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Biomedical subjects

Arthur C Grant

Publications and source records attributed to Arthur C Grant.

8 recordsLinked to original sources
PubMed2005

Interictal perceptual function in epilepsy.

Epilepsy can affect perception. Ictal perceptual experiences are common, but interictal perceptual function may also be affected. This article reviews the English-language literature on interictal perceptual disturbances in epilepsy. Although most studies report impaired perceptual ability, heightened sensitivity has also been described. There is a compelling, though not absolute, correlation between affected sensory modality and underlying epilepsy syndrome. Olfaction is clearly affected in temporal lobe epilepsy, while visual information processing is disturbed in occipital lobe epilepsy. The cause of interictal perceptual dysfunction is unknown, but propagating epileptiform discharges may play a role. The presence of specific perceptual disturbances in focal epilepsy syndromes is consistent with the view that epilepsy is a network disease, with the potential to affect neural circuits distant from the seizure focus. The use of thoughtfully selected psychophysical perceptual tasks may provide additional insight into the cognitive impact of different epilepsy syndromes and of ablative epilepsy surgery.

Epilepsy↗
PubMed2005

Somatosensory processing is impaired in temporal lobe epilepsy.

PURPOSE: Growing evidence suggests that temporal lobe epilepsy (TLE) is a network disease. In this view, the seizure focus may produce measurable deficits in specific cortical functions. METHODS: A tactile grating orientation (GrOr) discrimination task associated with parietal lobe function was administered at the index fingertip to 15 subjects with medically intractable TLE and to 19 neurologically normal controls. TLE subjects were tested bilaterally at baseline while taking their usual antiepileptic drugs (AEDs), and off AEDs during inpatient video-EEG monitoring (n = 9). Three subjects also were tested after temporal lobectomy. t Tests were used to compare baseline performance between TLE subjects and controls, and between hands ipsilateral and contralateral to side of seizure onset, with Bonferroni correction for multiple comparisons. TLE subjects' baseline thresholds were compared with those obtained off AEDs by using a repeated measures analysis of variance. RESULTS: TLE subjects were severely impaired bilaterally on the GrOr task, with mean discrimination thresholds nearly twice those of controls (p </= 0.001 for each hand). No significant difference was found in baseline performance between hands (p = 0.37), or between baseline and off-AED testing (p = 0.42). The three subjects tested after temporal lobectomy demonstrated improved performance compared with baseline, but statistics were not performed because of the small subject number. CONCLUSIONS: Patients with medically intractable TLE have impaired tactile GrOr discrimination bilaterally that is not due to nonspecific effects of AEDs. This impaired perceptual ability may be reversible with surgical removal of the seizure focus.

Adult↗
PubMed2004

Personality testing and epilepsy: comparison of two MMPI-2 correction procedures.

The Minnesota Multiphasic Personality Inventory-2 (MMPI-2) is widely used for assessing psychopathology. However, its reliability in people with neurologic disease has been questioned. This concern is especially true for epilepsy, a disease with symptoms, i.e., seizures, that frequently include experiences likely to suggest psychopathology. Correction procedures, in which select items are removed and the test is rescored, may improve MMPI-2 specificity. The MMPI-2 was administered to 27 subjects with epilepsy, and the results were compared before and after application of three correction procedures: rational, statistical, and combined. The statistical correction resulted in clinically significant T-score changes (> or = 5 points) in two MMPI-2 clinical scales, while a combined correction procedure produced clinically significant changes in three scales. In the subgroup of patients with intractable epilepsy, two noncorrected scale T-scores > or = 65 fell to the normal range with both the statistical and combined procedures. These results suggest cautious interpretation of standard MMPI-2 scores in patients with epilepsy.

Adult↗
PubMed2004

Carotid dissection associated with a handheld electric massager.

The extracranial internal carotid artery (ICA) is susceptible to injury and dissection from external shear forces applied to the neck. Traumatic ICA dissection usually occurs in the setting of a sudden, high amplitude force causing significant distortion of surrounding soft tissues. Weaker, repetitive forces applied for longer intervals may also pose a risk for ICA dissection. A 38-year-old woman with no significant stroke risk factors had sudden onset of severe dysarthria and left hemiparesis several days after receiving an approximately 20-minute neck massage with a handheld electric massager. The moving elements consisted of two approximately 2-cm-diameter spheres that percuss the skin with low amplitude and high frequency. Magnetic resonance imaging and angiography demonstrated acute infarction in the right middle cerebral artery territory and dissection of the extracranial right ICA. Handheld electric massager units may cause ICA dissection and disabling stroke.

Adult↗
PubMed2002

Epileptic monocular nystagmus.

The authors describe a case of epileptic monocular nystagmus in a cognitively intact adult with normal vision. Focal seizures originated in the occipital lobe contralateral to the involved eye, and an associated structural lesion was thought to represent a forme fruste of Sturge-Weber syndrome. It is hypothesized that the seizure discharge either activated a cortical saccade region and caused simultaneous supranuclear inhibition of ipsilateral eye movement or triggered monocular eye movement commands.

Adult↗
PubMed2002

Ictal EEG patterns in band heterotopia.

UNLABELLED: Band heterotopia (BH) or "double cortex" syndrome is a neuronal migration disorder resulting in a diffuse band of subcortical grey matter and variable abnormality of the overlying cortex. Patients with BH have a spectrum of psychomotor delay and seizures. Associated epileptic syndromes and interictal EEG findings have been described, but ictal EEG patterns are lacking. METHODS: We describe the clinical, interictal, and ictal EEG findings in two girls with BH and intractable seizures. RESULTS: Ictal EEG patterns correlated well with clinical seizure types, and did not have features unique to BH. Similarly, seizure behaviors and interictal EEG findings were typical of those seen in symptomatic generalized epilepsies. CONCLUSIONS: Despite evidence implicating the ectopic grey matter in seizure discharges, we conclude that seizure semiology and associated ictal EEG patterns in BH are no different from those seen in other causes of symptomatic generalized epilepsies.

Brain↗