ABSTRACT
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Subject(s)
Female , Middle Aged , Humans , Toothbrushing/adverse effects , Epilepsy, Reflex/etiology , Epilepsy, Reflex/drug therapyABSTRACT
AIMS: The purpose of this research was to study the spatio-temporal characteristics of the correlation that exists between two simultaneous EEG signals (coherence) in the interictal period in patients with partial epilepsy that is presumably symptomatic of the temporal lobe (ILAE). PATIENTS AND METHODS: A study of 13 patients, aged between 17-60 years, was conducted (53% females). A digital EEG was performed on each patient using the 10/20 system of electrode location. 24 artifact-free segments were selected from the recording made in a rest-waking state with the patient's eyes closed. Fourier's transformation was employed to obtain cross spectrum matrices, which were then used to calculate the intrahemispheric (Cohintra) and interhemispheric (Cohinter) coherences expressed by the Z transformation. These values were ordered by regions considering the known anatomical connections. RESULTS: In both the overall and the individual analyses, we found greater alterations of the Cohintra and the Cohinter in the temporal regions, and there was a predominance of the left hemisphere. The individual analysis of coherence, unlike the visual interpretation of the EEG recording, showed significant alterations in all the patients in the sample. CONCLUSIONS: Incorporating this type of tool would enable us to reach a more accurate topographic diagnosis in cases of epilepsy of unknown aetiology. At the same time the possible means of medical and surgical treatment available would be widened.
Subject(s)
Electroencephalography , Epilepsy, Temporal Lobe/physiopathology , Adolescent , Adult , Female , Humans , Male , Middle AgedABSTRACT
Aims. The purpose of this research was to study the spatio-temporal characteristics of the correlation that exists between two simultaneous EEG signals (coherence) in the interictal period in patients with partial epilepsy that is presumably symptomatic of the temporal lobe (ILAE). Patients and methods. A study of 13 patients, aged between 17-60 years, was conducted (53% females). A digital EEG was performed on each patient using the 10/20 system of electrode location. 24 artifact-free segments were selected from the recording made in a rest-waking state with the patients eyes closed. Fouriers transformation was employed to obtain cross spectrum matrices, which were then used to calculate the intrahemispheric (Cohintra) and interhemispheric (Cohinter) coherences expressed by the Z transformation. These values were ordered by regions considering the known anatomical connections. Results. In both the overall and the individual analyses, we found greater alterations of the Cohintra and the Cohinter in the temporal regions, and there was a predominance of the left hemisphere. The individual analysis of coherence, unlike the visual interpretation of the EEG recording, showed significant alterations in all the patients in the sample. Conclusions. Incorporating this type of tool would enable us to reach a more accurate topographic diagnosis in cases of epilepsy of unknown aetiology. At the same time the possible means of medical and surgical treatment available would be widened (AU)
Objetivo. Estudiar las características espacio-temporales de la correlación que existe entre dos señales simultáneas del EEG (coherencia) en el período interictal en pacientes con epilepsia parcial presumiblemente sintomática del lóbulo temporal (ILAE). Pacientes y métodos. Se estudiaron 13 pacientes (53% del sexo femenino), con edades de 17-60 años. A cada paciente se le realizó un EEG digital, utilizando el sistema 10/20 de colocación de electrodos. Del trazado en vigilia con ojos cerrados, se seleccionaron 24 segmentos, libres de artefactos. Mediante la transformada de Fourier, se obtuvieron matrices de espectros cruzados, con las que se calcularon la coherencias intrahemisféricas (Cohintra) e interhemisféricas (Cohinter), expresadas mediante la transformación Z. Estos valores se ordenaron por regiones considerando las conexiones anatómicas conocidas. Resultados. Tanto en el análisis global como individual encontramos mayores alteraciones de la Cohintra y la Cohinter en las regiones temporales, y predominó el hemisferio izquierdo. El análisis individual de la coherencia, a diferencia de la interpretación visual del EEG, evidenció alteraciones significativas en todos los pacientes de la muestra. Conclusiones. La incorporación de este tipo de herramienta permitiría un diagnóstico topográfico más preciso en las epilepsias cuya etiología se desconoce, y ampliaría las posibilidades de tratamiento médico y quirúrgico (AU)
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Electroencephalography , Epilepsy, Temporal Lobe/physiopathologyABSTRACT
INTRODUCTION: Since the 1980s, in relation to the spread of AIDS, there has been an enormous increase in cryptococcosis, a mycotic disorder which usually affects the central nervous system (CNS). This disease is caused by Cryptococcus neoformans, a microorganism acquired by inhalation of bird excrement. This germ produces a capsule which protects it from phagocytosis, can synthesize melanin which acts as an antioxidant of the cytotoxic lymphocytes and can reproduce at body temperature. Clinically it may show as chronic or subacute meningitis and/or encephalitis, as endocranial hypertension or as an intracranial space occupying lesion (crytococcoma). To establish the diagnosis, Chinese ink, culture and the latex agglutination test are useful. Treatment is with amphotericin B associated or not with fluocytokine and fluconazole, the protocol used depending on the clinical form. OBJECTIVE: To review the most up-to-date literature on cryptococcosis of the CNS to study the condition in relation to five cases. CLINICAL CASES: We report five patients with cryptococcosis of the CNS diagnosed and treated in the Instituto Nacional de Neurología y Neurocirugia de la Habana, Cuba, showing an increase in the frequency of the occurrence of cases not related to HIV infection, great variety of clinico-humoral presentation and the characteristics of the treatment given. CONCLUSION: Cryptococcosis can be cured completely when the condition is diagnosed early; without treatment it is invariably fatal.
Subject(s)
Brain Diseases/microbiology , Carbon , Cryptococcosis/diagnosis , Cryptococcus neoformans/isolation & purification , Adult , Amphotericin B/therapeutic use , Antifungal Agents/therapeutic use , Brain Diseases/diagnosis , Brain Diseases/drug therapy , Cerebrospinal Fluid Proteins/analysis , Coloring Agents , Cryptococcosis/drug therapy , Female , Fluconazole/therapeutic use , Humans , Latex Fixation Tests/methods , Male , Middle Aged , Tomography, X-Ray ComputedABSTRACT
INTRODUCTION: Behçet's disease is a multisystemic illness in which neurological abnormalities are seen in 5-48% of cases. CLINICAL CASES: We present 3 patients (2 men and 1 women) diagnosed as having Behçet's disease, according to the criteria of the 'International Study Group for Behçet's Disease' of 1990. We describe the clinical findings in these patients, the results of investigations done (MR or CT, evoked potentials-PEV, PESS, PEATC-EEG, ECN, CSF and neuropsychological tests), their course and response to treatment with hyperimmune human gammaglobulim at a dose of 400 mg/kg body weight in 2 patients. All three patients had repeated episodes of meningitis and alterations of the cranial nerves; two patients had epileptic seizures and two had signs of cerebellar disorders and dementia at some time during their illness. One patient died and the other two survived with severe disabilities. Cranial CT showed a cerebral infarct in one patient; evoked potentials showed axon damage in the two patients in whom this was studied. In the only patient in whom ECN was done, signs of axonal polyneuropathy were found. In all three patients there was pleocytosis in the CSF. In the patients in whom hyperimmune human gammaglobulin was given, the results were: one improved after this treatment; in the other there was clinical deterioration, but this was considered to be secondary to a curettage done the day before. CONCLUSION: The presence of neurological findings in Behçet's disease not caused by cerebral vein thrombosis worsens the prognosis of these patients.
