Gerald S. Golden

Prenatal development of the biogenic amine systems of the mouse brain.

Abstract The development of catecholamine- and serotonin-containing neural structures in the brain of the fetal mouse was studied utilizing the Falck-Hillarp technique of histofluorescence. The substantia nigra, ventral tegmental region, and striatum show progressive developmental changes following the initial appearance of fluorescence on gestational day 13. Fluorescent nigrostriatal axons are present on days 13 through 17. The locus ceruleus becomes visible on day 14. Axon terminals in the hypothalamus first are seen on day 19. Cells of the mesencephalic and pontine raphe systems become brightly fluorescent on day 13. Medullary raphe cells appear the following day. No serotonergic axon terminals were visualized in the fetus.

Gilles de la Tourette's Syndrome following Methylphenidate Administration

A nine‐year‐old boy with clinically typical ‘minimal brain dysfunction’ developed Tourettes syndrome eight weeks after the start of therapy with methylphenidate. Although methylphenidate was discontinued, the symptoms persisted. Treatment with haloperidol was effective. It is suggested that methylphenidate stimulated an increase in dopamine turnover and brought about the onset of Tourettes syndrome in a vulnerable patient.

The “locked-in” syndrome in children

Infectious diarrhea was originallysuspected because of acute onset with fever and leukocytosis, the severity of the diarrhea, and the presence of sheets of polymorphonuclear leukocytes in stool. The difficulty in culturing S. dysenteriae from the stool was a major factor in our failure to establish a correct diagnosis. This is not uncommon since 20% of patients known to be infected with Shigella may not have microorganisms cultured from their stool. The barium enema interpreted as ulcerative colitis added to confusion in diagnosisY Had proctosigmoidoscopy been done initially, diagnostic d i lemma would have been avoided, and a course of antimicrobial therapy might have reversed the pathologic,process before colectomy became necessary. Shigella dysenteriae type I. must be ~eturned to the list of causes of pseudomembranous colitis.

Idiopathic rhabdomyolysis in children.

Abstract Idiopathic rhabdomyolysis (myoglobinuria) in children differs clinically from adult cases. The childhood form generally presents with fewer attacks of greater severity and without an exertional precipitant. The mortality rate in children is high. Two fatal cases, in patients ages 3 years and 8 months and 9 months respectively, are reported. The second case is the youngest patient reported to have died with rhabdomyolysis. Both children had weakness of a subacute but relentlessly progressive nature. Weakness of the respiratory muscles led to death in each case after a course of several weeks. Myoglobinuria was never a prominent feature of the illness. The pathologic changes in the skeletal muscles of both cases were similar and consisted of widespread necrosis of individual muscle fibers randomly distributed among intact fibers. There was no evidence of inflammatory changes. Electron microscopic study of the muscle of Case 1 showed the affected fibers to be in various stages of necrosis. Phagocytosis and regeneration were also seen. These morphologic alterations of muscle are similar to those seen in adult cases of rhabdomyolysis, despite the differences in the clinical manifestations and in the prognosis.