Two new chronic paroxysmal hemicrania patients are described. In both, attacks can be precipitated mechanically by applying firm manual pressure to certain sensitive points on the neck, i.e. in the C2 area, in the transverse processes of the C4-C5 vertebrae, or beneath the posterior part of the skull on the symptomatic side. The most sensitive area seems to be the transverse process of C4-C5. Susceptibility to this type of attack is dependent on the flow of spontaneous attacks; attacks are easily precipitated in a phase with multiple spontaneous attacks, but are not readily precipitated otherwise. Under indomethacin protection, local tenderness is clearly diminished and attacks cannot be precipitated.

A detailed assessment of recovery endpoints and a simple performance test were employed to investigate recovery from anaesthesia. 150 patients participated in a comparative study using different doses of Althesin, thiopentone and methohexitone. Althesin was found to be suitable anaesthetic agent for the outpatient practice, although recovery was not as rapid as that following methohexitone.

CORRESPONDENCE elderly patients with refractory depression under going lithium augmentation, despite therapeutic doses of lithium and antidepressants.