Physiological reflections of mental workload

Studies reporting physiological responses as reflections of mental workload are reviewed briefly. The differing measures are located in a two-dimensional space whose axes represent first, practical application and second, relevance to actual central nervous system activity as viewed from spatial and systemic congruence. Traditional methods such as those using heart rate are identified as the most practical current measures, while evoked cortical potentials emerge as superior upon the latter axis. The potential of auditory canal temperature as an optimal composite measure is explored.

The treatment of depression in patients with epilepsy. A double-blind trial

Forty-two patients with depression and epilepsy were entered into an antidepressant trial of amitriptyline, nomifensine and placebo. The dose of the active drug was 25 mg tid, which was doubled in non-responders on the active drug after 6 weeks. At that point a further 6 week follow-up was carried out. Serum antidepressant and anticonvulsant levels were assessed. The results indicated that at 6 weeks all patients showed a decline in their depression scores but at 12 weeks nomifensine was superior to amitriptyline. The possible reasons for this and the clinical implications of this are discussed.

Clobazam as adjunctive treatment in refractory epilepsy

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Flupenthixol in depression. A study of serum levels and prolactin response

The relationship between improvement in symptomatology and changes in prolactin and serum cis-flupenthixol levels has been evaluated in 16 patients with a clinical diagnosis of depression, who were treated with 1 or 2 mg of flupenthixol in a once daily morning dose. No significant differences in clinical response were noted between those on 1 and 2 mg, and side effects were few. The presentation of some side effects, in particular extrapyramidal symptoms, were related to higher serum levels and prolactin levels particularly in the early stages of the study. Improvements in depressive symptoms were unrelated to serum levels, but at day 56 of the trial were positively correlated to changes in prolactin levels. Improvements in anxiety symptoms were positively related to serum levels at day 3 but negatively related at day 56. These results are discussed in the light of possible influences of dopamine antagonism in relation to an antidepressant effect.

Major tranquillisers used as antidepressants. A review

The use of major tranquillisers as antidepressants is reviewed and 34 double-blind trials evaluating this were found. Results suggest that some neuroleptics have antidepressant properties, although most studies have been conducted on mixed anxiety-depressive states. Advantages over the tricyclic antidepressants are the early onset of action and relative lack of side-effects. Post psychotic depression following major tranquilliser therapy is considered, and it is concluded that it is likely to be part of the underlying illness and not a drug-induced effect. It is suggested that further work with major tranquillisers in depression may be of value in exploring the mechanism of action of antidepressant drugs.

The lateralising significance of hypergraphia in temporal lobe epilepsy

Six patients with hypergraphia and epilepsy are presented and their clinical features compared with other patients reported in the literature. It is suggested that hypergraphia occurs more frequently in patients with right-sided non-dominant temporal lobe lesions, in contrast for example to the schizophreniform presentation of left-sided lesions. Other features of psychopathology possibly associated with non-dominant lesions, including elation, hypereligiosity and déjà vu experiences, are also discussed.

A case of anorexia nervosa with an associated urogenital malformation

A further case of anorexia nervosa with an associated urogenital malformation, namely hypospadias, is presented. The prevalence of urogenital abnormalities in patients with anorexia nervosa is much higher than expected on the basis of coincidence.

A relationship between anorexia nervosa and urogenital malformations has been suggested previously. We report a further case with certain unique features.

Osteitis deformans in the South African negro. A report of 3 cases

Osteitis deformans is a relatively common disease in Caucasians, but rare in the indigenous people in Africa. Three cases of Paget's disease occuring in South African Negroes are reported here. Gene marker studies confirmed the absence of Caucasoid genes in these patients.

Hepatoma presenting as a bone tumour: a case report

Osseous metastases from hepatoma are rare. One patient who had a lesion in the upper humerus is presented.