A methaemalbumin test was positive. Her haemoglobin concentration was 10 8 g/dl but subsequently fell to 5-3 g/dl. Her plasma bilirubin concentration was 26 ,umol/l, (156 mg/100 ml), but other liver function tests remained

Mycoplasmal infections may be complicated by a wide variety of systemic syndromes, including neurological disorders. Circumstantial evidence suggests that these are immunologically-induced. A detailed study of five patients with proven rnycoplasma pneumoniae and central nervous system signs showed that immunological factors were involved and suggested that the neurological symptoms were due to a vasculopathy. Case studiesCase 1 A 44-year-old right-handed clerk was admitted to hospital having developed a right hemiparesis with non-fluent aphasia some hours before. On admission he had a single grand ma1 seizure. Five days previously he had developed a severe upper respiratory tract infection with a productive cough.Previous medical history was unremarkable except that he had had hypothyroidism for the past 3 years, for which he took replacement therapy, and he had had attacks of sinusitis several years previously. Family history was non-contributory.On examination, the patient was mute and stu-

The Scottish Motor Neuron Disease Register (SMNDR) is a prospective, collaborative, population based study of motor neuron disease (MND) in Scotland. The register started in January 1989 with the aim of studying the clinical and epidemiological features of MND by prospectively identifying incident patients. It is based on a system of registration by recruitment from multiple sources, followed by the collection of complete clinical data and follow up, mainly through general practioners. In this report the register's methodology and the demography and incidence data for the first year of study are presented. One hundred and fourteen newly diagnosed patients were identified in 1989 giving a crude incidence for Scotland of 2*241100 000/year. Standardised incidence ratios showed a non-significant trend towards lower rates in north eastern regions and island areas.

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