ABSTRACT
Normal alpha rhythm begins to appear at three months. It was possible to observe successively, the rhythmicity, visual reactivity, occipital topography, and at the end of the first year, the first bursts of 7-8 Hz waves. Evolution of alpha was not linear with the age. Alpha frequency acceleration was important before the age of 11 years. In adults it decreased from 20 to 55, then there was a tendency to increase with aging. Amplitude was highest at 11-12 years, then its tendency was to decrease until 40, and to increase later. In pathology, for instance, alpha could be observed too early in newborn and infants with malformations, in children, in some psychiatric diseases, in adults and old people, alpha was replaced by theta waves in dementia: it seemed to be a very reliable sign, at the beginning of the disease.
Subject(s)
Alpha Rhythm , Mental Disorders/physiopathology , Nervous System Diseases/physiopathology , Adolescent , Adult , Aged , Aging/physiology , Brain Mapping , Child , Child, Preschool , Electroencephalography , Humans , Infant , Infant, Newborn , Middle Aged , Photic Stimulation , Reference Values , Theta RhythmABSTRACT
See-saw nystagmus is a pendular nystagmus with two distinct components: a conjugate torsional component and a disjonctive vertical component. The acquired form of nystagmus is usually seen with parasellar mass and less frequently in head injury or brainstem infarction. Almost all patients with parasellar mass or head injury have associated bitemporal hemianopia. We report the case of a 27-year-old man who developed intermittent daily oscillopsia five years after a severe head injury. On neurological examination, the patient showed a congenital left eye divergence with left eye convergence paresis, an anosmia, a right optic atrophy and a bitemporal hemianopia. Visual acuity was 7/10 and 3/10 for the right and left eyes. The rest of the neurological examination was unremarkable. Electroencephalogram during oscillopsia was normal. MRI revealed bilateral orbito-frontal low signal intensity on T1 weighted images. The brainstem, the diencephalon and the ventricular system appeared to be intact. Eye movement recordings exhibited intermittent see-saw nystagmus. Clonazepam treatment resolved the see-saw nystagmus. Slowly withdrawal of clonazepam was done without return of the see-saw nystagmus.
Subject(s)
Clonazepam/therapeutic use , Nystagmus, Pathologic/drug therapy , Adult , Anticonvulsants/therapeutic use , Craniocerebral Trauma/complications , Humans , Male , Nystagmus, Pathologic/etiologyABSTRACT
This study was undertaken to determine the sensitivity and specificity of the transcranial Doppler (TCD) for diagnosis of vasospasm after rupture of anterior communicating artery (CoA) aneurysm. Results provided by 164 carotid angiograms and TCD measures were compared in 40 patients with CoA ruptured aneurysm. Twelve patients demonstrated a vasospasm on 22 angiographies. The distribution of angiographic vasospasm was 95.5% anterior cerebral artery (A1), 77.3% pericallosal artery (A2) and 59.1% middle cerebral artery (M1). A TCD velocity value equal or superior to 120 cm/sec was the criterion for TCD vasospasm on M1. The sensitivity of TCD on M1 for diagnosing vasospasm on M1 with high specificity (96.4%) was only 66.7%. A TCD velocity value equal or superior to 80 cm/sec, or superior to the homolateral TCD value on M1, was the criterion for TCD vasospasm on A1. The association of TCD criteria on A1 and M1 increased sensitivity to 83.3%, but specificity decreased to 75%. These results demonstrate that TCD is not yet efficient enough to diagnose vasospasm accurately when it is limited to A1. Moreover, the fact that vasospasm limited to A1-A2 was symptomatic in three patients suggests that angiography is still necessary to diagnose VS after CoA ruptured aneurysm.
Subject(s)
Aneurysm, Ruptured/diagnostic imaging , Intracranial Aneurysm/diagnostic imaging , Ischemic Attack, Transient/diagnostic imaging , Ultrasonography, Doppler, Transcranial , Adult , Aged , Aneurysm, Ruptured/complications , Blood Flow Velocity , Cerebral Angiography , Female , Humans , Intracranial Aneurysm/complications , Ischemic Attack, Transient/etiology , Ischemic Attack, Transient/physiopathology , Male , Middle Aged , Sensitivity and SpecificityABSTRACT
Fifteen patients have been examined: ten suffered from partial epilepsy of presumed mesiotemporal origin (group 1) and the other five presented partial epilepsy with non mesiotemporal or extra temporal epileptic focus (group 2). But in all cases, visual inspection of EEG traces demonstrated focally temporal interictal spikes. We have studied the spike voltage distributions and their corresponding scalp current density fields. Spike voltage topography revealed no significant difference between the two groups. Conversely SCD fields pointed out different specific characteristics according to the group. In the group 1, the gradient was always transversal, between the anterior temporal and the homolateral pre-frontal zones whereas in the group 2 it was antro-posterior in four patients. A more complete analysis of interictal spike by SCD representation should be useful in présurgical evaluation of patients with focal epilepsy.