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Biomedical subjects

C E Darby

Publications and source records attributed to C E Darby.

4 recordsLinked to original sources

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

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

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

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