Quantitative EEG in obstructive sleep apnea syndrome: a review of the literature.

Obstructive sleep apnea syndrome (OSAS) is characterized by the recurrent cessation (apnea) or reduction (hypopnea) of airflow due to the partial or complete upper airway collapse during sleep. Respiratory disturbances causing sleep fragmentation and repetitive nocturnal hypoxia are responsible for a variety of nocturnal and daytime complaints of sleep apnea patients, such as snoring, daytime sleepiness, fatigue, or impaired cognitive functions. Different techniques, such as magnetic resonance imaging, magnetic resonance spectroscopy, and positron emission tomography, are used to evaluate the structural and functional changes in OSAS patients. With quantitative electroencephalographic (qEEG) analysis, the possible existence of alterations in the brain electrical activity of OSAS patients can be investigated. We review the articles on qEEG results of sleep apnea patients and summarize the possible explanations of these qEEG measures. Finally, we review the impact of continuous positive airway pressure (CPAP) treatment on these alterations to assess whether CPAP use can eliminate alterations in the brain activity of OSAS patients.

Predictors of Symptomatic Vasospasm After Subarachnoid Hemorrhage: A Single Center Study of 457 Consecutive Cases.

AIM: We set forth to identify predictors of symptomatic vasospasm in patients with subarachnoid hemorrhage (SAH). MATERIAL AND METHODS: We used multivariate logistic regression analysis of the prospective, hospital based, single center register of the Department of Neurosurgery, University of Debrecen, Hungary. Evaluated patients' characteristics were: sex, age, Hunt-Hess grade on admission, location of aneurysm, thickness of blood clot on initial CT scan (Fisher grade), hypertension. RESULTS: Between 1987 and 2004, 567 SAH cases were registered, 457 were included in this study. Symptomatic vasospasm developed in 22.5% of the cases. In univariate analysis, Hunt-Hess grades 2 and 3 and female sex were predictive for symptomatic vasospasm. In multivariate analysis, female sex remained a significant predictor: OR: 1.8 (1.005-3.2). CONCLUSION: Women are at more danger of developing symptomatic vasospasm after subarachnoid hemorrhage.

[Subarachnoid hemorrhage in Hungary: analysis based on the 2009 hospital reports]. / Adatok a magyarorszagi subarachnoidealis vérzésekrol: a kórházak 2009. évi jelentései alapján készült elemzés.

BACKGROUND AND PURPOSE: We analyzed the statistical characteristics of subarachnoid hemorrhage (SAH) in Hungary in 2009. METHODS: Using data supplied by the hospitals about their inpatient services to the National Health Insurance Fund with ICD-10 code 160. RESULTS: 1403 SAH hospital cases were recorded in 1028 patients. That is much more than we expected from previous data. 63.6% were women, hospital case fatality was 12.2%. The average hospital stay was 6.47 days. 763 CT examinations were done (74.2% of the patients). Hypertension was recorded in 61.3% of the patients. The incidence was increasing with age till the age group of 51-60 years, and decreased beyond that. In 531 patients the source of bleeding could be verified. Aneurysm of the anterior communicating artery was more frequent in men, aneurysm of the middle cerebral artery (MCA) and internal carotid artery in women. In total MCA aneurysm was the most frequent. Arteriovenous malformation was present in 7.6% of the patients. SAH was most frequent in January and February, rarest in April and August. CONCLUSION: SAH is more frequent in Hungary than previously thought.

Cortical spreading edema in persistent visual migraine aura.

We present imaging evidence of the spreading of cortical edema with reversibly restricted water diffusion from the left occipital to the temporoparietal cortex in persistent visual migraine aura in a 58-year-old man. The right-sided visual field defect lasting for 15 days was associated with discoupling of glucose metabolism and blood flow and the decreased apparent diffusion coefficient also suggested cytotoxic edema. At 8 weeks no signs were present, and magnetic resonance imaging became normal; therefore, long-lasting restricted cortical water diffusion, even if coupled with hypometabolism and edema, can be reversible in persistent visual migraine aura.

[Dietary aspects of epilepsy]. / Az epilepsziakezelés diétás vonatkozásai.

The ketogenic diet has been used long for the treatment of epilepsy. The high-fat, low-carbohydrate diet creates ketosis. Although the exact mechanism of action is unknown the results are consistent. Ten percent of the patients who start the diet become seizure free, 50% experiences 50% seizure reduction. The diet is hardly tolerable but also effective in therapy-resistant patients. Trials are under way with new methods, like the Atkins diet, low-glycaemic-index treatment, polyunsaturated fatty acids, to make the diet more tolerable and widely available.

Trends in the incidence of subarachnoid hemorrhage in Akita Prefecture, Japan.

OBJECT: The incidence of subarachnoid hemorrhage (SAH) in Japan has been reported to be among the highest in the world. The aim of this study was to analyze the incidence of SAH and its trends in Akita Prefecture, Japan. METHODS: The incidence rate of SAH between January 1, 1989, and December 31, 1998, was investigated using the prospective Akita Stroke Register. Computed tomography scans were obtained in all suspected cases of SAH. During the study period, 3257 patients with their first SAH were registered. The crude annual incidence rates of SAH in men, women, and both sexes were 20, 33, and 27 per 100,000 population per year, respectively. Age-standardized incidence rates remained stable. Crude incidence rates in women increased. In men the incidence reached a plateau after 55 years of age; in women it peaked in the eighth decade of life. The 28-day case fatality rate was 26.7%, without significant changes. Two diurnal peaks were observed: one at 7 a.m. and another at 5 p.m. The incidence was lowest in summer and highest in spring, in both sexes. CONCLUSIONS: The incidence of SAH in patients in Akita Prefecture is similar to that reported in other Japanese studies. The age-standardized incidence rates are stable. The increasing crude incidence in women is probably attributable to the aging of the Japanese population.

Projections of primary afferent fibers to last-order premotor interneurons in the lumbar spinal cord of rats.

It is well established that last-order premotor interneurons in the spinal cord have crucial importance in the integration of activities generated by the spinal motor apparatus, sensory information and volleys arising from higher motor centers, indicating that they play a substantial role in spinal motor functions. Despite extensive studies, synaptic input systems of these neurons have not been investigated in detail up to now with morphological approaches. On this basis, the present experiments were aimed at the visualization of possible contacts between primary afferents and last-order premotor interneurons in the lumbar spinal cord of rats using double label neural tracing methods in light microscopy. The findings show that terminal puncta of primary afferents do establish indeed appositions on last-order premotor interneurons. From the quantitative point of view, these appositions occur, however, in limited numbers. The study also shows that last-order premotor interneurons contacted by primary afferents tend to be concentrated at the segmental level of the innervated motoneurons, and are evenly distributed along the mediolateral extent of laminae V-VI and in the dorsal portion of lamina VII.