eLetters

616 e-Letters

  • Endozepine stupor or recurrent stupor due to covert administration of brotizolam?
    Akira Hirata

    Dear Editor

    Benzodiazepines are now the most prescribed group of psychoactive drugs, and their safety for therapeutic use has been established, but there also is the potential for abuse and addiction.[1]

    Endozepine stupor (ES) is characterized by repeated, spontaneous stuporous attacks lasting several hours or days, and responsiveness to flumazenil without administration of benzodiazepine. ES is caused by...

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  • Persistent vegetative state after severe head injury: we should not generalize
    Wakoto Matsuda

    Dear Editor

    We greatly appreciate the considerable and thoughtful comments offered by Boris Kotchoubey and his interest in our report of three cases in a persistent vegetative state (PVS) after severe head injury, who recovered from a prolonged disturbance of consciousness after the administration of levodopa.[1]

    As author points it out, PVS patient present a wide range of neurological symptoms and syndro...

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  • Making matters worse, ipsilaterally: A new explanation
    Iraj Derakhshan

    Dear Editor

    The Short Report by Ago and colleagues,[1] describing deterioration of pre-existing left hemiparesis by a subsequent ipsilateral hemispheric insult, contains a laterality-indexed aspect related to motor control in humans, not addressed by the authors.

    Cases similar to their patient are on record.[2] The explanation of the laterality indexed bilateral activation of motor cortices (or, as in...

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  • Persistent vegetative state: Should we generalize?
    Boris Kotchoubey

    Dear Editor

    Matsuda et al.[1] reported three cases of patients with traumatic persistent vegetative state (PVS), in which an active treatment with levodopa, starting after 3, 7, and 12 months, respectively, resulted in fast recovery of consciousness.

    All three patients had parkinsonian symptoms and MRI evidence of the damage to the substantia nigra or ventral tegmental area. This is an astonishing r...

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  • Difficult and recurrent meningitis
    O Jolobe

    Dear Editor

    Regarding Ginsberg's article: Difficult and recurrent.[1]

    The rationale underlying the author's use of a frequent dosing regimen for antibiotics in acute bacterial meningitis is a sound one, namely to compensate for the eventuality of missed doses,[1] the latter being one of the realities in a service tightly stretched for manpower. The unequivocal recommendation for a 4-hour dosing regime f...

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  • Depressive symptoms and cognitive decline
    Edward H Reynolds

    Dear Editpor

    I read with interest that Wilson et al.[1] have confirmed an association between depressive symptoms and subsequent cognitive decline in a large defined community followed prospectively for an average of 5.3 years. The various possible explanations were discussed by Stewart.[2]

    I wish to draw attention to one possible biological model of the risk factor or prodromal interpretation of th...

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  • Authors' reply to Dr Connemann
    Armand Hausmann

    Dear Editor

    In reply to the comments by Dr Connemann [1]:

    Although our study was designed to investigate rTMS add-on effects in an aggressive stimulation paradigm [2] we did not find a significant difference between the active group (n= 25) in comparison to sham (n=13) in a two week trial. Although we used aggressive parameters in an add-on setting neurocognitive measure even slightly improved in the acti...

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  • 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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