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1.
Arq. neuropsiquiatr ; 80(2): 208-210, Feb. 2022. graf
Article in English | LILACS | ID: biblio-1364371

ABSTRACT

ABSTRACT In 1951, the physiologist George Duncan Dawson presented his work with the averaging of the signal in the evoked potentials (EPs), opening a new stage in the development of clinical neurophysiology. The authors present aspects of Professor Dawson's biography and a review of his work on the EPs and, mainly, the article reveals the new technique in detail that would allow the growth of the clinical application of the visual, auditory, and somatosensory EPs.


RESUMO Em 1951 o fisiologista George Duncan Dawson apresentou seu trabalho com a promediação de sinal nos potenciais evocados, abrindo uma nova etapa no desenvolvimento da neurofisiologia clínica. Os autores apresentam aspectos da biografia do professor Dawson e uma revisão de seus trabalhos sobre os potenciais evocados, principalmente do artigo que mostrava a nova técnica, que viria a permitir o crescimento da aplicação clínica dos potenciais evocados visual, auditivo e somatossensitivo.


Subject(s)
Humans , History, 20th Century , Inventions , Neurophysiology/methods , Evoked Potentials , Evoked Potentials, Somatosensory , Evoked Potentials, Visual
2.
Arq. neuropsiquiatr ; 79(11): 1039-1042, Nov. 2021. graf
Article in English | LILACS | ID: biblio-1350138

ABSTRACT

ABSTRACT The year of 2021 marks 90 year since the death of the neuroscientist Constantin von Economo, whose research in various areas was extremely relevant for the field of neurology. He described lethargic epidemic encephalitis, published an atlas of the cytoarchitecture of the human cerebral cortex, and conducted multiple studies in neuroanatomy, neurophysiology, and clinical neurology. Von Economo's genius extended into other nonmedical fields such as aeronautics, and he had renowned artistic skills.


RESUMO O ano de 2021 marca o 90° aniversário da morte do neurocientista Constantin von Economo, ou Constantin Freiherr (Barão) von Economo. Von Economo realizou várias pesquisas de grande relevo na área da neurologia, com a descrição da encefalite letárgica epidêmica, a publicação do atlas sobre a citoarquitetura do córtex cerebral humano, além dos seus múltiplos estudos em neuroanatomia, neurofisiologia, bem como na neurologia clínica. A genialidade de von Economo se estendeu para outras áreas não médicas, com o seu grande interesse em aeronáutica, como piloto de avião, além dos seus reconhecidos dotes artísticos.


Subject(s)
Humans , Male , History, 20th Century , Encephalitis, Arbovirus , Neurology , Anniversaries and Special Events , Neuroanatomy , Neurophysiology
3.
Arq. neuropsiquiatr ; 79(10): 912-923, Oct. 2021. tab, graf
Article in English | LILACS | ID: biblio-1345319

ABSTRACT

Abstract Background: Adult-onset spinal muscular atrophy (SMA) represents an expanding group of inherited neurodegenerative disorders in clinical practice. Objective: This review aims to synthesize the main clinical, genetic, radiological, biochemical, and neurophysiological aspects related to the classical and recently described forms of proximal SMA. Methods: The authors performed a non-systematic critical review summarizing adult-onset proximal SMA presentations. Results: Previously limited to cases of SMN1-related SMA type 4 (adult form), this group has now more than 15 different clinical conditions that have in common the symmetrical and progressive compromise of lower motor neurons starting in adulthood or elderly stage. New clinical and genetic subtypes of adult-onset proximal SMA have been recognized and are currently target of wide neuroradiological, pathological, and genetic studies. Conclusions: This new complex group of rare disorders typically present with lower motor neuron disease in association with other neurological or systemic signs of impairment, which are relatively specific and typical for each genetic subtype.


RESUMO Antecedentes: Atrofia muscular espinhal (AME) de início no adulto representa um grupo de doenças neurodegenerativas hereditárias em expansão na prática clínica. Objetivo: Este artigo de revisão sintetiza os principais aspectos clínicos, genéticos, radiológicos, bioquímicos e neurofisiológicos relacionados às formas clássicas e recentemente descritas de AME proximal do adulto. Métodos: Os autores realizaram uma revisão crítica não sistemática descrevendo as principais apresentações de AME proximal de início no adulto. Resultados: Previamente restrito às apresentações de AME tipo 4 associada ao gene SMN1, este grupo atualmente envolve mais de 15 diferentes condições clínicas que compartilham entre si a presença de comprometimento progressivo e simétrico do neurônio motor inferior se iniciando no adulto ou no idoso. Novos subtipos clínicos e genéticos de AME proximal de início no adulto foram reconhecidas e são alvos atuais de estudos direcionados a aspectos neurorradiológicos, patológicos e genéticos. Conclusões: Este novo grupo complexo de doenças raras tipicamente se apresenta com doença do neurônio motor inferior em associação com outros sinais de comprometimento neurológico ou sistêmico, os quais apresentam padrões relativamente específicos para cada subtipo genético.


