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Biomedical subjects

D W Klass

Publications and source records attributed to D W Klass.

13 recordsLinked to original sources
PubMed1992

Effects of midazolam on electroencephalograms of seriously ill patients.

Midazolam hydrochloride, a water-soluble benzodiazepine for intravenous injection, is frequently used to provide sedation to mechanically ventilated patients in the critical-care unit. Although the effects of midazolam on the electroencephalograms (EEGs) of healthy volunteers have been reported previously, to our knowledge such effects in ill patients have not been documented. Herein we describe the effects of intravenously administered midazolam on the EEGs of eight seriously ill patients (age range, 49 to 80 years; mean, 69 years). The EEGs showed drug-induced relatively fast (alpha or beta) frequency activity superimposed on delta slowing in six patients and mild to moderate voltage attenuation in three patients. An alpha frequency coma pattern, a transient burst-suppression pattern, and a spindle coma pattern were also seen. Thus, the effects of intravenously administered midazolam on the EEGs of seriously ill patients are similar to those noted after the administration of other benzodiazepines. These potential effects should be considered when their EEG tracings are interpreted.

Aged↗
PubMed1979

Recording small sharp spikes with depth electroencephalography.

Two patients with intractable seizures and focal temporal sharp waves also had small sharp spikes as incidental findings in their scalp electroencephalograms. Depth electroencephalography verified the intracerebral origin of the small sharp spikes and differentiated them from the more significant epileptiform abnormalities.

Adolescent↗
PubMed1979

EEG activation and mathematical calculation.

Activation of epileptic seizures of epileptiform EEG abnormalities by specific types of intellectual activity has been documented only rarely. Despite infrequent occurrence, these cases are of interest in the study of epileptic mechanisms and cerebral integrative systems. We describe a 67-year-old woman with long-standing seizures who consistently activated right frontal spike discharges in the EEG when she attempted to perform mental arithmetic. The activating effect was not precisely related to the difficulty of the mathematical problem, nor to alerting or concentrated attention. No EEG activation resulted from reading, writing, reciting, revisualizing, or recalling numbers or other symbols.

Brain↗
PubMed1978

Contribution of the electroencephalogram in monitoring cardiac dysrhythmias.

It is often difficult to distinguish between episodic cerebral symptoms resulting from primary disorders of the brain and those resulting from cardiac dysrhythmias. When patients with such symptoms are referred for electroencephalography, the electrocardiographic activity recorded concurrently can provide additional useful diagnostic information. Two cases are presented to illustrate the contribution of the electroencephalogram in the diagnosis of significant cardiac dysrhythmias.

Aged↗
PubMed1977

Epilepsia partialis continua. A review of 32 cases.

Clinical, EEG, and autopsy findings were studied in 32 patients with epilepsia partialis continua. The seizures occurred at different ages and with diverse diseases of the brain. Facial and distal limb muscles were preferentially involved. Often, seizures suggested multifocal origin within a limited cerebral region, with low-amplitude, irregular, asynchronous contractions that could resemble other movement disorders. Twitching varied in rate, rhythm, intensity, and territorial extent continued sometimes for decades and was poorly responsive to therapy. Focal EEG abnormalities commonly consisted of discrete spikes, sharp waves, or slow-wave activity. Autopsy findings in eight patients showed consistent involvement of the motor cortex or closely adjacent areas. Clinical, EEG, and pathologic data favor a cortical origin of epilepsia partialis continua.

Adolescent↗
PubMed1977

Multicystic cerebral degeneration in neonatal herpes simplex virus encephalitis.

Typical herpetic papulovesicular skin lesions developed in an apparently normal infant at 12 days of age and were followed within 48 hours by signs and symptoms of acute encephalitis. Herpes simplex virus type 2 was cultured from the intact skin vesicles, and a fourfold increase in complement fixation titer to herpes simplex virus type 2 was found over the ensuing 24 days. The infant survived her acute illness, but was left with severe neurologic sequelae manifested as microcephaly with multicystic cerebral degeneration. The short-term and convalescent course is documented by serial, clinical, and EEG examinations, and the nature of the cerebral damage is demonstrated by computerized transaxial tomography.

Brain Diseases↗
PubMed1976

Spontaneous sleep and induced arousal. A depth-electroencephalographic study.

Although arousal effects from electric stimulation have been found in animals, reports of similar responses in humans have been uncommon. During depth electroencephalography in a 16-year-old boy for evaluation of intractable temporal lobe seizures, electric stimulation of a pair of contact leads located within the dorsal and medial portions of the thalamus but not within specific sensory nuclei produced unequivocal behavioral and electrographic arousals from spontaneous sleep. Lowvoltage stimuli were effective during non-REM and REM sleep. These findings verify the presence of a thalamic arousal system in the human.

Adolescent↗
PubMed1975

Alpha-coma. Electroencephalographic, clinical, pathologic, and etiologic correlations.

"Alpha-coma" denotes the conjunction of clinical coma with an electroencephalographic pattern resembling that of normal wakefulness and predominantly consisting of alpha activity. Clinical, EEG, and pathologic data from 13 patients with this syndrome were reviewed. The patients were divided into two groups, based on the pathogenesis of their conditions. The first group consisted of eight patients with brain stem strokes, and the second group consisted of five patients with diffuse hypoxic encephalopathy resulting from cardiac or pulmonary arrest. There were some differences between the EEGs of the two groups. In the first group, the alpha pattern was located more posteriorly, showed more variability and reactivity, and was more persistent in sequential recordings. In the second group, the alpha activity was transient and showed little reactivity. In both groups, this pattern indicated a poor prognosis for survival.

Aged↗