Biomedical subjects

Wojciech Kułak

Publications and source records attributed to Wojciech Kułak.

10 recordsLinked to original sources

PubMed2006

Neurophysiologic and neuroimaging studies of brain plasticity in children with spastic cerebral palsy.

Patients with cerebral palsy (CP) may have some problems other than this motor impairment: mental retardation, epilepsy and sensory disturbance. Healthy children and children with CP have an enhanced capacity for learning and memory compared to adults. There are few tools for brain plasticity investigations. The utility of the neurophysiologic and MRI techniques in the determination of brain reorganization and repair in patients with cerebral palsy is described. The authors discuss their results of quantitative EEG and spectroscopy MRI studies in children with CP. Quantitative EEG and spectroscopy MRI can be useful tools in the determination of these processes in children with CP.

Age Factors↗

PubMed2006

[Facial palsy as the first syndrome of multiple sclerosis in 16 years old girl].

INTRODUCTION: Multiple sclerosis (MS) is demyelinating disease characterized by scattered neurologic deficits the central nervous system. The large number of scattered lessions produce many clinical symptoms. Facial palsy is rarely ascribed to multiple sclerosis as first syndrome. MATERIAL AND METHODS: 16-years old girl with sequence of features: 1. facial palsy, 2. transitional sudden hearing loss 3. transitory vertigo is presented. In audiologic examination pure tone audiogram, impedance audiometry, ABR and ENG were done. Air and bone thresholds were normal, stapedial reflex was absent and ABR suggested retrocochlear involvement in affected ear. RESULTS: In this case after MRI examination multiple sclerosis was diagnosed. CONCLUSION: ENT specialists should considered MS like a reason of facial palsy.

Adolescent↗

PubMed2005

EEG spectral analysis and coherence in children with hemiparetic cerebral palsy.

BACKGROUND: Hemiparetic cerebral palsy (HCP) is described as having two main forms: arm-dominant, associated with large cortical/subcortical lesions and leg-dominant, associated with central white matter lesions. MATERIAL/METHODS: Twelve children with HCP underwent clinical assessment and imaging studies. For each child, 20 artifact-free EEG epochs, each of 2s duration, were selected for spectral analysis and coherence functions. The objective of this research was to estimate EEG spectral power, interhemispheric coherence (ICoh), and intrahemispheric (Hcoh) coherence in children with HCP as compared to healthy children. RESULTS: Significant differences between the HCP and control children were detected in the distribution of alpha, theta, delta and beta rhythms over the left and right hemispheres. The ICoh values in the alpha band in the temporal, parietal and occipital regions were significantly lower in the HCP patients than in the controls. There was a significant ICoh increase in the HCP in the theta and delta band, involving frontal and temporal derivations. The significantly lower ICoh values in the HCP children in the beta band involved the frontal, central, parietal and occipital derivations. A higher HCoh value in the HCP children in the alpha band was detected at the right hemisphere. CONCLUSIONS: The lower ICoh at the temporal, parietal and occipital derivations in the alpha band implies hypoconnectivity between the right and left hemispheres. HCoh asymmetry, which implies relative hypoconnectivity within the left hemisphere as compared with the right, suggests that functional hemispheric differentiation may be diminished.

Adolescent↗

PubMed2004

[Current data on interferon therapy of multiple sclerosis in patients at developmental age].

Multiple sclerosis (MS) is a rare disorder of the central nervous system in children. In spite of the investigations of the last decade its etiology has not been established. The authors of the paper presented data on the specific nature of children MS using the current literature. They also demonstrated the role of interferon (INF) and clinical trials of MS treatment in children. The authors described their own experiences in the treatment of a boy with the youth MS using INF. The patient has suffered from MS since he was 15; INF therapy was introduced after two relapses of the disease. The results of the 18-month therapy with INF suggest beneficial immunomodulatory effects of interferon on MS course in children. The presented patient is continuing the therapy while his clinical status is being observed.

Adjuvants, Immunologic↗

PubMed2003

Risk factors and prognosis of epilepsy in children with cerebral palsy in north-eastern Poland.

