RESUMO
Bickerstaff's brainstem encephalitis (BBE), characterized by acute ophthalmoplegia and ataxia, often causes impaired consciousness and hyperreflexia. A 17-year-old man was admitted with an acute meningitic condition including high and neck stiffness. His condition rapidly deteriorated over 2 weeks, and he showed ophthalmoplegia, ataxia, seizure, tetraplegia, comatose mentality, and optic neuropathy. Electroencephalography showed diffuse slow waves. Visual evoked potentials showed no responses in the right eye. This is the first case of BBE with Guillain-Barre syndrome presenting with optic neuropathy and seizure.
Assuntos
Adolescente , Humanos , Ataxia , Tronco Encefálico , Coma , Estado de Consciência , Eletroencefalografia , Encefalite , Potenciais Evocados Visuais , Síndrome de Guillain-Barré , Pescoço , Oftalmoplegia , Doenças do Nervo Óptico , Quadriplegia , Reflexo Anormal , ConvulsõesRESUMO
BACKGROUND: There exist considerable debates concerning about the effects of epilepsy surgery on cognitive function. To evaluate the effects of tailored anterior temporal lobectomy with amygdalohippocampectomy (ATLAH) on intelligence and memory, we compared the pre- and post-operative cognitive function in patients with mesial temporal lobe epilepsy (MTLE). METHODS: Thirty six patients who received unilateral tailored ATLAH from 1993 to 1997 and had been seizure-free for at least two years postoperatively were selected. Mean age at the time of surgery was 26.8 years and mean period of postoperative follow-up was 47 months. The change of cognitive function was assessed pre-and post-operatively using Korean Wechsler Adult Intelligence Scale (K-WAIS) and Rey memory test. We also assessed the correlation between the extent of hippocampal and lateral temporal cortical resection and cognitive changes respectively. RESULTS: In total patients (N=36), there was statistically significant improvement in performance IQ (PIQ, p2 cm) and in patients with smaller temporal cortical resection (4 cm). CONCLUSIONS: Patients became seizure free after tailored ATLAH may have improvement in performance IQ and full scale IQ. Right side resection, larger hippocampal resection, and smaller lateral temporal resection show better postoperative cognitive function. (J Korean Neurol Assoc 19(2):116~124, 2001)
Assuntos
Adulto , Humanos , Lobectomia Temporal Anterior , Epilepsia , Epilepsia do Lobo Temporal , Seguimentos , Inteligência , Memória , Convulsões , Lobo Temporal , Aprendizagem VerbalRESUMO
BACKGROUND: There exist considerable debates concerning about the effects of epilepsy surgery on cognitive function. To evaluate the effects of tailored anterior temporal lobectomy with amygdalohippocampectomy (ATLAH) on intelligence and memory, we compared the pre- and post-operative cognitive function in patients with mesial temporal lobe epilepsy (MTLE). METHODS: Thirty six patients who received unilateral tailored ATLAH from 1993 to 1997 and had been seizure-free for at least two years postoperatively were selected. Mean age at the time of surgery was 26.8 years and mean period of postoperative follow-up was 47 months. The change of cognitive function was assessed pre-and post-operatively using Korean Wechsler Adult Intelligence Scale (K-WAIS) and Rey memory test. We also assessed the correlation between the extent of hippocampal and lateral temporal cortical resection and cognitive changes respectively. RESULTS: In total patients (N=36), there was statistically significant improvement in performance IQ (PIQ, p2 cm) and in patients with smaller temporal cortical resection (4 cm). CONCLUSIONS: Patients became seizure free after tailored ATLAH may have improvement in performance IQ and full scale IQ. Right side resection, larger hippocampal resection, and smaller lateral temporal resection show better postoperative cognitive function. (J Korean Neurol Assoc 19(2):116~124, 2001)
Assuntos
Adulto , Humanos , Lobectomia Temporal Anterior , Epilepsia , Epilepsia do Lobo Temporal , Seguimentos , Inteligência , Memória , Convulsões , Lobo Temporal , Aprendizagem VerbalRESUMO
On rare occasions, sudden hearing loss may be associated with a migraine. To our knowledge, there have only been two prior reports of sudden hearing loss attributed to migraines. A 40 years old man had suffered from recurrent headaches with hemiparesis, vertigo, and hearing loss for the past three years. At this time, he presented with severe bilateral sensorineural hearing loss of sudden onset, anarthria, right hemiplegia, tinnitus, and vertigo. An audiogram showed a down-sloping sensorineural hearing loss of 77dB by pure tone average on the right side and 72dB on the left. Sixteen days later, audiographic findings improved to 30dB of pure tone average on both sides. Vasospasm of the labyrinthine arteries instigated by migraine might explain these inner ear symptoms. A history of migraine should be sought in patients with sudden hearing loss and when found, anti-migraine medications such as calcium channel block-ers should be considered.