Biomedical subjects
Publications and source records attributed to A J Gabor.
The electroencephalogram (EEG) of three patients with typical Creutzfeldt-Jakob disease (CJD) was characterized by periodic lateralized epileptiform complexes (PLEDs), which persisted and became bilateral. This unusual pattern preceded the characteristic EEG change of CJD. Persistence of PLEDs should suggest the diagnosis of CJD.
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A male patient who is now 15 years old has experienced a seizure disorder since age 9 years. The seizures were expressed as episodes of excruciating pain localized to the genital region. Appropriate anticonvulsant medication has controlled both pain and seizures.
We describe a patient whose absence seizures increased greatly in number after the addition of ethosuximide to ongoing phenobarbital therapy. This unusual response and review of other cases in the literature suggested the possibility of some as yet underfined interaction between ethosuximide and other anticonvulsant drugs. That a particular subytpe of epilepsy may be worsened by ethosuximide therapy is also considered.
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In order to investigate if ectopic spike generation was ubiquitous in and specific generation was ubiquitous in and specific to epileptogenic cortex, a method was devised to determine the limits of such an area based on a well-accepted physiologic characteristic of epileptogenicity. The limits of the penicillin-induced epileptogenic cortex were defined in terms of a retinal activation field; this is a circumscribed area whose stimulation by light evokes a characteristic cortical epileptiform wave. All lateral geniculate nucleus (LGN) neurons manifesting ectopic spike generation during interictal epileptiform waves had receptive fields within the activation field. During organized seizures, ectopic spike generation was observed in neurons with receptive fields outside the activation field. Because of these findings it was concluded that ectopic spike generation is a characteristic and specific feature of epileptogenic cortex and that it is a characteristic of the epeleptogenic process rather than a peripheral event related entirely to the direct effect of penicillin on neurons.
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In this study we have demonstrated an enhancement of cortically generated wave forms of the somatosensory evoked potential (SEP) following magnetic pulse stimulation of the human brain. Subcortically generated activity was unaltered. The enhancement of SEP amplitude was greatest when the median nerve was stimulated 30-70 msec following magnetic pulse stimulation over the contralateral parietal scalp. We posit that the enhancement of the SEP is the result of synchronization of pyramidal cells in the sensorimotor cortex resulting from the magnetic pulse.