Though epilepsy occurs in 15-90% of children with cerebral palsy (CP) its clinical course is not well defined. We therefore conducted studies of 198 children with CP seen in Pediatric Neurology Department of the Medical Academy in Białystok between 1994 and, 2001. The aim was to evaluate the risk factors, incidence and prognosis of epilepsy in CP. The overall epilepsy incidence was 41.4%. Epilepsy most commonly affected children with spastic tetraplegia 65.6%. Low birth weight, neonatal seizures, seizures during the first year of life, family history of epilepsy, severity of CP and computer tomography findings were found to be related to significantly increased risk of epilepsy in children with CP in the logistic regression analysis. Intractable epilepsy occurred in 51.2%, while in spastic tetraplegia it was even higher (60%). Controlled epilepsy was observed in 83.3% of spastic diplegia and in 72.7% of spastic hemiplegia. Polytherapy was commonly used in children with spastic tetraplegia 59.5%. Partial seizures secondarily generalized, infantile spasms and Lennox-Gastaut syndrome were the most frequently observed seizures in epileptic children with CP. Epilepsy is common in children with CP and has poor prognosis.

Adolescent↗

PubMed2003

[Spectral analysis and EEG coherence in children with cerebral palsy: spastic diplegia].

Cerebral palsy (CP) occurs in 1.4-3.0 per 1000 live births children. Major clinical features of CP are: spasticity of extremities, extrapyramidale movements, dyskinesis and ataxia. Spastic diplegia is the most common type of CP. Spectral analysis and coherence EEG are noninvasive measures of the functional relationship between brain regions and are evaluated to determine electrophysiologic abnormalities of neurologic and psychiatric disorders. The objective of this study was to estimate EEG spectral power density and coherence in children with spastic diplegia. A group of 29 children (15 girls and 14 boys) with DS recruited from the Department and Clinic of the Pediatric Neurology Ward in Medical Academy in Białystok, were studied. Their ages ranged from 6-14 years, mean 8.79 +/- 3.23 years. EEG results were compared with a control group of 31 healthy children with normal EEG records. For every subject, 20 artifact-free EEG epochs, each 2 s duration were selected for spectral analysis and coherence functions. A standard (fast fourier transformation) algorithm of signal processing was used. Significant decrease of power alpha at occipital derivations demonstrated in children with DS. On the other hand, there was an increase of theta power and delta bands almost in all leads. An increase of beta power was no significant compared with controls. Significant decrease of interhemispheric coherence values in children with DS for the alpha and theta band frequencies and in a few cases decrease of delta and beta bands were observed. Differences of intrahemispheric coherence values were detected at central-temporal and temporal-occipital leads. The presented results support anatomic-neurophysiologic abnormalities demonstrated in children with DS.

Adolescent↗

PubMedDate not supplied

Somatosensory and visual evoked potentials in children with cerebral palsy: correlations and discrepancies with MRI findings and clinical picture.

PURPOSE: To determine if there is any association between the findings of visual evoked potentials (VEPs), somatosensory evoked potentials (SEPs), and magnetic resonance imaging (MRI) findings with the neurodevelopment and severity in children with cerebral palsy (CP). METHODS: The present study included 15 children with spastic diplegic CP and five children with spastic hemiplegic CP and 42 healthy children as controls. The number of the controls was two-times greater than the study group to increase statistical power of this study. VEPs and SEPs were recorded in the CP children and compared with healthy controls. All MR scans were obtained using a 1.5 T MR scanner. RESULTS: A significant difference was found in the latencies P100 (VEP) between the CP and controls. No correlations between increased P100 latencies and asphyxia, prematurity, the CP severity, MRI findings and mental retardation were noted. A significant difference in N13-N20 conductions (SEPs) between the subjects with CP and the control group was found. SEPs were positively correlated with mental retardation in CP children. The brain lesions in MRI showed a significant correlation with the CP severity scores and mental retardation. CONCLUSION: The differences in VEPs and SEPs were determined between CP children and healthy children. The MRI findings were positively correlated with the CP severity and mental retardation.

Adolescent↗

PubMedDate not supplied

Calcium modulation in epilepsy.

