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Biomedical subjects

M C Spitz

Publications and source records attributed to M C Spitz.

11 recordsLinked to original sources
PubMed2000

Closed head injury resulting in paradoxical improvement of a seizure disorder.

People with epilepsy are prone to head injuries and these traumas are usually considered adverse events. We report the case of a 31-year-old woman who sustained a closed head injury as a result of a seizure. This accidental trauma resulted in a 1-year remission of her previously intractable complex partial seizures. The paradoxical improvement of a seizure disorder can occur as a result of a closed head injury. We postulate it simulated ablative epilepsy surgery.

Adult↗
PubMed1998

Subacute postictal aggression.

OBJECTIVE: To address clinical features of subacute postictal aggression, we examined aggressive behavior beginning hours to days after the acute confusional postictal period. METHODS: Six patients from our database of 1300 were assessed. Data was obtained from the patients, their family and caretakers, and medical records. One patient was studied with closed circuit video/EEG. RESULTS: There is clinical heterogeneity among these individuals with respect to etiology of epilepsy, age of onset, laterality, memory of adverse behaviors, and presence of psychosis. Several clinical features, including male gender, were common to all. The episodes of postictal aggression were not isolated events, but recurred repeatedly; the behaviors were uniquely stereotyped in each patient. Subacute postictal aggression was more likely after a cluster of seizures than after a single ictus. All patients had medically intractable epilepsy and were remorseful in the interictal period. CONCLUSIONS: Subacute postictal aggression, a rare phenomenon within the broad spectrum of epilepsy-related behaviors, appears to be a true clinical entity with several consistently observed manifestations.

Adolescent↗
PubMed1996

The imaging of epilepsy.

Based on the experience of a university neurological epilepsy center, the neurological classification and the gradation of neurological evaluation of patients with epilepsy are described. Into this the nature and the significance of the imaging of the brain are interwoven. The object, illustrated by several illustrative patients, is to stress the importance of the MRI and to note that based on the MRI findings and the clinical findings, the battery of sophisticated electroencephalographic evaluation is determined. Epilepsy is an area where imaging and all aspects of the clinical neurological evaluation integrate very well and in which correlation is most important.

Adult↗
PubMed1986

Dissociation of frontal N100 from occipital P100 in pattern reversal visual evoked potentials.

We studied the relationship between occipital P100 and frontal N100 in visual evoked potentials produced by pattern reversal in normal subjects and two groups of patients. Recording derivation was critical for interpretation since both Fz and Oz electrode sites are active. In 9 patients, but no normal subjects, P100 was absent. In these patients, use of a standard Oz-Fz montage resulted in the erroneous impression of a 'normal' P100 since a downward deflection was produced by the inverting effect of the amplifier on an intact N100 at Fz. When both P100 and N100 were present (at Oz and Fz respectively), their latencies were usually similar but not identical which contributed to apparent latency shifts or W-shaped wave forms in the Oz-Fz derivation. We conclude that use of a non-cephalic or relatively inactive scalp position (such as the mastoid) should be used as a reference site in addition to Fz to reduce interpretive errors.

Adolescent↗
PubMed1985

Familial tic disorder, parkinsonism, motor neuron disease, and acanthocytosis: a new syndrome.

We report two brothers who were of consanguineous parents and who displayed a unique association of motor and vocal tics, parkinsonism, distal muscular atrophy, and acanthocytosis. In the older brother, leg weakness and muscle wasting started at age 13, and he became wheelchair bound at 40. Electrophysiologic studies and muscle biopsy confirmed diffuse denervation. Involuntary vocalizations and facial tics began at age 36, but within 5 years the tics were replaced by progressive parkinsonism with supranuclear ophthalmoparesis. CSF studies implied impaired central dopamine and serotonin turnover. In the younger brother, orofacial tics started at age 36, vocalizations and fasciculations in the legs began 1 year later, and parkinsonian findings were present at age 40. This is the first report of an association of Tourettism, parkinsonism, motor neuron disease, and acanthocytosis occurring as an autosomal recessive syndrome.

Acanthocytes↗
PubMedDate not supplied

Central nervous system effects of chronic toluene abuse--clinical, brainstem evoked response and magnetic resonance imaging studies.

