A Case of Wernicke's Encephalopathy Associated with Hyperemesis Gravidarum / 영남의대학술지

Wernicke's encephalopathy is an acute-onset illness characterized by mental confusion, ataxia and ophthalmoplegia due to a thiamine deficiency. Immediate administration of thiamine prevents progression of the disease and reverses brain lesions. We have experienced a case of Wernicke's encephalopathy associated with hyperemesis gravidarum. As Wernicke's encephalopathy is mostly associated with chronic alcoholism, the possibility of Wernicke's encephalopathy may be ignored in young women. We emphasize the need for thiamine supplementation in the patient requiring intravenous alimentation such as hyperemesis gravidarum.

The Motor Cortex Mapping Using Transcranial Magnetic Stimulation in Normal Subjects

OBJECTIVE: To investigate the characteristics of the motor cortex map for abductor pollicis brevis muscle (APB) using transcranial magnetic stimulation (TMS) in normal subjects. METHOD: Ten adults without neurological disorder were studied. A piece of cloth which marked at 1 cm interval was fixed on the head of the subject. The motor cortex mapping for APB was done with butterfly magnetic stimulator, and then with round magnetic stimulator. RESULTS: The average optimal scalp position for left APB was located on lateral 6.2 cm, anterior 0.1 cm from Cz and that for right APB was located on lateral 6.0 cm, anterior 0.1 cm from Cz when stimulated with butterfly magnetic stimulator. The differences between hemispheres were less than 1 cm in the location of optimal scalp position and less than 10% in excitatory threshold (ET) irrespective of magnetic stimulator. The ipsilateral motor evoked potential (MEP) was not evoked in all subjects. The ET when stimulated with butterfly magnetic stimulator was higher to that when stimulated with round magnetic stimulator. CONCLUSION: We conclude that TMS using butterfly and round magnetic stimulator is useful for the motor cortex mapping.

Driving of Motor Vehicles of the Epileptic Patients / 영남의대학술지

No abstract available.

Antiepileptic Therapy for Latent Epilepsy / 영남의대학술지

The clinical state with EEG pattern similar to interval discharge of epileptics is named as latent epilepsy, which does not necessarily mean that the patient will develop epilepsy later. However, since there is possibility of developing epilepsy on later date, antiepileptic mainly dilantin was tried to control the abnormal EEG. Since January to October 1985, total 580 headache cases with more than moderately abnormal EEG visited the Neurology Clinic. Among them 162 cases with interval seizure pattern (ISP) of epilepsy were selected for the study. The main ISP was 1. diffuse theta and/or delta bursts and 2. spikes. Since the study in only analysis of clinical treatment of 162 cases without previous planning based on financial aid, about 30% of the patients did not return after the 1st EEG examination, in 42% failed to follow the EEG after the treatment and only remaining 28% of the cases were studied. Among 29 patients who were treated with Dilantin 100mg tid po, 16 improved and 13 not. Of the 13, 4 showed partial improvement and partial progression. Case1. In 4 weeks of antiepileptic therapy (AR), spikes disappeared but in 2 months developed bursts. Case2. In 17days of AR, spikes and bursts disappeared but in 3 months bursts reccured. Case3. In 1 week of AR, bursts disappeared but spikes developed. Case4. In 3 months of AR, no change of spikes and bursts and she discontinued the AR. In 6 months she developed grandma seizure. Eighteen cases, treated with other drugs except antiepileptics, all showed improvement. The other drugs were vincaprol, polygammalon, aronamin, ATP and hydergine. The improved cases had spikes more often than theta bursts. In view of the small number of the cases due to dropping most patients out of present study, it is considered meaningless to perform statistical analysis. Further well planned study with more patients is to be expected.

A Case of Invasive Thymoma with Metastasis to the Diaphragem in a Myasthenic Patient

Primary malignancy of the thymus gland in myasthenia gravis remains rare, especially metastasis of the malignancy to a distant organ. We have presented a case of myasthenia gravis with invasive thymoma and its meatastasis to the diaphragm. The literature concerned with this aspect is reviewed.

Clinical Analysis of Headache

Since opening of the Yeungnam University Hospital in May 1983 till September 1983, total 411 headache patients were treated at the Neurology clinic. It was found that considerable number of the cases had latent epilepsy and brain atrophy as the causes of the headache. In about 40% of the cases, EEG showed more than moderate abnormalities. These cases should not be sent to psychiatry directly as they are not indicated for surgery, but should be treated at neurology clinic primarily.

A Cases of Familial Spastic Paraplegia (FSP)

We present a family of FSP with review of literatures. Seeligmuller (1876) and Strumpell (1880) were the first to describe familial case of spastic paraplegia characterized by progressive weakness and spasticity of the lower limbs with little or no involvement of the upper extremities. This syndrome is heterogenous in inheritance, age of onset, severity and associated signs. A pure type without complications has been named "Strumpell's FSP". We have recently experienced a case of 17 years old male who had bilateral weakness and stiffness of lower extremities, and gait disturbance with family history. Differential diagnosis, particularly with familial amyotrophic lateral sclerosis, is discussed.