Ictal speech and language dysfunction in adult epilepsy: Clinical study of 95 seizures.

PURPOSE: To analyze the semiological characteristics of the language and speech disorders arising during epileptic seizures, and to describe the patterns of language and speech disorders that can predict laterality of the epileptic focus. METHOD: This study retrospectively analyzed 95 consecutive videos of seizures with language and/or speech disorders in 44 patients admitted for diagnostic video-EEG monitoring. Laterality of the epileptic focus was defined according to electro-clinical correlation studies and structural and functional neuroimaging findings. Language and speech disorders were analyzed by a neurologist and a speech therapist blinded to these data. RESULTS: Language and/or speech disorders were subdivided into eight dynamic patterns: pure anterior aphasia; anterior aphasia and vocal; anterior aphasia and "arthria"; pure posterior aphasia; posterior aphasia and vocal; pure vocal; vocal and arthria; and pure arthria. The epileptic focus was in the left hemisphere in more than 4/5 of seizures presenting with pure anterior aphasia or pure posterior aphasia patterns, while discharges originated in the right hemisphere in almost 2/3 of seizures presenting with a pure vocal pattern. No laterality value was found for the other patterns. CONCLUSION: Classification of the language and speech disorders arising during epileptic seizures into dynamic patterns may be useful for the optimal analysis of anatomo-electro-clinical correlations. In addition, our research has led to the development of standardized tests for analyses of language and speech disorders arising during seizures that can be conducted during video-EEG sessions.

[From the analogic to the digital era: technical EEG progress for presurgical investigations of refractory partial epilepsies]. / De l'ère analogique à l'ère numérique: évolution des techniques électro-encéphalographiques dans le bilan préchirurgical des épilepsies partielles pharmacorésistantes.

Over the past two decades, exploration of epileptic patients has benefited from technological advances in electroencephalography. Computerized equipment can simultaneously retrieve cerebral electric activity and signs of the patient's ictal activity. The computer era has improved reliability, storage and analysis of the recorded data and provides easier communication tools for multidisciplinary staff and patient case studies. Therefore, an increasing number of patients could benefit from presurgical investigations and surgical treatment.

Chronic intractable epilepsy associated with a tumor located in the central region: functional mapping data and postoperative outcome.

Out of 57 patients operated for intractable epilepsy of the central region, 8 harbored an indolent glioma (7 dysembryoplastic neuroepithelial tumors, 1 ganglioglioma). Mapping of the sensorimotor area with depth electrodes implanted for stereoelectroencephalographic exploration demonstrated no or abnormal motor responses after low-frequency stimulation, and variable sensory responses to high-frequency stimulation, suggesting reorganization of the sensorimotor cortex representation around the tumor and absence of functional tissue within the neoplastic volume. After lesionectomy (3 cases) or corticectomy including the tumor (5 cases), 6 (75%) patients were seizure-free (class I of Engel) at the time to follow-up. No permanent motor or sensory deficit was observed in 6 cases. In 2, a mild facial (in 1) and arm (in 1) deficit persisted. It is concluded that the resection of intrinsic low-grade tumors associated with long-standing epilepsy and located in the central region can be associated with excellent seizure outcome and no or minimal postoperative deficit because of functional reorganization of the sensorimotor cortex.

Comparative safety and immunogenicity of an acellular versus whole-cell pertussis component of diphtheria-tetanus-pertussis vaccines in Senegalese infants.

A diphtheria and tetanus toxoid two-component acellular pertussis vaccine (DTaP), consisting of 25 micrograms glutaraldehyde-detoxified pertussis toxin (PT) and 25 micrograms native filamentous hemagglutinin (FHA), was compared with diphtheria and tetanus toxoid whole-cell pertussis vaccine (DTwP) in a randomized, double-blind manner in 286 Senegalese infants inoculated at two, four, and six months of age. In infants receiving DTaP a significantly lower rate of local reactions, crying and fever was observed than in infants receiving DTwP. One month after the third dose, the geometric mean titres for FHA antibodies were higher in the DTaP group, whereas increases in PT antibody titres were higher in the DTwP group. More than 90% of the infants had a fourfold or more increase in antibodies to both PT and FHA with either vaccine. Diphtheria, tetanus, and polio antibody responses were also measured and found to be comparable between the two groups. The results of this pilot study support the implementation of a field trial to compare the protective efficacy of these vaccines against pertussis in the same setting.

Environmental sensitivities of quartz oscillators.

The frequency, amplitude, and noise of the output signal of a quartz oscillator are affected by a large number of environmental effects. The physical basis for the sensitivity of precision oscillators to temperature, humidity, pressure, acceleration and vibration, magnetic field, electric field, load, and radiation is examined. The sensitivity of quartz oscillators to radiation is a very complex topic and poorly understood. Therefore, only a few general results are mentioned. The sensitivity to most external influences often varies significantly both from one oscillator type to another and from one unit of a given type to another. For a given unit, the sensitivity to one parameter often depends on the value of other parameters and on history. Representative sensitivity to the above parameters is given.

Sensitivity of quartz oscillators to the environment: characterization methods and pitfalls.

The advantages and disadvantages of characterizing a complete quartz crystal oscillator or characterizing only the quartz resonator by using a passive phase bridge are discussed. Measurements of temperature sensitivities, including quasistatic or dynamic thermal conditions, are presented. One important point is how to measure the real temperature of the device under test (quartz crystal, for instance) rather than the temperature of the probe. Methods for measuring acceleration and pressure sensitivities are presented, and spurious effects of temperature changes are considered. Problems are discussed in connection with the measurement of the sensitivity to magnetic fields, and to electric fields. Methods used for measuring these sensitivities and the many pitfalls that can be encountered are the focus of the investigation.

[A case of bilateral lesions in the temporal convexity: attempt to define symptoms]. / Un cas de lesions bilaterales de la convexite temporale: tentative de definition des symptomes

The case is reported of a boy aged 15 who suffered a bilateral lesion of the temporal convexity after a brain traumatism; he died 5 years later and the symptoms during that period are described. The clinical picture is adequately described neither under the title of dementia, nor under that of aphasia. The concept of an abolition involving the systems of cultural mediation (linguistic, technical) is introduced. The status of echolalia and echo-praxia is discussed.