ABSTRACT
OBJECTIVE: To study the significance of electroencephalographic background activity and positive sharp waves in neonatal electroencephalogram as prognostic of cerebral palsy. METHOD: We studied prospectively and sequentially 73 newborns who had severe neonatal complications (neonatal anoxia, seizures, respiratory distress, sepsis, and meningitis). Nineteen newborns were excluded and 54 children formed the object of our study and were followed for 2 years. We analyzed gestational age, conceptional age, electroencephalographic background activity and positive sharp waves, which were correlated with cerebral palsy. RESULTS: There were no statistically significant correlation between gestational age and conceptional age and cerebral palsy; the electroencephalographic background activity was correlated with cerebral palsy as well as the positive sharp waves. CONCLUSION: Children with electroencephalographic background activity markedly abnormal and accompanied by positive sharp waves were associated with a worse prognosis.
OBJETIVO: Estudar o valor do ritmo de base e das ondas agudas positivas no eletrencefalograma neonatal como prognóstico da paralisia cerebral. MÉTODO: Nós estudamos, prospectiva e sequencialmente, 73 recém-nascidos que apresentaram complicações neonatais graves (anoxia neonatal, crises convulsivas, desconforto respiratório, septicemia e meningite). Dezenove recém-nascidos foram excluídos e 54 crianças formaram o objeto do nosso estudo e foram seguidas por 2 anos. Nós analisamos a idade gestacional, a idade corrigida, o ritmo de base e as ondas agudas positivas, que foram correlacionadas com a paralisia cerebral. RESULTADOS: Não houve correlação estatisticamente significante entre as idades gestacional e corrigida com a paralisia cerebral; o ritmo de base foi correlacionado com a paralisia cerebral, tanto quanto as ondas agudas positivas. CONCLUSÃO: Crianças com o eletrencefalograma com o ritmo de base marcadamente anormal e ondas agudas positivas estão associadas com pior prognóstico neurológico.
Subject(s)
Female , Humans , Infant, Newborn , Male , Cerebral Palsy/physiopathology , Electroencephalography , Gestational Age , Prognosis , Prospective Studies , Severity of Illness IndexABSTRACT
Wicket spikes (WS) are a benign eletroencephalogram (EEG) variant, seen mainly in adults, during sommolence, in the temporal regions, in many clinical situation. WS can appear in trains or isolatedly, sometimes being difficult to differentiate from epileptiform activity. We reviewed 2.000 EEG's, foud 65 with WS (3.25 per cent) and compared them with 65 normal EEG without WS. There was statistically significant (SS) association between WS and age over 33; adolescent age was correlated to absence of WS and age over 65, to the presence of WS; there was an inverse correlation between WS and epilepsy, related to differences in age; a SS association with cerebrovascular disorders disapeared after controling for age; a SS correlation with headache was also related to age; female predominance was not SS. There was a great variety of clinical situation associated with WS. We conclude that WS are a inespecific normal variant of the EEG that is age-related.
Subject(s)
Adult , Middle Aged , Female , Humans , Adolescent , Electroencephalography , Epilepsy/physiopathology , Temporal Lobe/physiopathology , Age Factors , Case-Control Studies , Cerebrovascular Disorders/physiopathology , Headache/physiopathology , Sleep Stages/physiology , Wakefulness/physiologyABSTRACT
We report on the clinical and EEG features of 15 patients with the syndrome of "continuous spike waves during slow wave sleep" (CSWSS). The differential diagnosis of CSWSS includes benign epilepsy of childhood with centro-temporal spikes, and Landau-Kleffner and Lennox-Gastaut syndromes. We found normal CT and MRI features in 6 cases, periventricular leukomalacia with and without diffure brain atrophy in 4 cases and hydrocephalus in 1 case. There was no association between specific neurological findings and CSWWS. Nine of our cases had relatively focal discharges, like some cases from the literature. The occurrence of CSWSS appears to be age-related, generaly between the ages of 5 to 12 years, with a strong temporal relation to the neupsychological determination in its nature, severity and prognosis. We believe that this striking disorder has been overlooked and that routine sleep EEG studies on epileptic children may disclose additional cases of CSWSS.
