620 e-Letters

  • Migraine–anxiety related dizziness (MARD): a non-diagnosis?
    JMS Pearce

    Dear Editor,

    Furman, Balaban, Jacob and Marcus correctly conclude that “Migraine and anxiety are two conditions that are frequently associated with dizziness and balance disorders, and that, migraine and anxiety are comorbid”. . However, it’s difficult to agree with their assertion that: “MARD is a newly defined condition wherein a patient presents with a combination of a balance disorder, migraine, and anxiety.”...

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  • Dementia as a complication of schizophrenia: letter to editor
    Amardeep Kumar

    Dear editor,

    The paper provides an interesting perspective about schizophrenia. Even though Kraeplin described the illness as 'dementia praecox', it's intriguing to find paucity of literature mentioning dementia like features in schizophrenia.

    It appears from the paper that a significant minority of patients with schizophrenia may have such presentation. However,in such cases it's very difficult to label...

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  • Hypertensive response of water ingestion in chronic autonomic failure: refining underlying mechanism
    Vinod K Gupta

    Dear Editor,

    Young and Mathias studied the cardiovascular effects of rapid water ingestion in multiple system atrophy (MSA) and pure autonomic failure (PAF) and discuss the possible mechanisms responsible for the hypertensive response. [1] Involvement of increased sympathetic nerve activity or denervation supersensitivity appears unlikely. Besides the response being as great in PAF as in MSA (with a more rapid ons...

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  • Risk of developmental delay in children born to epileptic mothers treated with antiepileptic agents
    bertrand de Toffol

    Dear Editor,

    We read the retrospective study by Adab et al [1] with interest; this paper raises the issue of risk of developmental delay in children aged 6 years and over born to epileptic mothers treated with antiepileptic agents during pregnancy. More specifically, foetal exposure to valproate could involve significant risk of impairment of verbal IQ in such children, despite no change in full scale IQ.

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  • Ddepression may result from low DHEA
    James M Howard

    dear Editor,

    I first suggested depression may result from low DHEA in 1985. (This has since been supported; a number of mental disorders / diseases have since been connected with low DHEA.) Subsequently, it has become clear that low DHEA may result in reduced growth and development of the brain, the malfunction of which may be exposed later in life by antagonism of low DHEA levels by cortisol and / or testost...

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  • Induction of Natural rythum and known Effects on cortex
    Jack R Kapp

    Dear Editor,

    If I may suggest, there is ample data on the effects of the state on the cortex and the relationship they have on tremmors to suggest a study that would explore the magnetic frequency of stimulation be adjusted to the patients own frequancy.

    Thank you.

  • Primary writing tremor and writer’s cramp are different nosologic entities
    Spiridon Papapetropoulos

    Dear Editor,

    We read with great interest the study by Djebbari and colleagues reporting on the factors predicting improvement in motor disability in writer’s cramp treated with botulinum toxin injections [1].

    The authors found a significant improvement on the BFM scale in both severity and disability scores after patients were treated with botulinum toxin injections. The pronation/flexion pattern of dyst...

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  • Dialated Virchow-Robin spaces:They do matter
    Alan Jackson

    Dear Editor,

    We noted with interest the findings of MacLullich et al [1] in a cohort of ageing healthy men, that increased numbers of enlarged perivascular spaces (EPVS; syn Virchow – Robin spaces (VRS)) are associated with worse non-verbal reasoning and, more generally, visuospatial cognitive ability after adjusting for prior intelligence. However, multiple linear regression showed that EPVS scores did not...

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  • Inappropriate emergency management or inappropriate selection ?
    Zui-Shen Yen

    Dear Editor,

    We read the paper by Chin et al.[1] with great interest. However, we have some doubts regarding their interpretations due to the study was a observational study. A causal effect between emergency management of status epilepticus (SE) and paediatric intensive care (PIC) admission was implied by the authors. However, we believe the authors should consider disease severity before interpreting the resu...

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  • Might intracranial pressure be a passive reflection of intracranial pH?
    Richard G Fiddian-Green

    Dear Editor,

    Where does fluid accumulate in intracerebral oedema, extracellulary, intracellularly or both? The distinction is important for it has a direct bearing on treatment of the intracranial compartment syndrome [1].

    If the fluid accumulates intracellularly then clamping the intra- arterial pH, using the Radiometer pH-stat automatic titrator or its equivalent[2], at an abnormally low level might r...

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