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Biomedical subjects

D E Jacome

Publications and source records attributed to D E Jacome.

At least 37 records · Page 2Linked to original sources
PubMed1998

Masturbatory-orgasmic extracephalic pain.

Two single men, one with compressive spondylitic cervical myelopathy and another with tethered cord and intraspinal lipoma, experienced severe paroxysmal ice pick-like pains, solely referred to the neck in the first and to the groin and genitalia in the second, that were precipitated by masturbation and masturbatory orgasms. Continuous, but less intense, background pain was reported by both patients over the same anatomic areas. Neither had intracranial lesions, epilepsy, or suffered from migraine. Recently, extratrigeminal ice pick status was reported in this journal. These two unusual cases represent examples of extracephalic ice pick-like pain triggered by sexual activity, in the absence of orgasmic cephalgia.

Headache↗
PubMed1998

Headaches, idiopathic intracranial hypertension, and pseudopapilledema.

A young woman with frontal headaches of several months' evolution and monocular transient "tunnel" obscurations that developed after a generalized seizure is described. She had elevation of the optic discs (pseudopapilledema), greater on the side of her visual symptoms. No intracranial lesions were identified. Cerebrospinal fluid pressure was increased, diagnostic of idiopathic intracranial hypertension (IIH). Because both IIH and pseudopapilledema may cause transient visual obscurations (TVO), fortuitous discovery of pseudopapilledema in a patient with TVO does not preclude the necessity of performing a diagnostic lumbar puncture. Establishing the correct diagnosis has obvious therapeutic and prognostic implications.

Adult↗
PubMed1997

Ritual relieved axial dystonia triggered by gaze-evoked amaurosis.

A woman with chronic posttraumatic axial lateropulsion cervical dystonia ("belly dancer's head") found relief of her spontaneous dystonic spasms by the sequential performance of an elaborate motor ritual. During an episode of left optic papillitis caused by central retinal vein occlusion, gaze-evoked amaurosis of the left eye developed, preceded by achromatopsia, during left lateral gaze. Gaze-evoked amaurosis triggered axial dystonia, which was followed by her unique, stereotyped, dystonia-relieving ritual that simulated a slow dance. Visual symptoms improved progressively in 1 year. Eventually, she was unable to trigger her dystonia by eye movements. Spontaneous dystonia remained otherwise unchanged from before the episode of papillitis and was still relieved by her unique ritual.

Aged↗
PubMed1997

Gaze-evoked orbicularis oculi myokymia.

The cases of six patients with pronounced, persistent, isolated gaze-evoked orbicularis oculi myokymia (GEOM) discovered fortuitously are described. None had brain-stem lesions, and two had associated, unusual cranial synkinesis (trigeminofacial, hypoglossal-facial, and spinal accessory-facial). Additional features included asymmetric blinking and pseudoblepharoclonus in a third patient and buccopharyngeal synkinesis and post-deglutional tremors in a fourth. Ptosis and pupillary changes were absent. With the possible exception of one case, GEOM seems to be a congenital benign oculofacial synkinesis of brain-stem origin.

Adult↗
PubMed1991

Language-apparent reflex epilepsy.

An adolescent with photosensitive epilepsy had absence seizures reproduced by forced voluntary eye closure in light or in darkness, independent of eyelid immobilization or ocular elevation. Attacks preferably occurred while speaking Spanish, her second language, mediated through brief, strong, automatic closing of the eyes during difficult word retrieval. Complex other multidirectional ocular movements or blinking, cognitive and language tasks were ineffective. Frontorolandic cortical epileptogenesis is seemingly responsible for light-provoked seizures in Papio papio, acting via hyperexcitable neuronal facial aggregates (i.e. Baba and Wada). Since orbicularis oculi muscle fibers mediating strong and weak contractions are differentially innervated by the facial nuclei, we submit that critical threshold tonic activation of specific nuclear aggregates explains this language-apparent reflex epilepsy, triggered by extreme eye closure. A "dopamine connection hypothesis" linking periodic eye closure, effortful memory and photosensitivity, based on its putative evolutive significance, is discussed.

Adolescent↗
PubMed1990

MRI studies in basilar artery migraine.

Magnetic resonance imaging (MRI) of the brain was performed in 18 patients with non-epileptiform basilar artery migraine (BAM). In a few subjects, mild enlargement of the cortical sulci and white matter T2 weighted increased signal intensity were present. Twelve of the patients also underwent computerized tomography (CT) of the head: 6 of the latter individuals had abnormalities on their MRI not detected by CT, but their finding did not modify the pre-existing diagnosis or influence clinical management. No evidence of biologic markers (i.e. congenital anomalies of the brainstem) was encountered and no signs of prior traumatic lesions, demyelinating disease or complicating stroke. MRI is a useful but limited complementary diagnostic tool in BAM.

Adolescent↗
PubMed1990

Unreactive EEG: pattern in locked-in syndrome.

Locked-in syndrome (LIS) is a state of complete paralysis except for ocular movements in a conscious individual, normally resulting from brainstem lesions. We report three patients with acute brainstem strokes and LIS whose repeated EEG recordings exhibited an "alpha coma" pattern including an unreactive alpha rhythm to multimodal stimuli. This finding is of importance since preservation of consciousness is often difficult to ascertain in LIS and presence of unreactive alpha on unresponsive patients is normally equated with vegetative states and discards LIS. Failure to diagnose LIS results in abandonment of communication efforts with these tragically affected individuals. Alpha reactivity cannot define consciousness.

