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Show LlT£RATlIIn ABSTRACTS /93 except alexia without agraphia, much of thl' sdllllarly discussion llf localization of ksions Sl'ems of academic interest primarilv. Just bdore Olll' gives up reading this papt'r, tIll' section "Ex,ll1lining till' Patient With ViSlh11 Recognitilln Dl'iects" prl'sl'nls six reireshingl~' t',lS\' steps tll help idl'ntifv thl'sl' baitling patients (i.e .. cop~' ,1 line dr,Hving, rl',ld a paragr'lph, shll\\' ,1 f,lI1111US face, de.). L.'III IL Sl'dll'id.... M. O. Presenting Signs and Symptoms in Multiple Sclerosis, Sanders EACM. Blll1l'n ELEM, van der Velde EA. ,'-klll ,\'l'lInll Sl'lllld 1986;73:269-72 (Mar). [Reprint requests to E. L. E. 1\1. Bollen, M.D., Department of Nt'ufllphvsiology, University Hospital Leiden, Rijnsburgerweg 10, 2333 AA Leiden, The Netherlands.] The disability outwme related to the presenting signs and s~'mptom5 was studied retrospectively in 193 patients with deiinite multiple sclerosis. Optic neuritis had the highest incidence of all presenting complaints (-l2'!c). Patients whose first sign was motor weakness were found to be more severely disabled, at all stages throughout the course of the disease, than patients with other presenting signs or symptoms. Patients presenting with sensory disturbances proved to be less seriously disabled. For the first 20 years, patients presenting with optic neuritis were less seriously disabled as well. However, after 20 years, their disability was comparable to patients with other presenting complaints. Optic neuritis tended to occur at a lower age than other initial signs and symptoms. After the development of optic neuritis, patients tended to experience an asymptomatic period. Wlllter M. IllY, M.D. Comparison of Amaurosis Fugax and Transient Cerebral Ischemia: A Prospective Clinical and Arteriographic Study. Hurwitz BJ, Heyman A, Wilkinson WE, Haynes CS, Utley CM. AIIII Nl'lIrol 1985;18:698-704 (Dec). IReprint requests to B. Hurwitz, Box 3184, Duke University Medical Center, Durham, NC 27710.] The authors studied the clinical associations, arteriographic findings, and long-term outcome of 93 patients with amaurosis fugax and 212 p,ltil'nts with transient ischemic attacks of the cerebral hemispheres. The group of patients with transient ischemic attacks included a significantly larger proportion of blacks and had a higher prevalence of hypertension than the group with amaurosis. Carotid bruits were noted more often in patients with amaurosis (71 'Ir.) than with transient ischemic episodes (42%). Operable atherosclerotic lesions of the carotid artery were more common in amaurosis (66';") than with transient ischemic attacks (52'1r). The 7-year cumulative rate of cerebral infarction was Jess in patients with amaurosis (14%) than in those with transient ischemic attacks (27%). This difference was still present after adjustment for race, hypertension, and type of therapy. This is, of course, not the first manuscript comparing patients with amaurosis fugax and transient ischemic attacks. Others have found no significant differences between these two groups. At any rate, whether or not there is a higher incidence of operable carotid lesion in one group or the other is, to an extent, clinically unimportant. Patients who are candidates for carotid surgery in both groups should have appropriate neuroradiologic evaluation. Walter M. Jay. M.D. Visual Changes Mediated by Beer in Retrobulbar Neuritis-An Investigative Case Report. Alvarez SL, Jacobs NA, Murray IJ. Br I Ophthall1101 1986;70:141-6 (Feb). [Reprint requests to Mr. N. A. Jacobs, F.R.C.S., Department of Ophthalmology, Charing Cross HospitaL Fulham Palace Rd., London W68RF, U.K.] A patient with established retrobulbar neuritis claimed that his visual acuity improved after drinking beer. Detailed psychoph~'sical and electrophysiological testing was carried out. The results of contrast sensitivity, spectral sensitivity, tlicker sensitivity, and visually-evoked potentials cunfirnll'd his llbservation. Significant improvement of the patit'nt's visual function was observed after two control trials with beer heated to body templ'fature. This ruled out a pure temperature (cooling) effect on nerve conduction by the beer. Neither a trial with the alcohol equivalent to beer (whiskey) nor one with alcohol-free lager improved his visual acuity. Walter M. Jay, M.D. I ct", N,·"n'·ol",I/",I",,,I. V"I. 6. N,•. 3. 1986 |