ABSTRACT
OBJECTIVE: In this study we analyzed the effects of transcranial magnetic stimulation (TMS) on sleep and on the self-perceived quality of life in epileptic patients. METHODS: A total of 24 male patients diagnosed with focal epilepsy were included in the study. Pharmacological treatment with levetiracetam was standardized at 2 g daily. Before TMS onset, all-night polysomnographic recording (PSG) was performed, and the Quality of Life in Epilepsy Inventory (QOLIE-31) was administered. Thereafter, patients underwent low-frequency repetitive TMS (1000 pulses/1 Hz) daily for 10 days. After the end of the treatment, a second polysomnographic study was performed, and the QOLIE-31 questionnaire was administered again. RESULTS: TMS induced a significant increase in sleep efficiency and in total sleep time, along with a decrease in sleep latency and the number of awakenings. In addition, the number of interictal discharges during sleep decreased significantly. Concerning the QOLIE-31 scale values, the patients showed great improvement in the self-perceived quality of life. CONCLUSION: The present results indicate that TMS may mediate therapeutic effects in the treatment of patients with focal epilepsy, and that TMS treatment is accompanied by improvement of sleep patterns as well as improvement in self-perceived quality of life. However, a study that includes a control group undergoing sham stimulation is needed to confirm these findings.
Subject(s)
Epilepsies, Partial/therapy , Quality of Life/psychology , Transcranial Magnetic Stimulation/methods , Adult , Anticonvulsants/therapeutic use , Electroencephalography/methods , Humans , Levetiracetam , Male , Piracetam/analogs & derivatives , Piracetam/therapeutic use , Polysomnography , Sleep Stages/drug effects , Surveys and QuestionnairesABSTRACT
Transcranial magnetic stimulation is a non-invasive method used to assess motor function in humans; however, some reports suggest it may cause internal ear damage (cochlear). Eighteen patients with normal auditory function (ages 2 months to 16 years, mean 6.8 years), two medical doctors and two technicians who performed the studies were tested with brain stem auditory evoked potentials, otoacoustic emissions, acoustic reflex and a pure tone audiometric and logoaudiometric test when possible, before and after transcranial magnetic stimulation for central motor conduction studies in different neurological conditions. All the tests were repeated two weeks and two months later. Patients had no auditory protection nor history of seizures. Motor evoked potentials and silent periods were recorded from the right abductor pollicis brevis and the first dorsal interosseous muscles at rest and during weak voluntary contraction when possible. A mean of 48 transcranial magnetic stimulations with 50%-75% Tesla intensity were used. Natural logarithmic transformation of latency and amplitude data had a normal distribution. There were no significant differences in auditory function testing.
Subject(s)
Deafness/etiology , Hearing Loss, Noise-Induced/etiology , Physical Stimulation/adverse effects , Transcranial Magnetic Stimulation/adverse effects , Adolescent , Audiometry, Pure-Tone , Child , Child, Preschool , Deafness/diagnosis , Evoked Potentials, Auditory, Brain Stem , Female , Hearing , Hearing Loss, Noise-Induced/diagnosis , Humans , Infant , Male , Otoacoustic Emissions, Spontaneous , Reflex, AcousticABSTRACT
The objective of this study was to determine the main clinical, neurophysiological and angiographic findings in brain death (BD) in children seen at the Instituto Nacional de Pediatría, a third-level facility in Mexico City, between 1991 and 1996. The following variables were retrospectively analyzed: sex, age, etiology, associated morbidity, duration of stay in hospital, and the results of two of three confirmatory studies (electroencephalogram, evoked potentials, radioisotopic angiography). In all, 125 patients were studied 78 male, median age 2 years (range: 18 days to 17 years)[. The most frequent etiology was infection (34%); 57% of the children developed associated morbidity. In 111 of 122 patients electrocerebral silence was observed; 100 of 107 had brain stem and somatosensory evoked potentials affording conclusive evidence of BD; and 83 of 90 patients had a positive radioisotopic angiography indicating BD. In 76 patients all three confirmatory studies were performed: for 15 there was at least one false-negative test result. Our age cohort showed a predominance of children less than 2 years old. BD etiologies in developing countries differ from those reported in developed countries.
Subject(s)
Brain Death/diagnosis , Radionuclide Angiography , Adolescent , Brain Death/physiopathology , Child , Child, Preschool , Electroencephalography , Female , Humans , Infant , Infant, Newborn , Male , Predictive Value of Tests , Retrospective StudiesABSTRACT
En la consulta audiológica se presenta un número cada vez mayor de niños que se quejan de mareos y vértigo. Los niños pueden tener una sensación verdadera de vértigo, originado por una enfermedad. Por otro lado pueden tener una alteración coclear orgánica, o bién una disfunción vestibular cuyos síntomas principales sean vértigo o desequilibrio. En escolares, el mareo puede se una manifestación de ansiedad, problemas de conducta o de hiperventilación; pero en la edad preescolar, esto es más raro. El niño con estos síntomas puede tener un problema vestibular o periférico; o bien de origen nervioso central. Requiere ser evaluado mediante una historia clínica cuidadosa y exploración audiológica con estudios audiométricos y vestibulares
Subject(s)
Humans , Electronystagmography , Nystagmus, Pathologic , Otoacoustic Emissions, Spontaneous , VertigoABSTRACT
Se dice que un niño tiene un trastorno del aprendizaje si su actuación es subnormal en una actividad específica que no puede ser atribuida a déficit intelectual o a limitaciones sensoriales, motoras, emocionales o motivacionales. El mejor ejemlo es el del niño con pobre aprendizaje del lenguaje de la lecto-escritura en relación a su edad. Esta alteración conocida como dislexia se hace estudios neurofisiológicos para tratar de establecer una relación en esta entidad. Se estudió esta anormalidad por electroencefalografía con una prueba de discriminación auditiva y potenciales evocadas visuales. Nuestros resultados mostraron una diferencia significativa en la potencia del alfa en la región parietotemporo-occipital izquierda (T3-T5-O1), entre el grupo control y el grupo de pacientes disléxicos. No se registraron cambios significativos en los potenciales evocados visuales
Subject(s)
Humans , Male , Female , Brain Mapping , Cerebrum/anatomy & histology , Dyslexia/diagnosis , Dyslexia/physiopathology , Electroencephalography , Evoked Potentials, Visual , MagnetoencephalographyABSTRACT
Lesions produced by exposure to noise are frequent in everyday life. Injuries may be found in all systems of the human body, from the digestive to the endocrine, from the cardiovascular to the nervous system. Many organs may be damaged, the ear being one of them. It is known that noise produced by factories, airports, musical instruments and even toys can cause auditory loss. Noises in nature can also cause acoustic trauma. This report is the case history of acoustic trauma caused by lightning. The patient was studied with CAT scan, electroencephalogram, and brain mapping, impedance audiometry with tympanogram and acoustic reflex, audiometry and evoked otoacoustics emissions: distortion products and transients.
