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ABSTRACT: There is now a considerable amount of research relating to memory functioning in epilepsy. The majority of studies have focused on the retention of new information, and few reports have measured memory for past events. This study aims to redress this and measure the efficiency of remote memory in epilepsy.
A remote memory questionnaire was prepared and administered to three groups of patients with epilepsy and a control group without epilepsy. The questionnaire assessed knowledge of public events that occurred between 1980 and 1991, inclusive. The epilepsy groups comprised 33 patients with temporal lobe epilepsy (TLE), 33 with extratemporal epilepsy (ExTE), and 10 with primary generalized epilepsy (PGE). Thirty control subjects were tested.
Patients with TLE performed significantly less well on the questionnaire than all other groups (p = 0.001), but no effect of laterality was recorded; patients with extratemporal or primary generalised epilepsy did not differ from controls. Performance on the questionnaire was not determined by verbal IQ, educational achievement, social class, or drug treatment, but was related to the number of generalised convulsions that had occurred since 1980. The strongest neuropsychological predictors of performance on this questionnaire were measures of verbal memory.
The study demonstrated weak memory for past events in patients with TLE, thereby providing evidence of a broader memory disturbance in this group than has been previously highlighted. A test of remote memory, such as the one designed for this study, is easy to administer and provides clinically important information not available from conventional neuropsychological tests.
Epilepsia 03/2000; 41(2):231-9. · 3.96 Impact Factor
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ABSTRACT: Thirty six patients with a history of partial epilepsy had MRI of the brain performed with conventional T1 and T2 weighted pulse sequences as well as the fluid attenuated inversion recovery (FLAIR) sequence. Abnormalities were found in 20 cases (56%), in whom there were 25 lesions or groups of lesions. Twenty four of these lesions were more conspicuous with the FLAIR sequence than with any of the conventional sequences. In 11 of these 20 cases, lesions thought to be of aetiological importance were only seen with the FLAIR sequence. In eight this was a solitary lesion. In the other three, an additional and apparently significant lesion (or lesions) was only seen with the FLAIR sequence when another lesion had been identified with both conventional and FLAIR sequences. The 11 additional lesions or groups of lesions were seen in the hippocampus, amygdala, cortex, or subcortical and periventricular regions. No lesion was found with any pulse sequence in 16 (44%) of the original group of 36 patients. In the eight cases where a lesion was seen only with the FLAIR sequence, localisation was concordant with the electroclinical features. Two of the eight patients with solitary lesions seen only on the FLAIR sequence underwent surgery, after which there was pathological confirmation of the abnormality identified with imaging. In one patient with a congenital cavernoma, the primary lesion was best seen with a contrast enhanced T1 weighted spin echo sequence. In this selected series, the FLAIR sequence increased the yield of MRI examinations of the brain by 30%.
Journal of Neurology Neurosurgery & Psychiatry 05/1995; 58(4):439-43. · 4.76 Impact Factor
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ABSTRACT: To investigate the use of six cerebral measures as correlates for hippocampal volumes and, therefore, to enable normalized absolute hippocampal volumes to be calculated via two correction processes.
Hippocampal volumes and six cerebral measures were estimated from MR data in 20 control subjects. Three of these measures (the cranial volume, the cerebral volume, and the midsagittal cranial area) were then applied to a group of 32 control subjects, and regression analysis was performed to investigate the linear relationship between hippocampal volume and each measure. Division of hippocampal volume by cerebral measure and correction via a covariance calculation enabled corrected absolute hippocampal volumes to be determined for 32 control subjects and 23 patients with temporal lobe epilepsy.
Correction processes reduced the variance in absolute hippocampal volumes in control subjects and enabled abnormally small absolute volumes to be defined. Of 11 patients with unilateral volume ratio abnormalities, 8 had unilateral abnormally small absolute hippocampal volumes. Of 12 patients with normal volume ratios, 4 had bilateral abnormally small absolute hippocampal volumes.
