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Publications (40)
To determine the relative magnitudes of neuron-specific enolase (NSE) levels after complex partial status epilepticus (SE), absence SE, generalized convulsive SE, and subclinical generalized convulsive SE (frequently referred to as acute symptomatic myoclonic status epilepticus).
NSE is a marker of acute brain injury and blood-brain barrier dysfunc...
To assess central nervous system (CNS) involvement with normal CNS examination, multimodality evoked potentials were obtained in 25 patients with confirmed multisystem sarcoidosis. Twelve patients had abnormal evoked potentials: brainstem auditory evoked potentials (BAEP) were abnormal in 5, median nerve somatosensory evoked potentials (SEP) were a...
Low serum cobalamin levels are common in conditions such as dementia and often represent mild deficiency. We surveyed serum cobalamin levels prospectively in spouses and blood relatives of demented patients to determine if any familial predisposition exists for the low levels. Cobalamin status in most of the relatives found to have low levels was a...
To determine whether complex partial status epilepticus (CPSE) causes brain injury in humans. Serum neuron-specific enolase (s-NSE) is an accepted marker of acute brain injury, and increases in s-NSE have been correlated with the duration and outcome of generalized convulsive status epilepticus. s-NSE levels in CPSE are unknown. Increase in s-NSE i...
Neuron-specific enolase (NSE) is a sensitive marker of brain injury after stroke, global ischemia, and coma. We report changes in serum NSE (s-NSE) in 19 patients who sustained status epilepticus. s-NSE peaked within 24 to 48 hours after status epilepticus. The mean peak s-NSE level for the entire group was elevated compared with the levels for nor...
Cobalamin levels are frequently low in patients with dementia, but it is unclear if they represent definable deficiency and what the mechanisms are. Therefore, patients being evaluated for dementia who had low cobalamin levels but no obvious evidence of deficiency were studied hematologically, neurologically and with metabolic tests and were re-eva...
In classic galactosemia, long-term neurologic sequelae can include low cognitive functioning and a curious neurologic syndrome with tremors, dysmetria, and ataxia. An abnormal white-matter signal on cerebral magnetic resonance imaging (MRI) is present in almost all patients; some have mild cerebral or cerebellar atrophy and focal white-matter lesio...
The P300 is a cognitive event-related potential partially generated by the amygdala/hippocampus complex, the most common source of temporal lobe epilepsy (TLE). In order to test the hypothesis that scalp P300 amplitude is reduced ipsilateral to the epileptogenic focus in TLE, we performed a prospective study of 15 subjects with TLE and compared the...
To determine whether exposure to antiepileptic drugs during pregnancy is associated with poor fetal outcomes (anomalies and death) and to assess the relative risks with phenobarbital, phenytoin sodium, and carbamazepine.
The design was a prospective case-control cohort study of pregnant women with epilepsy and their offspring. Outcomes were compare...
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. In...
A pilot case-control quantitative study of the hippocampus in patients with severe status epilepticus was performed to identify specific patterns of pyramidal cell loss. Pyramidal cell densities from five patients who died following status epilepticus were compared with five normal controls and five controls matched for age, hypoxia/ischemia, previ...
Auditory event-related potentials (ERPs) were performed in 20 patients with nontraumatic coma to determine the presence of a P300 ERP in coma and its association with the Glasgow Coma Score and awakening (Glasgow Outcome Score, > or = 3). A standard "oddball" paradigm was used: frequent tone, 1 kHz; rare tone, 2 kHz and 4 Hz; probability, 20%. The...
• Auditory event-related potentials (ERPs) were performed in 20 patients with nontraumatic coma to determine the presence of a P300 ERP in coma and its association with the Glasgow Coma Score and awakening (Glasgow Outcome Score, 3). A standard "oddball" paradigm was used: frequent tone, 1 kHz; rare tone, 2 kHz and 4 Hz; probability, 20%. The Glasg...
Twenty-one patients operated on for unruptured intracranial aneurysms were studied retrospectively in order to identify the incidence of postoperative seizures, factors predictive of seizures, and the response to discontinuation of antiepileptic drugs. The overall risk of postoperative seizures in initially seizure-free patients was 15.7%. Although...
Seventy patients with cerebral ischemia (21 with transient ischemic attack and 49 with stroke) were studied with short-latency median nerve somatosensory evoked potentials to characterize the evoked potentials in all ischemic patients and to investigate their efficacy for prognosis in stroke. Within 72 hours of symptom onset, all 70 patients receiv...
Brain-stem (BAEP) and middle-latency (MLAEP) auditory evoked potentials were recorded in zero noise and in 3 levels of continuous ipsilateral broadband noise. New information is presented on the effects of noise on BAEP wave I. Latency of wave I was not changed by increasing noise, but wave V latency linearly increased. Amplitude of waves I and V d...
