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Biomedical subjects

G Erba

Publications and source records attributed to G Erba.

At least 37 records · Page 2Linked to original sources
PubMed1992

Temporal lobectomy for complex partial seizures that began in childhood.

Forty-six consecutive patients who underwent surgery for intractable temporal lobe seizures originating in childhood are reported; invasive preoperative monitoring (e.g., depth electrodes and subdural arrays) was not used in the selection process. Our results, with respect to the control of seizures and improvement in behavior, are comparable to those of series in which invasive monitoring was used in the selection process. Eighty-five percent of the 46 patients (96% of the 28 operated after the introduction of long-term electroencephalographic monitoring) became either seizure free or experienced near total control of their seizures. Our results indicate that many patients can be selected successfully for temporal resection without exposure to the risk and expense of invasive presurgical procedures. A long duration of epilepsy prior to surgery in patients with neoplasia portended a less satisfactory outcome. Our results strengthen the argument for early operation in children with intractable epilepsy.

Adaptation, Psychological↗
PubMed1992

Cerebral hemicorticectomy for epilepsy.

Hemicorticectomy resulted in total or near-total control of seizures in 10 of 11 children with chronic epilepsy. During a median follow-up period of 5.5 years, there have been no deaths or delayed complications. The surgical outcome after hemicorticectomy compares favorably with that of more extensive surgical procedures, yet is associated with significantly less risk. The technique for hemicorticectomy is described and illustrated.

Adolescent↗
PubMed1991

Results of surgery for extratemporal partial epilepsy that began in childhood.

Thirty-five consecutive patients who underwent surgery for intractable extratemporal seizures originating in childhood are described. Candidates for surgery were selected on the basis of clinical criteria, neurodiagnostic imaging, and an electroencephalographic investigation that included the use of sphenoidal electrodes and long-term monitoring. Invasive preoperative monitoring was not used. Our results, with respect to the control of seizures and behavioral improvement, are comparable with series in which data from invasive recordings were used in the selection process. Sixty-three percent of the 35 patients (76.5% of those operated on after the introduction of long-term electroencephalographic monitoring) became either seizure free or experienced a reduction in their frequency of seizures by at least 75%. The favorable outcome in this group of patients strengthens the argument for early operation in children with intractable epilepsy, even when the seizure focus is outside the temporal lobe.

Adolescent↗
PubMed1988

Epilepsy surgery in children.

Neurosurgical procedures of established value in the treatment of the medically intractable epilepsies include temporal lobectomy, extratemporal cortical excision, hemispherectomy, and corpus callosotomy. The clinical decision to consider surgery in children with epilepsy requires an understanding of the natural history of pediatric seizures, the constraints of the presurgical evaluation, and the relationship between surgical outcome and tissue pathology. This article presents an overview of the indications, risks, and benefits of epilepsy surgery in the pediatric population.

Cerebral Decortication↗
PubMed1985

Primary generalised epileptic myoclonus: a frequent manifestation of minipolymyoclonus of central origin.

A group of patients with myoclonus is described whose jerks are preceded by a bilaterally synchronous, frontocentrally predominant, negative cerebral potential in the EEG. This potential may be a slow wave with variable timing in relation to EMG bursts, and in this circumstance the muscle jerks are usually small amplitude and multifocal ("minipolymyoclonus"). The cerebral negativity can also be shorter in duration and time-locked to limb jerks, which are larger in amplitude and more widespread. We propose that the physiology of this distinct form of myoclonus is similar to that of primary generalised epilepsy.

Adolescent↗
PubMed1984

Extraction of clinical information from electroencephalographic background activity: the combined use of brain electrical activity mapping and intravenous sodium thiopental.

Traditional visual inspection of electroencephalographic (EEG) tracings and computer-assisted topographic mapping were compared in their abilities to detect and locate supratentorial lesions following intravenous sodium thiopental administration. Of the 13 subjects, 8 had atrophic and 5 had mass lesions, all defined by computed tomographic scan and 11 confirmed at operation. EEGs made before and after thiopental administration were evaluated separately from topographic maps of statistical difference between EEGs at multiple frequency ranges made before and after thiopental injection. Topographic mapping of statistical difference accurately detected all thirteen lesions, whereas EEG detected eight. In addition to demonstrating reduced beta production overlying structural abnormalities, topographic mapping revealed regionally augmented beta, especially over irritative lesions. Moreover, localization was possible with the topographic method after the first thiopental injection, whereas a second injection was required for EEG localization by visual inspection. Changes in slow (delta) activity were also useful in delineation of atrophic lesions, in which delta was usually augmented but occasionally regionally reduced. Multielectrode studies with topographic mapping appear essential in delineating cerebral abnormalities, because both slow and fast activities may be increased or reduced over such areas. The relative response of EEG background activity to thiopental at different frequencies may assist lesion characterization as well as localization.

Adolescent↗
PubMed1982

Electroencephalographic correlates of near-drowning encephalopathy in children.

Findings of the serial EEGs of 9 children involved in fresh water near-drowning were correlated with neurological signs and final outcome. Our observations revealed that in young near-drowning victims there is a distinct evolution of the EEG which differs considerably from any stereotyped classification outlined for other types of encephalopathies. In patients with a poor clinical outcome, the early phase of near-drowning encephalopathy was characterized electrically by diffuse delta waves, often with alpha or beta frequencies superimposed (alpha-delta and beta-delta pattern). Additional features included poor sleep-waking differentiation and abnormal reactivity. Repetitive focal or multifocal biphasic or triphasic wave forms occurred exclusively in the group with a fatal outcome. The intermediate phase of the encephalopathy was signaled by an attenuation of all fast frequencies (alpha and beta rhythms), enhancement of delta activity, and disappearance of sleep parameters (if present in the earlier recordings). Finally, a modified burst suppression pattern occurred as a late EEG evolution in an encephalopathy of complex and protracted nature.

Brain Diseases↗
PubMed1980

Sleep hypoxemia in young adults with cystic fibrosis.

Hypoxemia, obstructive apnea, and disordered breathing during sleep have been documented in adult patients with chronic obstructive pulmonary disease. We studied sleep, oxygen saturation, and breathing in nine patients (ages 17 to 26 years) with cystic fibrosis (CF) lung disease by means of all-night polygraphic tracings. Two had brief episodes of oxygen desaturation during rapid eye movement (REM) sleep, and one patient with severe disease had prolonged desaturation with episodic worsening associated with disordered breathing in REM sleep and with cough. No patient had apnea or any evidence of upper airway obstruction, in contrast with studies of older patients. In three patients, nocturnal coughing contributed to disruption of sleep cycles. Sleep oxygen desaturation may contribute to the development or progression of cor pulmonale in some patients with CF, but it seems to be most severe only in those with advanced disease.

Adult↗