RESUMO
The present paper reports the long-term use of clozapine in a prospective sample of 46 chronic schizophrenics. In six months, 21 subjects had been excluded for a number of reasons. In four of them the reasons for exclusion were related to lack of response or adverse effects. The median daily clozapine dose was 400 mg in the remaining 25 patients. As a whole, there were remarkable improvements in core dimensions of psychopathology, global cognitive status, and level of functioning. We confirmed that clozapine is effective in a subgroup of schizophrenics with the severest forms of the disease. If tolerated after the first few months it leads to progressive gains in several domains of behavior. Clozapine should be tried in every patient with schizophrenia in whom positive symptoms, disorganization, or bizarre behavior are a matter of incapacitation despite efforts to keep them under control with other drugs.
Assuntos
Antipsicóticos/uso terapêutico , Clozapina/uso terapêutico , Esquizofrenia/tratamento farmacológico , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de TempoRESUMO
The relationship between the interruption of the human pyramidal tract and its attendant clinical manifestations has been a matter of concern to neurologists and neurosurgeons for over a century. We presently report three cases of unilateral pyramidal tract ischemic lesions within the cerebral hemispheres who presented with a contralateral pure spastic hemiplegia syndrome. In none could we find any disturbance in the somatosensitive evoked potentials of the four limbs. The review of some cases on record since the time of Charcot and Erb has made it clear that the pyramidal syndrome is a valid clinical concept which should be qualified according to the particular animal species one is referring to. In man, it manifests itself by paresis, hyperactive muscular reflexes, spasticity and Babinski sign. Based on this evidence we propose the idea of a "differential control" exerted by the pyramidal tract upon the segmental neuronal pool as its key mode of normal functioning.
Assuntos
Infarto Cerebral/etiologia , Hemiplegia/etiologia , Tratos Piramidais , Adulto , Idoso , Infarto Cerebral/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças da Medula Espinal/complicações , Tomografia Computadorizada por Raios XRESUMO
Orthostatic tremor (TO) is a recently described new type of a high frequency irregular tremor which affects antagonistic sets of muscles in the lower limbs only since the erect posture is maintained. We describe two other cases of this peculiar kind of tremor which may be not so uncommon as up to now realized and emphatize its main diagnostic and semeiological characteristics. TO may share some basic pathophysiological mechanism with tremors of the classical heredofamilial essential variety.