirium tremens. Furthermore, it has acquired a certain degree of importance in the treatment of agitation and sleep disorders in geronto-psychiatric patients. In the meantime, owing to the fact that doctors have been too ready to prescribe it for indications other than those mentioned above, a level of abuse of this substance--which has the potential for both psychological and physical dependence--has reached a point at which its usefulness threatens to become eclipsed.