The Sleep Disorders Questionnaire (SDQ) is a 176-item questionnaire designed to diagnose the presence of common sleep disorders. This study set out to assess the validity of a Dutch translation of the SDQ. Scores on 145 questionnaires were analyzed. A cluster analysis of these scores revealed the following clusters: healthy, depression, insomnia, narcolepsy, and apnea. The cluster classification proved correct for 67% of the subjects, as determined on the basis of polysomnography. These results show that the Dutch SDQ is a reasonably valid instrument for diagnosing sleep disorders.

Adolescent↗

PubMed1996

Critical illness polyneuropathy in multiple organ dysfunction syndrome and weaning from the ventilator.

BACKGROUND: Acute axonal polyneuropathy has been found in patients with multiple organ dysfunction syndrome. This 'critical illness polyneuropathy' (CIP) has been associated with difficult weaning from the ventilator in retrospective studies. OBJECTIVE: To test the hypothesis that CIP is related to the degree and number of organ dysfunctions, and to weaning problems. DESIGN: Prospective study of 18 months. SETTING: A multidisciplinary intensive care unit in a general hospital SUBJECTS: Thirty-eight patients under 75 years of age who had been mechanically ventilated for more than 7 days, without previous signs of or risk factors for polyneuropathy. MEASURES: Organ dysfunctions were quantified using a dynamic scoring system (0-12 points). Electromyography studies were performed during mechanical ventilation to identify patients with and without CIP. RESULTS: CIP was present in 18 out of 38 patients and associated with an increased organ dysfunction score (5.3 +/- 1.8 vs. 3.6 +/- 1.5; p = 0.003) and number of organs involved [median (range): 4 (3-5) vs. 2 (1-4); p = 0.009], in particular cardiovascular (p = 0.003), renal (p = 0.04), and hematopoietic failure (p = 0.04). Patients with polyneuropathy were ventilated longer, but this was not clearly due to more difficult weaning [median: 16.5 (1-48) vs. 9.5 (1-38) days; p = 0.26]. Polyneuropathy was present in 2 of 4 patients with normal weaning. CONCLUSIONS: Axonal polyneuropathy is related to the severity of multiple-organ-dysfunction syndrome. Its presence does not necessarily implicate difficult weaning from artificial ventilation.

APACHE↗

PubMed1994

H reflexes as a measure for uremic polyneuropathy. A longitudinal study in patients treated with dialysis or renal transplantation.

Assessment of peripheral nerve function in end stage uremia by clinical and conventional nerve conduction velocity studies was compared to that using H reflex measurements. The latter proved to be the most sensitive technique. The results of the test correlated well with clinical and with other neuro-physiological measures. Nerve function as evaluated by H reflexes remained stable during the first 2 years of dialysis, but deteriorated later on. H reflex latencies shortened after renal transplantation. The results of H reflex measurements did not correlate with biochemical parameters, which makes the test a less attractive overall measure for the efficiency of therapy in uremia. In the follow-up of patients under treatment for uremic polyneuropathy, however, recording of H reflexes provides an important measure.

Adult↗

PubMed1992

Electroencephalographic studies in workers exposed to solvents or pesticides.

The qEEG was studied in groups of young and old workers exposed to solvents (house and industrial painters) and in a group of workers exposed to pesticides. Three methods were used: a quantified visual scoring system, the neurometrics method and a multivariate analysis of mean frequencies. Using the visual assessment as well as the neurometrics method, the older painters showed more abnormalities than the younger painters and the pesticide exposed workers. The "profile" of abnormalities differed in all 3 groups. Changes of the mean spectral frequencies were mainly found in the subjects exposed to pesticides. In this study we concluded that the neurometrics method can be useful in neurotoxicological studies. With this technique minor changes in electrocortical function can be detected in seemingly normal workers. However, frequency parameters should be added to the power measures which are usually studied.

Adult↗

PubMed1988

Recovery from cerebral ischaemia. EEG, cerebral blood flow and clinical symptomatology in the first three years after a stroke.

