We recorded the motor evoked potentials (MEPs) from the abductor pollicis brevis muscle, after supramaximal electrical transcranial stimulation, and studied the effect of paired transcranial shocks with varying interstimulus time intervals, in 10 normal subjects, 4 patients with median nerve neuropathy and 2 patients with motoneurone disease. In relaxed muscles the amplitude of the MEP evoked by a single shock averaged 30% of the M wave. With intervals from 1 to 2.5 msec 2 shocks evoked one MEP far larger in size than the control MEP (70% of the M wave). With intervals of 10 msec and longer, the 2 shocks evoked 2 independent MEPs; the size of the MEP following the second shock (test) was inversely correlated with the size of the control MEP: the more the control MEP approached the size of the M wave, the smaller the test MEP. Single motor unit records showed that, in the normal subjects and patients with peripheral neuropathy, the same motor unit was activated either by the first or the second shock, whereas in the patients with motoneurone disease it fired twice. In active muscles, the control MEP averaged 70% of the M wave. With intervals of 10 msec and longer the test MEP was markedly suppressed; with 100 msec intervals it fully recovered. In relaxed muscles, by delivering a double shock at a 1.5 msec interval, thus evoking a large MEP, followed by a second double-shock, the test MEP was completely suppressed for a period of 20 msec; it began to recover at 50 msec intervals and fully recovered after 150 msec.(ABSTRACT TRUNCATED AT 250 WORDS)

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[Congenital analgesia].

The case of a 12 years old boy with a congenital anaesthesia covering all cutaneous and visceral districts is reported. There were no other neurological abnormalities apart a light mental retardation and loss of axon reflex after intradermal injection of hystamine. Notwithstanding this last finding a diagnosis of congenital indifference to pain was made. The differential diagnosis between indifference and insensitivity to pain is discussed.

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PubMedDate not supplied

[Neuropsychological training in the rehabilitative treatment of the adult hemiplegic].

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[Megacolon in a case of Steinert's myotonic dystrophy].

A case of Dystrophia Myotonica with a positive family history, cataract and myotonic bursts on EMG is reported. The patient underwent repeated respiratory infections, which were associated with an abnormal elevation of the diaphragm and with an enlargement of the colon. The frequency of pulmonary infections, which may arise many years before the appearance of neurological symptoms, is stressed. On the other hand enlargement of the colon is a rare finding. Its pathogenesis as well as therapeutic implications are discussed.

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PubMedDate not supplied

[Monocular ocular bobbing].

The ocular bobbing phenomenon consists of involuntary, abrupt, usually conjugate, brisk downward eye movements followed by a slow return to midposition; it is most often observed in cases of coma due to pontine vascular lesions. In the patient reported here, with a coma after basilar thrombosis, the movement was initially conjugate and subsequently limited to one eye, as described by SUSAC and coworkers under the heading "monocular bobbing" in 1970. The movement was increased in amplitude and frequency by labirintine caloric stimulation as well as by non specific manoeuvres like neck skin pinching and visual stimulation. Post-mortem examination showed a large ischaemic infarction of the pons, of the middle cerebellar peduncles and of the white matter of one cerebellar hemisphere.

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