1/45. The role of early left-brain injury in determining lateralization of cerebral speech functions.Preparatory to craniotomy for the relief of medically refractory focal epilepsy, the lateralization of cerebral speech functions was determined by the Wada intracarotid Amytal test in 134 patients with clinical and radiologic evidence of an early left-hemisphere lesion. Their results were compared with those for 262 patients (140 right-handed, 122 left-handed), who were tested in a similar way. One-third of the patients with early lesions were still right-handed, and 81% of these right-handers were left-hemisphere dominant for speech. In the non-right-handers, speech was represented in the left cerebral hemisphere in nearly a third of the group, in the right hemisphere in half the group, and bilaterally in the remainder. Bilateral speech representation was demonstrated in 15% of the non-right-handers without early left-brain injury and in 19% of those with evidence of such early injury, whereas it was extremely rare in the right-handed groups. In addition, nearly half the patients with bilateral speech representation exhibited a complete or partial dissociation between errors of naming and errors in the repetition of verbal sequences after Amytal injection into left or right hemispheres. This points to the possibility of a functionally asymmetric participation of the two hemispheres in the language processes of some normal left-handers. The results of the Amytal speech tests in this series of patients point to locus of lesion as one of the critical determinants in the lateralization of cerebral speech processes after early left-brain injury. It is argued that in such cases the continuing dominance of the left hemisphere for speech in largely contingent upon the integrity of the frontal and parietal speech zones.- - - - - - - - - - ranking = 1keywords = brain injury, brain, injury (Clic here for more details about this article) |
2/45. phenytoin induced rhinophyma treated by excision and full thickness skin grafting.A 49-year-old man suffering from post-traumatic epilepsy presented with a severe rhinophyma probably induced by phenytoin. Initial surgical shaving was soon followed by recurrence, formation of intraepidermal cysts and persistent infection. Ultimate treatment by full thickness excision and a full thickness skin graft resulted in a pleasing cosmetic result. Radical excision of the affected skin followed by full thickness skin graft nasal reconstruction should be considered for cases of recurrent severe rhinophyma with inclusion cysts to eradicate chronic infection and improve cosmesis.- - - - - - - - - - ranking = 3.5743750081252E-5keywords = trauma (Clic here for more details about this article) |
3/45. Concussive convulsions: emergency department assessment and management of a frequently misunderstood entity.Immediate concussive convulsions are an unusual but dramatic sequela to head injuries. Previously believed to be an epileptic phenomenon, they are now thought to be a brief traumatic functional decerebration that results from loss of cortical inhibition. With concussive convulsions generally occurring within seconds of head impact and lasting up to several minutes, patients are initially in a tonic phase, followed by a clonic convulsion. A postictal phase is generally brief if it occurs at all with these episodes. patients with isolated concussive convulsions have no evidence of structural brain injury as assessed with neuroimaging studies or physical examination. Neuropsychological testing often demonstrates transient cortical dysfunction consistent with the concussive episode. The long-term outcome for patients with isolated concussive convulsion is universally good, with no long-term neurologic sequelae and no increased incidence of early or late posttraumatic epilepsy. Emergency department management should focus on evaluation of the associated concussive injury. The concussive convulsion requires no specific therapy, and antiepileptic medication is not indicated.- - - - - - - - - - ranking = 0.16913042003112keywords = brain injury, brain, injury, trauma (Clic here for more details about this article) |
4/45. Effects of testosterone and clomiphene on spectral EEG and visual evoked response in a young man with posttraumatic epilepsy.The effects of testosterone and clomiphene on epilepsy was studied in a young man with posttraumatic seizures. In the control period, digital EEG and visual evoked potentials (VEPs) were recorded under carbamazapine therapy. After testosterone (T), seizures lessened and almost disappeared; the theta, delta, alpha, and beta powers decreased; VEPs increased. After clomiphene, VEPs considerably increased in size; clinical picture slightly improved; EEG power spectrum remained unchanged. It was suggested that T may be beneficial for epilepsy treatment by suppressing the EEG synchronization (slow wave activity) and attenuating the entropy state of the epileptic brain.- - - - - - - - - - ranking = 0.0054154430151964keywords = brain, trauma (Clic here for more details about this article) |
