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Biomedical subjects

I Drury

Publications and source records attributed to I Drury.

At least 55 records · Page 3Linked to original sources
PubMed1989

14-and-6 Hz positive bursts in childhood encephalopathies.

14-and-6 Hz positive bursts, a benign epileptiform variant, have also been described in comatose children with liver disease, chiefly Reyes syndrome. To determine the incidence of this pattern in children in stupor or coma, 154 portable EEGs in 111 children with mental status changes were reviewed. Seven children showed 14-and-6 Hz bursts in the setting of moderate to marked background slowing. They were similar to positive bursts seen in normals in location, duration, morphology, frequency and repetition rate. They differed in being readily activated by stimulation. The etiology was toxic/metabolic in 4 cases, primary cerebral insult in 2 cases and a combination of the two in 1 case. Amongst an age-matched control population, 5 of 75 showed 14-and-6 Hz positive bursts in stage I or II sleep. There were no statistically significant differences in incidence rates between the 2 groups. 14-and-6 Hz positive bursts may occur in diverse encephalopathies of childhood, not just Reyes syndrome. The similar incidence rate, morphology and topography to normals suggest that the presence of these wave forms in encephalopathies represents persistence of a normal EEG feature rather than an expression of some underlying pathophysiological process.

Acoustic Stimulation↗
PubMed1989

Epileptiform patterns of children.

Infants and children display almost the entire range of interictal and ictal epileptiform patterns, exclusive of those seen in the neonatal period. This paper reviews patterns seen in the idiopathic and secondary forms of epilepsies, both generalized and partial, as well as periodic patterns and benign epileptiform variants as they appear in childhood. The discussion focuses on interictal activities, the abnormalities most commonly seen in the EEG laboratory. Special attention is paid to differential diagnostic features; the distinctions between significant epileptiform patterns and normal background features of the maturing child's EEG can be particularly challenging. A large number of illustrations are provided to demonstrate not only the classic epileptiform patterns but also many of the less typical presentations, since children's EEGs show a greater number of atypical waveforms.

Cerebral Cortex↗
PubMed1987

Fulminant demyelinating polyradiculoneuropathy resembling brain death.

A fulminant polyradiculoneuropathy resulted in a clinical state like brain death. Sequential EEG studies showed normally reactive alpha activity and spontaneous variability between wakefulness, drowsiness and sleep. EEG studies are valuable in such states in suggesting at least partial integrity of cortical neuronal activities, where no clinical measure is available.

Brain Death↗
PubMed1985

Pyknoleptic petit mal.

Pyknoleptic petit mal is a childhood epilepsy syndrome characterized by frequent absence seizures and a specific EEG pattern. The EEG trait is dominantly inherited. It represents the paradigm of primary generalized epilepsy with cortico-reticular participation. The clinical features include disturbances of awareness and/or responsiveness and frequently associated events such as mild clonic components, postural changes and automatisms. Treatment is usually successful in eliminating seizures and the prognosis is favorable for terminal remission though generalized tonic-clonic seizures may ensue.

Adolescent↗
PubMed1985

An acute syndrome with psychiatric symptoms and EEG abnormalities.

Four patients with abrupt onset of psychosis had prominent periodic EEG abnormalities with diffuse sharp waves. Other laboratory studies, including CSF and CT, were normal. The EEG abnormalities disappeared within 1 to 7 days. Clinical improvement was complete and commenced after the EEG showed improvement. The cause remains obscure, but it seems to be a transient organic disturbance of cerebral function that must be distinguished from primary psychiatric disorders.

Acute Disease↗
PubMed1984

Primary intracerebral hemorrhage: impact of CT on incidence.

From 1975-1979, the incidence of primary intracerebral hemorrhage (PIH) increased in Rochester, MN, when compared with a previously decreasing incidence. Judging from patients with PIH who were alert at diagnosis, we estimated that 24% of the hemorrhages in earlier years had been mislabeled as infarction. The 30-day survival rate increased from 8% in 1945-1974 to 44% in 1975-1979. The incidence rate was about 45% higher in patients receiving anticoagulant treatment than in those who did not. The increased incidence rate and improved survivorship were attributed to more frequent identification of small PIH by CT.

Adult↗
PubMed1983

Aetiology of chronic constrictive pericarditis.

