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Biomedical subjects

G Spiel

Publications and source records attributed to G Spiel.

At least 19 recordsLinked to original sources
PubMed2001

Developmental language and speech disability.

Speech disabilities (articulation deficits) and language disorders--expressive (vocabulary) receptive (language comprehension) are not uncommon in children. An overview of these along with a global description of the impairment of communication as well as clinical characteristics of language developmental disorders are presented in this article. The diagnostic tables, which are applied in the European and Anglo-American speech areas, ICD-10 and DSM-IV, have been explained and compared. Because of their strengths and weaknesses an alternative classification of language and speech developmental disorders is proposed, which allows a differentiation between expressive and receptive language capabilities with regard to the semantic and the morphological/syntax domains. Prevalence and comorbidity rates, psychosocial influences, biological factors and the biological social interaction have been discussed. The necessity of the use of standardized examinations is emphasised. General logopaedic treatment paradigms, specific therapy concepts and an overview of prognosis have been described.

Child Language↗
PubMed1999

[Brief report of working group OPD-CA (children and adolescents) Axis IV: structural standard].

Apart from the structural differentiation of the body and its functions, the enlargement of the child's repertoire of possibilities to make experiences and to act is a manifestation of the development of the child's psychic structure which, advancing in years, may be considered as a treasure of all the experiences one has made with oneself, with the world and with the others. Structure will develop along with the interactional experiences with the world around us and becomes manifest in one's behaviour which may be witnessed and observed. The description of the psychic structure comprises three dimensions (perception of the self and of the objects, control, communication and bonding) which will be described by certain capabilities and will be assessed with the help of an anchoring example typical for each age which serves the purpose of clinical illustration. The adaptational achievement may then be assessed on the basis of a structural standard independent of age and may be ranged on a structural level. It appears that the exemplary description of different scopes of tasks typically to be performed at certain ages which serves as a basis for the assessment of the adaptational competence during childhood and adolescence seems to be a good policy. The purpose of our studies is the development of a valid instrument which is easy to handle in practice and which has a high interrater-reliability.

Adolescent↗
PubMed1998

Treatment of severe clozapine-induced neutropenia with granulocyte colony-stimulating factor (G-CSF). Remission despite continuous treatment with clozapine.

BACKGROUND: A 17-year-old boy suffering from a severe schizophrenic disorder of the paranoid type and mental retardation did not respond to treatment with typical antipsychotics, whereas under clozapine treatment he showed a favourable response. Discontinuation of clozapine led to an acute psychotic relapse. During clozapine treatment the patient developed severe neutropenia. METHOD AND RESULTS: Due to the history of unsatisfactory response to traditional antipsychotics, clozapine treatment was continued despite white blood cell (WBC) decline. Concomitant treatment with G-CSF was followed by a rapid normalisation of WBC. CONCLUSIONS: This case report is not intended to challenge the clinical practice of discontinuing clozapine upon the development of neutropenia/agranulocytosis, but rather to stimulate further research in the pathophysiology and clinical consequences of a clozapine rechallenge after a WBC decline, especially in patients with a rather complex symptomatology where no sufficient therapeutic results can be achieved with any other pharmacological intervention than clozapine.

Adolescent↗
PubMed1989

[Differential diagnosis of epilepsies in early childhood].

The last twenty years have seen substantial advances in knowledge concerning the diagnosis as well as the long-term evolution of epilepsies in infants and children. There is, however, no general agreement among epileptologists on the framework of epileptic syndroms in infancy and childhood. The main problems are the lack of a uniform terminology and the fact that there is little unanimity concerning definitions and what may be included under individual syndromic rubrics. In consequence the nosological limits between the various syndromes described are not distinct and they very often represent a heterogenous group of disorders and not a single entity. The present paper reviews the literature recently published and discusses diagnostic difficulties and nosological problems. In addition the attempt has been made to elaborate a "multi-dimensional" classification of syndromes, based on clinical (using the terminology of the international classification) and electroencephalographic criteria, but also taking into consideration aetiological and evolution data. Results show that it was possible to differentiate within a cohort of 77 infants aged 0-24 months (suffering from various types of epileptic disorders) several distinct and homogenous nosological entities and syndromes. As it is well known today, that the type of epilepsy which occurs in a child as well as the prognosis of the disease represent a confluence of age, heredity and structural brain abnormality, it seems apparent that adequate classification systems have to take into consideration the complexity of various factors "triggering" the onset and influencing the course of the disease, even when a number of cases remains outside resp. "borderline" such a syndromic classification.

