H-reflexes in the Flexor Carpi Radialis with Facilitation and with Facilitation & Averaging: Normative Data

OBJECTIVE: To determine the normal values of flexor carpi radialis (FCR) H-reflex without facilitation, with facilitation and with facilitation & averaging. And to compare the three methods. METHOD: The FCR H-reflex was tested in 60 healthy people. 1) H-reflexes was recorded in the FCR muscle without facilitation. 2) H-reflexes was recorded in the FCR muscle with facilitation and facilitation was carried out by contracting the FCR muscle with 1 kg of weight. 3) FCR H-reflex was tested by repetitive stimulation with facilitation and the multiple responses were averaged. RESULTS: Without facilitation, FCR H-reflexes were elicited only in 24 people out of 60 people and with facilitation, FCR H-reflexes were elicited in all 60 people. The mean latencies and amplitudes of the three methods were measured and normal limits of latency difference and amplitude ratio were calculated. In the FCR H-reflex without facilitation, with facilitation and with facilitation & averaging, the normal limits of latency difference were 1.0 msec, 1.0 msec, 1.1 msec and normal limits of amplitude ration were 0.37, 0.22, 0.57. CONCLUSION: FCR H-reflex with facilitation and with facilitation & averaging might be useful in the clinical diagnosis.

Classification of epileptic seizures according to the international league against epilepsy (ILAE) classifications of epileptic seizures (1981) and epilepsies and epileptic syndromes (1989) in chungnam national university hospital

Classification of epileptic seizures and syndromes is essential in the management of epileptic patients. Both of the classifications proposed by ILAE are still popularly applied in clinical situations. We tried to verify the differences and usefulness of each classification. During the two year period, 385 consecutive patients (248 male, 137 female) of five years of age or more were classified according to the ILAE classimification of epileptic seizures (1981). These patients were independently classified by two neurologists with the ILAE classification (1989) with same clinical informations. We tentatively add three different sub-categories (focal/multifocal structural lesions with generalized epilepsy, isolated and situation-related epilepsy, and unclassified epilepsy) on the ILAE classification (1989) because of some unclassifiable epileptics. In epilepsies and epileptic syndromes, 61.8% were localization related, 21.8% were generalized, 2.9% were undetermined, 10.9% were special syndrome, 2.6% were unclassifed. After the classification of some patients into the three sub-categories, observed amount of agreement was rised as 95.9%. In the classification of epilepsy and epileptic syndromes proposed by ILAE (1989), debatable definition of categories and resulting unclassifiable epileptic seizure limit the clinical application in some patients.

New-onset seizure in hospitalized patients

Systemic illnesses and preexisting disorders affecting the brain may decrease the seizure threshold in some conditions. For the non-neurologist, patient with new-onset seizure (NOS) is troublesome problem to manage properly. To verify the characteristics of patients with NOS, we analyzed their clinical features. From Jan. 1991 to Jul. 1995, 47 patients were consulted to the neurological department because of their NOS during the admission. We retrieved the medical records, laboratory data and consultation sheets. The most common cause of the NOS was a metabolic disorder (18 patients, 38.3%) and was followed by a previous cerebrovasular disease (6 patients, 12.8%). Ceneralized tonic-clonic seizure occurred in more than half of the patients (55.3%). Fifteen out of 26 initial EEGs revealed diffuse slowings only, whereas only four patients showed focal epileptiform discharges. Status epileptics occurred in seven patients and five of them died. Six patients out of 17 patients with metabolic causes died, comparing five patients out of 27 patients with other causes. It is suggested that the NOS associated with metabolic causes are most common in hospitalized patients and were associated with poor prognosis.

Variables Associated with Delayed Hospital Arrival of Stroke Patients Living in Taejon and Its Suburban Areas

Recent stroke researches have re-emphasized the critical therapeutic time window for antithrombotic and neuroprotective trials for the stroke victims. In this prospective study , we tried to reveal the variables that had delayed the presentation time of the acute stroke patients living in Taejon and its suburban areas. The time of stroke onset, distance from the place of stroke occurrence to the Chung-nam National Univorsity Hospital (CNUH), level of consciousness, basic demographic data, place of residence, and referral routes were assessed. During the study period of 8 months, 173 new patients visited the emergency department of the CNLTH.in the acute phase of stroke. Of 173 patients, 122 had cerebral ischemia (CI), 40 intracerebral hemorrhage (ICH), and 11 subarachnoid hemorrhage (SAH). Only 91 patients (52.6%) presented within 6 hours. Fourty-six percent of Cl, 65% of ICH, and 72% of SAH patients presented within 6 hours. There was no correlation between the presentation time and the age, sex, stoke subtype, distance from CNLTH, and place of residence. The vat-la ' bles that had significantly delayed the presentation time included the better initial consciousness level and referral route through the oriental medicine clinics. These findings suggest that the need for prompt management of stroke patient is poorly understood and that the onental medicine is still preferred by the general population. Tlius, we need to develop an education program and public activities as well as an effective patient dehvery system to nunmum the neuronal damage following stroke.

Brachial artery entrapment syndrome

No abstract available.