The ideal antiepileptic drug (AED) should correct the aberrant pathophysiology of epileptogenesis without interfering with normal neurotransmission A new group of drugs with antiepileptic efficacy, without sedative properties, would be an exciting prospect. Theoretical considerations and results from experimental animal models of epilepsy have put forward the possibility that calcium (Ca2+) antagonists may form such a group. The initiation of epileptogenic activity in the neuron is thought to be connected with the phenomenon known as "intrinsic burst firing", which is activated by an inward Ca2+ current. Ca2+ is described as the primary mediator of "excitotoxic" neuronal damage. Both necrotic and apoptotic cell death is associated with Ca2+ entry into the cells during status epilepticus. The Ca2+ channel blockers depressed epileptic depolarizations of neurons. In this review, we present anticonvulsant effects of cinnarizine, flunarizine, nifedipine, nimodipine, nicardipine, amlodipine, isradipine, niguldipine, diltiazem, verapamil and dantrolene in animal models of seizures. Also, a detailed analysis of interactions between Ca2+ blockers and AEDs was performed. Clinical trials in intractable epilepsy support to a certain degree antiepileptic properties of Ca2+ antagonists.

Animals↗

PubMedDate not supplied

A multicenter, placebo-controlled, double-blind study of efficacy of a new form of carbamazepine (Carbatrol) in refractory epileptic patients.

Carbatrol (CBR) is a new multiple-unit, sustained-release dosage form of carbamazepine (CBZ) developed by Pharmavene. We present a multicenter, outpatient, randomized, double-blind parallel group study (No PI 101) carried out in two centers in Poland. CBR was evaluated in 47 patients with uncontrolled partial onset seizures. During the 28-day baseline period, patients were required to have at least two seizures and to take CBZ at a therapeutic level, a second antiepileptic drug was allowed but not valproic acid (VPA ). Patients were randomized to VPA or to CBR (dosages 800, 1200, 1600 mg/day). Criteria for escape relative to baseline were: two-fold increase in monthly seizure frequency, two-fold increase in 2-day seizure frequency, two-fold increase in weekly seizure frequency, single generalized tonic-clonic seizure (GTCs) if none occurred during baseline or prolongation of GTCs. The primary efficacy variable was the number of patients escaping in each treatment group. Nineteen patients on VPAand 7 on CBR met escape criteria. CBR adverse experiences were all mild or moderate in severity. CBR therapy was effective in the treatment of partial complex seizures with or without generalization.

Adolescent↗

PubMedDate not supplied

A comparative study of vigabatrin vs. carbamazepine in monotherapy of newly diagnosed partial seizures in children.

Carbamazepine (CBZ) is a drug of choice for the treatment of simple or complex partial seizures and secondary generalized seizures in adults and children. Vigabatrin (VGB) is a relatively new second line antiepileptic drug and was first registered for use in Poland more than ten years ago. Few reports have been published on the comparison of efficacy of VGB in children with epilepsy. The objective of this study is to evaluate the safety, efficacy and EEG effects of initial VGB monotherapy compared with initial CBZ monotherapy in children with newly diagnosed epilepsy. We present results of a prospective, outpatient and open study carried out in the University Hospital Center in Białystok. Twenty-six children with partial epilepsy treated with VGB and 28 patients treated with CBZ were studied. The evaluation of the efficacy of the two drugs did not reveal any significant differences. Very good (reduction > 75%) seizure control was achieved in 22 out of 26 patients (84.6%) in the VGB group. One patient had a 50-75% decrease of seizures (good effect), similarly one child had a 25-50% reduction of seizures (mild effect). In two patients, we observed increased seizures (myoclonic jerks). Very good seizure control was achieved in 17 out of 28 patients (60.7%) in the CBZ group. Good seizure control was achieved in 5 out of 28 patients (17.8%) and mild control was seen in two children. No improvement was observed in 4 (14%) of the patients. The EEG background activity was improved in VGB-treated patients. No effect on the EEG background activity was observed in CBZ-treated children. VGB seems to be a safe and effective antiepileptic drug as primary monotherapy for epilepsy in children with similar proportion of side effects as CBZ.

Adolescent↗