Occurrence of both neurofibromatoses 1 and 2 in the same individual with a rapidly progressive course.

We describe a family in which the father had neurofibromatosis-1 and the mother neurofibromatosis-2. Their son presented at the age of 8 years with bilateral acoustic neuromas, meningioma, and numerous neurofibromas. We believe that the occurrence of the genes responsible for both forms of neurofibromatosis in the same patient had a synergistic effect on the early rapid growth of neurofibromatoses 1 and 2 neoplasms.

Vocal cord paralysis as a presenting sign in the Shy-Drager syndrome.

A 70-year-old patient with bilateral vocal cord paralysis, accompanied by inspiratory stridor and increased snoring, is presented. Respiratory dysfunction, deteriorating over 18 months, necessitated permanent tracheostomy. Only two and a half years after the onset of symptoms the patient developed extrapyramidal signs combined with severe autonomic failure, suggesting a diagnosis of Shy-Drager syndrome. Vocal cord palsy preceding any other neurological or autonomic manifestations of that syndrome has been infrequently described. This diagnosis should be considered in cases of vocal cord palsy of undetermined etiology, especially when associated with increased snoring or episodes of sleep apnea.

Diphenylhydantoin and phenobarbital suppress the dopaminergic neurotoxicity of MPTP in mice.

The combined administration of MPTP with the anticonvulsant drugs diphenylhydantoin or phenobarbital suppressed the MPTP-induced striatal DA depletions in mice. Co-treatment with diazepam, sodium valproate or carbamazepine was ineffective. The mechanism responsible for the protective effect of diphenylhydantoin and phenobarbital against DA neurotoxicity of MPTP is unknown but some previously available findings suggest that they may act, in part, via inhibition of MAO-B and/or DA reuptake in the striatum.

Systemic administration of antioxidants does not protect mice against the dopaminergic neurotoxicity of 1-methyl-4-phenyl-1,2,5,6-tetrahydropyridine (MPTP).

We examined whether DA neurotoxicity of 1-methyl-4-phenyl-1,2,5,6-tetrahydropyridine (MPTP) can be prevented by combined systemic administration of antioxidants. C57 black mice were injected s.c. with MPTP (30 mg/kg), once daily for two days, alone, or with ascorbic acid (1 g/kg), alpha-tocopherol (100 mg/kg), or dimethylsulfoxide (50 microliters) i.p. for two days before, two days with and two days after MPTP, and decapitated 30 days later. MPTP once (30 mg/kg), alone, or with ascorbic acid (200 mg/kg) or cysteamine (75 mg/kg), two days before, one day with and 4 days after, and decapitated 10 days post-MPTP. MPTP once (15 mg/kg), alone, or with ascorbic acid (500 mg/kg, alpha-tocopherol (100 mg/kg), cysteamine (50 mg/kg) or sodium selenite (2.5 mg/kg), 90 min before and again 90 min after MPTP, and decapitated 7 days later. In all experiments, the marked striatal DA depletions produced by MPTP alone (by 40-70% from controls) were unchanged by cotreatments with the various antioxidants. Findings do not favor intraneuronal generation of superoxides and related cytotoxic free radicals as a major factor in the DA neurotoxicity of MPTP. They suggest that if natural Parkinson's disease is caused by an MPTP-like neurotoxin, early treatment with antioxidants is unlikely to protect nigrostriatal neurons and prevent disease progression.

Paroxysmal atrial fibrillation associated with an attack of multiple sclerosis.

A young woman presented with an acute right pontine lesion and paroxysmal atrial fibrillation. The lesion was later proven by magnetic resonance imaging to be due to multiple sclerosis. To our knowledge, cardiac arrhythmias have not been previously described in this condition. Published support for this possible association is reviewed.