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Biomedical subjects

R E Harbaugh

Publications and source records attributed to R E Harbaugh.

64 records · Page 4Linked to original sources
PubMed1983

Forebrain commissurotomy for epilepsy. Review of 20 consecutive cases.

During the past 10 years, 20 patients with intractable generalized, generalized and partial, and partial seizures have been treated here by surgical division of one or more of the forebrain commissures. Modifications in the operative technique and extent of operation have resulted in continued good results in seizure control with decreased morbidity. The present operation, a two-stage division of the corpus callosum and underlying hippocampal commissure, is demonstrated to be effective in controlling intractable seizures. Good or excellent results account for more than 80 per cent of the series. Historical background, indications for operation, criteria for patient selection, operative technique, results, complications, and the value of forebrain commissurotomy as a research tool are presented.

Adolescent↗
PubMed1982

Pediatric cerebellar infarction: case report and review of the literature.

Infarction in the vertebrobasilar system is uncommon in children. Cerebellar infarction presenting as a posterior fossa mass lesion is distinctly rare. We recently treated a 13-year-old boy with such a lesion as a complication of basilar artery migraine. A review of the literature on vertebrobasilar infarction in children is presented and the therapeutic alternatives in cerebellar infarction are discussed.

Adolescent↗
PubMed1982

Telencephalic theory of generalized epilepsy: observations in split-brain patients.

The anatomical structures involved in the origin and spread of generalized seizures in humans have not been fully elucidated. Cortical, centrencephalic, and corticoreticular theories have been proposed to explain the clinical and electroencephalographic findings in patients with primary, generalized epilepsy or secondarily generalized seizures. Our observations in patients undergoing forebrain commissurotomy for intractable, generalized seizures lead us to propose a telencephalic theory of generalized epilepsy. This theory stresses the importance of the cerebral cortex as the site of origin of seizure discharge and the function of the forebrain commissures in the rapid propagation and bilateral synchronization of such discharge. These observations plus a review of the data generated from animal models of epilepsy are presented as evidence for such a theory. Although none of our patients had classical petit mal epilepsy, our findings suggest a secondary role of the brain stem reticular formation in generalized seizures and may be cogent to the discussion of primary, generalized epilepsy.

Adolescent↗
PubMed1982

Implanted continuous epidural morphine infusion system. Preliminary report.

A number of reports have shown that epidural or intrathecal administration of morphine provides pain relief. Since February, 1981, the authors have used an implantable pump and epidural catheter for continuous epidural morphine infusion in patients with chronic pain. This system has functioned well, without respiratory or infectious complications. Functional characteristics of the system, technique of implantation, and preliminary results in two patients treated by this method are presented.

Adenocarcinoma↗
PubMed1981

External ventricular drainage for control of posthemorrhagic hydrocephalus in premature infants.

Over a 3-year period, 11 premature infants with intraventricular hemorrhage and posthemorrhagic hydrocephalus were managed initially with prolong external ventricular drainage via a subcutaneously tunneled catheter. The mean duration of drainage for this group was 20.7 days. Although two patients died before shunting was considered, no morbidity or mortality was observed to result from this technique. Seven patients required a shunt after stabilization of their medical problems. Two patients, followed for 24 and 40 months, have not required shunting procedures. External ventricular drainage via a subcutaneously tunneled catheter has been found to be a safe and reliable initial method of treating posthemorrhagic hydrocephalus in premature infants.

Cerebral Hemorrhage↗
PubMedDate not supplied

Novel CNS-directed drug delivery systems in Alzheimer's disease and other neurological disorders.

Increasing knowledge of the neurochemical aspects of central nervous system function raises the possibility of treating Alzheimer's disease (AD) and other neurological diseases by the appropriate manipulation of neurotransmitters, neuromodulators, neurohormones or neurotrophic factors. Clinical application of this knowledge may, however, be inhibited by long standing problems with drug delivery to the central nervous system (CNS). Novel, CNS-directed, drug delivery systems might be used to overcome many of these problems. The problems encountered in drug delivery to the brain, present experience with the clinical use of some novel drug delivery systems and the advantages and disadvantages of these systems will be discussed.

Alzheimer Disease↗
PubMedDate not supplied

Continuous ICV infusion of scopolamine impairs sustained attention of rhesus monkeys.

Systemic administration of anticholinergic agents impairs cognitive performance in animals and man. The anticholinergic, scopolamine, has profound effects on peripheral and central cholinergic function, making interpretation of its effects on cognitive performance difficult. To circumvent this problem, scopolamine was administered directly to the central nervous system of rhesus monkeys using a subcutaneously implanted infusion pump connected to a cannulae directed toward the right lateral ventricle. Intracerebroventricular (ICV) infusion of scopolamine (0.004, 0.012, 12.5, and 40.0 micrograms/kg/h) produced a dose-dependent decrease in the number of responses on a continuous performance task. Response decrements produced by scopolamine were seen mainly during the last half of the test session and at short stimulus durations. These data suggest that scopolamine produces a deficit in sustained attention or slowing of information processing that is mediated through direct central cholinergic blockade in the rhesus monkey.

Animals↗
PubMedDate not supplied

Anticonvulsant activity of intracerebroventricularly administered glial GABA uptake inhibitors and other GABAmimetics in chemical seizure models.

The antiseizure activities of glial or neuronal GABA uptake inhibitors and GABA agonists were compared following intracerebroventricular administration in 2 acute models of chemoconvulsion in rats. The glia-selective GABA uptake inhibitor, 4,5,6,7-tetrahydroisoxazolo[4,5-c]pyridin-3-ol (THPO), given at doses of 100-750 micrograms, i.c.v., protected against maximal pentylenetetrazol (PTZ) seizures and increased the latency to isonicotinic acid hydrazide (INH) seizures for at least 1 h following central administration. THPO failed to increase PTZ seizure thresholds. In contrast, the more potent partly glia-selective GABA uptake inhibitor, cis-4-hydroxynipecotic acid (30-300 micrograms), which is also a substrate for neuronal and glial transport systems, protected only 33% of rats against PTZ-induced tonic extension and had no effect on INH seizure latency. The neuron-selective uptake inhibitor L-2,4-diaminobutyric acid (DABA) at 1500 micrograms exhibited anti-PTZ activity initially and then, after a delay, produced proconvulsant behavior and spontaneous myoclonus in some animals. Intracerebroventricular injection of the GABA receptor agonist, muscimol, at toxic doses, gave rise to mixed anticonvulsant (INH seizures) and proconvulsant (PTZ seizure thresholds) effects. The results suggest that THPO, of the 4 compounds tested, possesses significant anticonvulsant activity. Its ability to suppress tonic but not generalized minor seizures suggests that it may block seizure spread.

Aminobutyrates↗