Acta neurologica Scandinavica
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Acta Neurol. Scand. · Nov 1993
Effects of movement-related cortical activities on pain-related somatosensory evoked potentials following CO2 laser stimulation in normal subjects.
We investigated the change in pain perception produced by the application of movement and vibration to areas adjacent to, and remote from, the painful stimulus. Pain-related somatosensory evoked potentials (pain SEPs) and the pain threshold were evaluated following CO2 laser stimulation in 17 normal subjects. ⋯ This finding was not produced by vibration or movement imagery of the limbs without active movement. Therefore, interactions between pain perception and movement-related cortical activities must take place in some areas of the brain without relieving pain.
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We report a patient who presented palatal myoclonus (PM) after anoxic brain damage that was completely abolished by the administration of opioid agonists. This suggests the involvement of peptide systems in the development of PM.
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Acta Neurol. Scand. · Jun 1993
Outcome of resective surgery for intractable partial epilepsy guided by subdural electrode arrays.
The aim of this paper was to evaluate the outcome and the factors predictive for a good prognosis of resective surgery for intractable partial epilepsy guided by subdural electrode arrays (SEA's) and operative electrocorticography. Sixty-four patients, aged 8-52 years, were evaluated with chronic SEAs in order to record interictal and ictal activity and delineate speech and motor areas by functionally mapping. Resection were individualized to each patient's SEA recorded electrocorticogram and operative electrocorticogram and functional mapping results (tailored resection). ⋯ Patients with no postresection spikes had a better prognosis than patients with residual postresection spikes evaluated with operative electrocorticography. Sex, age, duration of epilepsy prior to surgery, extent of temporal lobe resection and structural abnormalities determined by MRI were not associated with a favorable seizure outcome after surgery. We conclude that complete resection of the interictal and ictal field mapped with SEA's and absence of postresection spikes on operative electrocorticography are associated with an excellent seizure outcome.
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The pulsatility index (PI) registered by the transcranial doppler (TCD) was examined in relation to arterial pCO2 (paCO2) and epidural pressure (ICP). In 10 normal subjects PI was studied during variations in paCO2. In 10 neurosurgical patients with head injuries concomitant measurements of PI and ICP were obtained. ⋯ PI changed with 2.4% pr mmHg ICP. In the subgroup of patients with raised ICP (15 mmHg <) paCO2 was found not to influence the PI-reflection of the ICP, probably because paCO2-changes affected PI as well as ICP. The results suggest that the noninvasive bedside TCD-registration may be a useful marker of the ICP and probably replace the former invasive methods of measuring ICP.
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Acta Neurol. Scand. · May 1993
Predictive value of P300 event-related potentials compared with EEG and somatosensory evoked potentials in non-traumatic coma.
Developments in ethical decision making are increasing demand for more accurate predictions of outcome in coma. New neurophysiologic tests are needed to improve the ability to predict awakening as well as poor outcome. We have recently reported that the P300 event-related potential (P300) correlates with awakening and depth of nontraumatic coma. ⋯ The data indicates that the P300 and SEP are more effective than the EEG in predicting awakening, and that the SEP and EEG are more effective than the P300 in predicting poor outcome. We conclude that, in addition to EEG and SEP, the P300 should be considered in the prognostic evaluation of patients in nontraumatic coma. Further, simplified scales for the EEG and SEP are predictive of depth of coma and outcome.