Subject(s)
Humans , Radiology , Muscular Atrophy, Spinal/genetics , Motor Neuron Disease , Rare Diseases , Neurophysiology
5.
Rev. cuba. invest. bioméd ; 40(1): e727, ene.-mar. 2021.
Article in Spanish | LILACS, CUMED | ID: biblio-1289446

ABSTRACT

Introducción: Los trastornos de espectro autista se caracterizan por presentar un déficit en la interacción y comunicación social con presencia de patrones repetitivos y restrictivos de comportamiento, intereses y actividades. En ellos estarían implicadas causas genéticas, ambientales y del desarrollo del sistema nervioso central. Un mayor conocimiento de la neuroanatomía y la neurofisiología ayudaría a comprender mejor este trastorno del neurodesarrollo. Objetivo: Profundizar en el conocimiento neuroanatómico y neurofisiológico de los trastornos del espectro autista. Métodos: Se realizó una búsqueda bibliográfica acerca del tema en las bases de datos LILACS, Scopus, SciELO, Pubmed, Medigraphic. Se escogieron 13 documentos, todos correspondientes a artículos originales que abordan el tema desde diferentes aristas. De los documentos, dos fueron localizados en Scopus, uno en Pubmed, cuatro en Medigrafhic, dos en LILACS y cuatro en SciELO. Resultados: Los trastornos de espectro autista se producen por una alteración estructural y funcional de la corteza cerebral. Los estudios de neuroimágenes han demostrado las alteraciones estructurales, fundamentalmente en la corteza prefrontal y sus conexiones, principal región encefálica implicada en la regulación de la conducta social. Las técnicas de secuenciación genómica de nueva generación muestran el origen genético en casos donde los estudios previamente señalados han resultado ser normales. Conclusiones: La profundización del conocimiento neuroanatómico y neurofisiológico de los trastornos de espectro autista permiten comprenderlos mejor(AU)


Introduction: Autism spectrum disorders are characterized by social deficits and communication difficulties, as well as restrictive, repetitive behavior patterns, interests and activities. Their causes may be genetic, environmental or related to the development of the central nervous system. Broader knowledge about neuroanatomy and neurophysiology could lead to a better understanding of this neurodevelopmental disorder. Objective: Gain insight into the neuroanatomy and neurophysiology of autism spectrum disorders. Methods: A bibliographic search about the topic was conducted in the databases LILACS, Scopus, SciELO, Pubmed and Medigraphic. A total 13 documents were selected, all of which were original papers approaching the topic from different perspectives. Two of the documents were obtained from Scopus, one from Pubmed, four from Medigraphic, two from LILACS and four from SciELO. Results: Autism spectrum disorders are caused by a structural and functional alteration of the cerebral cortex. Neuroimaging studies have shown the structural alterations, which mainly occur in the prefrontal cortex and its connections, the principal encephalic region involved in social behavior regulation. New generation genomic sequencing techniques reveal a genetic origin in cases where previous studies have been normal. Conclusions: Broader knowledge about the neuroanatomy and neurophysiology of autism spectrum disorders lead to their better understanding(AU)


Subject(s)
Humans , Male , Female , Social Behavior , Social Control, Formal , Neurodevelopmental Disorders/genetics , Autism Spectrum Disorder/genetics , Neuroanatomy/education , Neurophysiology/education
6.
Rev inf cient ; 100(5): 1-10, 2021.
Article in Spanish | LILACS, CUMED | ID: biblio-1348801

ABSTRACT

Introducción: Recientemente se inició la formación de profesionales en una nueva modalidad de Programas Técnico Superior de Ciclo Corto, en la especialidad de Neurofisiología Clínica. Esto responde a la necesidad de la formación de profesionales de la salud en el estudio de las enfermedades neurológicas. La estimulación magnética transcraneal constituye una herramienta importante en el diagnóstico y tratamiento de estas enfermedades. Sin embargo, se carece de un programa para la formación de los estudiantes en el estudio y aplicación de esta técnica. Objetivo: Diseñar un programa de curso propio sobre generalidades de la estimulación magnética transcraneal, para estudiantes de primer año de Neurofisiología Clínica. Métodos: Se realizó una investigación didáctica metodológica utilizando los métodos empíricos y teóricos observación, histórico lógico, estudio documental y bibliográfico, dialéctico, análisis y síntesis, inducción y deducción. Resultados: Se propuso un programa para curso propio que se estructuró en siete temas, con carácter presencial y duración de 32 horas. Se presentaron los contenidos por temas, objetivos, conocimientos esenciales a adquirir, habilidades principales a dominar y sistema de evaluación. Conclusiones: La aplicación de este programa contribuye al desarrollo de habilidades y el desempeño exitoso de los profesionales en formación, en el campo del conocimiento de la técnica de estimulación magnética transcraneal para el diagnóstico y tratamiento de las enfermedades neurológicas(AU)