Subject(s)
Humans , Child, Preschool , Child , Adolescent , Electroencephalography , Epilepsy/physiopathology , Sleep Wake Disorders/diagnosis , Sleep/physiology , Age Factors , Epilepsy/diagnosis , Follow-Up Studies , Seizures/diagnosis , SyndromeABSTRACT
Estudamos com EEG quantitativo e topográfico (mapeamento cerebral) quatro pacientes com exames pregressos de EEG convencional mostrando foco de linha média. O estudo quantitativo revelou-se mais preciso na definiçao do foco, localizando o seu hemisfério de origem e definindo a atividade focal como parassagital. Estes achados deverao ser validados em estudos futuros com amostragem maior.
Subject(s)
Child , Female , Humans , Adolescent , Brain Mapping , Electroencephalography , Epilepsies, Partial/diagnosisABSTRACT
We describe a case of non-ketotic hyperglycemia (NKH), heralded by complex partial seizures and aphasia of epileptic origin, besides versive and partial motor seizures. This clinical picture was accompanied by left fronto-temporal spikes in the EEG. The seizures were controlled by carbamazepine only after the control of the diabetes. A month later, carbamazepine was discontinued. The patient remained without seizures, with normal language, using only glybenclamide. Complex partial seizures, opposed to simple partial seizures, are rarely described in association to NKH. Epileptic activity localized over language regions can manifest as aphasia.
Subject(s)
Humans , Female , Middle Aged , Aphasia , Epilepsy, Complex Partial , Hyperglycemic Hyperosmolar Nonketotic Coma/diagnosis , Anticonvulsants/therapeutic use , Carbamazepine/therapeutic use , Epilepsy, Complex Partial/drug therapy , Glyburide/therapeutic use , Hyperglycemic Hyperosmolar Nonketotic Coma/drug therapy , Hypoglycemic Agents/therapeutic useABSTRACT
A agenesia e lipoma do corpo caloso é uma associaçäo muito rara. Relatamos o caso de uma paciente de 18 anos com raras crises epilépticas desde os 6 anos de idade, exame neurológico normal, assim como eletrencefalograma normal. A tomografia computadorizada do crânio e a ressonância magnética mostraram o lipoma e a agenesia de corpo caloso
Subject(s)
Humans , Female , Adolescent , Brain Neoplasms/diagnosis , Corpus Callosum/abnormalities , Lipoma/diagnosis , Anticonvulsants/therapeutic use , Brain Neoplasms , Epilepsy/drug therapy , Lipoma , Magnetic Resonance Imaging , Tomography, X-Ray ComputedABSTRACT
No presente estudo apresentamos um conceito de aderência e agrupamos seus diversos fatores de influência. O conceito de aderência por nós sugerido procura enfatizar a conscientizaçäo individual. Os fatores que interferem na aderência säo aqui agrupados em técnicos, biológicos, psicológicos, sociais e mistos
Subject(s)
Humans , Epilepsy/psychology , Patient Compliance , Treatment Refusal , Anticonvulsants/adverse effects , Interpersonal RelationsABSTRACT
Análise de 84 pacientes em relaçäo à aderência ao tratamento. O método empregado para a avaliaçäo da aderência constou de duas entrevistas com cada paciente, uma realizada pelo médico e outra pela enfermeira. Em nossos resultados detectamos maior número de pacientes epilépticos näo-aderentes na entrevista realizada pela enfermeira (72,6%) em relaçäo àquela conduzida pelo médico (23,3%). O esqucimento foi a principal barreira à aderência (50%). A duraçäo do tratamento e a mudança de serviços médicos influenciaram negativamente na aderência. Por este estudo verificamos a importância de análise dos fatores que possam interferir na aderência e a utilidade da entrevista minuciosa para o diagnóstico de näo-aderência
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Epilepsy/psychology , Interview, Psychological , Patient Compliance , Treatment Refusal , Anticonvulsants/adverse effectsABSTRACT
Em um estudo multicêntrico, aberto, nao comparativo, 83 pacientes portadores de insuficiência cerebrovascular crônica, com idade entre 50 e 75 anos, foram tratados com nicergolina 10 mg na posologia de uma drágea três vezes ao dia. Os pacientes foram avaliados de acordo com o RCPM (teste de classificaçao de estado mental do Royal College of Physicians modificado) como também através de seu perfil (sintomas e sinais psicoafetivos e orgânicos). Na grande maioria dos pacientes, a nicergolina proporcionou significativa melhora na evoluçao do quadro afetivo e orgânico. A tolerabilidade e a eficácia foram consideradas excelentes.