In a consecutive series of 32 cases of chronic constrictive pericarditis treated by pericardiectomy during the past 25 years, four were attributable to rheumatoid disease, two to trauma, one to sarcoidosis, and four, at a maximum, to tuberculosis. In the remaining 21 cases of undetermined aetiology there was no evidence of tuberculosis. It appears, therefore, that tuberculosis was not a common cause of chronic constrictive pericarditis during the period under review, which included the 1950s and early 1960s when tuberculosis was widespread.

Adolescent↗
PubMed1983

The continuing decline in the incidence of stroke.

The incidence of stroke has continued to decline in the population of Rochester, Minnesota, up to the end of the last decade. The rate of occurrence of new episodes of stroke in the period 1975-1979 was only 46% of the equivalent rate during the period 1945-1949. The magnitude of the decline in incidence rates was similar in both sexes, but the timing differed. Females showed a progressive decline beginning early in the period of observation, but most of the decline in males occurred in the last 10 years of the study.

Adult↗
PubMedDate not supplied

Outcome of diabetic pregnancy with spontaneous labour after 38 weeks.

One hundred and forty-eight patients with well controlled insulin dependent diabetes that were allowed to labour spontaneously from 1981 to 1994 were reviewed. There were 2 perinatal deaths, giving a perinatal mortality rate of 13.5/1000. One hundred and twenty-four patients (84 per cent) had a normal vaginal delivery, 13 (9 per cent) forceps delivery and 11 (7 per cent) caesarean section. Twenty-one infants (14 per cent) required admission to a Special Care Baby Unit. One third of infants weighed 4 Kg or more, however there was only 1 case of shoulder dystocia. We compared these results with those of the general hospital population of 1987. The 2 main differences are; 1) the Caesarean section rate in labour was higher for this diabetic group than for the general hospital population, 7 per cent versus 3.4 per cent, 2) the birth weight was heavier, 33 per cent of infants of the diabetic group weighed 4 Kg or more versus 18 per cent of the general hospital population. The other parameters were comparable. We conclude that conservative management of pregnancy in well controlled diabetic women is advantageous, resulting in a high vaginal delivery rate without an increase in shoulder dystocia, and a low perinatal morbidity and mortality rate.

Diabetes Mellitus, Type 1↗
PubMedDate not supplied

EEG abnormalities aid diagnosis of Rett syndrome.

Nine girls with Rett syndrome had 22 electroencephalographic studies performed over 5 years. Nineteen walking tracings demonstrated moderate background slowing. Focal epileptiform activity was observed in 13 studies, 10 of which had bilateral independent foci. Spikes were invariably maximal in central regions, diphasic or triphasic, and of very short duration. In 3 patients, epileptiform activity preceded clinical seizures by up to 2 years. Two children had spontaneous hyperpnea preceding apnea during wakefulness with further background slowing. Video monitoring of 2 children revealed that episodic behavioral changes were not seizures. Ten of 12 sleep recordings had abnormal background activity with absent or rudimentary spindles. Normal activity occurred only in girls younger than 2 1/2 years of age. Epileptiform activity was markedly increased during sleep in 8 tracings in which both wakefulness and sleep were obtained. It was characterized by bilaterally independent and bisynchronous spike-and-wave activity, maximal in parasagittal areas. One patient had bursts of high-voltage slow-wave activity followed by attenuation. No apneic episodes were recorded during sleep. In Rett syndrome, electroencephalographic abnormalities include background slowing, centrally located short-duration spikes, and increased epileptiform activity during sleep. This activity commonly preceded clinical seizures in patients studied at initial presentation.

Child↗
PubMedDate not supplied

Benign partial epilepsy of childhood with monomorphic sharp waves in centrotemporal and other locations.

We reviewed EEGs from children whose history and clinical course was compatible with benign partial epilepsy of childhood with centrotemporal spikes. In 21% of patients with a single EEG focus, the discharge was outside the centrotemporal area. In 37.5% of patients with more than one focus, one was in the centrotemporal area while the other was not. We suggest that the typical EEG features of this syndrome are the normal background, the stereotypic morphology of the sharp waves, and their activation by drowsiness and sleep, not their exclusive location in the centrotemporal regions. Insistence on a centrotemporal location for the EEG discharges in this syndrome may lead to a misclassification of the type of epilepsy in some children with implications for therapeutic decisions and prognostic statements.

Adolescent↗