ABSTRACT
Six females with Rett syndrome (RS)--all seriously motor disabled with clinical symptomatology indicating not only brain but also spinal cord impairment--were investigated using auditory and somatosensory evoked responses techniques. In all patients the responses representing the pathways through the upper spinal cord were delayed suggesting an impairment of the central conduction time. The findings mean an involvement of the sub-cortical structures, the brain stem and the cervical spinal cord in the disease process. From the natural clinical course and the present findings, it is concluded that RS is also characterized by spinal cord impairment appearing with increasing age and stage of diseases.
Subject(s)
Brain Diseases/physiopathology , Brain Stem/physiopathology , Intellectual Disability/physiopathology , Spinal Cord/physiopathology , Adolescent , Adult , Brain Diseases/genetics , Child , Evoked Potentials, Auditory , Evoked Potentials, Somatosensory , Female , Humans , Intellectual Disability/genetics , Neural Conduction , Reaction Time , SyndromeABSTRACT
Cortical evoked potentials following stimulation of the lower urinary tract have been recorded in humans. Of 26 patients investigated 9 had no urinary signs or symptoms except genuine stress incontinence, while the remaining 17 had various neurogenic bladder disorders. Monopolar and bipolar stimulation of the bladder and urethra was performed using conventional and newly designed suction-type electrodes. While no cortical evoked potentials could be obtained from patients with complete transverse spinal cord lesions polyphasic cortical evoked potentials (N45, P60, N80 and P100 msec.) were recorded in response to monopolar bladder stimulation in all patients with stress incontinence. Following bipolar stimulation a response with lower amplitude and with latencies slightly divergent could be recorded. This response is assumed to be evoked only from bladder afferent nerves, while the monopolar response could include activity from adjacent structures. The most consistent pattern was recorded at the Cz site. Cortical evoked potentials following stimulation of the urethra were more difficult to evoke but they resembled those obtained after bipolar stimulation of the bladder. The method, when fully developed, may be helpful in the clinical investigation of patients affected by various neurogenic disorders of the lower urinary tract. So far, in our limited series a delayed response at P2 has been observed in patients with uninhibited neurogenic bladders.
Subject(s)
Cerebral Cortex/physiopathology , Evoked Potentials, Somatosensory , Urinary Bladder, Neurogenic/physiopathology , Urinary Incontinence, Stress/physiopathology , Urinary Tract/innervation , Adult , Aged , Electric Stimulation/instrumentation , Female , Humans , Male , Middle Aged , Urethra/innervation , Urinary Bladder/innervationABSTRACT
A standard technique for recording trigeminal somatosensory evoked potentials (TEP) in response to stimulation of the second branch of the trigeminus nerve is described. Thirty-six nerves of 18 apparently healthy subjects have been investigated. A characteristic polyphasic wave was repeatedly observed. It consisted mainly of a P20, N30, P40, N50 sequence of deflections. Intraindividual variations were minimal. The response pattern varied according to the positions of the recording and stimulating electrodes. The method is useful in detecting functional integrity of the afferent pathways of the 5th cranial nerve, and it can be used as a diagnostic tool for routine investigation of the trigeminus nerve.
Subject(s)
Electroencephalography , Trigeminal Nerve/physiology , Adult , Electric Stimulation , Evoked Potentials, Somatosensory , Facial Paralysis/diagnosis , Female , Herpes Simplex/diagnosis , Humans , Male , Middle Aged , Reaction Time/physiology , Somatosensory Cortex/physiology , Synaptic Transmission , Trigeminal Neuralgia/diagnosisABSTRACT
This investigation has been directed to estimate to what extent a GABA derivative, beta-(p-chlorophenyl)-gamma-aminobutyric acid (baclofen), is active at the cortical and subcortical level. Selected nonpsychotic patients with slight depression symptoms were given 30 mg of baclofen daily for a period of 3-5 weeks. Brief Psychiatric Rating Scale and Standardized Hamilton Interview for Depression were used for clinical evaluation. EEGs were recorded prior to and at different times during treatment. An automatic analysis completed by multivariant statistics of EEG spectral values was performed. EEG changes were characterized by a significant increase of slow waves and decrease of fast activity. These results can support the view that baclofen is effective even at the highest levels of the central nervous system.