Correction processes can define absolute hippocampal volumes for correlation studies and may enable identification of unsuspected bilateral hippocampal volume loss.
American Journal of Neuroradiology 05/1995; 16(4):637-43. · 2.93 Impact Factor
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ABSTRACT: Body sway and vibration perception in the lower limbs were measured in 32 normal subjects and 25 patients with peripheral neuropathies; nerve conduction studies were also performed in the patients with neuropathies. Body sway was measured by means of force-plate posturography, and three methods were used to assess vibration perception: a neurothesiometer, a semiquantitative tuning fork, and the bone vibrator of a conventional audiometer. Body sway and vibration perception were increased in the patients with peripheral neuropathies and there was significant correlation between these measures.d These findings, together with the lack of correlation between sway and muscle strength, indicate that the main source of unsteadiness in these patients is the loss of proprioceptive information. Vibration perception and body sway did not correlate with the electrophysiological variables, indicating that these measures assess different aspects of peripheral nerve function. In all subjects there was close correlation between vibration perception as assessed by the neurothesiometer and the audiometer could be used to screen proprioceptive function in patients with balance disorders. In normal subjects age correlated with vibration perception (measured with the neurothesiometer and audiometer) and also with body sway standing on foam. This suggests that the increased body sway in elderly people may partly be due to redue proprioception in the lower limbs.
Journal of Neurology Neurosurgery & Psychiatry 04/1995; 58(3):335-40. · 4.76 Impact Factor
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ABSTRACT: We gave 58 patients with refractory partial seizures who were undergoing video-EEG telemetry a variety of memory tests shortly after the telemetry commenced, and we reassessed memory for this material 48 hours later. Thirty patients had one or more seizures during this period; 22 of these had complex partial seizures, secondary generalized seizures, or both. Eighteen patients did not have any seizures during the study period. Patients who had seizures forgot no more than patients who did not have seizures. There was no correlation between memory performance and the timing of seizures or the number of seizures. These findings indicate that isolated seizures do not generally cause patients to forget material they have recently learned.
Neurology 03/1995; 45(2):236-40. · 8.31 Impact Factor
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Neurology 10/1994; 44(9):1770-1. · 8.31 Impact Factor
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ABSTRACT: 3,4-Diaminopyridine was administered to 6 patients with inflammatory demyelinating neuropathies in whom partial conduction block was demonstrable. Four had Guillain-Barré syndrome and 2 had chronic inflammatory demyelinating neuropathy. Nerve conduction studies were performed before the administration of a single oral dose of 3,4-diaminopyridine, and at regular intervals thereafter. Neither resolution of conduction block nor clinical benefit were seen.
Annals of Neurology 10/1993; 34(3):406-9. · 11.09 Impact Factor
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ABSTRACT: We report a 44 year old man who developed external ophthalmoplegia and predominantly respiratory, truncal and bulbar weakness with brisk reflexes, histological evidence of an inflammatory myopathy and a high titre of acetylcholine receptor antibodies, one month after starting hydroxyurea and allopurinol for chronic myeloid leukaemia. The temporal relationship suggests a possible association between this patient's unusual neuromuscular disorder and either the chronic myeloid leukaemia or its treatment.
Postgraduate Medical Journal 05/1993; 69(810):312-4. · 1.94 Impact Factor
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BMJ 09/1992; 305(6852):517-8. · 14.09 Impact Factor
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ABSTRACT: A review was undertaken of all cases of tuberculous meningitis seen in Wellington since 1962. It showed, in conjunction with an earlier study, a steady decline in the incidence of the disease since 1940. There was a relatively high incidence in Maori and Pacific Island Polynesians. Good outcome was seen in 17/28 (61%). Poor recovery was associated with delayed treatment, confusion or stupor at presentation, and male sex. The diagnosis is not excluded by a normal peripheral white count, ESR, chest x-ray or cerebrospinal fluid.
The New Zealand medical journal 11/1989; 102(878):554-6.
