ABSTRACT
Cerebral somatosensory evoked potentials(SEPs) produced by stimulation of peripheral nerves provide a useful diagnostic index of conduction in somatosensory pathways to the cortex. Thus the integrity of both the dorsal column-medial lemniscus pathway and primary sensorimotor area has been considered an essential requirement to record a normal SEP. There are suggestions that SEPs contain several components arising from different neuronal sources, the early short latency potentials corresponding to the lemniscus-mediated responses and the late waves to the diffuse spino-thalamic projections. The present work analyses the influence on SEPs of focal brain lesions, using the computerized tomography in detecting and localizing brain lesions. Somatosensory evoked potentials were recorded in 20 patients with focal brain lesions recognized by computerized tomography. 1) Patients with primary sensorimotor area(PSMA) damages(group I) had a very abnormal of the early component(No, Po, Nl, Pl) in 100% on the lesion side. 2) Patients presented supratentorial lesions, sparing PSMA(group II), 87.5% showing abnormal SEPs in early components and characterized by increment of amplitude in late components. 3) Brainstem damage(group III) produced a distortion of the early components especially N11, N20msec in latency. 4) In incomplete spinal cord injuries, the SEPs is indeed signal of functional recovery, of posterior column, and incorrespondance with clinical improvement.
Subject(s)
Humans , Brain Stem , Brain , Evoked Potentials, Somatosensory , Neurons , Peripheral Nerves , Spinal Cord InjuriesABSTRACT
Major neurological features of achondroplasia are attributed to premature synostoses of the pedicles of the vertebrae and of the base of the skull producing obstruction of the ventricular fluid circulation or compression of the medulla and spinal cord. Significant hydrocephalus is due to the obstruction of the cerebrosspinal fluid pathways at the level of the foramen magnum or the disturbance of CSF absorption caused by increased superior sagittal sinus pressure. In generally, the hydrocephalus in achondroplasia is of the communicating type in the pattern, so the CSF diversionary shunt may not be indicate. But, shunting procedures may be needed in patients who showed signs of severe IICP such as bulging fontanels and enlarged lateral ventricle. In this case, we experienced that the hydrocephalus in achondroplasia is prosorption following the stenosis of the foramen magnum and increased superior sagittal sinus pressure.
Subject(s)
Humans , Absorption , Achondroplasia , Constriction, Pathologic , Foramen Magnum , Hydrocephalus , Lateral Ventricles , Skull , Spinal Cord , Spine , Superior Sagittal Sinus , SynostosisABSTRACT
Orthostatic hypotension with other signs of progressive neuronal degeneration particularly affecting the autonomic nervous system has been recognized independently and is called Shy-Drager syndrome. Degenerative changes in the autonomic ganglia, loss of neurons in the intermediolateral columns and degenerative changes in the neurons of the cortex and basal ganglia have been reported on examination of this condition. The authors report a case of Shy-Drager Syndrome with symptoms of orthosatatic hypotension, dysarthria, Parkinson's features, muscle wasting, sexual impotence, atonic bladder and loss of sweating.
Subject(s)
Male , Autonomic Nervous System , Basal Ganglia , Dysarthria , Erectile Dysfunction , Ganglia, Autonomic , Hypotension , Hypotension, Orthostatic , Neurons , Shy-Drager Syndrome , Sweat , Sweating , Urinary BladderABSTRACT
Orthostatic hypotension with other signs of progressive neuronal degeneration particularly affecting the autonomic nervous system has been recognized independently and is called Shy-Drager syndrome. Degenerative changes in the autonomic ganglia, loss of neurons in the intermediolateral columns and degenerative changes in the neurons of the cortex and basal ganglia have been reported on examination of this condition. The authors report a case of Shy-Drager Syndrome with symptoms of orthosatatic hypotension, dysarthria, Parkinson's features, muscle wasting, sexual impotence, atonic bladder and loss of sweating.