[Diagnostic value of periodic lateralized complexes in the EEG (author's transl)]. / Der diagnostische Wert periodischer lateralisierter Komplexe im EEG.

Periodic lateralized discharges (PLDs) were studied in 68 patients. Seventy nine percent had seizures, mostly of the partial motor type, and 62 percent showed signs of acute seizure activity. In the majority of cases, localizing signs were present at neurological examination or in structural tests. Among the etiological causes, vascular accidents, chronic seizure disorders, space occupying lesions, CNS infections and several other disorders could be identified. None of the EEG characteristics were linked to any clinical variables except the mode of appearance of PLDs. Episodically occuring PLDs correlated to chronic seizure disorders. For pathophysiological explanations, a relationship to the clonic phase of a convulsive seizure was stressed.

Involuntary motor phenomena in the locked-in syndrome.

Several involuntary movements were observed in patients who were totally immobile except for vertical gaze due to bilateral pyramidal transverse lesion at the pontine or midbrain level. In those conscious locked-in patients extensor spasms and flexor spasms could be elicited by nonspecific stimulation. Mimic pain reactions, pathological crying, and primordial screaming ("cat crying') were also noted. Other motor patterns were whining, moaning, groaning, sighing, and yawning. The pathophysiological implications of these observations are discussed.

The EEG at different stages of acute secondary traumatic midbrain and bulbar brain syndromes.

One hundred and thirty EEGs were analysed from 113 patients with acute secondary traumatic midbrain and bulbar brain syndromes. The EEG pattern was related to the stage of the midbrain syndrome caused by supratentorial brain shift. A decrease in the number of different EEG patterns was associated with increasing intracranial pressure. Unfavourable prognosis was indicated by the disappearance of sleep or sleep-like activities alternating pattern and loss of reactivity. Lateralization by the EEG proved to be superior to clinical findings in full stages of the midbrain syndrome. EEG abnormalities due to the herniation itself interfered with EEG changes due to secondary circulatory, respiratory and metabolic encephalopathies. In such cases, the above mentioned regularities were blurred.

[The value of EEG after sleep deprivation (author's transl)]. / Zum diagnostischen Wert des EEG nach Schlafentzug.

Seventy seven adult epileptics and 30 patients with clinically non epileptic seizures were subject to a 24 hours sleep deprivation. The waking records of these patients were normal or unspecific abnormal. After sleep deprivation 29 (37%) of epileptics had abnormal EEG with epileptiform or focal activity, more often in cases with frequent (26 (60%) patients out of 43) epileptic seizures. Patients with sporadic attacks only exceptionally showed specific EEG changes (3 patients (8,8%) out of 34). Drug induced sleep emerged to be diagnostically less helpful. Twenty nine out of 30 patients with clinical nonepileptic seizures had no additional abnormalities in the EEG after sleep deprivation.

[Hyperammonemia during parenteral nutrition of intensive-care patients]. / Hyperammoniämie bei der parenteralen Ernährung von Intensivpflegepatienten.

Metabolic features of parenteral feeding with conventional amino acid solutions were examined in 47 patients over a long period. 30 patients were kept alive by artificial respiration. The metabolic parameters ammonium, blood urea nitrogen, GOT, alkaline phosphatase were carried out, in 6 patients the pattern of amino acids was analysed. All patients showed a significant increase of ammonium during the course of parenteral feeding. The amino acids demonstrated pattern of imbalance. The other other parameters were not changed significantly. Traumatic, hypoxic or toxic liver damage might influence the reduction of liver function.

[Electrophysiogical and neuropharmacological studies in a patient with progressive myoclonus-epilepsy (author's transl)]. / Elektrophysiologische und neuropharmakologische Studien bei einer Patientin mit progressiver Myoklonusepilepsie.

A progressive form of myoclonus-epilepsy was described in an 21 year old girl. Electrophysiological and neuropharmacological studies were carried out. The typical EEG-pattern, the close association of cortical discharges and myoclonic jerks, the form of myoclonus indicated a "pyramidal" myoclonus. Pharmacological data suggested that two possible mechanisms--a partial deafferentation of cortical neurones and a failure of thalamic, extrapyramidal and brain stem reticular formations--might be responsible for the EEG-abnormalities and concomitant myoclonus. Results from neuropharmacological studies demonstrated a suppressive effect (on EEG-discharges and myoclonic jerks) of clonazepam, diazepam, phenobarbital, taurine, levodopa and budipin. Taurine, levodopa and budipin might induce a new aspect in therapy of progressive myoclonus epilepsy and of myoclonus caused by other etiologic factors.

[Periarticular ossification following severe brain injury]. / Periartikuläre Ossifikationen nach schwerem Schädel-Hirn-Trauma.

A particular ossification should be considered besides primary neurological causes, if there are functional restrictions of the joint movements after severe head trauma. New bone formation has been seen extending from the periarticular tissue. The problems of the new bone formation in both hip-joints are shown in a patient with traumatic apallic syndrome. After exact indication and with careful and atraumatic operative technique functional restitution of the joints can be achieved without danger of recurrence.