The evidence presented by the nine cases described in this paper indicates that primary arteritis of the aorta is a single clinico-pathological entity of which Takayashu's syndrome is a part. Different segments of the aorta may be affected resulting in a variety of symptom complexes. In this series, the mode of presentation was hypertension consequent on renal artery stenosis. Early diagnosis is important and surgical treatment is indicated to relieve the hypertension which carries an immediately serious prognosis.
A case of sarcoidosis is reported in the hope that this seemingly rare disease in Malaysia will be better recognised. A brief review of the literature is made and various points regarding the aetiology, pathology, clinical features and diagnosis are discussed.
Complicated migraine is not well known. It is associated with transient and protean sensory and motor
nenrological features although disturbance of mood, affect and psyche has also been described.
This paper is based on a study of ten patients suffering from complicated migraine and attempt is made
to describe various neurological symptoms and signs.
It becomes apparent from this study that there arc diverse manifestations of this interesting disorder.
Furthermore complicated migraine seems to affect a younger age group and there may not be any
family history of migraine. In most cases the nenrological symptoms precede the attacks of headaches.
The nenrological deficit may persist after longer periods. Initially, the attacks arc usnally followed by
complete recovery, with repeated attacks there may be residual neurological deficit. Though the exact
aetiology of the migraine remains unknown, it has been suggested that it is due to spasm or oedema of
cerebral vascular system. If the vessels involved are the carotid artery system, the symptoms and signs
obviously would be due to involvement of cerebral hemisphere, whereas affection of basilar artery
would produce signs and symptoms of cerebellar or brain stem deficiency.
At times it may be extremely difficult to differentiate between a typical attack of migraine and headache
due to an underlying pathology e.g. intracranial angioma or space occupying lesions, which may
require investigations such as angiography. The angiography may prove fruitless and cause deterioration
in neurological signs. A careful follow-up should be planned for cases with complicated migraine
to exclude any underlying pathology.
Spirit possession in an Indian family is described. Its importance as a culture-bound phenomenon is stressed. Its nature as a hysteria, and as a culturally sanctioned and accepted means of expression of emotions and feelings, are discussed.
Two Malaysian Chinese male children are described with Wiskoll-Aldrich syndrome, which has rarely been reported in the East. Classical features were found, with bleeding and infections, low titres of isohaemagglutinins and IgM, but variable IgG and IgA. The immune response was broadly disturbed. Survival of one child was sufficiently long for a Iymphoreticular malignancy or appear.
The concept of specific reading retardation was discussed, and compared with other terms used as synonymous with it viz. dyslexia and minimal brain dysfunction. It was suggested that specific reading retardation may be a more suitable term to use. The feature's of specific reading retardation, the evaluation of reading disability and management in terms of supportive psychotherapy, environmental manipulation and remedial education was described, using a case-report. of a 13-year old boy with such a disorder as an example.
Study site: Psychiatric clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
A forty-four year old wife of an alcoholic husband with irregular employment sought repeated medical care for her headache, bodyache, chest pain and alleged falls at home. The family backgrounds of the battered wife and the violent husband, his alcoholism and their financial problems all contributed to the violence in marriage. Their six children had lived in fear and two of them had behaviour problems. Awareness of the multiple problems associated with a battered wife should prompt cooperation between medical, social and other workers involved in the management.
Study site: medical outpatients clinic of
T.H. Woon
M.B., B.S., M.D., M.R.A.N.Z.C.P.
Associate Professor and Head
Department of Psychological Medicine
Faculty of Medicine
University of Malaya
Kuala Lumpur, 22-11
and
Shirley George
M.B., B.S., M.P.M.
Psychiatrist
Psychiatric Unit
General Hospital, Seremban.
Running Title:
Battered wife - psychodynamics and social background of a
Malaysian family - alcoholic husband - medical symptoms -
multidisciplinary management.
University Hospital to the psychiatric Walk- inClinic
A case of pseudomyxoma peritonei is reported. Pathogenesis, clinical features and modes of treatment are discussed. This patient appears to have responded to laparotomy, paracentesis and instillation of cyclophosphamide intraperitoneally.
The peculiar anatomical features render the common peroneal nerve particularly susceptible to injury at the knee. The present investigation revealed that the deep division of the nerve is more inclined to be injured when compared to the superficial division.
The diagnosis and management of brain death is discussed in this paper. Criteria recommended by the Conference of Medical Royal Colleges and their Faculties in U.K. were used in the diagnosis of brain death. It is felt that brain death should be considered as death of the individual and a plea is made to draw up guidelines on management of patients with brain death.
Two Malaysian boys of Chinese origin who satisfy the necessary criteria of subacute sclerosing panencephalitis are reported. A brief description of the symptomatology, epidemiology, laboratory finding, pathology, pathogenesis and treatment of the illness was also given.
Numerous aetiopathologic factors have been enumerated as the possible causes of injuries to the common peroneal nerve at knee. This report presents a case of postero-lateral displacement of the upper end of fibula consequent to the displacement of fractured lateral tibial plateau leading to common peroneal nerve palsy which has not been reported before.