Biomedical subjects
Publications and source records attributed to J Leicester.
A 59-year-old man with a 30-year history of an unusual movement disorder characterised by involuntary axial spasms that occur only in recumbency is described. Clinical and electrophysiological evidence suggest that this disorder is best characterised as a simple tic of unusual form. We have coined the term "recumbent tic" to describe this disorder.
Of 478 patients treated at a single institution for prostate cancer, 29 developed spinal cord or cauda equina compression. In 5 patients, spinal cord compression was the first evidence of malignancy. Clinical features were predominantly pain, weakness, sensory and sphincter disturbance. The median duration of symptoms was 2 weeks, although the diagnosis was made rapidly at presentation. Clinical diagnosis correlated well with myelographic findings. Only 1 patient suffered neurological deterioration as a consequence of myelography. The functional outcome was dependent on the ability to walk prior to treatment. The median survival in those who were bedridden following treatment was 6 weeks (range 3.5-13) and 21 weeks (range 7-110+) in those who were ambulant following therapy.
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It is likely that adult-onset motor neuron disease is inherited more frequently than has previously been believed. We have studied 9 families with familial motor neuron disease and have found apparently wide variation in penetrance. Only one has autosomal dominant inheritance with high penetrance and in this family the average age of onset is similar to that reported in reviews of familial motor neuron disease. The remaining families have a pattern consistent with autosomal dominant inheritance with diminished penetrance. The average ages of onset in these families are comparable with those in sporadic motor neuron disease. Low penetrance appears to be related to higher average age of disease onset because gene carriers have an increased likelihood of dying from other causes before developing motor neuron disease. When penetrance is low the family history may be unknown, causing affected individuals to be mistakenly regarded as having sporadic disease. We conclude that the incidence of familial motor neuron disease is likely to have been underestimated by the exclusion of apparently sporadic cases in which the familial disease has low penetrance. These results and conclusions imply that the lower average age of disease onset reported in familial motor neuron disease may be due to selective recognition of high penetrance families with lower average ages of onset.
Two patients are described in whom clonic perseveration was observed following infarction of the midbrain and thalamus. In one patient perseveration was confined to movements of one side of the body and was associated with a grasp reflex on the same side. In the other patient perseveration occurred in movements of both sides of the body and involved drawing, writing and speech. It was possible to induce clonic perseveration in both patients by passive limb movements, a feature of this condition which has not been described previously. Evidence is presented that this type of perseveration is, to some extent, under voluntary control. It is suggested that the role of psychological factors in perseveration has been underestimated in the past.
By sectioning one optic tract in Siamese kittens and allowing sufficient time for the affected ganglion cells to degenerate and disappear, we have obtained maps of the distribution of ipsi- and contralaterally projecting ganglion cells in the retina of the Siamese cat. As previous work predicted, many ganglion cells in the Siamese cat retina project contralaterally which, in the normally pigmented cat, would project ipsilaterally. The transition from the pattern of projection typical of nasal retina (all contralateral) to that typical of temporal retina (most ipsilateral) is much more gradual in the Siamese cat than in the normally pigmented cat, and is centred 1.7-3 mm temporal to the area centralis, instead of at the area centralis. In the Siamese cat only a few ganglion cells at the area centralis project ipsilaterally, as against nearly 50% in the normally pigmented cat. The proportion of ipsi-projecting cells reaches the 50% level 1.7-3.0 mm into temporal retina, and overall the zone of transition may be several millimetres wide, as against about 0.2-0.5 mm in in the normall pigmented cat. Evidence is presented that the degree of the abnormality of nasotemporal division varies between individual Siamese cats and that the abnormality is more severe among large or "giant" cells than among the population as a whole.
A case of cerebral abscess due to Listeria monocytogenes in a patient receiving immunosuppressive treatment is reported. Early diagnosis was facilitated by a cerebral scan.
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