Heart-rate changes on standing in elderly patients with orthostatic hypotension

1. The heart-rate changes on standing were studied in 16 elderly patients with idiopathic orthostatic hypotension and compared with those of 20 controls. The mean age of both groups was 78 years, and all were in sinus rhythm. 2. The patients with orthostatic hypotension differed from the control patients in having no early peak in heart rate, and a significantly smaller and slower rise in heart rate within the first 40 s after standing (P less than 0.05). 3. It is concluded that there is a failure of the autonomic reflex in elderly patients with orthostatic hypotension, which may contribute towards their symptoms.

Complex visual hallucinations in partial blindness due to eye disease

Three patients experienced complex formed hallucinations during progressive visual failure from eye disease. The hallucinations began abruptly, were brightly coloured stereotyped figures, animals or objects, and appeared to be provoked by light. As blindness progressed the clarity, frequency and duration of the hallucinations faded. The patients had no abnormalities other than their eye disease, which in two cases was macula degeneration, and choroideraemia in the third.

Nervous endemic cretinism in Eastern Nepal

31 children and adolescents from the mountainous region of Eastern Nepal were examined in order to outline the clinical pattern of cretinism found there. They correspond to the description of nervous endemic cretinism found elsewhere: psychomotor retardation, deafness, and a variable degree of spastic diplegia. There was no clinical evidence of hypothyroidism. The disorder appears to be related to gestational iodine deficiency and it is suggested that injections of iodinated poppyseed oil ("Lipiodol") would be the most suitable form of prophylaxis.