Biomedical subjects

C D Binnie

Publications and source records attributed to C D Binnie.

9 recordsLinked to original sources

PubMed1979

Visual and computer-assisted assessment of the EEG in epilepsy of late onset.

A study was made of 275 patients presenting with suspected epilepsy after the age of 20 years. In 122 it was concluded that the attacks were non-epileptic. In 60 others cerebral pathology was found. If the EEG was visibly abnormal the risk of cerebral pathology was 8 times greater than when the record was normal. The EEGs were also assessed by an automatic pattern recognition technique, which classified them as abnormal by reference to a control population of 300 volunteers. 90% of EEGs from patients with pathology were classified as abnormal and, conversely, 86% of patients with abnormal records (as assessed by the automatic analysis) had pathology.

Adult↗

PubMed1979

Television epilepsy--the role of pattern.

Patients with photosensitive epilepsy were asked to view normally functioning 625-line televisions while the EEG was monitored. In the first of two studies paroxysmal EEG activity was reliably induced by television at a viewing distance related to a patient's sensitivity to intermittent photic stimulation (IPS); patients who were sensitive to diffuse IPS at 50 Hz were sensitive to the television at greater viewing distances than those who were not. No such relationship was obtained with patterned IPS. On the other hand, patterned IPS was generally more epileptogenic than diffuse IPS with the same luminance. In the second study, where the angular subtense of the television screen and the subtense of its lines were manipulated independently, the convulsive response was found to be a function of both factors, the relative contribution of each depending on the viewing distance at which the patient was sensitive. For patients sensitive at normal viewing distances, where 50 Hz diffuse flicker appeared to be responsible for the induction of paroxysmal activity, the probability with which paroxysmal activity was induced was closely related to the subtense of the screen. For patients sensitive only at closer viewing distances the probability was influenced not by the subtense of the screen but by the subtense of its lines, suggesting that the paroxysmal activity was induced by the 25 Hz pattern alternation produced by the scan. A television with a small screen was considerably less epileptogenic than one with a large screen for all patients, presumably due to the reduced contribution of both diffuse flicker and pattern alternation.

Adolescent↗

PubMed1979

Neurophysiological aspects of pattern-sensitive epilepsy.

The capacity of striped patterns (square-wave gratings) to induce paroxysmal EEG activity in a group of pattern-sensitive epileptic patients is shown to depend on: 1. The spatial frequency of the pattern. The optimum spatial frequency lies between 1 and 4 cycles/degree in every patient tested. 2. The orientation of the pattern. Although, for the patient group as a whole, no one orientation is consistently more likely to induce paroxysmal activity than any other, the responses of individual patients can show marked orientation selectivity. 3. The brightness contrast of the pattern. The probability of paroxysmal EEG activity increases dramatically as contrast is increased from 0.2 to 0.4. Red/green gratings at isoluminance fail to induce paroxysmal activity. 4. The size of the pattern. There is considerable variation between patients in the subtense of a centrally-fixated circular pattern necessary to induce paroxysmal activity with a given probability. However, for every patient an increase in the probability of paroxysmal activity from near zero to near unity is effected by an increase in the angular subtense of the pattern by a factor of two. Patterns other than square-wave gratings are capable of inducing paroxysmal activity but, in general, patterns that stimulate more than one orientation system are less epileptogenic. The above findings are compatible with the hypothesis of a seizure trigger in the striate cortex and are incompatible with a trigger confined to the lateral geniculate nucleus of the thalamus. Further evidence against a geniculate trigger is obtained from an investigation of the response of a pattern-sensitive patient to a diffuse (unpatterned) flickering field in which it is shown that the effects of counter-phase interocular flicker implicate binocular mechanisms.

Adolescent↗

PubMed1979

The delayed effect of sodium valproate on the photoconvulsive response in man.

The acute effect of a single oral dose of sodium valproate on the photoconvulsive response has been studied. In 7 of 9 patients naive to this drug photosensitivity was abolished or reduced. A similar effect was seen in only 2 of 7 already receiving chronic sodium valproate therapy. The effect appeared 1 to 5 hr (mean, 3 hr) after attainment of peak sodium valproate concentration and lasted up to 5 days.

Adolescent↗

PubMed1979

Fluorescent lighting and epilepsy.