Adrenocorticotropic Hormone↗
PubMed1989

[Strategies of data reduction in computer-assisted EEG analysis in the time domain--measurement of theoretical aspects and redundancy relations within and between various strategies of data reduction].

The enormous amount of data after performing computer assisted EEG-analysis makes necessary reduction methods. Different strategies have been proposed. Traditionally the distribution of frequencies is shown by using frequency bands. The aim of this paper is to compare different strategies of data reduction regarding frequency distribution and to discuss results concerning validity. Three data reduction methods and their mutual relations will be discussed. The classification with regard to frequency bands, the computation of quartils of the frequency spectrum and the search for prominent frequencies. It will be shown wether or not calculated values are redundant and reflect identical information (latent dimensions).

Child↗
PubMed1987

Influence of television on photosensitive epileptics.

We examined 32 epileptics (20 female; 12 male; aged 6-73 years) who had displayed photoconvulsive reactions to flickering light in the EEG; they were examined with regard to their risks of getting epileptic seizures upon watching television (TV) under certain conditions. On a colour TV set each patient was shown a 3-min videofilm with slow- and fast-moving parts under 16 different conditions. The conditions had the following variables: (1) colour - monochrome; (2) dark room - light room, and (3) four different distances from the screen. In addition, each patient was subjected for 3 min to manipulated image interferences, including the vertical rolling of the picture. The results of this TV stimulation were always negative, i.e. in no patient did TV provoke a reproducible paroxysmal discharge in the EEG, nor was there any epileptic seizure. Our findings are discussed in connection with the corresponding literature.

Adolescent↗
PubMed1987

[Valproic acid monotherapy in epilepsies in childhood and adolescence].

The effectiveness and side effects of a DPA monotherapy were evaluated in 96 children and adolescents over a period of five years. In addition the attempt has been made to find correlations between sex, age of seizure onset, etiology of the disease, types of seizures, and EEG abnormalities on the one hand, and the clinical response to the drug on the other hand. The results are in many respects similar to other observations with DPA: good therapeutic effect in cases with seizure onset between the age of 7-10 years, cryptogenic or genetic etiology, primary generalized seizures, and a generalized pattern in EEG (without focal changes). On the contrary positive effect of DPA in partial epilepsies and secondarily generalized epilepsies was seen only in those patients who had a seizure onset between seven and ten years and a cryptogenic etiology (syndrome of benign rolandic epilepsy in childhood can be suspected in these cases).

Adolescent↗
PubMed1986

[Data display and reduction in computer-assisted EEG analysis in the time domain].

Analysis of EEG frequency spectra leads in two fields to problems demanding optimal data reduction methods: especially if topological aspects have to be considered, it is likely that the rather limited memory capacity of laboratory computer systems will be exceeded; furthermore severe methodological problems arise in statistical analysis of combined data sets, including frequency spectra, other physiological, and non-physiological data. Three data reduction methods are discussed: the classification with respect to frequency bands, the search for prominent frequencies, and the computation of quartiles of the frequency spectra. There is some evidence in favour of the method of prominent frequencies. This method seems to preserve much of the differential information of the frequency spectra.

Computers↗
PubMed1986

[Demonstration of an interpolation method for determining approximate maximum and minimum points as a prerequisite for EEG analysis in the time domain using computers with limited memory capacity].

