[Computerized tomography of the head in patients with epilepsy]. / Tomografia komputerowa glowy u chorych na padaczke.

A detection of structural changes in the brain of epileptic patients is of importance to the choice of therapeutical management. Incidence and character of lesions in CT-scans of the skull were analysed in the random group of epileptic patients. Normal areas in CT-scans were prevailing in young patients. Atrophic lesions to the brain increased with the patients' age and duration of the disease. Normal results were obtained in post-traumatic epilepsy and that of unknown etiology similarly to atrophic lesions whereas localized lesions were found in all patients with cerebral tumors. Partial epilepsy, especially of short duration, was characterized by high incidence of localized lesions. Normal EEG records were rare in patients with localized lesions detected with CT-scans whereas normal CT-scans may be related to abnormal EEG record. Presence of the localized lesions in some patients and atrophic areas did not limit clinical results of monitored therapy. CT-scanning of the skull should be performed in case of all patients with epilepsy even if there are no significant changes in EEG records or clinical status.

[Effect of dehydrobenzperidol (DHB) on cortical and thalamic somatosensory evoked potentials in patients with muscle dystonia]. / Wplyw dehydrobenzperidolu (dhb) na korowe i wzgórzowe somatosensoryczne potencjaly wywolane rejestrowane u chorych w dystoniach miesniowych.

Investigations of somatosensory evoked potentials in patients with muscular dystonia meet with difficulties due to abnormal muscle tone and dyskinesia producing myogenic artifacts deforming potentials recorded after their evoking. For obtaining better conditions for recording of somatosensory evoked potentials single dose of DHB was used. Somatosensory evoked potentials were recorded before and after operations and during stereotactic thalamotomy of the complex of the VL nucleus in the thalamus. The authors report the results of investigations in the above mentioned three periods of treatment in hospital. The results suggest the hypothesis that DHB affects the cerebellofugal transmission organizing the proper muscle tone.

[Effect of diazepam on somatosensory evoked potentials]. / Wplyw diazepamu na somatosensoryczne potencjaly wywolane.

Somatosensory evoked potentials (SEP) were recorded in 15 patients with extrapyramidal disturbances after intravenous administration of 10 mg of diazepam (Relanium, Polfa). Cortical SEP were recorded before and after operations and thalamic SEP were recorded during stereotaxic interventions on thalamic nuclei VL and Vim. The results demonstrated that diazepam had a significant positive influence on the recording of SEP, eliminating muscular artifacts caused by increased muscular tonus and extrapyramidal tremor. Diazepam had no evident effect on the SEP and caused no changes of the short-latency specific cortical SEP. This effect was, however, evident on the later components of the SEP and it seemed to affect mainly the N63 wave whose amplitude was always reduced or absent. In the postoperative investigations the cortical SEP in the hemisphere operated on (contralateral to the site of stimulation) were reduced in the phase of short-latency components. In the ipsilateral hemisphere the cortical SEP remained similar to the normal ones, and after diazepam their amplitude was markedly reduced. Intraoperatively recorded thalamic SEP showed after diazepam a considerable decrease of the amplitude of all components, sometimes the curve was completely flat, including the specific phase of the potential. On the other hand, diazepam failed to extinguish cortical SEP which showed even a greater amplitude of short-latency and long-latency components than in the records obtained without this drug, with the exception of disappearing N63 component.

[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 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.

[Fisher's syndrome]. / Zespól Fishera.

The authors describe a 43-year-old man with ophthalmoplegia, ataxia and areflexia and with 0.42 g/l of protein in the cerebrospinal fluid. EMG disclosed some slowing down of the conduction velocity in the motor fibres of the extremities. Treatment with synacthen depot, cocarboxylase and vitamins gave a good effect. The described case corresponds closely to Fisher's syndrome and may be a special form of brain-stem encephalitis involving the mesencephalon.

[Results of short and long-term treatment of parkinsonism with L-dopa]. / Wyniki krótko- i dlugotrwalego leczenia choroby Parkinsona przy uzyciu L-dopa

The results of substitutive treatment of Parkinson's disease with L-dopa were assessed using a special chart for periodical examinations. This chart contains, among others, a 100-point scoring scale of parkinsonian disability which makes possible objective comparison of the condition of patients after various duration of treatment. The obtained results were compared according to age, sex, duration of disease, results of previous anticholinergic treatment. Ophthalmological examinations were carried out determining the width and reactions of pupils, accomodation and intraocular tension as well as side effects. The results of scoring demonstrated a high therapeutic effectiveness of L-dopa, lack of significant ophthalmological abnormalities and mild degree of side effects due to peripheral and autonomic-system reactions to L-dopa.

[Hereditary episodic adynamia. Gamstorp's disease]. / Adynamia napadowa dziedziczna -- choroba Gamstorp

The authors report a family in which the mother and her one son had typical eipsodes of flaccid muscular paralysis with raised serum potassium level during the episode. In the period between these episodes only myotonia was observed. Histological examinations and EMG confirmed the diagnosis. Myotonia was present in two other siblings.