Drake D. Duane

Alternate-day prednisone: preliminary report of a double-blind controlled study.

Thirteen patients with moderately severe myasthenia gravis participated in a double-blind study using either 100 mg of prednisone or an equivalen numbder of placebo tablets on alternate days. Anticholinesterase therapy was continued on a demand basis. At the end of 6 months the code was broken. Seven patients were on placebo and three of these had improved to such a degree that steroid therapy was not indicated. Four of these patients ultimately were started on prednisone and improved. Of the six patients on prednisone, three showed no improvement and three were improved. At the end of 2 years, the seven patients still taking prednisone were on maintenance dosage of this drug. Three of this group had experienced relapses when the dosage was cut to 15 to 25 mg on alternate days, and they again improved when the prednisone dosage was increased. No statistical evaluation is possible because of the small number of patients. It can be stated that seven patients improved with steroid therapy. Conversely, not all patients treated with alternate-day prednisone improved. Finally, any evaluation of treatment of myasthenia gravis must take into consideration the potential for spontaneous improvement, as demonstrated by three of the patients treated with placebo.

Tardive dyskinesia in depressed patients: successful therapy with antidepressants and lithium.

Abstract Depression appears to be common in patients with tardive dyskinesia (TD), and we hypothesized that this refractory movement disorder might respond to antidepressant treatment. We treated 19 TD patients with tricyclic antidepressant therapy supplemented within two to three weeks with lithium carbonate. All patients fulfilled the Research Diagnostic Criteria for major depressive disorder, although seven of them denied being dys phoric. The Abnormal Involuntary Movement Scale and the Hamilton Rating Scale were used to measure dyskinesia and de pression, respectively. Of the 19 patients, 11 (58%) experienced moderate or marked improvement in both dyskinesia and de pression. The authors conclude that treatment with a tricyclic antidepressant and lithium may alleviate tardive dyskinesia in patients with depressive symptoms.

Toward a definition of dyslexia: A summary of views

And a second point to be emphasized is that such underachievement, when encountered in written language, is often the result of an innate biologic predisposition in language learning of the individual. If the first point is not appreciated, any discussion of definition will be merely academic and have no impact on the practical world of delivery of educa tional services. If such appreciation is achieved, however, the second point, regarding the innate biologic predisposition to this disability, assumes its proper importance in determining the specific remedial methods that should be employed and in deciding to whom such services should be offered.

A neurologic overview of specific language disability for the non-neurologist

This paper represents a condensation of a 2-hour oral presentation that made extensive use of visual aids in color, many of which could not be reproduced. Several of the areas that received more elaboration in the oral presentation have been shortened in the interest of space.

Medical Trends and Issues in Learning Disabilities

The logotype of the Mayo institution depicts three shields representing clinical service, research, and education. An approach to current trends and issues in medicine related to educational underachievement (referred to in the United States as “specific learning disabilities”) can be organized into these same three categories of service, research, and education. These concerns are appropriate not only in medicine but also in the fields related to the diverse behaviors underlying unexpected school failure. Physicians have made and will continue to make important contributions to the recognition of academic underachievement and particularly to clarification of the relationship of underachievement to biologic determinants. The views that follow are in part influenced by my experiences and those of my colleagues at the Mayo Clinic involved in the Learning Disabilities Assessment Program.