Facilitation of Cortical Excitability by Action Related Sentence

OBJECTIVE: To investigate the effect of action related visual and auditory stimuli on the motor evoked potential (MEP) of hand. METHOD: Right handed fifteen healthy adults without neurological deficit were included. Visual lingual stimulation was given on the computer monitor with the sentence and auditory lingual stimulation was given 10 repetitions of the above sentence using computer speaker with eyes closed. MEPs from transcranial and transcervical magnetic stimulation were recorded on the abductor pollicis brevis of the right hand. RESULTS: The latency of MEPs was shortened and the amplitude of MEPs with transcranial magnetic stimulation after lingual stimulation (p<0.05). However, the latency and amplitude of with transcervical stimulation did not show significant changes. CONCLUSION: Cortical excitability was enhanced by action related visual or auditory stimuli. Exercise accompanied by visual or auditory lingual stimulation rather than simple exercise might be useful for facilitating cortical excitability.

Hypoglycemic Encephalopathy in an Alcoholic: A case report

Severe hypoglycemia leading to permanent brain damage is rare in non-diabetic population. We present one case where chronic alcoholism combined with prolonged fasting lead to such a state. A 51-year-old male patient, a chronic alcoholic, was found unconscious and brought to the emergency room. At the time of hospitalization, consciousness was stupor and he had a blood glucose of 5 mg/dl and MRI of the brain showed high signal density of the inner temporal gyrus and both hippocampus in T2 weighted imaging. There was no history of diabetes. After two months of rehabilitation, improvements were showed to Rancho Los Amigos recognition scale IV, fair grade of muscular strength in upper and lower limbs, FIM score of 21, and dysphagia was improved and nutrition supply was intaken orally. An alcoholic for a long period of time without adequate nutrient supply was experienced to develop into hypoglycemic encephalopathy and therefore reported.