| Pathologic-anatomical findings and cerebral localization in stereotactic treatment of extrapyramidal motor disturbances in multiple sclerosis. | |
| | |
MedLine Citation:
|
PMID: 1093787 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Two postmortem case of multiple sclerosis treated by sterotactic operations for the intention shaking of limbs, trunk, and head, and for the action myoclonus are analyzed to determine the location of the substrate of myoclonic and ballistic movements, the location of the coagulations for relief of these movements, and whether fresh demyelinating foci are elicited by intracerebral interventions. In the first case of a clinically typical multiple sclerosis, the foci responsible for the severe action myoclonus and intention ataxia of the trunk are demyelinations in the right and left red nucleus resulting in nerve cell damage and loss and an almost complete destruction of myelinated fibers. The restricted foci in the white matter of the cerebellum which do not involve the cerebellar nuclei are not extensive enough or old enough to be the cause of the action myoclonus but may, perhaps, sustain the pathogenesis. - In the second case of cerebral palsy and combined multiple sclerosis (detected post mortem), the combination of the severe damage of putamen and caudate nucleus by status marmoratus and the extensive nerve cell and fiber damage due to demyelinating foci in the substantia nigra are probably the substrate of the jactitation and intention myoclonus of the left limbs. The stereotactic coagulation of the dentatothalamic and pallidothalamic fibers in the base of V. o.p. and V.o.a. at the point where they pass through the zona incerta (location confirmed post mortem) resulted in a nearly complete relief of hyperkinetic movements. In the first case, fresh demyelinating foci are present in both hemispheres with stereotactic interventions; these foci are located, amongother places, around the coagulation and the electrode track. In the second case, post mortem serial brain sections demonstrate that stereotactic operations even in subacute multiple sclerosis can be carried out without eliciting any exacerbation of demyelination foci. Therefore, the danger exists that stereotactic intervention in cases of multiple sclerosis may precipitate fresh demyelinating foci. As our clinical experience [Riechert and Richter, 1972a, b] indicates, however, this occurred in markedly less than 10% of the cases. |
| | |
Authors:
|
T Riechert; R Hassler; F Mundinger; F Bronisch; K Schmidt |
Related Documents
:
|
11619047 - A note on the treatment of drummer bock: an early danish account of multiple sclerosis? 12000197 - Globular amyloid deposits in the wall of the gastrointestinal tract: report of six cases. 946897 - Lymphosarcoma of bowel in childhood. 18801097 - A unique case of multiple dermatomyofibromas. 14675467 - Kiwi fruit allergy: a review. 11619047 - A note on the treatment of drummer bock: an early danish account of multiple sclerosis? |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Confinia neurologica Volume: 37 ISSN: 0010-5678 ISO Abbreviation: Confin Neurol Publication Date: 1975 |
Date Detail:
|
Created Date: 1975-08-18 Completed Date: 1975-08-18 Revised Date: 2004-11-17 |
Medline Journal Info:
|
Nlm Unique ID: 7600680 Medline TA: Confin Neurol Country: SWITZERLAND |
Other Details:
|
Languages: eng Pagination: 24-40 Citation Subset: IM |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Basal Ganglia Diseases / etiology, pathology, surgery* Brain / pathology* Brain Mapping Caudate Nucleus / pathology Cerebellar Nuclei / surgery Cerebellum / pathology Cerebral Palsy / complications*, pathology, surgery Demyelinating Diseases / etiology Diencephalon / surgery* Female Globus Pallidus / surgery Humans Male Middle Aged Multiple Sclerosis / complications*, pathology, surgery Myoclonus / etiology, pathology Neural Pathways Putamen / pathology Red Nucleus / pathology Stereotaxic Techniques* / adverse effects Substantia Nigra / pathology Thalamic Nuclei / surgery |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Fractures of tibial plateaus. A review of the literature.
Next Document: Permeability changes in the blood-brain barrier: causes and consequences.