Platelet aggregation of migraineurs during and between attacks.

Platelet aggregation induced by ADP, collagen and platelet-activating factor was studied in common (migraine without aura) and classical migraine (migraine with aura) patients during and between attacks. The EC50* values for ADP and platelet-activating factor were significantly higher, whilst that for collagen was significantly lower in classical migraine patients during headache-free intervals compared to healthy volunteers. The EC50 values obtained for common migraine sufferers during symptom-free periods were similar to those of controls. During attacks, the EC50 value for ADP, but not for collagen and platelet-activating factor, was significantly higher than that of the controls. In healthy subjects a positive correlation was found between ADP and collagen-induced aggregation. In contrast, there was a U-shaped correlation matrix in classical migraine patients. The present observations show that platelet aggregation is altered in migraine patients and this raises the possibility that platelet-activating factor may be involved in the pathogenesis of migraine.

Autotransplantation of superior cervical ganglion to the caudate nucleus in three patients with Parkinson's disease (preliminary report).

Striatal cervical ganglionic implants have been utilized for the first time for treatment of three patients suffering from Parkinson's disease. Tissue grafts from the superior cervical ganglion have been dissected and immediately transplanted into the head of the caudate nucleus. The grafted tissue placed in a cavity of the caudate nucleus remains in contact with the cerebrospinal fluid in the lateral ventricle. Three and six months after surgery, none of the patients has had any major complications and their lower score of Unified Parkinsonism Rating Scale (UPRS) points was associated with an improvement of the signs of Parkinson's disease. Present data have provided some optimism that grafting of superior cervical ganglion is a feasible approach in Parkinson's disease.

[Clinical characteristics of cluster headache]. / A cluster típusú fejfájás klinikai jellemzöi.

The authors describe in detail the clinical characteristics of 48 patients suffering from cluster headache. They investigate the question of nomenclature and survey the clinical forms of diagnosis. They deal with differential diagnosis comparing migraine, trigeminal neuralgia and headaches origin from systemic illness. They point out that the clinical characteristics of their patients co-responding to the data in the literature. They emphasize that the precise anamnesis can result the diagnosis of this type of headache which is the basis of the treatment.

Selegiline in the early and late phases of Parkinson's disease.

Selegiline is a useful adjuvant drug in the treatment of Parkinson's disease. In the early phase selegiline can be given in monotherapy. Its effect is not always sufficient to eliminate all the symptoms. In spite of this observation the administering of selegiline as monotherapy can be useful because in case of the immediate introduction of levodopa therapy untoward effects may appear in an early stage of treatment. In the course of substitution therapy selegiline successfully replaces about 30% of levodopa administered in "de novo" parkinsonian patients. Selegiline has a favourable beneficial effect in reducing the mild forms of response fluctuations. The addition of selegiline in such patients to the continuing substitution therapy prevents the development of more severe "on-off" manifestations. In severely disabled patients with irregular response swings or permanent akinesia the use of selegiline as an adjuvant drug cannot modify anymore the course of the disease.

(-)Deprenyl in the treatment of decompensated Parkinson's disease.

Two main forms of declining motor performance are evident in Parkinson's disease: response fluctuations and "loss of benefit", i.e., the progression of the disease without "on-off" symptoms. (-)Deprenyl has a favourable beneficial effect in reducing the mild forms of response fluctuations. The addition of (-)deprenyl in such patients to the continuing substitution therapy prevents the development of more severe "on-off" manifestations. In severely disabled patients with irregular response swings or permanent akinesia the use of (-)deprenyl as an adjuvant drug cannot modify anymore the course of the disease.

L-deprenyl in the treatment of Parkinson's disease.

The experiences of a six years' follow-up study with L-Deprenyl are summarized. L-Deprenyl may be effective in influencing the very early Parkinsonian symptoms but usually levodopa derivates must be given in addition. In the course of substitution therapy L-Deprenyl successfully replaces about 30% of levodopa administered to optimally treated patients. Concerning the "on-off" phenomena L-Deprenyl seems to be beneficial in the mild forms of "end-of-dose deterioration".

Clinical evaluation of deprenyl (selegiline) in the treatment of Parkinson's disease.

The experiences of a seven-year study on deprenyl in the treatment of Parkinson's disease are summarized. It was found that the main advantage of deprenyl was that it permitted the reduction of the dose of levodopa in optimally treated patients. In the initial stage of Parkinson's disease deprenyl is only partially sufficient as monotherapy. Deprenyl can administered successfully for correcting the "wearing off" effect.

[Clinical experience with tiapride in the treatment of extrapyramidal syndromes]. / Expérience clinique du tiapride dans le traitement des syndromes extrapyramidaux.

Tiapride was given at an average dosage of 300-900 mg per day, intramuscularly for the first three days, then by oral route, to 62 patients with abnormal movements of various types. The best responses were recorded in chorea and bucco-lingua-facial dyskinesia as well as in dyskinetic movements induced by levo-dopa in Parkinson patients. Clinical and biological tolerance of tiapride was excellent, with only one case of drowsiness and two cases of galactorrhea.

Experiences with L-deprenyl in Parkinsonism.

In about 2/3 of the cases studied (152 patients), the combination of deprenyl and the substitution-therapy has a favourable effect as it tends to normalize motor activity. Although the administering of deprenyl renders neither L-Dopa nor the decarboxylase inhibitor superfluous, their side effects can be slightly reduced as their dose is reduced. Therefore it is advised to give all patients a trial with this drug.