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Biomedical subjects

M E Drake

Publications and source records attributed to M E Drake.

At least 109 records · Page 6Linked to original sources
PubMed1985

Abnormal somatosensory evoked potentials in amyotrophic lateral sclerosis.

A patient with typical clinical and electromyographic features of amyotrophic lateral sclerosis (ALS) was found to have abnormal somatosensory evoked potentials (SEPs). Evoked responses are generally considered to be normal in ALS despite occasional pathological and clinical evidence of sensory involvement. Thus, abnormal SEPs are considered to argue against a diagnosis of ALS. Based on the present case and a review of the literature, we suggest that abnormal SEPs need not exclude a diagnosis of ALS.

Adult↗
PubMed1985

Computerized spectral analysis of the interictal EEG in epilepsy.

Eight seizure patients without encephalopathy, frequent seizures, brain lesion, or medication intoxication had significant slowing of alpha-frequency activity, as compared to nonepileptic controls, that was evident in compressed spectral analysis but not in standard EEG. Those patients with cognitive or behavioral problems or taking more than one antiepileptic medication had a greater degree of slowing. Differences between seizure patients with and without cognitive or behavioral symptoms, and between specific antiepileptic drugs, were suggested but could not be assigned significance due to small numbers. The findings suggest that interictal changes in brain function that are not revealed by standard EEG may relate to observed changes in interictal behavior and cognition, and that computerized spectral analysis of the interictal EEG may be of value in the assessment of seizure patients before and during therapy.

Adolescent↗
PubMed1985

Interictal EEG prediction of response to antiepileptic drug monotherapy.

Forty-eight patients had sleep-deprived EEGs prior to antiepileptic drug monotherapy. The majority were seizure-free after one year, or had more than 50% reduction in seizure frequency. Among those with normal EEGs 50% were seizure-free, while 75% with diffuse slowing, 44% with focal abnormality, and 83% with generalized epileptiform discharges were fully controlled. Freedom from seizures was achieved in 13% taking phenobarbital, 50% taking phenytoin, 63% taking carbamazepine, and 100% taking valproate. The sleep-deprived interictal EEG should be an integral part of initial assessment and drug selection in patients with clinical histories of convulsive seizure.

Adolescent↗
PubMed1985

Saline activation of pseudoepileptic seizures: clinical EEG and neuropsychiatric observations.

Twenty patients with suspected pseudoseizures underwent saline infusion during prolonged sleep deprived EEG with video monitoring and nasopharyngeal electrodes. No patients had definite clinical evidence of epilepsy, but 35% had abnormal EEGs, 10% with epileptiform activity. Patients with epileptiform discharges did not experience pseudoseizures with saline infusion. Patients with generalized EEG slowing responded to saline infusion with characteristic seizures. Three groups of patients were differentiated. Eight patients had characteristic attacks with saline infusion, and in these patients females predominated, mean age was lower, and somatoform disorder was common. Six patients each either failed to respond to saline or had episodes different from their characteristic spells. These patients were more often male and more often had diagnoses of personality disorders. The findings suggest that, although saline infusion may identify pseudoseizures and confirm their non-epileptic nature, some patients may not be sufficiently suggestible to respond to saline infusion, while others may have non-epileptic attacks which are different from the spells under evaluation. Psychiatric and neuropsychological features suggestive of pseudoseizures may be more readily identified by psychiatric interview or psychometric testing. Ethical issues regarding saline infusion in the guise of a potent convulsant should also be considered.

Adult↗
PubMed1985

Acute cerebellar syndrome in infectious mononucleosis: documentation of two cases with Epstein-Barr virus infection.

Acute cerebellar ataxia has been described occasionally with infectious mononucleosis. Two additional cases are reported with serologic identification of Epstein-Barr virus (EBV) infection in blood and cerebrospinal fluid. As with previously described cases, the outcome was benign, and examination and laboratory studies did not indicate diffuse neurologic involvement. Visual and brainstem auditory-evoked responses were normal. Electroencephalograms (EEG) demonstrated 14 and 6 per second positive spikes in both patients. This pattern is considered a normal variant and has been recorded from depth electrodes and reported with deep midline lesions. These cases support the prognosis of benign cerebellar involvement in infectious mononucleosis and suggest that evidence of EBV infection be sought in patients with acute ataxia. The significance of 14/sec and 6/sec positive EEG spikes is uncertain.

Acute Disease↗
PubMed1984

Clinical correlates of very fast beta activity in the EEG.