Introduction: Recently began the training of professionals in a new modality of short-cycle Higher Technical Programs, in the specialty of Clinical Neurophysiology. This responds to the need of training health professionals in the study of neurological diseases, whose incidence rates have increased in recent years. Transcranial magnetic stimulation is an important tool in the diagnosis and treatment of these diseases. However, there is a lack of a program for the training of students in the study and application of this technique. Objective: Tto design an own course program on the generalities of transcranial magnetic stimulation, for first-year students of Clinical Neurophysiology. Method: A methodological didactic research was carried out using the empirical and theoretical methods, observation, logical historical, documentary and bibliographic study, dialectic, analysis and synthesis, induction and deduction. Results: A program for the course was proposed, structured in seven topics, with a face-to-face character and a duration of 32 hours. The contents were presented by topics, objectives, essential knowledge to acquire, main skills to master and an evaluation system. Conclusions: The application of this program contributes to the development of skills and the successful performance of professionals in training, in the field of knowledge of the transcranial magnetic stimulation technique for the diagnosis and treatment of neurological diseases(AU)


Introdução: Iniciou recentemente a formação de profissionais numa nova modalidade de Cursos Técnicos Superiores de Ciclo Curto, na especialidade de Neurofisiologia Clínica. Isso responde à necessidade de formação de profissionais de saúde no estudo das doenças neurológicas. A estimulação magnética transcraniana é uma ferramenta importante no diagnóstico e tratamento dessas doenças. No entanto, falta um programa de treinamento dos alunos no estudo e aplicação desta técnica. Objetivo: Desenhar um programa próprio sobre as generalidades da estimulação magnética transcraniana, para alunos do primeiro ano de Neurofisiologia Clínica. Método: Realizou-se uma investigação metodológica didática utilizando os métodos empírico e teórico de observação, histórico lógico, estudo documental e bibliográfico, dialética, análise e síntese, indução e dedução. Resultados: Foi proposto um programa de curso próprio, estruturado em sete temas, com caráter presencial e duração de 32 horas. Os conteúdos foram apresentados por tópicos, objetivos, conhecimentos essenciais a adquirir, competências principais a dominar e um sistema de avaliação. Conclusões: A aplicação deste programa contribui para o desenvolvimento de competências e o desempenho bem sucedido de profissionais em formação, no domínio do conhecimento da técnica de estimulação magnética transcraniana para o diagnóstico e tratamento de doenças neurológicas(AU)


Subject(s)
Humans , Curriculum , Allied Health Personnel , Transcranial Magnetic Stimulation , Neurophysiology/education , Cross-Sectional Studies , Qualitative Research , Applied Research
7.
Int. j. morphol ; 38(6): 1803-1809, Dec. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1134514

ABSTRACT

RESUMEN: La percepción del dolor resulta de múltiples y dinámicos mecanismos en el sistema nervioso central (SNC) y periférico que inhiben o facilitan el estímulo y respuesta nociceptiva. Sin embargo, la principal capacidad de modulación esta a cargo del SNC. Los estímulos nociceptivos son detectados por terminaciones nerviosas libres de neuronas periféricas que sinaptan con neuronas aferentes secundarias de la médula espinal. Luego estas fibras decusan para formar las vías nociceptivas ascendentes. Una vez alcanzadas las estructuras subcorticales, se activan las neuronas del tálamo, quienes envían el estímulo hacia la corteza somatosensorial, desencadenando la percepción consciente del dolor y activando el sistema inhibitorio descendente. Para que la modulación nociceptiva se realice, es necesaria la participación de diversas sustancias o neurotransmisores que conectan áreas del SNC especializadas. Por lo tanto, el objetivo de este estudio fue realizar una revisión de la literatura respecto de los mecanismos que participan en los procesos de modulación central del dolor.


SUMMARY: Pain perception results from multiple and dynamic mechanisms in the central nervous system (CNS) and peripheral nervous system that inhibit or facilitate stimulation and nociceptive response. However, neuromodulation is mainly a function of the CNS. Nociceptive stimulus is detected by peripheral neurons receptors that synapse with the secondary afferent neurons of the spinal cord. These fibers cross to conform the ascending nociceptive pathways. Once the subcortical structures are reached, the thalamus`s neurons are activated; the thalamus send the stimulus to the somatosensory cortex, triggering the conscious perception of pain and activating the descending inhibitory system. For the nociceptive modulation to be carried out, the participation of various substances or neurotransmitters that connect specialized CNS areas is necessary. Therefore, the aim of this study was to review the literature regarding the mechanisms involved in central pain modulation processes.


