Neurological manifestations of cancer.
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Biomedical subjects
Publications and source records attributed to D Riddoch.
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The effects of long-term corticosteroid treatment have been assessed in 20 patients with polymyositis. Cases were only accepted if a muscle biopsy showed the characteristic features of inflammation and muscle fibre degeneration. If the muscle disorder was only a minor feature of generalised collagen disease or there was evidence of coexisting neuropathy, the patients were excluded. Over a mean follow-up period of 5 years, 8 patients died and only 4 improved. These results have been compared with those in other series. An attempt has been made to correlate muscle biopsy findings with prognosis, and the reasons for the poor outcome are discussed.
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The case histories are reported of six women who developed chorea while taking oral contraceptive drugs. The chorea that results from taking compounds containing oestrogen and progestogen has many features in common with chorea gravidarum, and the pathogenesis is probably similar. In some of the patients, however, the sudden onset of symptoms suggests a vascular aetiology.
The case is reported of a young woman who suffered from lymphoid interstitial pneumonia. Involvement of the brain by what appeared to be an identical pathological process led to her death, and the orbital tissues were also involved at one stage. The cause of this condition is unknown, but the hypotheses are put forward that it may represent one facet of delayed hypersensitivity or that a slow virus is the responsible aetiological agent. Although lymphoid interstitial pneumonia has previously been reported as an isolated entity, the evidence from this case suggests that it might represent part of pluri-systemic disease.
The immunoglobulins G, A, M, and D have been measured in the cerebrospinal fluid of 207 patients with neurological disease. Raised levels of IgG, expressed as a percentage of total cerebrospinal fluid (C.S.F.) protein, were found in 62% of 45 cases of multiple sclerosis compared with 14% of 160 cases with various other neurological disorders. Thus measurement of the IgG level is probably a useful confirmatory investigation in multiple sclerosis. IgA and IgM were found only in the C.S.F. of patients with a raised protein level, and IgD was not detected.
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Muscle phosphoglycerate mutase deficiency results in a myopathic condition characterised by repeated cramps, possible myoglobinuria and muscle pain. We present a family with muscle phosphoglycerate mutase (PGaM) deficiency, mild glycogen storage and some exertional myalgia. Investigations of muscle biopsy tissue showed a residual PGaM activity in muscle due to a small amount of brain isoenzyme. The enzyme was also measured in blood cells and a full investigation of muscle metabolism was also carried out. Electron microscopy revealed mitochondria with similar morphological features in two patients investigated.