McAlpine's Multiple Sclerosis by A. Compston, et al.,

By A. Compston, et al.,

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However, Russell Brain argues that factors distributed in the cerebrospinal fluid could as easily gain access to the brain parenchyma through the Virchow–Robin spaces, as could material crossing the vessel walls. By the second edition (Brain 1940), Brain’s reading of the pathological papers of Dawson (1916), Putnam (1936; Putnam and Adler 1937) and Greenfield and King (1936) presents a much clearer view of the sequence of perivascular lymphocytic infiltration, lipid ingestion by fat granule cells, myelin degeneration, fibroglial proliferation, and some axonal loss leading to formation of the sclerotic plaque.

D. Adrian, who also developed methods for recording electrical activity from peripheral nerves. Intracellular recordings later led to elucidation of the conduction of the nerve impulse by Sir Alan Hodgkin (1914–1998) and Sir Andrew Huxley. 20A,B). Subsequently, the prevalence of abnormal visual evoked potentials was described in multiple sclerosis (Halliday et al 1973a). Distinctions were made from the reduced amplitude with preserved latency that usually (though not invariably) characterizes compression of the anterior visual pathway (Halliday et al 1976); and the important observation was made that, with time, there may be a return towards normal in latency of the evoked potential.

The most direct method for examining body fluids that reflect brain activity was the introduction of lumbar puncture in life. ) First used at the Middlesex Hospital in London by Walter Essex Wynter (1860–1945) to treat children with tuberculous meningitis (described by Robert Whytt in 1768), the procedure was routinely applied in neurology by Heinrich Iraneaeus Quincke (1842–1922) from 1891. He measured the pressure and examined the chemical constituents of cerebrospinal fluid. 20 (A) The original system used to record visual evoked potentials.

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