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Patient Information

When you hear hoofbeats, don't think of

Except in neurology.

• Amyotrophic Lateral Sclerosis
• Creutzfeldt-Jakob Disease and Mad Cows
• Guillain Barre Syndrome, the original "pit and the pendulum" nightmare disease of inexorable paralysis. A highly effective TREATMENT - plasmapheresis - is available. But rapid diagnosis is essential and the condition is often mistaken at first for the anxiety which invariably accompanies it.
• Carpal Tunnel Syndrome - As real as it is fashionable, readily diagnosed with Electrodiagnostic Testing.
• Tarsal Tunnel Syndrome Rare but also real, one cause for foot pain sometimes overlooked.
• Meralgia Paresthetica - Also rare, a bothersome but easily diagnosed condition, when recognized.
• Neuroleptic Malignant Syndrome - A devastating neurologic reaction to major tranquilizers including phenothiazines, butyrophenones, and some of the "atypical" neuroleptics such as Respirdol. Incidence rates conservatively estimated at 1% of those treated. Mortality rates estimated from 10 to 30% and more depending on the report.
• Headaches - a complex subject, a few observations based on experience.
• Benign Positional Vertigo. - The most frequent cause of dizziness in the elderly...
• NMS, or Neurologic Malignant Syndrome, a catastrophic reaction to major tranquilizers (phenothiazines and butyrophenones) and anti-depressants with upwards of 20% mortality. A silent epidemic.
• Menière's Syndrome: a cause of dizziness neither common nor benign - causes progressive unilateral hearing loss.
• Human Memory - The most fascinating subject in neurology. Thanks in part to research on ECT induced amnesia, much has been confirmed about the anatomical substrate of memory deficits, usually resulting from dysfunction and damage to the mesial temporal lobes and hippocampal formations, the diencephalon including the thalamus and the basal forebrain all of which are critical to memory encoding and retrieval and all of which just happen to be in the ECT path, right between the electrodes.

  I give credit to Larry Squire who has studied ECT damaged individuals for twenty years now at UC San Diego and bravely confirms what was well established in the 1950's. (See Squire, LR: Neuroanatomy of Memory from the Annual Review of Neuroscience. 1993, 16:547-63). The Karma (TO CYCLE) of human experimentation appears to be such that one can only discover what was already known.

  With regard to what we really care about, enhancing our memories, the Medieval teachers of "rhetoric" knew more. This 14th Century illustration is a "peg system," still the mainstay for memorizing lists for contemporary masters such as Harry Lorayne. Note that "in the first place" is a church window someone was gazing out....bored?

  

• Sexual Intercourse has been associated with ruptured aneurysms, the ultimate nightmare of neurologic emergencies, and many lesser nightmares. The problem of inadequate potency - if MEDICATIONS aren't the cause, is only partially understood but if a male experiences nocturnal tumescence (erections during sleep or provoked by a full bladder in the morning) his peripheral nerves are probably just fine.

Books

• I PIOMBI, by Giovanni Casanova: a wonderful book published 208 years ago, still alive and well. Casanova was Italian but he wrote mostly in French. He personally oversaw the publication of this account, his lifetime best story, and for some reason it hasn't been translated as a "stand-alone" story before. I can read it for the 1000th time and it stays fresh. My translation includes:
  1. 
  2. Translator's Introduction
  3. Casanova's Foreword
  4. Part One (and it was For Sale.)

  

• Shock Treatment Is Not Good For Your Brain which was published in 1975 by Glide Press, will be reissued here on the Internet. In the 20 years since I wrote the book, I have found no reason to change my LOW OPINION of the practice.

Articles

• 
• Shock Treatment, Brain Damage and Memory Loss, A Neurologic Perspective a review of the literature published in the American Journal of Psychiatry, Volume 134:9, page 1010. September, 1977.
• Electroshock Therapy, Published in Psychology Today Magazine, August 1975
• Cyanide, Consciousness and Pain: Is Execution by Lethal Gas Cruel and Unusual Punishment? Submitted for publication 1995.
  

Quotations

Essays