Norepinephrine has been shown to improve signal-to-noise ratios of sensory systems, including that of the auditory system. Yohimbine has been observed to cause a selective increase of cerebral norepinephrine. It was administered in one dose to sensorineurally impaired subjects with the object of improving their speech hearing in noise. Speech intel...
Short-latency somatosensory evoked potentials were recorded in 13 patients with myotonic dystrophy (MyD). The MyD were compared with age-matched controls. The mean conduction latency between the brachial plexus and dorsal column nuclei (EP-N14) was significantly longer for the MyD. Results suggest an afferent conduction disturbance in MyD.
Short-latency somatosensory evoked potentials were recorded in 13 patients with myotonic dystrophy (MyD). The MyD were compared with age-matched controls. The mean conduction latency between the brachial plexus and dorsal column nuclei (EP-N14) was significantly longer for the MyD. Results suggest an afferent conduction disturbance in MyD.RésuméDes...
Interhemispheric transmission time (ITT) was derived from vibratory somatosensory evoked potentials (VSEP) arising in homologous cortical sensory--association areas of normals. Two different vibratory sources, an audiometer bone oscillator or an Optacon, were used to stimulate each index finger independently. ITT was calculated by subtracting the l...
A diagnostic procedure during a nutritionally supported fast week followed by conventional food sensitivity management achieved major improvement for 80% of a migraine panel. This procedure gave a reliable (0.8 correlation coefficient) prognosis on the substantial value of this approach for selection of the treatment of migraine. The study gave two...
A subject is described who can voluntarily select and hold either of two qualitatively different states of consciousness. Evidence is presented which confirmed differential left or right hemisphere dominance in each state. Asymmetries of EEG alpha and task performance scores indicated a state-dependent shift in functional lateralization. Evoked res...
Pattern-shift visual evoked potentials (VEPs) were recorded in 17 patients with myotonic dystrophy. Abnormalities of latency or amplitude were found in 10 patients (59%) with no obvious retinal or other significant ocular abnormality. All patients had a visual acuity of 20/30 or better. Since most patients had bilateral VEP abnormalities, localizat...
A diagnostic procedure developed for adults and children which includes a week-long fast nutritionally supported with a chemically defined diet was applied to a pilot group of children having ADD/HA syndrome. A probable etiology of food hypersensitivity was shown for a majority of the panel with several standard subjective tests. Three neurological...
: A group of 11 patients with a variety of lesions affecting the 3rd ventricle have been treated using a direct transcallosal interfornicial approach to the region. In 3 patients, no attendant hydrocephalus was present. In an effort to minimize potential cortical injury related to the approach, we studied the venous anatomy in the region of the cor...
: A group of 11 patients with a variety of lesions affecting the 3rd ventricle have been treated using a direct transcallosal interfornicial approach to the region. In 3 patients, no attendant hydrocephalus was present. In an effort to minimize potential cortical injury related to the approach, we studied the venous anatomy in the region of the cor...
Two patients with radiologically confirmed total agenesis of the corpus callosum, and free of gross focal hemispheric pathology, received a battery of lateralized and free-field language and perceptual-motor tests. These tasks allowed a comparison of (1) agenic findings with previous results from surgical commissurotomy patients, and (2) the inter-...
An automated technique for EEG frequency analysis was employed in the study of nine children with sickle cell disease. Quotients, Q(1) (delta+theta/alpha+beta) and Q(2) (theta/alpha+8), were calculated from the computed power in each frequency range. Recordings from occipital-parietal and temporal-frontal areas resulted in a higher Q(1) for sickle...
Visual evoked responses (VERS) were recorded from commissurotomy patients and normal subjects in order to investigate the electrophysiological correlates of cerebral lateralization and independent hemispheric processing. A verbal task consisted of detecting rhyming words and a spatial task consisted of comparing matching shapes. Stimuli were delive...
Studies of patients who have undergone surgical section of the forebrain commissures indicate that the two hemispheres are specialized for different cognitive functions. The left hemisphere has been described as superior in speech, calculation, and related linguistic or analytic activities, while the right hemisphere is superior in configurational,...
Linguistic and related cognitive abilities were investigated two years after dominant left hemispherectomy for cerebral malignancy in a 12 year old female. Auditory comprehension of speech was superior to other modes of language abilities with expressive speech being the least developed. Findings suggested an isolation or non-communication between...
Cognitive abilities were investigated in three patients with hemispherectomy for noninfantile disease. Two had the right and one had the left hemisphere removed. Results indicate that after right hemispherectomy in the mature brain the left hemisphere remains decidedly more proficient in verbal than nonverbal functions. In the developing younger br...
Evoked responses can be characterized with respect to latency and amplitude.
The latency of the evoked response depends upon whether the person is right-handed or left-handed. In right-handed subjects, the left (dominant) hemisphere has a longer latency than the right when used as a direct hemisphere. Similarly, when the so-called dominant (right)...