The retinal nerve fiber layer surrounding the optic discs provides a unique clinical opportunity to view directly pathologic changes in the neural components of a major sensory pathway in the brain. Minute changes in this neural tissue are best seen in bright red-free light of a direct ophthalmoscope. This report, stressing the neurosurgical significance of peripapillary retinal signs, illustrates and discusses 1) how incipient papilledema obliterates the normally glistening highlights and striations of the nerve fiber layer before any recognizable change is seen in the optic disc, 2) how focal axon degeneration from acute and insidious forms of optic neuropathy causes multiple slit-like thinnings in the arcuate nerve fibers before any recognizable signs of pallor or functional change occurs in the optic nerve, 3) how atrophy, direct or transsynaptic, of an optic tract causes diagnostic homonymous patterns of axon loss in the peripapillary nerve fiber layer and optic disc of the two eyes, and 4) how recognition of fundoscopic signs of hemiretinal and optic hypoplasia allows the neurosurgeon to differentiate the bitemporal or homonymous hemianopias of developmental origin from the acquired effects of brain tumor.

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Involuntary movement is one of the most disturbing and problematic side effects of L-dopa in the treatment of Parkinsonism. Several attempts have been made to reduce this complication, such as an addition of adjuvant, (4) and use of slow release L-dopa. However, the problem remains unsolved probably because hyperkinesis occurs when the akinesis of Parkinonism is overcorrected by L-dopa and produces hyperkinesis (15).
For more than 15 years we have been treating Parkinsonian patients with stereotactic thalamotomy or pallidotomy or both and began to use L-dopa since 1968. We found that the previous operation reduces the incidence and severity of L-dopa induced involuntary movements in the treated limbs suggested by several authors (1) (15) (17) (20).
This paper is an analysis of L-dopa induced involuntary movements seen in 29 cases in 121 Parkinsonian patients treated with L-dopa, 94 cases with the previous stereotactic procedures and 27 non-surgical cases.

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During the past several years the authors have been engaged in the studies of the neuronal activities in the human epileptogenic foci. However, this is not, of cause, the sole way of the approach to the nature of the epileptogenesis. The combination of the physiology and the morphology is a dream of many workers. From this viewpoint electron microscopic studies were also made in some of these cases. Indeed there have been numerous reports concerning the histopathological studies of the epileptogenic foci. However, the electron microscopic findings combined with the results of extracellular unit study are extraordinarily rare. Therefore, it would be significant to present in this paper the details of the fine structures of the three human cortical epileptogenic foci.

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