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PubMed2006

[Is it possible to avoid pathological grief if relatives of patients with palliative diseases are supported?].

The transition from normal to pathological grief is smooth. If it is almost impossible to define normal grief with all the existing descriptions of grief phases and systematic models, then it is all the more difficult to define pathological or complicated grief, especially as the existence of remaining grief, or remaining grief that rises to the surface again through memories, are considered normal processes of grief. Remaining grief does not compare with unfinished deep mourning, and so it is not pathological. The response to grief in this case report seems to be pathological or complicated because the process involved in grieving has been replaced by a kind of emotional stagnation, marked by aggression and a feeling of guilt. The family-centred therapeutic approach, taking in the whole family and aimed at discovering potential risk factors for the relatives and the strain they are under, as well as a recognition of the next-of-kin as "secondary patients" have an important role to play in the avoidance of pathological grief.

Communication↗
PubMed2005

Metaplastic breast carcinoma: clinical-pathologic characteristics and HER2/neu expression.

BACKGROUND: Metaplastic breast carcinomas (MBC) are rare primary breast malignancies characterized by the co-existence of carcinoma with non-epithelial cellular elements. They can be classified as monophasic spindle cell (sarcomatoid) carcinoma, biphasic carcinosarcoma, adenocarcinoma with divergent stromal differentiation (osseous, chondroid and rarely rhabdoid) as well as adenosquamous and pure squamous cell carcinomas. There is a paucity of information on clinically relevant pathologic features and clinical outcomes for these rare tumors. The aim of this study was to review the pathologic features and clinical outcomes of all cases of MBC seen at a single institution between 1971 and 2000. METHODS: A computerized search of the Queen Elizabeth II Health Sciences Center (QEII HSC) surgical pathology files was performed for the years 1971-2000. Tumor blocks from identified cases were reviewed and immunohistochemistry was performed for estrogen and progesterone receptors (ER/PR), HER2/neu protein overexpression and cytokeratin profile. Clinical outcome information was obtained from hospital files and telephone contact with treating physicians. RESULTS: Twenty-six (26) cases were retrieved with only one case identified before 1990. All tumors were high grade with a median tumor size of 3.7 cm (range 1.4-9.5 cm). Thirteen cases had lymph node dissections available for evaluation, with 4 demonstrating nodal metastases. Five of 26 cases were ER positive within the adenocarcinomatous component, only two of which also expressed PR. Associated ductal carcinoma in situ (DCIS) was present in 11 cases. HER2/neu over-expression was seen in only one (1/26) adenosquamous carcinoma (3 + membranous staining of the malignant glandular component). At 23 months median follow-up, disease free survival (DFS) for the entire group was 53%. CONCLUSIONS: Although a rare breast cancer subtype, MBC is of considerable interest due to its pathological heterogeneity and differences in clinical behavior compared to typical breast carcinomas. Increasing pathologic recognition of MBC as a discrete entity is suggested by the number of MBC diagnoses in the last decade compared to previous years. The poor DFS associated with MBC suggests that further research exploring mechanisms of carcinogenesis and identifying clinically relevant prognostic factors is needed to direct optimum clinical care. Importantly, MBC variants appear to rarely overexpress the HER2/neu oncoprotein.

Adult↗
PubMed2005

The role of perceived control and overconfidence in pathological gambling.

Two studies sought to determine whether perceived control has different effects on confidence assessment and betting decisions among pathological and problem gamblers than among non-problem gamblers. In Study 1, 200 college students who were frequent gamblers (80 female and 120 male, median age 20) completed the South Oaks Gambling Screen (SOGS) and then engaged in a task in which they answered questions, assessed confidence in each answer, and considered bets on their answers that were fair if they were well-calibrated, but unfavorable if they were overconfident. Probable pathological and problem gamblers earned significantly fewer points than non-problem gamblers. This was due to greater overconfidence among pathological and problem gamblers, which led to systematically less favorable bets. In Study 2, using 384 participants (105 female and 279 male, median age 20), control was independently manipulated and bets were constructed to make point value independent of overconfidence. Problem and pathological gamblers showed both greater overconfidence and greater bet acceptance. They were less affected by control in their betting decisions than non-problem gamblers, but more affected in the slope of their betting function. It is concluded that pathological and problem gamblers process information about confidence and control differently from non-problem gamblers.