Subject(s)
Humans , Pain/physiopathology , Central Nervous System/physiology , Pain Perception/physiology , Chronic Pain/physiopathology , Nociceptive Pain/physiopathology , Neural Inhibition , Neuroanatomy , Neurophysiology
8.
Rev. cuba. med. mil ; 49(4): e651, tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1156516

ABSTRACT

Introducción: la especialidad de neurofisiología se ocupa del estudio, la evaluación del sistema nervioso (central y periférico), su modificación funcional, de los órganos sensoriales y musculares, tanto en condiciones normales como patológicas. La normalización de la información sobre esta especialidad es compleja, porque cada institución hospitalaria cubana tiene sus propias fuentes de gestión. Esta situación dificulta la homogeneización de los datos, la recopilación de información estadística y su inclusión en el registro médico digital único del paciente cubano. Objetivo: presentar un componente de software que informatiza las solicitudes de estudios neurofisiológicos para las instituciones de salud cubanas, que utilizan el Sistema de Información Hospitalaria XAVIA HIS. Método: se entrevistaron a especialistas del Centro Cubano de Neurociencias CNEURO, para definir el proceso de gestión de las solicitudes de estudios neurofisiológicos. Se aplicó la entrevista semiestructurada, que permitió la adaptación a los entrevistados para aclarar términos, identificar ambigüedades y reducir los formalismos. Para el desarrollo se utilizaron herramientas de software libre (JBoss Developer Studio como entorno integrado de desarrollo, Java como lenguaje de programación orientado a objetos, JBoss como servidor de aplicaciones y PostgreSQL v9.4 como sistema de gestión de bases de datos), que garantizan las políticas de desarrollo de software y soberanía tecnológica de Cuba. Resultados: las solicitudes de estudios neurofisiológicos en el sistema XAVIA HIS, se informatizaron a partir de un componente de software, basado en el estándar HL7-CDA para documentos clínicos. Conclusiones: los especialistas en neurofisiología disponen de funcionalidades para la estandarización, almacenamiento y gestión de la información de la especialidad, lo cual conduce al enriquecimiento de la historia clínica digital del sistema XAVIA HIS(AU)


Introduction: The Neurophysiology specialty deals with the nervous system (central and peripheral) study and assessment and its functional modification and the sense and muscular organs, both in normal and pathological conditions. Information standardization on this specialty is complex because each Cuban hospital institution has its own management sources. This situation makes it difficult to homogenize the data, gather statistical information and include it in the Cuban patient unique digital medical record. Objective: Describe a software component that computerizes neurophysiological studies requests for Cuban health institutions that use the XAVIA HIS Hospital Information System. Method: Specialists from the Cuban Neuroscience Center CNEURO were interviewed to define the neurophysiological studies requests management process. The semi-structured interview was applied, which allowed the adaptation to the interviewees in order to clarify terms, identify ambiguities and reduce formalisms. Free software tools were used for development (JBoss Developer Studio as an integrated development environment, Java as an object-oriented programming language, JBoss as an application server and PostgreSQL v9.4 as a database management system) that guarantee the Cuban software development and technological sovereignty policies. Results: Neurophysiological studies requests in the XAVIA HIS system were computerized using a software component, based on the HL7-CDA standard for clinical documents. Conclusions: Neurophysiology specialists have functionalities for the specialty information standardization, storage, and management, which leads to the XAVIA HIS system digital medical record enrichment(AU)


Subject(s)
Humans , Software , Neurosciences , Community Health Services/organization & administration , Electronic Health Records , Neurophysiology , Cuba
9.
Int. j. morphol ; 38(6): 1614-1617, Dec. 2020. graf
Article in Spanish | LILACS | ID: biblio-1134487

ABSTRACT

RESUMEN: La neuroanatomía y la neurofisiología han permitido en gran parte entender de forma más integrada las estructuras que conforman el sistema nervioso y los mecanismos asociados con la transmisión de los potenciales de acción, relacionados con la vía corticoespinal en la ejecución de movimientos voluntarios. Se realizó una revisión histórica sobre la vía corticoespinal, desde el punto de vista neuroanatómico y neurofisiológico mediante una revisión de literatura en distintas bases de datos y libros de texto dedicados a estas vías nerviosas. La información obtenida se ordenó cronológicamente, seleccionando los datos más relevantes que desde el punto de vista neuroanatómico y neurofisiológico han permitido comprender su mecanismo funcional. Actualmente se tiene un conocimiento muy depurado de los distintos elementos que componen la vía corticoespinal, lo que permitirá su aplicación en el campo de la salud y resolver múltiples problemas de la función motora.


SUMMARY: Neuroanatomy and Neurophysiology have, in large part, permitted a more thorough understanding of those structures that conform the nervous system and mechanisms associated with the transmission of action potentials associated with the corticospinal tract. This assertion is made based upon a literature review of various databases and textbooks dedicated to said nerve tracts. The information obtained was ordered chronologically, and data was selected that, from the neuroanatomical and neurophysiological viewpoints, were most relevant and have permitted the comprehension of its functional mechanism. The thorough understanding of those elements that compose the corticospinal tract will permit its application in the health field and resolve multiple motor function problems.