Fluorescent tubes flash at twice the mains frequency (100 Hz in Europe). With aging, 50-Hz brightness modulation appears. A survey of tubes used in our institute showed that 42% exhibited brightness modulation up to a depth of 20% or occasionally 30%. The effects of fluorescent lighting on the EEGs of 20 patients with photosensitive epilepsy have been studied. In no patient did the 100-Hz flicker of normally functioning tubes elicit paroxysmal activity. In 8 of 13 subjects sensitive to 50 Hz, IPS paroxysmal discharges were evoked by 50-Hz brightness modulation, but only at modulation depths of 50% or more. It is concluded that as paroxysmal activity could not be elicited by normally functioning tubes nor at those depths of modulation occurring in practice, fluorescent lighting is unlikely to present a hazard to photosensitive patients.

Adolescent↗

PubMed1979

Sodium valproate: serial monitoring of EEG and serum levels.

The clinical and electroencephalographic (EEG) effects of sodium valproate were studied in four patients by means of serial 24-hour EEG recordings and simultaneous hourly determinations of serum drug concentrations. The patients all had frequent clinical seizures and generalized spike-wave discharges. Valproate appeared to reduce diurnal paroxysmal discharges (PD) and clinical seizures, but the effect on nocturnal PD was less marked. The extent and duration of the depression of PD and seizures varied. Altering the distribution of the total daily dose may change the pattern of clinical seizures and PD. Valproate concentrations fluctuated widely over 24 hours, and the significance of single estimations often cited in the literature appears dubious. Peak serum concentrations above 100 micrograms per milliliter may be necessary in some patients to achieve clinical and EEG improvement.

Adolescent↗

PubMed1978

Computer-assisted interpretation of clinical EEGs.

A multivariate pattern recognition technique has been developed, to distinguish the EEGs of patients with cerebral pathology from those of normal controls and to localize any abnormalities detected. Two methods of feature extraction have been used, power spectral density and slope descriptor analysis, together with various types of feature compression. These techniques have been evaluated on EEGs from 63 patients with proven pathology. Spectral analysis proved more reliable than slope descriptor analysis and predicted the site of cerebral pathology more accurately than did visual assessment of the EEGs. This apparent improvement over the diagnostic reliability of visual analysis in considered to justify further development and evaluation of this technique.

Adult↗

PubMed1977

Television epilepsy and pattern sensitivity.

Properly functioning domestic television sets may induce seizures in epileptic patients (TV epilepsy). We investigated the effects of different types of visual stimuli on paroxysmal electroencephalographic (EEG) activity in 32 patients known to be sensitive to intermittent photic stimulation (stroboscopic light). We monitored sensitivity to patterns of horizontal and vertical lines, both stationary and vibrated (pattern sensitivity), and to normal broadcasts on a domestic, black and white (405- or 625-line) TV receiver (TV sensitivity). Twenty-three of the 32 patients were sensitive to pattern. Twenty-two were sensitive to vibrated patterns, and 11 to static patterns (P less than 0-01), All patients sensitive to pattern were also sensitive to TV; The association between sensitivity to pattern and to TV was significant. Clinical history of TV epilepsy (16 out of 32 patients) and laboratory evidence of pattern or TV sensitivity were not significantly associated. The high incidence of pattern sensitivity among flicker-sensitive patients and its association with TV sensitivity suggests that linear patterns produced by the raster of a black and white set as it scans, or "line-jitter" produced by the raster in areas of low TV-signal strength may contribute to the epileptogenic effect of TV.

Adolescent↗

PubMed1976

The contingent negative variation and psychological findings in chronic hepatic encephalopathy.

Early diagnosis of chronic hepatic encephalopathy (CHE) in the latent stage before the appearance of clinical signs, should reduce both morbidity and mortality as deterioration is often preventable by treatment. Since existing diagnostic procedures are inadequate, we have investigated a test in which morphine is used as a provocative agent and any resulting change in cerebral function assessed by measurement of the CNV in conjuction with a psychological trail test. Twenty six patients were studied, 6 of whom had clinically overt CHE. A significant correlation (P less than 0.05) between the change in CNV amplitude with morphine and the initial CNV amplitude, consistent with the theoretical model of Tecce (1972), was found. However, the CNV and trail test results taken as a whole did not allow even those patients with overt CHE to be distinguished and we conclude that it is unlikely that differing degrees of latent CHE could be detected.

Chronic Disease↗