Adult↗
PubMed2007

Prevalence of adult problem and pathological gambling between 2000 and 2005: an update.

BACKGROUND: Excessive gambling is a prominent Public Health problem with high prevalence rates in many countries. Substance abuse and other co-morbidities often constitute a major health hazard for the person which gambles with a loss of material and social resources, as well as being a major concern for his or her significant others. The present study updates and extends prevalence data to include work published between 2000 and 2005 in English and other European languages. METHODS: In a three-step search and exclusion process, studies with current adult prevalence rates were gathered. RESULTS: Almost all studies fulfil basic research standards. The weighted mean prevalence rates for excessive gambling (problem and pathological) are 3.0% for the South Oaks Gambling Survey (problem 1.2%; pathological 1.8%), 3.3% for the Canadian Problem Gambling Index (problem 2.4%; pathological 0.8%) and 3.1% for the DSM-IV (problem 1.9%; pathological 1.2%). CONCLUSION: The prevalence rates are comparable and relatively stable between countries and across survey instruments, and do not differ from earlier reviews. The regular epidemiological monitoring of excessive gambling remains a major Public Health issue although the distinction between pathological and problem gambling is not appropriate for epidemiological research. Further studies are needed with respect to concomitant lifestyle characteristics.

Adult↗
PubMed2005

The value of PSA, free-to-total PSA ratio and PSA density in the prediction of pathologic stage for clinically localized prostate cancer.

OBJECTIVE: The ability of prostate-specific antigen (PSA), free/total PSA and PSA density to predict the pathologic stage in prostate cancer has not been clear yet. In this study, we evaluated the value of PSA subgroups in the prediction of pathologic stage after radical prostatectomy. METHODS: A total of 42 subjects 55-78-years-old who underwent radical retropubic prostatectomy were included in the study. Preoperative PSA, free/total PSA and PSA density (PSAD) values were compared according to the pathologic stages of radical prostatectomy specimens. Receiver operating characteristics (ROC) curves were measured for each parameter. RESULTS: The clinical stage that was estimated for all patients was between T1N0M0 and T2bN0M0. Pathologic examination revealed organ-confined disease in 18 patients. The area under curve (AUC) for organ confinement was 0.553 for PSA, 0.446 for free/total PSA ratio and 0.706 for PSAD. Cut-off values providing the best sensitivity and specificity in ROC analysis for PSA, free/total PSA and PSAD were 7.1, 0.15, and 0.17, respectively (likelihood ratio: 0.9, 1 and 2). The positive predictive values at these cut-off values were 0.54, 0.56, and 0.70, respectively. Only PSAD cut-off values was found statistically borderline significant for predicting organ-confined disease. CONCLUSION: While PSAD is more helpful than PSA and free/total PSA ratio for prediction of organ-confined disease, none of these parameters are significant predictor of pathologic stage for clinically localized prostate cancer.

Aged↗
PubMed1989

The pathology of alkaptonuric ochronosis.

The gross and microscopic pathology of alkaptonuric ochronosis is presented from a study of pathologic specimens from six cases in our files and from a review of the literature. Emphasis is placed on the most clinically relevant organ systems involved by ochronosis: musculoskeletal, cardiovascular, genitourinary, eye, and skin. Recent electron microscopic discoveries from several affected organs, including the synovium, articular cartilage, cardiovascular system, eye, and skin, are included in this report. In addition, the molecular pathology of alkaptonuria is briefly discussed. The pathologic literature regarding alkaptonurin ochronosis is fragmented, as most cases of this rare entity are reported individually or as small series of cases. A comprehensive review of alkaptonuria has not appeared since the clinicopathologic review of the world literature by O'Brien et al in 1963. The purpose of this report is to present an updated and unified pathologic study of alkaptonuric ochronosis.

Alkaptonuria↗
PubMed1996

Acute pathologic features with angiographic correlates of the nearly or completely occluded lesions of the cervical internal carotid artery.