In 43 patients suffering from unilateral supratentorial ischaemia the changes over an interval of 3 years in clinical score, quantified EEG (using the neurometric method) and CBF (Xenon inhalation method) were studied. The patients were examined 3 times: shortly after the onset of ischaemia and respectively 3 and 36 months after this first measurement. Three patients died from causes not related to cerebral ischaemia. In the surviving patients the EEG and clinical score improved, often dramatically; the CBF values did not change significantly. Most of the changes occurred in the first 3 months after the stroke. For the evaluation of the prognostic value of the various parameters, 2 sub-groups of patients with different outcome but comparable initial clinical scores were studied. A persistent neurological deficit was predicted by a low CBF at the first measurement. The neurometric parameters obtained from the initial EEG had no value in this respect.

Adult↗

PubMed1986

The effect of reconstructive vascular surgery on clinical status, quantitative EEG and cerebral blood flow in patients with cerebral ischaemia. A three month follow-up study in operated and unoperated stroke patients.

Follow-up studies over a period of 3 months were carried out on 100 patients with a unilateral ischaemia in the territory of the middle cerebral artery. Twenty-six patients underwent an STA-MCA bypass operation and 23 patients, a carotid endarterectomy. Fifty-one unoperated patients served as a reference group. A clinical examination, quantitative electroencephalogram (qEEG) and cerebral blood flow study (CBF) were performed before, 2 weeks after and 3 months after surgery. In the unoperated patients these examinations were carried out shortly after admission, 3 weeks later and 3 months thereafter. In the unoperated group, a highly significant improvement of clinical score and qEEG was found, but there were no changes in CBF values. The bypass patients showed a transient deterioration of clinical score and qEEG after surgery. Further, over the 3 month post-operative period, the bypass patients and the endarterectomy patients showed no improvement in CBF and qEEG. Thus, a beneficial effect of reconstructive surgery over the period studied could not be demonstrated.

Brain↗

PubMed1985

The use of neurometrics in the study of patients with cerebral ischaemia.

The 'neurometric' method, as developed by John, was used for the study of patients with one-sided supratentorial ischaemia. The results of a reference group of 64 normal volunteers were compared with those of a group of 94 patients. This patient group included 54 patients with permanent neurological deficit (completed stroke or partial non-progressive stroke) and 40 patients with transient neurological symptoms (reversible ischaemic neurological deficit or transient ischaemic attacks). In 90% of all patients the neurometric method indicated that the EEG had to be considered as abnormal (compared with 3% of false positives in the reference group). A significant overall asymmetry was found in 82% of all patients compared with 2% in the reference group. During the follow-up period of 3 months there was a significant improvement of the EEG (as indicated by 3 neurometric parameters) as well as an improvement in clinical condition. In 57.5% of the EEGs, both the neurometric score and the visual assessment of the EEG indicated that some abnormality was present. In 6.6% of the cases both methods failed to indicate any abnormality. In 34.0% the neurometrics method revealed an abnormality in the EEG which was not found by visual assessment. In only 1.9% of the patients did visual assessment suggest abnormalities which could not be confirmed by neurometrics. In the group of EEGs which were considered as normal by visual assessment, the neurometrics method revealed abnormalities in 84%. The neurometric method is at the moment the most sensitive approach for detecting abnormalities in the EEG of patients with unilateral cerebral ischaemia. However, the method seems not very accurate for lateralization or localization of the lesions.

Adult↗

PubMed1985

Somatosensory evoked potentials in minor cerebral ischaemia: diagnostic significance and changes in serial records.

Frontal, central and parietal short and middle latency somatosensory evoked potentials (SEPs) arising after stimulation of the contralateral median nerve were studied in 10 normal adults. Stable SEPs were recorded: a frontal P21-N30 complex and an N20-P23-P28-N35-P42 complex in the centro-parietal region. The use of a chin reference electrode allowed identification of (the thalamic) P15 and N18. SEP studies of 20 patients with unilateral cerebral ischaemia were also performed, about 4 and 18 days after the stroke. In 13 out of 18 patients with a minor stroke (TIA, RIND and PNS) abnormalities of the frontal and/or parietal SEPs were demonstrated. Improvement in these SEPs occurred in 5 cases. In two patients who suffered from a major ischaemic deficit, the SEPs were highly abnormal and did not show any change in the course of time. SEP studies may be useful for the diagnosis of minor cerebral ischaemia as well as quantification of recovery; an even more important indication for this neurophysiological method might be detection of subclinical lesions in patients who have suffered from transient cerebral ischaemia even weeks before the SEP studies are carried out.

Adolescent↗

PubMed1982

Evoked potential changes in clinically definite multiple sclerosis.

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Diagnosis, Differential↗