The EEG analysis in the time domain provides several advantages compared to the power spectra analysis, based on a FFT. There is the possibility to differentiate frequency, amplitude and other elementary characteristics of the wave form. This technique of EEG analysis is based on the definition of distinct characteristics of the wave form. Problems for calculating the frequency distribution arise--according to Harner, 1977--due to the fact, that the digitalization rate has to be very fast to reach an adequate resolution. On the other hand a high digitalization rate of 5 ms or below produces problems concerning the limited memory capacity of laboratory computers, especially if more than one derivation should be analysed simultaneously, to make further topological analyses possible. Three procedures of EEG analysis to calculate frequency distributions are shown, two of them are based on an interpolation technique to calculate adjusted minima-maxima. The results of these procedures using two different digitalization rates, were compared and discussed to respect similarity of resulting frequency distributions.

Computers↗
PubMed1986

[Carbamazepine (Tegretol) monotherapy in epilepsies with partial and/or secondary generalized seizures in childhood and adolescence].

The effectiveness and side effects of a carbamazepine monotherapy were evaluated in 40 children and adolescents (22 boys and 18 girls with an age distribution between 1 and 16 years) over a period of 6 years. In addition the attempt has been made, to find correlations between sex, age of seizure onset, aetiology of the disease, types of seizures, and EEG-abnormalities on the one hand, and the clinical response to the drug on the other. Selection criteria were, that the patients were under continuous follow-up, that they suffered from partial or/and secondarily generalized seizures and that Tegretol was the first and only drug at the beginning of the examination. The treatment with the Carbamazepine-monotherapy was successful in 63% of the patients, 37% remained resistant to the treatment. Carbamazepine proved to be effective against partial seizures as well as secondarily generalized grand-mal-seizures. The therapeutic range of the serum carbamazepine levels during monotherapy varied between 15-35 mu Mol/l. 40 patients entered, 38 completed the study. In two cases the drug had to be stopped owing to allergic skin rash due to the drug. No other serious side effects were observed in any of the remaining 38 patients. The most frequent laboratory changes were an increase of Gamma-GT and leucopenia. All the cases who became seizure-free (Responder) were compared with the remaining cases with unfavourable treatment results (Nonresponder) in order to find out whether there are significant differences between the two groups, as far as sex, age ... etc. (see above) are concerned.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

[Automatic EEG analysis in the time domain and its possible clinical significance--presentation of a flexible software package].

The intention of the automatic EEG analysis is to take several EEG characteristics into account and therefore be usable for different applications to quantify events in the EEG. This procedure of analysis is based on the estimation of maxima and minima points within the measured data and the calculation of the wavelength of the half-waves. This is done by correction of the actually measured maxima-minima-points along the t-axis by means of an interpolation technique, and the frequency of half waves are calculated from this solution with an accuracy of half a Hertz. This method was necessary because our equipment allows only a digitalisation rate of 8 ms (Harner, 1977). Using this procedure it is possible to record the frequency distribution, the distribution of amplitudes, and the distribution of steepness as distributions of elementary EEG characteristics. To characterize specified EEG patterns, the EEG data can be classified according to categories of combinations of quantified characteristics. If we consider topological aspects as well there are the following possibilities: 1 element. characteristic--1 EEG channel; 1 element. characteristic--2 or more EEG channels; several element. characteristics--1 EEG channel; several element. characteristics--2 or more channels. There are possibilities of data reduction, exemplified on the distribution of frequencies without taking into account the topological aspects. The above mentioned methods of data reduction are useful for one EEG channel. On the other hand a comparison of the EEG activity in different channels can be done.

Brain Diseases↗
PubMed1986

[Cerebrospinal fluid changes in Garin-Bujadoux-Bannwarth meningoradiculitis].

56 cerebrospinal fluid (CSF) and 46 matched serum samples were investigated in 23 patients, who suffered from meningopolyneuritis Garin-Bujadoux-Bannwarth. CSF cells and proteins were elevated for several months. The most prominent findings were the predominantly lymphocytic cell reactions with high numbers of plasma cells and the persistence of humoral immune reactions, i.e. intrathecally produced IgG, IgM and IgA. Both give evidence that the responsible infectious agent has rather low pathogenic but high immunogenic properties and that it has a tendency for a long persistence in the nervous system.