BACKGROUND: The true pathologic process of nearly or completely occluded lesions of the cervical internal carotid artery (ICA) has not been studied sufficiently. This information is important in determining the critical indications for endarterectomy. METHODS: Acute pathologic features of these advanced occlusive lesions of the ICA were studied in 40 patients who underwent emergency carotid endarterectomy. Gross morphologic and histopathologic features of these occlusive lesions were examined, and the relationship between the clinical information and the pathologic characteristics was investigated. RESULTS: Thirty-seven lesions had histologic features of advanced atherosclerosis complicated by fresh intraplaque hemorrhages with or without transintimal extension. Thinwalled neovessels were thought to be an important etiologic factor in producing intraplaque hemorrhage. The remaining three lesions without these changes had strangulated embolic material at the occluded portion. A good correlation between these pathologic features and angiographic findings was found. CONCLUSION: The presented results clearly indicate that intraplaque hemorrhage is the most important factor in producing and determining the acute pathologic features of symptomatic and advanced atheromatous occlusive ICA lesions.

Acute Disease↗
PubMed1986

Pathology in tropical medicine.

The pathology o f a parasitic disease is a major link between the investigating parasitologist and those concerned with its epidemiology, socioeconomic impact, clinical treatment and control. The epidemiologist requires information about the incidence and prevalence of major pathological lesions attributable to on infection, which in turn will determine the social and economic impact of the disease and thus its priority for control. For both diagnosis and treatment, the clinician requires an understanding of the pathological mechanisms, and the potential for new drugs or vaccine development largely depends on such understanding. Recent years have seen remarkable improvements in determining the nature of pathology associated with parasitic infections. and in understanding their causative mechanisms. With this issue, Parasitology Today begins a series of special reviews designed to bring together these insights into parasite pathology (see pages 271-282). In this introductory overview. Charles Mackenzie traces the origins and development of the science.

Editorial↗
PubMed1986

Type 1 error and power of the linear trend test in proportions under the National Toxicology Program's modified pathology protocol.

This paper investigates the relationship between the probability of detecting a statistically significant linear trend in the proportion of animals observed to have tumors for the modified pathology protocol currently being employed by The National Toxicology Program. We considered over 300 possible dose-response relationships and tested at 5% and 1% significance levels. The results indicate that a small loss in the probability of detecting a statistically significant result will occur when the modified protocol is used instead of the previous pathology protocol. This loss varies as a function of the design of the study in terms of dose and animal allocation and as a function of the steepness of the dose-response relationship. The absolute difference between the probability of a statistically significant result for the original pathology protocol and that for the modified pathology protocol never exceeded 0.03. This difference was always less than 8% of the probability of a statistically significant result for the original pathology protocol.

Animals↗
PubMed1989

Atropine and/or diazepam therapy protects against soman-induced neural and cardiac pathology.

Toxic doses of the organophosphonate anticholinesterase agent soman can produce neural and cardiac lesions in animals that survive the acute poisoning. The ability of two standard antidote drugs, atropine and diazepam, along with the oxime pralidoxime (2-PAM) Cl, were evaluated for their ability to block these pathological effects. Rats were challenged with a fixed dose (85 micrograms/kg, sc) of soman and treated im 5 min later with 25 mg/kg 2-PAM Cl and one of the following combinations of atropine (0.0, 1.0, 3.2, 10.0, or 32.0 mg/kg) and diazepam (0.0, 0.1, 0.32, 1.0, or 3.2 mg/kg) in a balanced design. The severity of acute anticholinesterase intoxication signs was rated 1 hr after exposure; Body weights and behavioral reactivity ratings were obtained daily for 16 days after exposure; brains and hearts of all surviving subjects were then evaluated for pathological changes. Soman challenge resulted in 33% lethality in animals that received only 2-PAM therapy; both atropine and diazepam reduced lethality in a dose-dependent fashion. Across all treatment conditions greater than 50% of the deaths occurred later than 24 hr after intoxication and treatment. Acute intoxication signs were differentially moderated by the two drugs: atropine reduced all six signs in a dose-dependent fashion; diazepam had no effect on lacrimation and eye bulb protrusion, antagonized signs of salivation and motor abnormalities in a dose-dependent manner, and antagonized the effects of soman on signs of physical activity and coordination only at low doses. All doses of diazepam and the highest dose of atropine moderated body weight loss and a syndrome of behavioral hyperreactivity observed after exposure. Brain pathology was significantly reduced by all doses of diazepam and/or the highest dose of atropine, but no single drug or drug combination was effective in protecting all animals in a group from some brain pathology. Both drugs blocked the development of cardiac lesions in a dose-dependent fashion. The results demonstrate that diazepam or high doses of atropine can antagonize the development of brain lesions that result from soman exposure. Pharmacological management of epileptiform motor abnormalities during the acute intoxication is critical for this effect. In contrast, soman-induced cardiac pathology may occur secondarily as a consequence of the severe brain lesions or develop independently of brain lesion formation due possibly to sympathetic overstimulation.