We describe the results of neurological evaluation, magnetic resonance imaging (MRI) of the brain and brainstem auditory evoked response (BAER) testing in 11 chronic toluene vapor abusers. Neurological abnormalities were seen in four of 11 individuals and included cognitive, pyramidal, cerebellar and brainstem findings. MRI of the brain was abnormal in three of 11 individuals and revealed the following abnormalities: 1) Diffuse cerebral, cerebellar, and brainstem atrophy; 2) Loss of differentiation between the gray and white matter throughout the CNS; and 3) Increased periventricular white matter signal intensity on T2 weighted images. BAERs were abnormal (control mean +/- 3 S.D.) in five of 11 individuals. As a group, the latency of V (p less than 0.01), the III-V interpeak (p less than 0.05) and the I-V interpeak latencies were prolonged compared to controls. All three individuals with abnormal MRI scans also had abnormal neurological examinations and BAERs. Two of five individuals with abnormal BAERs, however, had normal neurological examinations and MRI scans. Our data support previous findings of diffuse white matter involvement in chronic toluene abusers and suggest that BAERs may detect early CNS injury from toluene inhalation even at a time when neurological examination and MRI scans are normal. BAERs, therefore, may be a sensitive screening test to monitor individuals at risk from toluene exposure (either abusers or industrially exposed individuals) for early evidence of CNS injury.

Adult↗
PubMedDate not supplied

Panic disorder in seizure patients: a diagnostic pitfall.

Panic disorder is a psychiatric diagnosis whose main feature is paroxysmal attacks of anxiety that strike suddenly without apparent provocation. Physicians explain the attacks as an ictal phenomenon in patients with known seizures because of their similarities to complex partial seizures. We report eight patients with seizures and panic disorder. Recognition of a second diagnostic entity resulted in a beneficial change in treatment in six of the eight. We did not find an increased incidence of panic disorder in our seizure clinic population as compared with the general population.

Adult↗
PubMedDate not supplied

Severe burns as a consequence of seizures in patients with epilepsy.

We report 10 seizure-related thermal injuries severe enough to require hospitalization in patients with epilepsy. Eight of the ten incidents were with patients who had had seizures with impaired consciousness two or more times a month. This suggests that seizure frequency is a risk factor and implies the importance of striving for optimal seizure control. Two burns each occurred from an electric iron, a hand-held hair dryer, and stove-top cooking. Minimizing these activities, especially in patients with frequent consciousness-altering seizures, may be useful. Three burns occurred while showering; these resulted in the most severe injuries, with hospital stays of 29, 30, and 41 days. Simple plumbing devices may have prevented these injuries.

Accidents, Home↗
PubMedDate not supplied

Risk factors for burns as a consequence of seizures in persons with epilepsy.

To explore the risk factors and circumstances for burns in a population of persons with epilepsy, we surveyed 244 University of Colorado Health Sciences Center Seizure Clinic patients. Twenty-five had at least one seizure-related burn requiring medical attention (12 were hospitalized), 21 reported burns requiring medical attention not related to seizure activity, and 199 reported no burns. All patients with seizure-related burns had alteration of consciousness during most seizures. Statistical models with logistic regression indicated that a useful model for assessing risk of seizure-related burns in this population of patients could be constructed using three significant variables; lifetime total number of seizures experienced by the patient, the presence of interictal neurologic impairment, and gender. The remainder of the variables studied (percentage of seizures that occurred nocturnally, percentage of seizures preceded by a simple partial seizure (SPS) warning, self-care status, number of seizures in adult life, seizure type, patient age, age of onset of seizure disorder, and presence of burns not associated with seizure) were either not significantly correlated with seizure-related burns or did not significantly improve the success of the statistical model in light of the other variables studied. Most injuries occurred in the home during activities that might have been avoided. They included 10 burns incurred while cooking, 5 incurred while showering (with a plumbing system that permitted exposure to scalding water), and 3 caused by exposed room heaters. A subset of epileptic patients are at increased risk for burns and should minimize situations in which they can be burned.

Accident Prevention↗