Search PubMed⌕ Search

Biomedical subjects

D Bergen

Publications and source records attributed to D Bergen.

30 records · Page 2Linked to original sources

Correlation between diffuse EEG abnormalities and cerebral atrophy in senile dementia.

Thirty-five elderly patients were investigated because of clinical signs of dementia. The presence or diffuse cerebral atrophy, and its severity, were determined by the use of computed tomography (CT scan). All of the patients were also examined by electroencephalography (EEG), and the presence of diffuse abnormalities, especially diffuse slowing, was noted. Specifically, patients with normal or near-normal EEGs were compared with those with severe diffuse slowing. No correlation between the presence or severity of diffuse EEG abnormalities and the degree of cerebral atrophy as measured by CT scan was found. Though the EEG is clearly identifying physiological dysfunction of nerve cells in demented patients it does not appear to be reliable tool for the prediction of diffuse cerebral atrophy in this population.

Age Factors↗

Movement phosphenes in optic neuritis: a new clinical sign.

Positive visual phenomena (phosphenes) elicited by eye movements have been described in normal individuals and in myopes with vitreous opacities. In the present paper we describe eye movement-induced phosphenes that appear to be related to optic nerve involvement in patients with optic neuritis and multiple sclerosis. This phenomenon is not associated with vitreous or retinal defects, nor is it similar to phosphenes observed in normal individuals. Instead, it shares many characteristics with the well-known Lhermitte sign and is believed to represent a similar phenomenon.

Adult↗

Levodopa-induced myoclonus.

Twelve parkinsonian patients on long-term levodopa therapy developed intermittent, myoclonic body jerks. The movements consisted of single unilateral or bilateral abrupt jerks of the extremities and occurred most frequently during sleep. Although directly related to daily dosage of levodopa, the myoclonus was specifically blocked by the serotonin antagonist, methysergide. Levodopa-induced myoclonus may be related to intermittent increases of activity of serotonin in the brain and results from levodopa-induced dysregulation of serotonin activity.

5-Hydroxytryptophan↗

Deanol in the treatment of levodopa-induced dyskinesias.

Levodopa-induced dyskinesias frequently limit the clinical efficacy of levodopa therapy in Parkinson's disease. Deanol recently has been reported to be of value in relieving the dyskinesias by acting through a central cholinergic mechanism. Seventeen outpatients with levodopa-induced dyskinesias were given deanol in dosages of 300 to 900 mg per day. The dyskinesias improved in four of the patients, remained unchanged in five, and worsened in eight. In all four patients who showed improvement after institution of deanol therapy, the improvement continued after the patients were switched to a placebo. One of these patients also demonstrated improvement in his parkinsonism, while two others experienced a worsening in their parkinsonism. Deanol does not appear to be effective in the treatment of levodopa-induced dyskinesias.

Aged↗

Infarction after surgery for focal epilepsy: manipulation hemiplegia revisited.

The success of surgery for seizure focus resection depends on postoperative reduction or disappearance in number of seizures, improvement in psychosocial functioning, and low morbidity and mortality. Permanent neurologic sequelae are most often not discussed in this context. Deficits more than a superior quadrantanopsia are not expected after temporal lobectomy. Four cases of ischemic stroke after seizure focus resection, each distant from the site of tissue removal, are reported. These are the first such radiologically documented reports of "manipulation hemiplegia." The permanent neurologic deficits are not attributed to resected tissue or edema.

Adolescent↗

Magnetic resonance imaging as a sensitive and specific predictor of neoplasms removed for intractable epilepsy.

Twenty-three patients had magnetic resonance imaging (MRI) and computed tomography (CT) of the head prior to surgery for medically intractable epilepsy. Eleven patients had neoplasms, mostly astrocytomas. Six of the 11 tumors were seen on CT. In five of the six cases, the MRI showed a focal area of increased signal on T2-weighted images. All 11 tumors were detected by MRI. None of the non-neoplastic lesions produced an abnormal T2-weighted signal area on MRI. Only one of the non-neoplastic lesions was seen on both CT and on MRI. MRI allowed clear discrimination between tumors and non-neoplastic lesions in patients coming to surgery for intractable epilepsy.

Adult↗

Correlation of abnormalities of interictal n-isopropyl-p-iodoamphetamine single-photon emission tomography with focus of seizure onset in complex partial seizure disorders.

Single-photon emission tomography (SPECT) scanning with n-isopropyl-p-iodoamphetamine (IMP) was performed on 23 patients with complex partial seizures undergoing long-term video electroencephalographic (EEG) seizure monitoring. Twenty-one of the 23 patients had abnormalities on SPECT scanning consisting of areas of decreased activity reflecting diminished cerebral blood flow. In 15 of these 21 patients, there was good correlation between the site of the abnormality on SPECT scan and the site of origin of seizures monitored by EEG. Of the six remaining patients, four had multifocal SPECT abnormalities, with one of the abnormal areas corresponding with an ictal site. The two remaining patients had SPECT abnormalities and major ictal EEG foci in entirely different areas. In contrast to the high proportion of abnormal SPECT scans, only 10 of 23 focal abnormalities were discovered on magnetic resonance imaging (MRI) scans. Three patients who had seizures within 2 h of an initial scan were rescanned 4-5 h after injection. Focal areas of increased blood flow were noted on all three scans, although not always at the ictal site. The SPECT scan appears to be useful in interictal localization of seizure foci. Postictal scans may also be useful, although our numbers are too small to draw conclusions.

Adult↗

Vagus nerve stimulation for treatment of partial seizures: 3. Long-term follow-up on first 67 patients exiting a controlled study. First International Vagus Nerve Stimulation Study Group.

Vagus nerve stimulation (VNS) has demonstrated a significant anticonvulsant effect in preclinical studies, in pilot studies in humans, and in the acute phase of a multicenter, double-blinded, randomized study. After completion of a 14-week, blinded, randomized study, with 31 receiving high (therapeutic) VNS and 36 receiving low (less or noneffective) VNS, 67 patients elected to continue in an open extension phase. During the extension phase, all 67 patients received high VNS. Seizure frequency during the 3-month treatment blocks was compared with a 12-week baseline. For both groups, all periods of high VNS demonstrated a significant decrease in seizure frequency (p < 0.01 level) as compared with baseline. For the 16-18-month period of VNS, data were available for 26 of the 31 patients randomized to high VNS. This group achieved a 52.0% mean seizure frequency percentage reduction as compared with baseline. For those converted from low to high VNS, data were available for 24 of the 36 patients at the 16-18-month time period. This group reported a mean seizure frequency percentage reduction of 38.1% as compared with baseline. No significant change in the safety/side effect profile was reported during long-term follow-up. The previously reported side effects of hoarseness/voice change, coughing, and paresthesia (sensation in neck and jaw) continued to occur during VNS. These side effects were well tolerated. During the follow-up period, 1 patient died of thrombotic thrombocytopenic purpura (TTP) and 5 patients discontinued treatment because of unsatisfactory efficacy.

Adult↗