The left lateral occipital cortex exhibits decreased thickness in children with sensorineural hearing loss.

Patients with sensorineural hearing loss (SNHL) tend to show language delay, executive functioning deficits, and visual cognitive impairment, even after intervention with hearing amplification and cochlear implants, which suggest altered brain structures and functions in SNHL patients. In this study, we investigated structural brain MRI in 30 children with SNHL (18 mild to moderate [M-M] SNHL and 12 moderately severe to profound [M-P] SNHL) by comparing gender- and age-matched normal controls (NC). Region-based analyses did not show statistically significant differences in volumes of the cerebrum, basal ganglia, cerebellum, and the ventricles between SNHL and NC. On surface-based analyses, the global and lobar cortical surface area, thickness, and volumes were not statistically significantly different between SNHL and NC participants. Regional surface areas, cortical thicknesses, and cortical volumes were statistically significantly smaller in M-P SNHL compared to NC in the left middle occipital cortex, and left inferior occipital cortex after a correction for multiple comparisons using random field theory (p < 0.02). These regions were identified as areas known to be related to high level visual cognition including the human middle temporal area, lateral occipital area, occipital face area, and V8. The observed regional decreased thickness in M-P SNHL may be associated with dysfunctions of visual cognition in SNHL detectable in a clinical setting.

Giant epidermoid cyst of the occipital area with bone invasion: A case report.

Epidermoid cysts are slowly growing pseudotumors usually measuring <2 cm in diameter. Large epidermoid cysts invading bones have been rarely reported in the literature. They may be a source of diagnostic difficulties before pathological analyses, and radiological examinations are essential to determine the extension of the cyst and to guide the surgical technique. We report, herein, on a patient having an unusually large epidermoid cyst located in the left occipital area invading the occipital bone.

Relationship between cortical resection and visual function after occipital lobe epilepsy surgery.

OBJECTIVE In this study, the authors investigated long-term clinical and visual outcomes of patients after occipital lobe epilepsy (OLE) surgery and analyzed the relationship between visual cortical resection and visual function after OLE surgery. METHODS A total of 42 consecutive patients who were diagnosed with OLE and underwent occipital lobe resection between June 1995 and November 2013 were included. Clinical, radiological, and histopathological data were reviewed retrospectively. Seizure outcomes were categorized according to the Engel classification. Visual function after surgery was assessed using the National Eye Institute Visual Functioning Questionnaire 25. The relationship between the resected area of the visual cortex and visual function was demonstrated by multivariate linear regression models. RESULTS After a mean follow-up period of 102.2 months, 27 (64.3%) patients were seizure free, and 6 (14.3%) patients had an Engel Class II outcome. Nineteen (57.6%) of 33 patients had a normal visual field or quadrantanopia after surgery (normal and quadrantanopia groups). Patients in the normal and quadrantanopia groups had better vision-related quality of life than those in the hemianopsia group. The resection of lateral occipital areas 1 and 2 of the occipital lobe was significantly associated with difficulties in general vision, peripheral vision, and vision-specific roles. In addition, the resection of intraparietal sulcus 3 or 4 was significantly associated with decreased social functioning. CONCLUSIONS The authors found a favorable seizure control rate (Engel Class I or II) of 78.6%, and 57.6% of the subjects had good visual function (normal vision or quadrantanopia) after OLE surgery. Lateral occipital cortical resection had a significant effect on visual function despite preservation of the visual field.

Ictal blinking, an under-recognized phenomenon: our experience and literature review.

Ictal blinking (IB) is a very rare disease manifesting as an epileptic motor event in children and adults. Until now it has not been included in any classification of focal seizures of the International League Against Epilepsy Commission. It could be unilateral or bilateral, isolated or in association with other motor manifestations such as limbs' clonus and spasms. Its pathogenesis has not been clearly established: paroxysmal discharges from different areas of the brain could cause IB by activation of trigeminal fibers. Herein authors report three infants and a child with IB, observed in three pediatric centers in two different countries. We also performed a review of literature data, suggesting IB as a seizure type to be included in international classifications, and describing the specific electroencephalographic pattern of this condition.

Visuo-motor integration in unresponsive wakefulness syndrome: A piece of the puzzle towards consciousness detection?

PURPOSE: The unresponsive wakefulness syndrome (UWS) is characterized by either a profound unawareness or an impairment of large-scale cortico/subcortical connectivity. Nevertheless, some individuals with UWS could show residual markers of consciousness and cognition. In this study, we applied an electrophysiological approach aimed to identify the residual visuomotor connectivity patterns that are thought to be linked to awareness, in patients with chronic disorder of consciousness (DOC). METHODS: We measured some markers of visuomotor and premotor-motor integration in 14 patients affected by DOC, before and after the application of transcranial direct current stimulation, delivered over the dorsolateral prefrontal cortex and the parieto-occipital area, paired to transorbital alterning current stimulation. RESULTS: Our protocol induced a potentiation of the electrophysiological markers of visuomotor and premotor-motor connectivity, paired to a clinical improvement, in all of the patients with minimally conscious state and in one individual affected by UWS. CONCLUSIONS: Our protocol could be a promising approach to potentiate the functional connectivity within large-scale visuomotor networks, thus allowing identifying the patients suffering from a functional locked-in syndrome (i.e. individuals showing an extreme behavioral motor dysfunction although with somehow preserved cognitive functions that can be identified only through para-clinical tests) within individuals with UWS.

Location, Location, Location: Alterations in the Functional Topography of Face- but not Object- or Place-Related Cortex in Adolescents with Autism.

In autism, impairments in face processing are a relatively recent discovery, but have quickly become a widely accepted aspect of the behavioral profile. Only a handful of studies have investigated potential atypicalities in autism in the development of the neural substrates mediating face processing. High-functioning individuals with autism (HFA) and matched typically developing (TD) controls watched dynamic movie vignettes of faces, common objects, buildings, and scenes of navigation while undergoing an fMRI scan. With these data, we mapped the functional topography of category-selective activation for faces bilaterally in the fusiform gyrus, occipital face area, and posterior superior temporal sulcus. Additionally, we mapped category-selective activation for objects in the lateral occipital area and for places in the parahippocampal place area in the two groups. Our findings do not indicate a generalized disruption in the development of the entire ventral visual pathway in autism. Instead, our results suggest that the functional topography of face-related cortex is selectively disrupted in autism and that this alteration is present in early adolescence. Furthermore, for those HFA adolescents who do exhibit face-selective activation, this activation tends to be located in traditionally object-related regions, which supports the hypothesis that perceptual processing of faces in autism may be more akin to the perceptual processing of common objects in TD individuals.

Atypical Fibroxanthoma of Scalp Involving Occipital Bone

Atypical fibroxanthoma is a pleomorphic spindle cell neoplasm characterized by a variable combination of cells with fibroblastic and histiocytic features. It occurs mostly on sun-exposed area of the head and neck of elderly person and is a clinically benign reactive lesion despite apparent malignant histologic features. However, because of its potential for metastasis, it is widely regarded as a low-grade sarcoma. We report a 30-year-old woman with atypical fibroxanthoma developed on the left occipital area. The lesion was 1.5 x 2 cm sized papule. There was no skin lesion such as ulcer or eschar. However, mass was involving occipital bone and composed of dense, pleomorphic spindle cells and several bizarre multinucleated giant cells. After wide excision of the scalp and occipital bone, the defect was covered with bone cement, bipedicled local flap and the donor site was covered with STSG. The wound healed completely without complication. It remained free of recurrence for a period of about 1 year follow up.