Animals↗
PubMed1995

Cortical mapping of Alzheimer pathology in brains of aged non-demented subjects.

1. The presence of Alzheimer-type neurofibrillary pathology and amyloid deposits within the brains of 27 aged non-demented subjects was investigated by immunoblotting and immunohistochemistry using antibodies directed against pathological Tau proteins 55, 64 and 69 and beta A4 respectively. 2. The abnormal Tau triplet, a biochemical marker of neurofibrillary degeneration was quantified by western blot and densitometric analysis in several cortical areas including the entorhinal cortex (EC), hippocampus and Brodmann areas (BA) 38, 20, 22, 35, 9, 44 and 39. 3. The abnormal Tau triplet was detected in the EC and the hippocampus of most of the controls aged over 70 years. In few control cases abnormal Tau proteins were also detected in the isocortex, in BA38 alone or also in BA20. Some cases and especially those with Tau pathology in the temporal lobe contained numerous senile plaques (SP) in the neocortex. 4. The authors conclude that control cases with Tau pathology in the temporal lobe and numerous SP in the neocortex were likely to be subclinical stages of AD whereas others with Tau pathology exclusively detected in the EC and hippocampus and without or few SP in the neocortex were related to normal aging.

Aged↗
PubMed1986

The comparative pathology of open chest vs. mechanical closed chest cardiopulmonary resuscitation in dogs.

We compared the pathologic changes following open-chest cardiopulmonary resuscitation (OCCPR) vs. closed chest cardiopulmonary resuscitation (CCCPR) in 28 healthy mongrel dogs subjected to experimentally induced ventricular fibrillation (VF). VF was induced in 29 dogs. No treatment was given for 3 min, then mechanical CCCPR was given for the next 12 min. External defibrillation (80 joules) was then attempted twice. One dog was resuscitated. The remaining 28 dogs were divided into 2 groups of 14 each. Group A received continued CCCPR and group B received OCCPR. All dogs received advanced cardiac life support and were followed until resuscitated or dead. All dogs were autopsied and gross pathology scores and histopathology scores were determined for each animal, and for each of 19 separate tissues within each animal. The mean gross pathology scores for the following tissues were significantly greater for dogs that received OCCPR vs. those that received CCCPR: skin (3.4 vs. 1.2; P less than 0.001), subcutaneous tissue (3.7 vs. 0.6; P less than 0.001), chest wall muscle (3.7 vs. 0.5; P less than 0.001), and pleura (1.9 vs. 0.1; P less than 0.001). The mean total gross pathology score was also greater in dogs that received OCCPR vs. those that received CCCPR (17.2 vs. 7.7; P less than 0.001). The mean histopathology scores for the following tissues were significantly greater for dogs that received OCCPR vs. those that received CCCPR: skin (2.5 vs. 0.0; P less than 0.001), subcutaneous tissue (2.2 vs. 0.1; P less than 0.001), muscle (2.3 vs. 0.1; P less than 0.001), pleura (1.6 vs. 0.0; P less than 0.001), pericardium (1.4 vs. 0.2; P less than 0.01), epicardium (2.5 vs. 0.2; P less than 0.001), myocardium (2.5 vs. 0.3; P less than 0.001), and endocardium (1.9 vs. 0.5; P less than 0.01). The mean total histopathology score was also greater in dogs that received OCCPR vs. those that received CCCPR (20.1 vs. 7.4; P less than 0.001). The histopathology score for brain tissue was greater for the CCCPR group than for the OCCPR group (1.9 vs. 0.4; P less than 0.05). This study showed that OCCPR in dogs following VF caused more severe pathologic changes than CCCPR. These changes were attributed to thoracotomy-induced chest wall injury and to internal defibrillation induced myocardial injury. However, OCCPR caused less severe microscopic brain lesions than CCCPR.

Animals↗
PubMed1992

Familial Alzheimer's disease with the amyloid precursor protein position 717 mutation and sporadic Alzheimer's disease have the same cytoskeletal pathology.

