ALTHOUGH the diagnosis of polymyositis depends on a combination of clinical, pathologic, and laboratory findings, the significance and importance of abnormal results to various laboratory tests in cases of polymyositis is controversial. To determine which tests are helpful in diagnosing, evaluating the activity, and determining the clinical course and prognosis of the disease, data on 102 patients with polymyositis who had not received steroid therapy before their examination at the Mayo Clinic were analyzed. Two of the important laboratory procedures, electromyography and muscle biopsy, require special analysis and will be considered in a subsequent publication. An analysis of the effects of steroid therapy on the same group of 102 patients was reported previously.1 Materials and Methods All of the patients were thought to present a characteristic picture of the syndrome of active polymyositis. In 80 of the cases, the disease was chronic; in 11 cases, it was acute and
Dialysis and transplantation are now standard treatments for end-stage renal failure. Often, neurologists are consulted regarding the neurological complications of these therapeutic procedures. In addition to previously reported complications, neurovascular disease is being recognized as a cause of mortality and morbidity in these patients. We report two cases of apparent thromboembolic stroke in young patients with renal failure -- one treated by dialysis and the other by renal transplantation. The risk factors of both dialysis and transplant are identified and data from the American College of Surgeons/National Institutes of Health Transplant Registry are reviewed.
Amyotrophic lateral sclerosis is a progressive dengenerative neuromuscular disease of insidious onset. It involves upper and lower motor neurons and causes both spastic and atrophic muscular symptoms. More than one fourth of patients have complaints relating to the head and neck (bulbar palsy); thus, the otolaryngologist may be the first physician to see them. Predominant symptoms are slurred speech, hoarseness, dysphagia, and dyspnea. Muscular weakness, atrophy, and fasciculation are noted on examination. The course is relentless, and only 20% of patients survive five years after diagnosis.