Aged↗
PubMed1990

Bruxism.

Explore the source record for details and available documents.

Bruxism↗
PubMed1989

Temporal lobe syncope: clinical variants.

Temporal lobe syncope (TLS) is a term coined by Landolt. Characteristically, the patient has psychomotor and drop attacks, and the interictal electroencephalogram (EEG) shows temporal lobe epileptic abnormalities. TLS is synonymous with type III complex partial seizures (CPSs) in the Delgado Escueta classification. Several variants of TLS can be recognized including atonic akinetic, simple akinetic, atonic, atonic-tonic complex (automatisms), sexual seizures, stress-induced convulsions, and gelastic atonic seizures. TLS must be distinguished from drop attacks of vertebrobasilar insufficiency and associated EEG abnormalities, and from hereditary tachyarrhythmias mimicking stress-induced convulsions. Epileptic falls and drop attacks are discarded by ictal EEG recordings. Recognition of TLS variants is important in the prospective evaluation of the surgical treatment of epilepsy given the past conflicting reports on the differential outcome of surgically treated CPSs. TLS is an attractive clinical term, easy to remember, and with pathophysiologic relevance to the clinician confronting the patient with a history of syncope and whose EEG discloses temporal lobe paroxysmal activity. The detailed ictal electrophysiology of TLS is unknown.

Adult↗
PubMed1989

EEG features in transient global amnesia.

Forty-seven patients with one or more episodes of transient global amnesia (TGA) were studied by means of standard and 24-hour ambulatory cassette recording electroencephalography (EEG). Only one individual, with a left frontal hemorrhage, had intracranial lesions. TGA was multiple in 16 of the patients (34%), the attacks recurring with an average time span of one every 3 years. No patient required anticonvulsant therapy and all episodes of TGA were self-limited and rather benign. Only 13 patients were known to be hypertensive and 2 had a history of classic migraine. The average time span of EEG recordings after TGA was 2.7 days. Three individuals had recordings during the actual clinical attack, 2 of whom had paroxysmal abnormalities (one with periodic lateralized epileptiform discharges and the other with left temporal sharp wave and central spike and wave discharges). The remaining patient had no change in the EEG. The percentage of EEG abnormalities encountered was 36% (17 patients) but only 10.6% (5 patients) disclosed specific paroxysmal activity. Activation procedures, sleep and 24-hour ambulatory studies were overall of no additional value to the standard recordings. TGA seemingly represents a benign circulatory disturbance affecting the memory zones of the brain, rather than a primary epileptic disorder.

Aged↗
PubMed1989

Periodic complexes and alternating rotatory nystagmus with cyclic pupillary changes.

A 69-year-old male, with a history of a previous subdural hematoma, multistroke dementia and ventricular shunting for hydrocephalus, exhibited while comatose isolated periodic alternating rotatory nystagmus with cyclic pupillary changes and periodic alternating gaze. His simultaneous EEG showed PLEDs and subsequently burst-suppression pattern. The latter abnormality was associated, in addition, to transient eyelid opening, synchronized with the EEG bursts. Complex neuro-ophthalmologic clinical signs, sometimes subtle, may be the sole manifestation of EEG periodic complexes that have potential prognostic and therapeutic implications.

Aged↗
PubMed1988

Ictal bradycardia.

A patient had complex partial seizures manifested as transient confusion and profound bradycardia. These attacks were diagnosed by simultaneous EEG-ECG recordings and were suppressed by carbamazepine. Bradycardia is an exceptional cardiac accompaniment of partial seizures.

Aged↗
PubMed1988

Transient global amnesia and left frontal haemorrhage.

A patient developed spontaneous, acute, dominant frontal lobe haemorrhage neighbouring on a zone of pre-existing post-traumatic encephalomalacia manifesting clinically as transient global amnesia. Amnesia can be secondary to disease of the frontal lobe, affecting pathways interconnecting the basal forebrain and hippocampus of the temporal lobe.

Aged↗
PubMed1988

Writing tremor myoclonus.

A patient with a 9-year history of primary writing tremor is described. Spontaneous postural tonic abduction and tremor of the right index finger was also present. Atypical features included unidirectionality of the tremor, writing-associated and independent, bilateral proximal upper limb myoclonus. No clinical response was obtained after intravenous benztropine and subtotal lidocaine infiltration of the right first dorsal interosseous muscle motor point. There was no dystonia present. This case illustrates the sporadic occurrence of writing tremor of the primary type in the absence of dystonia, otherwise a common feature of writer's cramp.

Dystonia↗
PubMed1988

Ictus emeticus induced by photic stimulation.

It has been recently established that ictus emeticus originates from mesial temporal lobe structures. We herein report a patient with generalized epilepsy who exhibited ictus emeticus reflexly triggered by intermittent photic stimulation accompanied by generalized photoparoxysmal responses on the electroencephalogram. All seizures and EEG abnormalities ceased after treatment with valproic acid. The occurrence of ictus emeticus in generalized epilepsy is an apparent paradox, better explained by the theory of "secondary temporalization" implying the selective engagement of temporal lobe structures during generalized seizures.

Electroencephalography↗