[The sinusoidal infusion test--an additional filling test for evaluating the mechanisms of the volume-pressure compensation in the intracranial cerebrospinal fluid space]. / Sinusoidalny test infuzyjny--test dopelnieniowy dla oceny mechanizmów kompensacji objetosciowo-cisnieniowej wewnatrzczaszkowych przestrzeni plynowych.

A diagnostic additional filling test is described which is used for the assessment of the mechanisms of volume-pressure compensation. In the test infusion is used of "physiological" sinusoidal relationship between the infused volume and time. The duration of the test is 10 minutes and it does not require pressure stabilization. On the basis of 23 clinical tests the values were determined of four indices of method "invasiveness" which were compared with analogous indices obtained in the group of tests with stable infusion rate. The obtained results indicate that the sinusoidal test is less invasive and is better tolerated by the patients.

[Writer's cramp syndrome treated successfully by thalamotomy]. / Zespoly kurczu pisarskiego leczone pomyslnie talamotomia.

In the literature the prevalent until now opinion was that writer's cramp was a disturbance of psychic origin or an occupational neurosis. However, the authors treated successfully three cases of this syndrome with thalamotomy in the years 1976-1982. Two cases were in subject with right-handedness who had graphospasm with evidence of increasing difficulty in writing until complete impossibility of further writing, after several years postural and intentional tremor appeared, and dystonic symptoms developed in the right foot. The third cases had a history of 16 years of writer's cramp and after years symptoms of right-sided dystonia with involuntary movements of the right upper extremity and continuous tics and spams of the facial muscles. After thalamotomy in all cases writer's cramp, tremors and involuntary movements disappeared, writing became again possible and the efficiency of right extremities returned. The described cases of writer's clamp were focal forms of dystonia which became generalized after years. The indications to stereotaxic treatment in these syndromes should be established much earlier.

[Cryohypophysectomy in acromegaly and gigantism by the stereotaxic method]. / Kriohipofizotomia w akromegalii i gigantyzmie metoda stereotaktyczna.

The authors report results of surgical treatment of 30 patients treated by cryohypophysectomy by the stereotactic method through the nose and sphenoid sinus in the years 1967-1979. The material included 28 cases of acromegaly and 2 cases of gigantism. The pathological manifestations in acromegaly and gigantism were analysed for demonstration which of them can regress after surgical treatment. The results of hormonal determinations, particularly the levels of growth hormone, 17-KS and hydroxysteroids, as well as blood glucose curves, were compared before and after cryohypophysectomy and their normalization was observed after the operation. There was principally no need for substitutive treatment after surgical treatment with the exception of 4 cases in which this treatment was given during several postoperative months. The indications to this method of therapy include cases of acromegaly and gigantism with presence of active intrasellar adenomas. Patients should be referred for treatment early before development of skeletal deformities.

[Effect of cryosurgery of the thalamic nuclei on somatosensory evoked potentials]. / Wplyw kriochirurgicznych uszkodzen jader wzgórzowych na somatosensoryczne potencjaly wywolane.

Somatosensory evoked potentials were recorded in two groups of patients with extrapyramidal syndromes including: 1) parkinsonian syndromes, 2) spasmodic torticollis. In the first group stereotactic lesions were produced at the borderline between VOp and Vim nuclei, and in the second group they were situated in VOa and VOi thalamic nuclei. Short-latency components of the potentials were analysed assuming that they were the specific parts of the somatosensory potential and their value was doubtless, in contrast to the late latency components. It was found that stereotaxic lesions the VOa and VOp thalamic nuclei caused no disappearance of the short-latency potentials but reduced their amplitude. In cases with oscillation potentials recorded before the operation, they disappeared after the operation and this disappearance was correlated with clinical improvement.

[Thalamic somatosensory potentials after peripheral stimulation and cortical somatosensory potentials after electric stimulation of thalamic nuclei VOa and VOp (preliminary report)]. / Somatosensoryczne potencjaly wzgórzowe po draznieniu obwodowym oraz somatosensoryczne potencjaly korowe po elektrycznym draznieniu jader VOa I VOp wzgórza (doniesienie wstepne).

In patients with extrapyramidal syndromes thalamic action potentials were recorded during operations with a five-point brain electrode and in the same cases somatosensory evoked potentials were recorded from the skull. Thalamic potentials were recorded after peripheral stimulation, and evoked potentials from the skull were recorded after electrostimulation of thalamic nuclei VOa and VOp. At the thalamic level a short-latency positive-negative potential had a maximal amplitude in one only lead, which confirmed sharp projection of body surface into various thalamic nuclei. Somatosensory evoked potentials recorded from the skull in response to stimulation of thalamic nuclei were usually biphasic and stimulation of VOa and VOp nuclei gave potentials with similar configuration of phases. This confirms the divergence of the projection fibres from the thalamus to the cortex.

[Effect of electric stimulation of the amygdaloid body and hippocampus on bioelectrical activity recorded from these structures and from skull surface in epilepsy]. / Wplyw draznienia elektrycznego ciala migdalowatego i hipokampa na czynnosc bioelektryczna rejestrowana z tych struktur oraz powierzchni czaszki w padaczce.

The authors discuss the morphology of records of spontaneous and stimulated bioelectric activity in an analysis of selected 15 EEG records using electric stimulation of deep temporal structures using relatively low parameters of stimulation (optimal: 2--3 V, 50 Hz, 1 msec, duration 5 sec). Attention is called also to the fact that seizure activity is absent in leads from skull surface during long-lasting bioelectric seizure activity in deep cerebral structures. It is concluded that induction of afterdischarges and analysis of the directions of their spread may be of practical importance from the point of view of diagnosis and therapy. The authors state also that induction of bioelectric afterdischarges in deep temporal structures, particularly in the hippocampus caused in these patients no disturbances of consciousness and memory.

The effect of medial amygdalotomy and anterior hippocampotomy on behavior and seizures in epileptic patients.

In 70 patients with epilepsy and severe behavioural disturbances with EEG changes in the temporal regions, we performed EEG investigations of deep temporal structures, temporal cortex and scalp, using Talairach's stereotactic apparatus. Taking into account the recorded changes we performed 115 stereotactic lesions on the medial amygdala (both unilaterally and bilaterally) and on the anterior hippocampus (cornu Ammonis). The results in epileptic processes were: total recovery in 11.4%, evident clinical improvement in 74.3% and no improvement in 14.3%. Similar results were obtained in behavioural disturbances. Bilateral amygdalotomy and unilateral hippocampotomy in selected cases may produce recovery or amelioration and make possible return to normal social life for epileptic patients with severe behavioural changes.

[Method of objective recording of motor disorders and assessment of improvement in the treatment of dyskinesias]. / Metoda obiektywnej rejestracji zaburzen i oceny poprawy ruchowej w leczeniu dyskinez.

A method of objective evaluation of dyskinesias before surgical treatment and improvement obtained after stereotaxic surgery, is described. The method is based on the principle of recording photographically the movements of an extremity with a light source attached to it. Four sets for recording motor activity disturbances and improvement achieved after operation are presented. The method can be applied for evaluating the effects of conservative pharmacological treatment as well as for assessing the effects of exercises during rehabilitation treatment. The method which allows objective recording of motoro disturbances to be recorded can be used generally in view of its simplicity.