Subject(s)
Humans , History, Ancient , History, 17th Century , History, 18th Century , History, 19th Century , History, 20th Century , Pyramidal Tracts/anatomy & histology , Pyramidal Tracts/physiology , Neuroanatomy/history , Neurophysiology/history
10.
Arq. neuropsiquiatr ; 78(8): 512-522, Aug. 2020. tab, graf
Article in English | LILACS | ID: biblio-1131740

ABSTRACT

ABSTRACT Background: Neurophysiological studies are ancillary tools to better understand the features and nature of movement disorders. Electromyography (EMG), together with electroencephalography (EEG) and accelerometer, can be used to evaluate a hypo and hyperkinetic spectrum of movements. Specific techniques can be applied to better characterize the phenomenology, help distinguish functional from organic origin and assess the most probable site of the movement generator in the nervous system. Objective: We intend to provide an update for clinicians on helpful neurophysiological tools to assess movement disorders in clinical practice. Methods: Non-systematic review of the literature published up to June 2019. Results: A diversity of protocols was found and described. These include EMG analyses to define dystonia, myoclonus, myokymia, myorhythmia, and painful legs moving toes pattern; EMG in combination with accelerometer to study tremor; and EEG-EMG to study myoclonus. Also, indirect measures of cortical and brainstem excitability help to describe and diagnose abnormal physiology in Parkinson's disease, atypical parkinsonism, dystonia, and myoclonus. Conclusion: These studies can be helpful for the diagnosis and are usually underutilized in neurological practice.


RESUMO Introdução: Os estudos neurofisiológicos são métodos auxiliares para compreender melhor as características e a natureza dos distúrbios do movimento. A eletromiografia (EMG), em associação com o eletroencefalograma (EEG) e o acelerômetro, podem ser utilizados para avaliar um espectro de movimentos hipo e hipercinéticos. Técnicas específicas podem ser aplicadas para melhor caracterizar a fenomenologia, ajudar a distinguir a origem psicogênica da orgânica e avaliar o local mais provável de geração do movimento no sistema nervoso. Objetivo: Pretendemos fornecer ao clínico uma atualização sobre ferramentas neurofisiológicas úteis para avaliar distúrbios do movimento na prática clínica. Métodos: Revisão não sistemática da literatura publicada até junho de 2019. Resultados: Uma diversidade de protocolos foi encontrada e descrita. Dentre eles, inclui-se o uso de EMG para a definição do padrão de distonia, mioclonia, mioquimia, miorritmia e painfull legs moving toes, além do uso de EMG em associação ao acelerômetro para avaliar tremor e, em associação ao EEG para avaliar mioclonia. Ademais, técnicas para medida indireta de excitabilidade cortical e do tronco encefálico ajudam a descrever e diagnosticar a fisiologia anormal da doença de Parkinson, parkinsonismo atípico, distonia e mioclonia. Conclusão: Esses estudos podem ser úteis para o diagnóstico e geralmente são subutilizados na prática neurológica.


Subject(s)
Humans , Dystonia , Movement Disorders/diagnosis , Myoclonus/diagnosis , Tremor/diagnosis , Electroencephalography , Electromyography , Neurophysiology
11.
Rev. chil. fonoaudiol. (En línea) ; 18: 1-16, nov. 2019. ilus, tab
Article in Spanish | LILACS | ID: biblio-1095039

ABSTRACT

En los últimos años, dentro del ámbito clínico se ha pugnado por la integración de un marco teórico inter/multidisciplinar que permita explicar de forma integral las alteraciones del lenguaje. Esto adquiere mayor relevancia cuando se proponen categorías disgnósticas que se limitan a describir el daño y no a explicar las causas subyacentes. Así, los objetivos de este trabajo son: (1) identificar los factores neurofisiológicos y neuropsicológicos alterados, a partir de la perspectiva neuropsicológica de Luria, en un niño con problemas de lenguaje y (2) realizar un análisis lingüístico de los errores fonológicos para determinar la relación existente entre ambos elementos. El método que se siguió fue un estudio de caso ­de tipo descriptivo­donde se realizó un análisis cualitativo de los déficits fonológicos del paciente. Los resultados muestran que el niño presentaba un amplio rango de alteraciones fonológicas: asimilación, sustitución, omisión e inserción, todos ellos relacionados con el mecanismo de análisis y síntesis cinestésico y la organización secuencial de movimientos y acciones. Estos resultados sugieren que existe una relación entre los factores neuropsicológicos alterados y el tipo de error fonológico presentado. Se propone aquí, que los déficits del lenguaje pueden explicarse en mayor medida si se considera un enfoque neuropsicológico y lingüístico. Finalmente, la inclusión de la lingüística al campo clínico fonoaudiológico permitiría explicar los fenómenos observados de manera más integral.


Over the last years, the need of an inter/multidisciplinary framework has been advanced within clinical contexts that might integrally explain language alterations. This need is even more relevant when diagnostic categories that have been proposed describe mostly the damage, but they do not explain underlying causes. Thus, the aims of this work are: (1) identifying the altered neurophysiological and neuropsychological factors, from a Lurian neuropsychology perspective, in a child with language deficits and, (2) carry out a linguistic analysisof phonological errors to determine the relation between both facts A single-case study was implemented, and qualitative analysis was conducted to describe the child's phonological deficits. Results showed that the child had a wide range of phonological alterations: assimilation, substitution, omission, and insertion, all of them related with a deficit in kinesthetic analysis and synthesis mechanism, and sequential organization of movements and actions. These findings suggest that there is a relation between altered neuropsychological factors and type of phonological error observed. We propose that language deficits can be explained better if we consider a neuropsychologic and linguistic approaches. Finally, if a linguistic approach is including in the speech pathology clinical context, we can expect explain the observed phenomenon in a more integral way.


