Myasthenia gravis on the Dutch antilles: an epidemiological study.

We carried out an epidemiological study on the prevalence and annual incidence of myasthenia gravis on tropical islands Curaçao and Aruba in the period 1980-1995. Twenty-one patients (seven men and 14 women) were identified. The point prevalence increased from 29 per million in 1980 to about 70 per million in 1990-1995; the annual incidence over the total period was 4.7 per million. The female:male ratio was 2:1; purely ocular cases (2/21) comprised 9.5% and thymomas (4/21), 19%. These data are in accordance with most other epidemiological studies in non-tropical areas. No other studies on myasthenia gravis in tropical areas have been reported.

Longstanding isolated cerebral systemic lupus erythematosus in an 8-year-old black girl. Resemblance with multiple sclerosis.

We describe a 12-year-old girl with SLE who presented with longstanding isolated neurological symptoms resembling MS. The literature concerning the difficulties in diagnostic procedures in cerebral SLE are reviewed in comparison to MS.

[Cerebral hemorrhages and infarcts following use of cocaine]. / Hersenbloedingen en -infarcten na gebruik van cocaïne.

With increasing abuse of cocaine and purity of this drug, the incidence of strokes in relatively young people is also increasing. We describe two patients, one 29 years, the other one 33 years old. Both were well-known cocaine users. The first patient presented with an intracranial haemorrhage; the computed tomography of the brain is shown. The second patient showed a cerebral ischaemic infarction. The most frequent vascular complications are described. The physiological backgrounds of cerebrovascular accidents are given. Use of cocaine can be suggested by the presence of benzoylecgonine in urine samples.

Intracerebral bilateral symmetrical calcifications, demonstrated in a patient with pseudohypoparathyroidism.

Bilateral Symmetrical Calcifications (B.S.C.) in cerebro represent calcium deposits usually found in the basal ganglia and/or dentate nucleus. They can be the result of diverse disorders, but can also present themselves without any underlying disease. Most often they are asymptomatic, but if the calcifications are extensive, extrapyramidal and cerebellar signs may arise. The following case concerns a patient with pseudohypoparathyroidism. Besides the usual signs and symptoms found in this disease, the patient also showed extensive B.S.C. The etiology and clinical symptoms of B.S.C. will be discussed. Furthermore, attention will be given to the syndrome of the pseudohypoparathyroidism and the effects of hypocalcemia.

Measurement of the Achilles tendon reflex for the diagnosis of lumbosacral root compression syndromes.

The Hoffmann reflex and the Achilles tendon reflex were measured in a group of 194 subjects suspected of having a lumbosacral root compression syndrome. The Achilles tendon reflex was elicited manually with a metal hammer. There was a high correlation between the H-M interval and the Achilles tendon reflex-M interval. The usefulness of the Achilles tendon reflex was evaluated in a selected sub-group of 61 patients with proven L5 or S1 root compression. Neither the H-reflex nor the Achilles tendon reflex appeared to be of any value in detecting L5 root compression. Both the H-reflex and the Achilles tendon reflex proved to be useful for diagnosis of S1 root compression syndromes, the latter being the more sensitive method.