Sweating in the forehead, on the eyelids, in the face and on the trunk was measured with the Evaporimeter during 31 spontaneous cluster headache attacks of varying severity in 18 patients. The evaporimeter measures evaporative water loss (sweating + transepidermal water loss) rapidly and accurately as g/m2/h. The patients themselves acted as controls. Sweating was also estimated in 25 healthy individuals at a temperature of 27 +/- 1 degree C, and a mean relative humidity of 19%. During eight severe attacks, sweating in the medial part of the forehead on the symptomatic side was invariably increased. In moderate attacks the increment was less pronounced and in the inter-cycle period, no definite increase was found. The cause of increased sweating during cluster headache attacks remains enigmatic.

In a central institution for persons with mental retardation, the dental status in 30 adult patients with Down syndrome was compared with that in a carefully selected group of gender- and age-matched mentally retarded patients. This investigation showed an increased frequency of periodontitis in the population with Down syndrome. The caries rate, however, did not differ demonstrably between the groups. Edentulism was more frequent in patients with Down syndrome than in controls, and this fact may substantiate the observation of increased frequency of periodontitis. Caries seems to be less prevalent in institutionalized patients with mental retardation than in the population at large.

ABSTRACT. Clinical and laboratory endocrine variables in 29 adult institutionalized patients with Down's syndrome were compared with those of matched controls consisting of other mentally retarded patients from the same institution. Of the clinical variables, testes volume and body height were significantly lower in patients with Down's syndrome than in control patients. The thyroid function tests documented a higher average TSH level in Down's syndrome than in other mentally retarded patients. However, there was no clear‐cut correlation between TSH and thyroid hormone levels. The data indicate that there is a tendency towards primary thyroid dysfunction in Down's syndrome. In addition, there is some evidence indicating a relative failure of TSH secretion. In male patients, estradiol was elevated compared to controls. FSH and LH also seemed slightly higher in the study group, but the differences only reached statistical significance when patients on chronic medication were omitted. Prolactin was significantly greater in the Down's syndrome patients than in the controls, both over the entire sample and in the subgroup of men with Down's syndrome, with P‐values of around 0.001. The elevation of prolactin was not due to medication and did not correlate to thyroid function or difficulties during blood sampling. In females, the difference was not statistically significant. Laboratory tests that may be associated with endocrine disease or might indicate disease which could influence the endocrine status, were also included in this study. Compared with the controls, ESR, creatinine and uric acid levels were higher in Down's syndrome patients, while albumin was lower, all with P‐values lower than 0.001. Vitamin B12 was moderately lower in Down's syndrome patients than in controls (P<0.05).

ABSTRACT. This communication presents the ocular findings in 30 patients with Down's syndrome residing in a central institution for the mentally retarded. The findings have been compared to those in matched controls consisting of mentally retarded people from the same institution. The ocular status in patients with Down's syndrome has been extensively studied previously, and to a large extent, findings in previous materials were confirmed. However, in this institution, which consisted of adult patients only, some unusual findings have also been made: nine of the 30 patients had keratoconus, which is a remarkably high figure. A compilation of data shows that only one of the patients with Down's syndrome had nearly normal ocular status.

Letters to the Editor selves may be sufficient to give rise to obsessive-compulsive behaviour.3 The behavioural symptoms appeared in our patient after an interval of days (obsessions) to weeks (compulsions, apathy) after the putaminal stroke and progressed over subsequent months. Likewise, patients have been described who presented obsessive-compulsive behaviour or "psychic akinesia" (apathy, lack of motivation) after a period varying from days to years after basal ganglia lesions, often with a progressive worsening over time in the initial phase.3 4 7The behavioural changes in our patient occurred about 23 years after the onset of Parkinson's disease. Interestingly, although Parkinson's disease is one of the most common neurological disorders affecting the basal ganglia, reports concerning the occurrence of obsessive-compulsive behaviour in Parkinson's disease are surprisingly scanty. ' Neuropsychological examination disclosed in this patient a widespread cognitive impairment, with a severely reduced capacity to control attentional resources.In our patient, compulsive verbal iterations could contribute to her marked breakdown of attentional control, which in turn might partially account for her poor cognitive performance. In dual task paradigms when a secondary task (for example, counting from 1 to 5 repeatedly) is performed concurrently with the task of interest (primary task), performance on one or both tasks will deteriorate if the processing demands of the two tasks exceed the available attentional resources. In this patient, the incessant verbal iterations might act as a sort of articulatory suppression "secondary" task that, during various "primary" cognitive tasks, could interfere with the operation of a limited capacity processing system, such as the supervisory attentional system or the central executive component of the working memory model.The putamen receives projections from the supplementary motor area, and, in turn, projects back to this area through the internal segment of the globus pallidus and the nucleus ventralis lateralis of the thalamus. Because the left supplementary motor area seems to be involved in motor planning of speech,8 the association in our patient between obsessive-compulsive behaviour mainly characterised by verbal iterations and a dysfunction in the basal ganglia-frontal loop system in the dominant hemisphere for language is of interest.