Subject(s)
Humans , Male , Child , Electroencephalography , Language Disorders/physiopathology , Neurophysiology , Neuropsychology
12.
Rev. bras. neurol ; 55(3): 33-37, jul.-set. 2019. ilus, tab
Article in English | LILACS | ID: biblio-1022916

ABSTRACT

Luigi Luciani (1840-1919) was an illustrious Italian citizen and physiologist whose research scope covered mainly cardiovascular subjects, the nervous system, and fasting. He published in 1891 a modern landmark of the study of cerebellar physiology - "Il cervelletto: nuovistudi di normal and pathología physiology" / "The cerebellum: new studies on normal and pathological physiology." In his experiment, a dog survived after cerebellectomy, reporting a triad of symptoms (asthenia, atonia, and astasia). In this way, the eminent neurophysiologist improved the operative technique and sterile processes to redirect the issue of cerebellar symptoms. Luciani died at age 78, a hundred years ago, and left mainly the understanding of the role of the cerebellum in regulating postural tone and muscle strength, which represented a step forward in understanding cerebellar motor physiology. In recent decades, cognitive / affective function has been added to the cerebellar motor, and there has also been a better understanding of cerebellar circuits.


Luigi Luciani (1840-1919) foi um ilustre cidadão e fisiologista italiano, cujo escopo de pesquisa abrangia principalmente assuntos cardiovasculares, sistema nervoso e jejum. Ele publicou em 1891 um marco moderno do estudo da fisiologia do cerebelo - "Il cervelletto: nuovistudi di fisiologia normale and patologica" / "O cerebelo: novos estudos sobre fisiologia normal e patológica". Em seu experimento, um cão sobreviveu após a cerebelectomia, com o relatório de uma tríade de sintomas (astenia, atonia e astasia). Dessa maneira, o eminente neurofisiologista aprimorou a técnica operatória e os processos estéreis para redirecionar a questão dos sintomas cerebelares. Luciani morreu aos 78 anos, cem anos atrás, e deixou principalmente a compreensão do papel do cerebelo na regulação do tônus postural e da força muscular, o que representou um passo adiante na compreensão da fisiologia motora cerebelar. Nas últimas décadas, a função cognitivo / afetiva foi adicionada à motora cerebelar e, também, houve uma melhor compreensão dos circuitos do cerebelo.


Subject(s)
Humans , History, 19th Century , History, 20th Century , Neurosciences/history , Cerebellum/physiology , Neurophysiology/history , Cerebellum/injuries , Italy
13.
Rev. otorrinolaringol. cir. cabeza cuello ; 79(2): 240-247, jun. 2019.
Article in Spanish | LILACS | ID: biblio-1014443

ABSTRACT

RESUMEN La rehabilitación vestibular es un concepto terapéutico utilizado en pacientes que presentan síntomas como vértigos y/o mareos, asociados a una afectación vestibular, además de otras manifestaciones clínicas. Este artículo busca entregar un análisis amplio de los elementos que interactúan para definir una patología, como a su vez intervenir en su compensación. Serán presentados elementos neuroanatómicos, fisiológicos y conceptuales de la rehabilitación para este tipo de pacientes con un enfoque clínico basados en la evidencia.


ABSTRACT Vestibular rehabilitation is a therapeutic concept used in patients suffering from dizziness and/or dizziness, in addition to other clinical manifestations. This article gives a broad analysis of the elements that interact to define a pathology, as well as to intervene in their compensation. Neuro anatomical, physiological and conceptual elements of rehabilitation for this type of patients will be presented with a clinical approach based on evidence.


Subject(s)
Humans , Vestibular Diseases/physiopathology , Vestibular Diseases/rehabilitation , Neurophysiology , Reflex, Vestibulo-Ocular/physiology , Vestibule, Labyrinth , Neuronal Plasticity/physiology
14.
16.
Article in English | WPRIM | ID: wpr-785599

ABSTRACT

A 34-year-old male was brought to the hospital with a chest gunshot wound. Pulseless upon arrival, blood pressure was absent for 10 minutes. A thoracotomy resulted in return of spontaneous circulation. On hospital day 5, with brainstem reflexes present, he was unresponsive to call or pain, exhibited generalized hyperreflexia and bilateral Babinskys. Median nerve somatosensory evoked potentials (mSSEPs) and brainstem auditory evoked potentials were obtained. International Federation of Clinical Neurophysiology recommendations for mSSEPs and brainstem auditory evoked potentials were followed. Despite absence of the N20 responses from cortical mSSEPs no withdrawal from care was agreed upon. After awaking on day 7, mSSEPs were repeated and present. The patient survived and was discharged with minor deficits. Bilateral absence of N20 responses from mSSEPs performed beyond 48 hours after resuscitation from cardiac arrest is highly associated with bad neurological outcomes. However, variation due to hypothermia, noisy signals, medications, and brain hypo-perfusion must be taken into account.