Beta activity of 30-40 hz is rarely encountered, and has been reported to be more common in retarded individuals and those with psychiatric disorders. Of 3752 records in 1982-83, 0.8 percent demonstrated beta activity of 30 hz or faster, with a disproportionate representation of psychiatric symptoms and mental retardation in comparison with the general EEG referral population. No other specific correlations were evident, but the activity also occurred in neurologically and psychiatrically normal individuals. Although these findings may imply an association between very fast beta activity and psychiatric illness or mental subnormality, that association may be spurious or nonspecific in view of the small and heterogenous population demonstrating this type of beta activity. Controversy concerning very fast beta activity, as well as other infrequent or controversial patterns, may be lessened by application of spectral analysis and statistical techniques which are increasingly available for clinical EEG studies.

Adult↗
PubMed1984

Unilateral pruritus and Nocardia brain abscess.

We studied a patient with unilateral itching associated with Nocardia brain abscess. Pruritus without a primary cutaneous eruption often indicates an underlying medical disorder, but has rarely been described in cerebral disease such as MS or infarctions. Our patient also had sensory loss and motor findings contralateral to the cerebral lesion, suggesting that itching may have cerebral representation contiguous to other sensations.

Adult↗
PubMed1984

Assessment of SIADH in psychosis with a water-loading test: case report.

A man taking haloperidol presented with psychosis, polydipsia, and the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). A water-loading test indicated that haloperidol did not cause the SIADH. In patients taking haloperidol or other neuroleptics associated with SIADH who develop psychosis, polydipsia, and complications of SIADH such as hyponatremia, water loading may be helpful in adjusting psychotropic medications so as to control psychosis while avoiding the complications of hyponatremia.

Adult↗
PubMed1984

Posterior cerebral artery occlusion without hemianopia.

A 42-year-old man had ischemic infarction from an occlusion of the left posterior cerebral artery (PCA), but had no visual field defect by examination or Goldmann perimetry. Arteriograms showed distal filling of the occluded PCA, but no collateral blood flow from the carotid circulation, suggesting collateral flow from leptomeningeal anastomoses. Visual field sparing may occur in surgical occlusion of the PCA, but rarely occurs in stroke. An infarction from PCA occlusion is not excluded by complete visual field sparing, and studies looking for other causes of the neurologic deficit may not be necessary.

Adult↗
PubMed1984

Status epilepticus after baclofen withdrawal.

Baclofen is widely used in the treatment of spasticity of spinal origin. It is relatively free of side effects or toxic actions on the nervous system or other organs. Agitation, personality change, and auditory and visual hallucinations have been described following its abrupt withdrawal. One patient with generalized seizures and one with complex partial seizures after baclofen withdrawal have been reported. This paper presents a patient who developed status epilepticus after baclofen withdrawal, and who sustained hypoxic cerebral injury. This observation further emphasizes the possibility of infrequent complications of baclofen therapy, and the advisability of gradual changes in baclofen dosage.

Baclofen↗
PubMed1983

Conversion of ischemic to hemorrhagic infarction by anticoagulant administration. Report of two cases with evidence from serial computed tomographic brain scans.

Anticoagulant therapy is appropriate for embolic cerebral infarction due to valvular heart disease or cardiac dysrhythmia, as well as for stroke-in-evolution. Various incidences of hemorrhagic complications have been cited in patients given anticoagulants after stroke or transient cerebral ischemia. Conversion of ischemic to hemorrhagic infarction has been shown to occur experimentally. We describe two patients in whom this conversion occurred in the absence of hypertension or excessive anticoagulation and was substantiated by serial computed tomographic brain scans. This finding suggests that conversion of ischemic to hemorrhagic infarction may occur even with appropriate and carefully administered anticoagulation therapy.

Adult↗
PubMed1983

Acute psychosis, polydipsia, and inappropriate secretion of antidiuretic hormone.

A relationship between acute psychosis, water ingestion, and the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) has been reported. This syndrome was observed in a psychotic patient who ingested massive amounts of water and became symptomatically hyponatremic with seizures. Although he had been taking haloperidol, the SIADH responded to fluid restriction alone. SIADH was clearly established, and a temporal relationship to his acute exacerbation of psychosis and polydipsia could be shown. This case illustrates that psychosis, polydipsia, and SIADH are often associated as a triad, and that psychiatric history must be considered in the evaluation of this syndrome.

Drinking↗