The cytoskeletal pathology of a patient with familial Alzheimer's disease (AD) associated with the probably causal amyloid precursor protein (APP) codon 717 Val----Ile mutation is described. In addition to moderately extensive beta A4 protein deposition within the substance of the brain and in blood vessel walls (congophilic angiopathy), there was abundant cytoskeletal pathology in the form of neurofibrillary tangles, plaque neurites and neuropil threads. Interestingly, plentiful cortical and subcortical Lewy bodies were also seen. In order to compare the cytoskeletal pathology in this case with that seen in sporadic cases of AD we (1) studied the immunohistochemical profile of the amyloid and cytoskeletal pathology with antibodies to beta A4 protein, tau, phosphorylated neurofilament epitopes and ubiquitin and (2) performed a biochemical fractionation and Western blot analysis for the abnormally phosphorylated form of tau (A68) characteristically seen in AD. No substantial difference between the familial case and sporadic cases could be found. We conclude that it is now reasonable to hypothesise that an abnormality in APP metabolism is responsible not only for the deposition of beta A4 protein, but also for the range of cytoskeletal pathology, typical of AD.

Alzheimer Disease↗
PubMed1989

Radiation therapy for pathologic stage III Hodgkin's disease with and without chemotherapy.

Ninety-eight patients with pathological Stage (PS) III Hodgkin's disease treated between 1969 and 1984 were retrospectively analyzed. Treatment consisted of radiation therapy (RT) alone in 46 patients and combined radiation therapy and chemotherapy (CMT) in 52 patients. The median follow-up was 10 years (range 3-19 years). Fifteen-year year survival for patients with Stage III1-is better than for Stage III2 patients (82% vs 53%; p = .014). Patients with Stage III1A have a favorable prognosis regardless of treatment modality. The probability of freedom from relapse at 15 years for patients with pathological Stage III1A treated with radiation therapy is 70%, compared to 83% for pathological Stage III1A patients treated with combined modality therapy (p = .56). In patients with pathological Stage III2A, III1B, and III2B relapses were less frequent with the use of combined modality therapy compared to radiation therapy. We conclude that pathological Stage III1A patients may be treated with radiation therapy alone; the other subsets of patients benefit from combined radiation and chemotherapy.

Adult↗
PubMed1991

The significance of the pathology margins of the tumor excision on the outcome of patients treated with definitive irradiation for early stage breast cancer.

To evaluate the significance of the pathology margins of the tumor excision on the outcome of treatment, an analysis was performed of 697 consecutive women with clinical Stage I or II invasive carcinoma of the breast treated with breast-conserving surgery and definitive irradiation. Complete gross excision of the primary tumor was performed in all cases, and an axillary staging procedure was performed to determine pathologic axillary lymph node status. The 697 patients were divided into four groups based on the final pathology margin from the primary tumor excision or from the re-excision if performed. These four groups were: (a) 257 patients with a negative margin (greater than 2 mm), (b) 57 patients with a positive margin, (c) 37 patients with a close margin (less than or equal to 2 mm), and (d) 346 patients with an unknown margin. The patients with positive final pathology margins were focally positive on microscopic examination. Patients with grossly positive margins or with diffusely positive microscopic margins were treated with conversion to mastectomy. There was a significant difference in the total radiation dose for the four groups (median dose of 6000 vs 6500 vs 6400 vs 6240 cGy, respectively; p less than .0001). There was no significant difference among the four groups for 5-year actuarial overall survival (p = .19), no evidence of disease (NED) survival (p = .95), or relapse-free survival (p = .80). There was no significant difference among the four groups for five year actuarial local or regional control (all p greater than or equal to .29). Subset analyses did not identify any poor outcome subgroups. These results have demonstrated that selected patients with focally positive or close microscopic pathology margins can be adequately treated with definitive breast irradiation. Patient selection and the technical delivery of radiation treatment including a boost may have been important contributing factors to the good outcome in these patients.

Adult↗
PubMed1994

Neonatal cerebral Doppler flow velocity waveforms in the pre-term infant with cerebral pathology.