Subject(s)
Adult , Blood Pressure , Brain , Brain Stem , Critical Care Outcomes , Evoked Potentials, Auditory, Brain Stem , Evoked Potentials, Somatosensory , Heart Arrest , Humans , Hypothermia , Male , Median Nerve , Nervous System Diseases , Neurophysiology , Prognosis , Reflex , Reflex, Abnormal , Resuscitation , Thoracotomy , Thorax , Wounds, Gunshot
17.
Rev. ADM ; 75(4): 202-213, jul.-ago. 2018. tab
Article in Spanish | LILACS | ID: biblio-915340

ABSTRACT

El bruxis mo muestra una fi siopatología compleja, donde se involucran señales aferentes y eferentes reguladas por el SNC a través de la expresión de neurotransmisores que repercute en una hiperactividad muscular disfuncional y eventualmente dañina. Para intentar comprender bruxismo desde sus particularidades neurofi siológicas, fue realizada una revisión bibliográfi ca en las bases de Medline y PubMed con el objetivo de establecer la relación entre neurotransmisores y el sistema neuromasticatorio, señalando las posibles alteraciones en su liberación que desencadenen irregularidades en los movimientos rítmicos de la mandíbula (rhythmic jaw Mmovement [RJM]) durante el sueño, inducidos por desórdenes en el sistema nervioso central, por trastornos psicológicos y psiquiátricos, drogadicción y prescripciones médicas, y en alguna medida a una respuesta reactiva a situaciones locales y cambios adaptativos. El funcionamiento masticatorio depende de la integración del aporte sensorial (aferente) de componentes como lo son el ligamento periodontal, músculos masticatorios, dientes y articulación temporomandibular, que puede ser perturbado; cuando alguna de estas partes sufre alteraciones en su integridad, infl amación o sobrecarga funcional o por alteraciones morfológicas, observándose una variedad de respuestas adaptativas y compensatorias (eferentes). En bruxismo esta información local es de relevancia menor, ya que este se rige por cambios centrales observados durante el sueño o bien alteraciones de infl uencia psicológica durante el bruxismo diurno. Consiguientemente, el bruxismo trae apareados cambios biológicos, emocionales y de conducta que repercuten en músculos mayores, preferentemente localizados en cabeza y cuello, ocasionando de manera secundaria numerosas alteraciones; particularmente en la región estomatognática, se observan diversos deterioros como daño de las mucosas, dolor miofascial y articular y atrición dental. La comprensión de los complejos procesos neurofi siológicos que determinan la aparición y persistencia de bruxismo puede ayudar a establecer estrategias de control y tratamiento (AU)


Bruxism shows a complex pathophysiology, where afferent and aff erent signals regulated by the CNS, through the expression of neurotransmitters with repercussion in dysfunctional and eventually harmful muscular hyperactivity. To try to understand bruxism from its neurophysiological peculiarities, a bibliographic review was carried out on the bases of Medline and PubMed, with the aim of establishing the relationship between neurotransmitters and the neuromasticatory system, pointing out the possible alterations in their release that trigger irregularities in the rhythmic movements of the jaw (rhythmic jaw movement [RJM]) during sleep induced by disorders in the central nervous system, psychological and psychiatric alterations, drug addiction and medical prescriptions, and to some extent, a reactive response to local situations and adaptive changes. The masticatory functioning depends on the integration of the sensory input (aff erent) of components such as the periodontal ligament, masticatory muscles, teeth and temporomandibular joint, which can be disturbed when any of these parts suff er alterations in their integrity, infl ammation, functional overload or morphological alterations, observing a variety of adaptive and compensatory (efferent) responses. In bruxism, this local information is of minor relevance, since it is governed by central changes observed during sleep or changes in psychological infl uence during daytime bruxism. Consequently, bruxism brings with it biological, emotional and behavioral changes that aff ect major muscles, preferably located in the head and neck, causing in a secondary way many other alterations. Particularly in the stomatognathic region, several deteriorations are observed, such as mucosal damage, myofascial and joint pain and dental attrition. The understanding of the complex neurophysiological processes that determine the appearance and persistence of bruxism can help to establish control and treatment strategies (AU)


Subject(s)
Humans , Anxiety Disorders , Bruxism , Central Pattern Generators , Neurophysiology , Neurotransmitter Agents , Stress, Psychological , Facial Pain , Mandible/physiology , Stomatognathic System
18.
Article in English | WPRIM | ID: wpr-765255

