[Anthroposophic medicine].
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Biomedical subjects
Publications and source records attributed to M Engel.
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Cerebral potentials prior to speaking were recorded in 36 healthy righthanded subjects. Subjects began holding breath at irregular intervals prior to the voluntary onset of speech. This was done in order to avoid respiration-related potential shifts. The Bereitschaftspotential (BP) or readiness potential started already 2 s prior to the onset of speaking and was present over either hemisphere. During the last 100 to 200 ms of preparation period, the BP became significantly lateralized towards the left hemisphere. The close temporal relation to speech onset characterized this hemispheric lateralization to be an indicator of the final motor mechanisms for speech. Still, the BP was a bilateral phenomenon, i.e. it was also present over the right hemisphere, indicating involvement of the non-dominant hemisphere as well. The data are compatible with the view of an early bihemispheric motor preparation for speech followed by a late left hemisphere preponderance as the final common pathway.
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A 9 1/2-year-old boy developed a progressive dyskinesia 7 years after an angiographically demonstrated internal cerebral vein thrombosis. CT revealed bilateral thalamic lesions, more severe on the side contralateral to the movement disorder, without striatal involvement. This is a rare example of survival after internal cerebral vein thrombosis in a child and demonstrates that movement disorders may be delayed consequences of childhood stroke.
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Five patients with shunt-dependent hydrocephalus were observed to have apparently normal ventricular size despite marked increases in ventricular pressure after shunt malfunction. Elastance (dP/dV) was determined in four of these patients by removing increments of cerebrospinal fluid and measuring the resulting pressure. These patients without ventricular enlargement and with markedly increased ventricular pressure had high elastance. This group of patients with "normal volume" hydrocephalus had distal shunt occlusions, in contrast to previously reported patients with cephalic shunt obstructions after ventricular decompression. Initial shunting in early infancy, prolonged shunt dependency, and lack of recent shunt revision were common factors in these patients. Markedly elevated pressure with normal volume is a threatening clinical entity, requiring prompt surgical intervention
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