Neuropsychological performance in frontal lobe epilepsy. (73/706)

The search for a special neuropsychological profile of frontal lobe epilepsy subjects (FLE) has so far led to inconclusive results. In this paper we compared the preoperative neuropsychological performance of FLE and temporal lobe epilepsy (TLE) subjects. We further investigated whether frontal lobe lesions of epileptogenic cause produce the same type of cognitive dysfunction as do tumours of the frontal lobe. Sixteen FLE subjects were compared to 16 TLE subjects as well as to a group of 10 subjects after the removal of frontal lobe tumors (TUM) and a healthy control group. A set of neuropsychological test measures routinely used for presurgical evaluation, an emotional conceptualization task and two associative learning tasks were administered. We found that subjects with frontal lobe damage were significantly impaired relative to controls on a wide range of cognitive functions independent of neurological cause. FLE subjects could hardly be discriminated from TLE subjects as both groups showed a similarly reduced level of neuropsychological performance. Our results demonstrate the devastating effect that frontal lobe epilepsy can have on cognitive functioning. Routinely used neuropsychological test measures lack the specificity to distinguish between frontal and temporal lobe epilepsy. Highly specialized measures are necessary to reveal differences.  (+info)

Perinatal cardiac arrest. Quality of the survivors. (74/706)

Steiner, H., and Neligan, G. (1975). Archives of Disease in Childhood, 50, 696. Perinatal cardiac arrest: quality of the survivors. Twenty-two consecutive survivors of perinatal cardiac arrest have been followed to a mean age of 4 1/4 years, using methods of neurological and developmental assessment appropriate to their ages. 4 showed evidence of gross, diffuse brain-damage (2 of these died before the age of 3 years). These were the only 4 survivors of the first month of life who took more than 30 minutes to establish regular, active respiration after their heartbeat had been restored. The arrest in these cases had occurred during or within 15 minutes of delivery, and followed antepartum haemorrhage, breech delivery, or prolapsed cord. The remaining 18 were free of any evidence of brain damage. In the majority of these the arrest had occurred during shoulder dystocia or exchange transfusion, or was unexplained; the heartbeat had been restored within 5 minutes in most cases, and regular, active respiration had been established within 30 minutes thereafter in all cases.  (+info)

Perception of facial affect in chronic schizophrenia and right brain damage. (75/706)

This study was designed to compare the performance of 50 chronic schizophrenics (CS) to that of 30 right brain-damaged patients (R), and 50 healthy controls (N) on several facial perception measures: Emotion Labelling and Recognition, and the Benton Facial Recognition Test. CSs were diagnosed according to DSM-IV criteria and their psychiatric state was assessed using the PANSS scale. All subjects were right handed. Their cognitive state was assessed using the MMSE. Subjects rated their current mood on a visual analogue scale. The results showed that the CSs and Rs were significantly impaired compared to Ns for the emotional tasks but did not differ from each other. Moreover, the patient groups were significantly less accurate in recognising emotionally neutral facial stimuli. Each subject group had more difficulty processing negative relative to positive affect. The deficit in schizophrenia was found to be stable, which may reflect a trait-like, rather than a state-dependent, characteristic. Moreover, some support is provided for the notion that facial affect perception in chronic schizophrenia is associated with right hemisphere dysfunction.  (+info)

Models of learning disability: their relevance to remediation. (76/706)

A scheme of classification is suggested for physicians faced with clinicians' numerous and varied prescriptions for remedial management of children with learning disabilities. Three explanatory models of the causes of learning disability -- the difference, deficit and delay models -- and two strategies of management -- the process-oriented and goal-oriented -- are delineated. Remedial methods are classified according to their implicit explanatory model and the clinician's adherence to the process-oriented or goal-oriented approach. A pragmatic conservative, goal-oriented strategy is advocated, in which individualized instruction is tailored to the child's current abilities and learning requirements.  (+info)

Cranial MR findings in chronic toluene abuse by inhalation. (77/706)

BACKGROUND AND PURPOSE: Chronic abuse of toluene by inhalation causes variable white matter changes and thalamic hypointensity on T2-weighted MR images. The purpose of our study was to assess cranial MR findings in a large series of patients who chronically abuse toluene-containing solvents to investigate the factors causing the qualitative variability of white matter changes and thalamic hypointensity. METHODS: We studied the neurologic signs, symptoms, and cranial MR findings in 41 patients who chronically abused thinner, a toluene-containing solvent. We classified white matter changes as diffuse or restricted. We tested the associations of the development of white matter lesions and thalamic hypointensity with patient age at onset of abuse and duration of abuse. RESULTS: MR images revealed white matter lesions in 46% of the patients, atrophic dilatation of ventricles and sulci in 27%, and thalamic hypointensity in 20%. White matter changes were restricted in 53% and diffuse in 47%. The development of white matter changes and thalamic hypointensity were significantly associated with duration of abuse longer than 4 years (P <.05 and P <.01, respectively). CONCLUSION: White matter changes seem to start in the deep periventricular white matter, and they spread into peripheral white matter, causing the loss of gray matter-white matter differentiation with continued toluene abuse. The deposition of iron due to demyelination and axonal loss is the most probable mechanism for the thalamic hypointensity found in solvent abusers.  (+info)

Ectopic calcification around joints of paralysed limbs in hemiplegia, diffuse brain damage, and other neurological diseases. (78/706)

Mechanical deformity associated, with neurological disease is commonly encountered in the form of contractures, or pre-existing arthritis. Less common is the occurrence of ectopic calcification around the joints of a paralysed limb. Two forms of this are presented in a series of twenty patients. Para-articular calcification with the appearance of myositis ossificans around large joints of the affected limbs occurred most often. The interior of the joints was not affected, nor was there evidence of bony injury. In some cases, however, the excessive outgrowth of bone around the joint eventually resulted in a functional ankylosis by a uniting bar of bone outside the joint. The second form of calcification was periosteal, which unlike the first type was resorbed and left an area of cortical bony thickening.  (+info)

Disrupted synaptic development in the hypoxic newborn brain. (79/706)

Infants born prematurely risk significant life-long cognitive disability, representing a major pediatric health crisis. The neuropathology of this cohort is accurately modeled in mice subjected to sublethal postnatal hypoxia. Massively parallel transcriptome analysis using cDNA microchips (9,262 genes), combined with immunohistochemical and protein assays, reveals that sublethal hypoxia accentuates genes subserving presynaptic function, and it suppresses genes involved with synaptic maturation, postsynaptic function, and neurotransmission. Other significantly affected pathways include those involved with glial maturation, vasculogenesis, and components of the cortical and microtubular cytoskeleton. These patterns reveal a global dysynchrony in the maturation programs of the hypoxic developing brain, and offer insights into the vulnerabilities of processes that guide early postnatal cerebral maturation.  (+info)

Globus pallidus lesions associated with high mountain climbing. (80/706)

Acute mountain sickness (AMS) occurs commonly in hikers who are rapidly exposed to high altitude environments. Despite the numerous reports of AMS, few studies have reported pallidal lesions associated with altitude sickness. A previously healthy 49-yr-old Korean patient, after ascent to 4,700 m, suffered symptoms consistent with AMS. After returning home, the patient showed changes in personality characterized by abulia, indifference, and indecisiveness. T2 weighted brain magnetic resonance imaging showed high signal lesions involving bilateral globus pallidus. Our case suggests that globus pallidus injury should be included in the differential diagnosis of patients with personality or cognitive change after recovery from AMS.  (+info)