ABSTRACT

Intraoperative monitoring (IOM) utilizes electrophysiological techniques as a surrogate test and evaluation of nervous function while a patient is under general anesthesia. They are increasingly used for procedures, both surgical and endovascular, to avoid injury during an operation, examine neurological tissue to guide the surgery, or to test electrophysiological function to allow for more complete resection or corrections. The application of IOM during pediatric brain tumor resections encompasses a unique set of technical issues. First, obtaining stable and reliable responses in children of different ages requires detailed understanding of normal ageadjusted brain-spine development. Neurophysiology, anatomy, and anthropometry of children are different from those of adults. Second, monitoring of the brain may include risk to eloquent functions and cranial nerve functions that are difficult with the usual neurophysiological techniques. Third, interpretation of signal change requires unique sets of normative values specific for children of that age. Fourth, tumor resection involves multiple considerations including defining tumor type, size, location, pathophysiology that might require maximal removal of lesion or minimal intervention. IOM techniques can be divided into monitoring and mapping. Mapping involves identification of specific neural structures to avoid or minimize injury. Monitoring is continuous acquisition of neural signals to determine the integrity of the full longitudinal path of the neural system of interest. Motor evoked potentials and somatosensory evoked potentials are representative methodologies for monitoring. Free-running electromyography is also used to monitor irritation or damage to the motor nerves in the lower motor neuron level : cranial nerves, roots, and peripheral nerves. For the surgery of infratentorial tumors, in addition to free-running electromyography of the bulbar muscles, brainstem auditory evoked potentials or corticobulbar motor evoked potentials could be combined to prevent injury of the cranial nerves or nucleus. IOM for cerebral tumors can adopt direct cortical stimulation or direct subcortical stimulation to map the corticospinal pathways in the vicinity of lesion. IOM is a diagnostic as well as interventional tool for neurosurgery. To prove clinical evidence of it is not simple. Randomized controlled prospective studies may not be possible due to ethical reasons. However, prospective longitudinal studies confirming prognostic value of IOM are available. Furthermore, oncological outcome has also been shown to be superior in some brain tumors, with IOM. New methodologies of IOM are being developed and clinically applied. This review establishes a composite view of techniques used today, noting differences between adult and pediatric monitoring.


Subject(s)
Adult , Anesthesia, General , Anthropometry , Brain Neoplasms , Brain , Child , Cranial Nerves , Electromyography , Evoked Potentials, Auditory, Brain Stem , Evoked Potentials, Motor , Evoked Potentials, Somatosensory , Humans , Infratentorial Neoplasms , Intraoperative Neurophysiological Monitoring , Longitudinal Studies , Monitoring, Intraoperative , Motor Neurons , Muscles , Neurophysiology , Neurosurgery , Peripheral Nerves , Prospective Studies
19.
Article in English | WPRIM | ID: wpr-717431

ABSTRACT

Spinal cord stimulation (SCS) is a common therapeutic technique for treating medically refractory neuropathic back and other limb pain syndromes. SCS has historically been performed using a sedative anesthetic technique where the patient is awakened at various times during a surgical procedure to evaluate the location of the stimulator lead. This technique has potential complications, and thus other methods that allow the use of a general anesthetic have been developed. There are two primary methods for placing leads under general anesthesia, based on 1) compound muscle action potentials and 2) collisions between somatosensory evoked potentials. Both techniques are discussed, and the literature on SCS lead placement under general anesthesia using intraoperative neurophysiological mapping is comprehensively reviewed.


Subject(s)
Action Potentials , Anesthesia, General , Evoked Potentials, Somatosensory , Extremities , Humans , Neurophysiology , Spinal Cord Stimulation , Spinal Cord
20.
Gut and Liver ; : 375-384, 2018.
Article in English | WPRIM | ID: wpr-716025

ABSTRACT

Anorectal disorders are common and present with overlapping symptoms. They include several disorders with both structural and functional dysfunction(s). Because symptoms alone are poor predictors of the underlying pathophysiology, a diagnosis should only be made after evaluating symptoms and physiologic and structural abnormalities. A detailed history, a thorough physical and digital rectal examination and a systematic evaluation with high resolution and/or high definition three-dimensional (3D) anorectal manometry, 3D anal ultrasonography, magnetic resonance defecography and neurophysiology tests are essential to correctly identify these conditions. These physiological and imaging tests play a key role in facilitating a precise diagnosis and in providing a better understanding of the pathophysiology and functional anatomy. In turn, this leads to better and more comprehensive management using medical, behavioral and surgical approaches. For example, patients presenting with difficult defecation may demonstrate dyssynergic defecation and will benefit from biofeedback therapy before considering surgical treatment of coexisting anomalies such as rectoceles or intussusception. Similarly, patients with significant rectal prolapse and pelvic floor dysfunction or patients with complex enteroceles and pelvic organ prolapse may benefit from combined behavioral and surgical approaches, including an open, laparoscopic, transabdominal or transanal, and/or robotic-assisted surgery. Here, we provide an update on the pathophysiology, diagnosis, and management of selected common anorectal disorders.


Subject(s)
Biofeedback, Psychology , Constipation , Defecation , Defecography , Diagnosis , Digital Rectal Examination , Humans , Intussusception , Manometry , Neurophysiology , Pelvic Floor , Pelvic Organ Prolapse , Rectal Diseases , Rectal Prolapse , Rectocele , Ultrasonography
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