eLetters

589 e-Letters

  • Amygdala enlargement and psychiatric comorbidity in imaging-negative patients with refractory TLE
    Ludger Tebartz van Elst

    Dear Editor

    In their interesting paper Bower and colleagues report results of a study employing manual amygdala volumetry to imaging-negative patients with refractory temporal lobe epilepsy (TLE).[1] They identify 7 out of 11 patients in whom they diagnose amygdala enlargement and postulate this might be attributable to developmental abnormality or low grade tumor.

    However, in discussing their interesting o...

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  • Factors predicting the treatment response to rivastigmine in Alzheimer’s dementia
    Giuseppe Bellelli

    Dear Editor

    We read with attention the report of Adler and colleagues.[1]

    By studying 20 patients with Alzheimer’s disease (AD) assigned to rivastigmine, the authors found that baseline short-term memory performances and EEG data are useful for predicting response to treatment at 6 months.

    We would like to contribute to this topic with our own personal data on 24 AD subjects treated for 9 months w...

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  • Vestibular Stimulation in the Insane
    A G Gordon

    Dear Editor

    Dodson [1] described the successful and “novel” use of cold-water caloric ear irrigation in a manic woman, stating that the effect of this procedure on psychiatric symptomatology has not been reported. In fact, there is nothing new [2] about shock measures that overstimulate, exhaust, or generally reset the vestibular system, including cold water poured onto the head, swings to induce vertigo, emetics t...

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  • Sufficient power to detect a slight effect?
    Bernhard J Connemann

    Dear Editor

    The report by Hausmann et al.[1] adds to negative experiences with rTMS as an add-on strategy in patients with major depression.[2] However, again, the evidence is not completely convincing. In this study, only "slight" effects were expected, but the sample size did not appear to account for that. 25 vs. 13 patients may not suffice to detect - and even less to refute - slight effects.

    Thi...

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  • On the non-specific link between migraine and depression
    Vinod K Gupta

    Dear Editor

    Williams and colleagues underscore the non-specific relationship between depression and pain in patients seen early at neurology clinics in wide range of unconnected disorders; patients with primary headaches constituted a substantial cohort in this study.[1] This clinical study makes an important contribution to maintain perspective in primary headache research.

    Several epidemiological studies...

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  • Passive Vasodilation and Cerebral Blood Flow
    Michael L. Daley

    Dear Editor

    The authors' proposed physiological models of the relationship between arterial blood pressure (ABP) and cerebral blood flow (CBF) illustrated in Figures 1 and 2 are not entirely correct. In particular, as depicted in each figure the apparent average radius of the vascular bed and CBF appear to increase linearly with ABP during passive vasodilation. Since flow is laminar and vascular resistance is i...

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  • Concerns on fibromuscular dysplasia endovascular treatment
    Jose E Cohen

    Dear Editor

    I have read with interest the article written by Finsterer et al. However, I do have several concerns and remarks in relation to it.

    First, the authors describe a stenotic lesion at the L-ICA that I do not actually see in the diagnostic angiogram. Moreover, this lesion was treated wih a stent-graft. Second, the image of the R-ICA corresponds to a classic carotid artery dissection, probabl...

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  • Response to Dr Levyman
    Phillip A Low

    Dear Editor

    We thank Dr Celio Levyman for his supportive comments.[1]

    We fully agree with him that, in patients with baroreflex failure, it is necessary to adopt approaches to combat orthostatic hypotension without increasing supine hypertension. It is also important to follow up an open study with a blinded study. We expect to complete, within the next month, a double- blind placebo controlled study, funded by...

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  • A new light to orthostatyc hypotension
    Celio Levyman MD ScM

    Dear Editor

    The issue of orthostatic hypotension is a very common an important diseable picture of many diseases, as Singer et al. points. Parkinson disease and diabetic neuropathy are the most common clinical situation of these cases, and even the very well controlled patient, with tilt-test table measures to the choice of therapeutic strategies in most cases shows frustanting results.

    This novel...

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  • Does MS-related plasma beta-endorphin vary in circadian manner?
    J. Christopher Sullivan

    Dear Editor

    As it is well known, endorphin levels change in different circumstances, for example, in injury, illness, or as a result of circadian influences, among others.[1-7] It would be helpful to know which was the primary stimulus for endorphin level changes in MS patients. Perhaps a further experiment can show that it is or is not circadian.

    References

    (1) Covelli V, Massari F, Falla...

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