5/45. Post-traumatic acute rise of ICP related to subclinical epileptic seizures.The authors report a case of post-traumatic intracranial hypertension with ICP paroxysmal rise related to subclinical epileptic seizures. The interest of detecting such a phenomenon is emphasized from a practical therapeutic point of view.- - - - - - - - - - ranking = 0.00017871875040626keywords = trauma (Clic here for more details about this article) |
6/45. Symptomatic epilepsy with facial myoclonus triggered by language.We report on a patient with a left frontal lesion who, many years after an injury, developed non-fluent aphasia and facial myoclonic jerks triggered by speaking and listening to spoken language. At age 57, the patient first noted that he would begin to stutter when delivering lectures at conferences. The stuttering would worsen if he continued talking. The video-polygraphic EEG recording shows brief paroxysms of spikes and polyspikes, followed by a slow wave, more evident in the left fronto-temporal region. The myoclonic jerks originating from the submental area correlate with EEG abnormalities. Clinically, these jerks determined a form of stuttering. The triggering factors were reading, speaking and listening to spoken language. This case had several characteristic features: facial myoclonus was the only seizure type experienced by the patient; the seizures and language impairment had a very late onset--about 50 years after the traumatic event that produced a dramatic lesion in the left fronto-polar region. (Published with videosequences.)- - - - - - - - - - ranking = 0.0029064627872287keywords = injury, trauma (Clic here for more details about this article) |
7/45. Episodic coma in a new leukodystrophy.Among the leukodystrophies of a hypomyelinating nature, childhood ataxia with diffuse central nervous system hypomyelination exhibits the unique feature of rapid decrease in mental status after relatively minor head injuries or otherwise noncomplicated febrile illnesses. This article reports the case of a child with progressive spastic quadriparesis in whom unconsciousness developed repeatedly as a result of minor head trauma and required prolonged critical-care nursing. Although cognition is believed to be relatively preserved in this disorder, this child developed progressive cognitive decline. A detailed review of the literature is presented along with discussion of the potential mechanisms of neurologic deterioration.- - - - - - - - - - ranking = 3.5743750081252E-5keywords = trauma (Clic here for more details about this article) |
8/45. Macrodosage of phenytoin.Large doses (up to 1200 mg) of phenytoin were required to achieve therapeutic plasma concentrations and to control post-traumatic seizures in a 62-year-old woman. The elimination half-life of phenytoin was calculated to be 3.5 hours. Frequent monitoring of the plasma concentration was essential to optimize the therapeutic control and to avoid systemic toxicity.- - - - - - - - - - ranking = 3.5743750081252E-5keywords = trauma (Clic here for more details about this article) |
9/45. "Moya-moya' disease caused by cranial trauma.A case of "moya-moya" disease of a 12-year-old boy is reported. The clinical history started at 3 years 2 months after cranial trauma. The patient developed mental retardation, hemiparesis and seizures.- - - - - - - - - - ranking = 0.00017871875040626keywords = trauma (Clic here for more details about this article) |
10/45. Secretion of natriuretic peptides caused by an epileptic attack.OBJECTIVE: To describe clinical features of a patient with secretions of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) during an epileptic attack. PATIENT: A 65-year-old woman experienced frequent bouts of polyuria, pyrexia and general fatigue after several years of a cerebral contusion involving the left fronto-temporal lobe caused by a traffic accident. Her urine output and urinary sodium excretion increased, and plasma ANP and BNP concentrations were markedly high during each attack. electroencephalography (EEG) showed serial seizure discharge in the left anterior temporal region during the attacks, indicative of epileptic focus. CONCLUSION: ANP and BNP secretions probably were triggered by epileptic stimulation on the diencephalon beyond the focus.- - - - - - - - - - ranking = 0.015010650747895keywords = contusion, brain (Clic here for more details about this article) |
| | Next -> |