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Familial cerebral hemorrhage
305 SCIENTIFIC
MEETING
OF THE NETHERLANDS
SOCIETY
OF NEUROLOGY
HELD IN AMSTERDAM
ON DECEMBER
12,
1979 MOTOR IRRADIATION AND ASSOCIATED MOVEMENTS IN HEMIPLEGIA A. J. H. PREVO,
s. L. VISSER
and 1. H.
A. VAN DER DRIFT
(Amsterdam)
The voluntarily produced electrical activity in synergistic and remaining muscle groups is considerably increased in the affected limbs in hemiplegic patients. This increased associated muscle activity or motor irradiation may be demonstrated by associated movements or synergy patterns as dinical features. Classification and clinicai studies of associated movements were particulary reported in detail for several decades ago in old neurological literature. More recently a few quantitative data on electromyographic analysis of motor irradiation during voluntary movements in hemiplegia were published. In our study the amount of motor irradiation in distal muscle groups in the hemiplegic arm, initiated by proximal isometric contractions, was compared to the amount of voluntarily produced electrical activity in the same distal muscle groups acting a agonists. EMG was recorded with surface electrodes. The mean integrated amplitude was determined by computer analysis. Hemiplegic motor behaviour was also evaluated by testing the performance of selective movements and the occurence of associated movements. Twenty hemiplegic patients were studied. Hemiparesis existed for at least one year. The result were compared to normal volunteers. It appears that the disturbed voluntary movements in the affected arm may be attributed almost enterily to a decrease of voluntarily produced electrical activity in agonists. The decrease of EMG output and activity in agonists during voluntary contractions was much more striking than the increased motor irradiation.
SCIENTIFIC OCTOBER
MEETING
OF
THE
‘AMSTERDAMSCHE
NELJROLOGENVEREENIGING’
KELD
IN
AMSTERDAM
ON
1979
10,
FAMILIAL CEREBRAL HEMORRHAGE A. R. WA~ENDORFF,
G. TH. A. M. BOTS,
L. WENT,
L. I. ENDTZ
(Amsterdam)
Nine cases of cerebral hemorrhage in a Scheveningen family were reported, eight of which were fatal. The clinical picture in all was one of repeated cerebrovascular accidents, starting in the fifth and sixth decade. In 4 there was a history of migraine, complicated in 3. One had the clinical appearance of Alzheimer’s disease. There was no evidence of hypertension. Microscopic examination done in 6 cases, revealed an increased number of arteriolae in leptomeninges and cortex of cerebrum and cerebellum. These vessels showed thickening of their walls. Both amyloid and hyaline degeneration were found but no senile plaques nor neuro~brilla~ tangles, including in the case with dementia. The brains showed signs of multiple hemorrhages and infarcts. No amyloid was found outside the brain in the cases investigated. In addition to the 9 proven cases of cerebral hemorrhage there are 4 suspected cases, as well as a history of dementia in 5. The occurrence of a similar affliction in a published Icelandic and in two non published Katwijk (The Netherlands) families was discussed. Amyloid angiopathy has also been encountered in some instances of other. mostly non familial brain diseases.
SCIENTIFIC NOVEMBER
MEETING 1,
OF
THE
“AMSTERDAMSCHE
NEUROLOGENVEREENIGING’
HELD
IN
AMSTERDAM
ON
1979
THE ANATOMICAL BASIS OF THE BLINK REFLEX IN THE CAT G. HOLSTEGE
and
G. A. GRAVELAND
(Rotterdam)
The blink reflex is an important part of the neurological examination in clinical practice. The electromyographic registration of this reflex also appeared to be of additional clinical value (KIMURA, 1973 and ONGERBOER DE VISSER and GOOR, 1974). The afferent limb of the reflex loop is probably the nervus supra-orbitalis, a sensory root of the trigeminal nerve and the efferent limb is the facial nerve. In man two
MEETING
OF THE NETHERLANDS
SOCIETY
OF NEUROLOGY
HELD IN AMSTERDAM
ON DECEMBER
12,
1979 MOTOR IRRADIATION AND ASSOCIATED MOVEMENTS IN HEMIPLEGIA A. J. H. PREVO,
s. L. VISSER
and 1. H.
A. VAN DER DRIFT
(Amsterdam)
The voluntarily produced electrical activity in synergistic and remaining muscle groups is considerably increased in the affected limbs in hemiplegic patients. This increased associated muscle activity or motor irradiation may be demonstrated by associated movements or synergy patterns as dinical features. Classification and clinicai studies of associated movements were particulary reported in detail for several decades ago in old neurological literature. More recently a few quantitative data on electromyographic analysis of motor irradiation during voluntary movements in hemiplegia were published. In our study the amount of motor irradiation in distal muscle groups in the hemiplegic arm, initiated by proximal isometric contractions, was compared to the amount of voluntarily produced electrical activity in the same distal muscle groups acting a agonists. EMG was recorded with surface electrodes. The mean integrated amplitude was determined by computer analysis. Hemiplegic motor behaviour was also evaluated by testing the performance of selective movements and the occurence of associated movements. Twenty hemiplegic patients were studied. Hemiparesis existed for at least one year. The result were compared to normal volunteers. It appears that the disturbed voluntary movements in the affected arm may be attributed almost enterily to a decrease of voluntarily produced electrical activity in agonists. The decrease of EMG output and activity in agonists during voluntary contractions was much more striking than the increased motor irradiation.
SCIENTIFIC OCTOBER
MEETING
OF
THE
‘AMSTERDAMSCHE
NELJROLOGENVEREENIGING’
KELD
IN
AMSTERDAM
ON
1979
10,
FAMILIAL CEREBRAL HEMORRHAGE A. R. WA~ENDORFF,
G. TH. A. M. BOTS,
L. WENT,
L. I. ENDTZ
(Amsterdam)
Nine cases of cerebral hemorrhage in a Scheveningen family were reported, eight of which were fatal. The clinical picture in all was one of repeated cerebrovascular accidents, starting in the fifth and sixth decade. In 4 there was a history of migraine, complicated in 3. One had the clinical appearance of Alzheimer’s disease. There was no evidence of hypertension. Microscopic examination done in 6 cases, revealed an increased number of arteriolae in leptomeninges and cortex of cerebrum and cerebellum. These vessels showed thickening of their walls. Both amyloid and hyaline degeneration were found but no senile plaques nor neuro~brilla~ tangles, including in the case with dementia. The brains showed signs of multiple hemorrhages and infarcts. No amyloid was found outside the brain in the cases investigated. In addition to the 9 proven cases of cerebral hemorrhage there are 4 suspected cases, as well as a history of dementia in 5. The occurrence of a similar affliction in a published Icelandic and in two non published Katwijk (The Netherlands) families was discussed. Amyloid angiopathy has also been encountered in some instances of other. mostly non familial brain diseases.
SCIENTIFIC NOVEMBER
MEETING 1,
OF
THE
“AMSTERDAMSCHE
NEUROLOGENVEREENIGING’
HELD
IN
AMSTERDAM
ON
1979
THE ANATOMICAL BASIS OF THE BLINK REFLEX IN THE CAT G. HOLSTEGE
and
G. A. GRAVELAND
(Rotterdam)
The blink reflex is an important part of the neurological examination in clinical practice. The electromyographic registration of this reflex also appeared to be of additional clinical value (KIMURA, 1973 and ONGERBOER DE VISSER and GOOR, 1974). The afferent limb of the reflex loop is probably the nervus supra-orbitalis, a sensory root of the trigeminal nerve and the efferent limb is the facial nerve. In man two