Borrelia Infections↗
PubMed1985

[Presentation of a new tachistoscopic test procedure for measuring functional hemisphere asymmetries of the optic field].

A newly developed tachistoscopic test using visual half-field-stimulation was tried on a clinical population of 178 primary school children. Words and geometric figures were presented. The results showed inconsistent effects of increased tiredness on the one hand and training effects on the other hand, while doing the test. The amount of asymmetry in the performance was not effected. The construction of the test was based on results of a previous study with similar items on a normal population of the same age. Therefore the items within a pair of simultaneously presented words or geometric figures in the two visual half-fields are generally of equal difficulty as perception is regarded. Therefore asymmetries in the perception are due to functional hemispheric asymmetry. Vertical oriented four-letterwords show no significant difference between reproduction from the right or left visual half-field. This discrepant finding regarding to the literature is discussed in respect of different methodology, different age distribution of the population, and different state of skills in reading and writing. Geometric figures showed marked asymmetries on the level of reproduction. Such items were much better recognized, if they were presented in the left visual half-field.

Adult↗
PubMed1984

[Complicating etiological factors in pregnancy and the perinatal period for epilepsy in childhood].

The aim of this survey, examining childhood epilepsies with pathological findings in pregnancy and perinatal, was to find out if patient collective was homogenous considering the parameters: type of seizures, EEG and Computer Tomography, or if a further syndromatological differentiation could be made. We found, that on one side our examined population could be divided into two subgroups, based on the combination of seizure type and EEG findings. On the other hand the CAT-findings and the number of focal slow wave activity or of increased tendency to focal paroxysmal activity show a very good correspondence with the diagnostic criteria of our patient collective.

Age Factors↗
PubMed1984

[Tuberous sclerosis. Clinical and computer tomography findings in infancy and childhood].

Tuberous sclerosis was diagnosed in 21 patients (13 female, 8 male) at an age of 3 months to 17 years, 8 of them being younger than 1 year at the time of diagnosis. 14 cases occurred sporadic, 7 patients had a positive familial history of the disease. The diagnosis was based on typical cutaneous lesions (white spots in 19, adenoma sebaceum in 12), cerebral seizures (20 patients) and intracranial calcifications which were found in all 17 patients who were investigated by cranial computerized tomography, especially in all 5 patients who were investigated in the first year of life. In addition two patients showed tumors arising from the region of the frontal horns. Histological examination which was performed in one of them showed the typical picture of a subependymal giant cell astrocytoma. Seizures occurred within the first year of life in 15 of 20 patients. The most common seizure type were infantile spasms (11 patients), grand mal (10 patients) and partial seizures (7 patients). In two children Todd's palsies were observed. Mental retardation of variable degree was observed in 11 patients. Cystic renal lesions were found in one patient with severe haematuria and they were suspected in 3 others on ultrasonographic examination. Retinal phakoma was found in only one patient, cardial rhabdomyoma was suspected in another one who suffered from congenital multifocal atrial tachycardia. The diagnosis in the first year of life was based upon the typical trias of white spots, seizures and intracranial calcifications on CT examination.

Adolescent↗
PubMed1983

[Presentation of a new dichotic hearing test for the measurement of functional hemispheric asymmetries].

A newly developed dichotic test was tried on a clinical population of 197 primary school children. The results show a right ear advantage; that is better achievements in reproduction of verbal material presented to the right ear. This effect can only be reliably proved by double presentation of the material, once in inverse form. Changes in the test performance while doing the test; as well as the importance of the intervening variable, dominance of one word over the other within a pair simultaneously presented are discussed - first of all a statistical analysis was made to isolate the words that dominate most clearly in their setting. As a result of the recorded item-total (subtest) correlation as well as the estimation of reliability, there is a possibility to develop a more reliable test instrument in a second step. With cluster analysis the diagnostic value of the dichotic examination was shown in a group of 60 subjects, especially with a view to the formal pathogenesis of achievement disorders in early primary school age.

Child↗