In a longitudinal study of 217 infants delivering at < 37 completed weeks gestation, Doppler flow velocity waveforms were obtained, and resistance index (RI) values calculated from the middle (MCA) and anterior (ACA) cerebral arteries during the first 10 days of life. Sixty infants demonstrated ultrasound evidence of cerebral pathology, of which five cases were congenital, and an additional 13 cases were complicated by patent ductus arteriosus during the study period. The Doppler data obtained during the first week of life from the remaining 42 infants who developed cerebral pathology, and 15 infants who had evidence of metabolic acidosis at delivery without ultrasound evidence of cerebral pathology were compared with local reference data obtained from non-acidotic infants with normal cranial ultrasound from 24 h of age. In those infants who had evidence of minor periventricular haemorrhage alone (Grade I/II PVH), there was no significant difference between the ACA or MCA RI during the study period compared with the reference data. In those groups of infants who demonstrated major PVH (Grade III/IV) or persistent periventricular flares, the ACA and MCA RI was found to be consistently significantly higher than the reference group throughout the study period. In those infants who developed ultrasound evidence of periventricular cystic leukomalacia (PVCL), the MCA RI was significantly lower than the reference data between 48 and 72 h of age, there being no significant difference in the ACA RI. The Doppler findings in those infants with evidence of metabolic acidosis at delivery (umbilical arterial pH < 7.20; BD > 8 mmol/l) but with normal ultrasound findings were similar to those infants who developed PVCL, namely a significant fall in MCA RI between 48 and 72 h of life, with no significant difference in the ACA RI during the study period. These findings suggest that variable changes in cerebral vascular resistance occur with the evolution of, or as a consequence of the development of cerebral pathology in the pre-term infant, and these changes of increased and decreased vascular resistance are discussed. Further investigation of the changes occurring in the cerebral circulation in the early neonatal period of infants who develop PVCL is required to clarify the vascular changes taking place, but if the findings of this study are confirmed, this technique may provide a means of identifying infants at risk of developing ischaemic cerebral pathology at an early stage when it may be possible to initiate therapeutic intervention to limit the cerebral damage.

Acidosis↗
PubMed1992

The diagnostic potential of synovial effusion in meniscal pathology.

During a 20-month period, 382 arthroscopies were performed and the type of washout fluid obtained was noted. When a torn meniscus was found, the fluid was macroscopically abnormal in 97.4% of cases. A crystal clear washout was associated with no demonstrable pathology in over half the cases, the remainder having mainly patellofemoral joint pathology and other articular lesions. Only 6.3% of those with a clear fluid washout had meniscal pathology. Of those with abnormal fluid, 68% had meniscal pathology, with a normal arthroscopic examination being found in only 8.5%. In addition, when the fluid from traumatic effusions was examined microscopically, a typical droplet containing lipid crystals was found to be present and to account for an oily macroscopic appearance. These data support the use of fluid irrigation of the knee as a screening test for intraarticular pathology, especially of the menisci, that may allow a reduction in the number of negative arthroscopies.

Adolescent↗
PubMedDate not supplied

Comparison of SPECT, EEG, CT, MRI, and pathology in partial epilepsy.

Twenty children with partial epilepsy who had surgery between the ages of 4 1/2 months and 18 years were studied preoperatively with electroencephalography (EEG), computed tomography (CT), and technetium-99m hexamethylpropyleneamineoxime 99mTc-HmPAO single photon emission computed tomography (SPECT; 20 interictal, 4 postictal). Fourteen had magnetic resonance imaging (MRI). All had an epileptiform focus (12 unilateral, 8 predominantly unilateral) on EEG. The combination of interictal and postictal regional cerebral blood flow (rCBF) abnormalities alone correlated with EEG foci in 16 of 20 patients. Interictal rCBF abnormalities correlated with EEG foci in 14 of 20. CT findings correlated with EEG foci in 14 of 20. MRI findings correlated with EEG foci in 13 of 14. Pathology demonstrated tumor in 6, cortical dysplasia in 4, mesial temporal sclerosis in 3, Sturge-Weber in 2, cavernous hemangioma in 1, Rasmussen encephalitis in 1, porencephalic cyst and gliosis in 1, and cysts found at surgery (but normal histology) in 2. Interictal and postictal SPECT, EEG foci, and CT findings each correlated with the pathology site in 17, 19, and 15 patients, respectively. MRI correlated with pathology site in 13 of 14 patients. Postictal and interictal abnormalities of rCBF correlated with EEG and pathology as frequently as CT. In 5 patients with normal CT scans and in 1 with a normal MRI, postictal and interictal rCBF correlated with EEG and pathology results; however, these 6 patients all had abnormalities on CT or MRI. SPECT, therefore, may be considered a valuable additional diagnostic procedure in the evaluation of epilepsy surgery candidates in that it adds to the evidence of abnormality at the involved site.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