Biomedical subjects

Jürg Lütschg

Publications and source records attributed to Jürg Lütschg.

6 recordsLinked to original sources

PubMed2006

Fast improvement of verbal memory function after left temporal tumour resection.

CASE REPORT: A 7-y-old, right-handed girl presented at our clinic with complex partial seizures, behavioural problems and word-finding difficulties. Clinical examination was normal, but electroencephalogram revealed bilateral epileptic discharges in the temporal and paracentral leads. Magnetic resonance imaging showed an intracerebral mass in the left mesial temporal lobe in the areas of the gyrus temporooccipitalis medialis and gyrus parahippocampalis. Neuropsychological testing brought to light an above-average general intelligence, but the girl performed below average in verbal memory tests and average in figural memory tests. RESULTS: The tumour was completely removed by surgery. Neuropsychological testing 3 and 11 wk after tumour resection demonstrated above-average verbal learning and memory abilities and improved visual memory. The emotional disturbances, seizures and electroencephalogram abnormalities disappeared completely during the postoperative follow-up. CONCLUSION: After resection of a left temporal brain tumour, the patient was free of seizures, and neuropsychological functions recovered completely within weeks.

Brain Neoplasms↗

PubMed2005

Acceptance and timeliness of standard vaccination in children with chronic neurological deficits in north-western Switzerland.

UNLABELLED: There are no special recommendations for basic vaccinations in patients with chronic neurological deficits distinct from the nationwide advocated schedule in Switzerland. Reports describing adverse neurological events possibly related to vaccinations have attracted public attention. It is unclear if patients with chronic neurological deficits are more reluctantly vaccinated compared to healthy children. We therefore investigated the acceptance of vaccinations in such patients and healthy controls in a retrospective case-control study. At the University Children's Hospital, Basel, Switzerland we investigated 100 patients with chronic neurological deficits and 200 age-matched healthy controls regarding the issue of vaccination rates and ages. The total number of administered vaccinations against diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b (Hib), mumps, measles, rubella and hepatitis B were significantly lower in patients compared to healthy controls ( P < 0.01 for each of the respective vaccines). Patients had an increased risk to receive the third pertussis, diphtheria, and tetanus vaccinations (relative risks (RR) for late vaccination 1.53, 1.53, and 1.54 respectively, P < 0.01 for all comparisons), the second (RR = 1.60, P < 0.05) and third Hib vaccinations (RR = 1.52, P < 0.05), and the third polio vaccination (RR = 1.43, P < 0.05) later than controls. CONCLUSION: Children with chronic neurological deficits received fewer vaccinations than healthy controls. In addition, patients received vaccinations later than healthy children. Hence, it may be assumed that children with chronic neurological deficits are at an increased risk to acquire preventable infections. Therefore, vaccination should be promoted as part of the consultation during a routine appointment with the specialist.

Adolescent↗

PubMed2005

Cerebral hemodynamic changes in response to an executive function task in children with attention-deficit hyperactivity disorder measured by near-infrared spectroscopy.

The aim of the present study was to evaluate the hemodynamic changes in both prefrontal regions induced by a cognitive task in children with a developmental attention-deficit disorder in comparison to normal controls using near-infrared spectroscopy (NIRS). A total of 11 boys with a mean age of 10.4 (+/-1.2) years that met the DSM-IV criteria for attention-deficit hyperactivity disorder (ADHD) participated in the study and were compared with 9 healthy age- and sex-matched controls. Using a trail-making test designed for the task of connecting numbers from 1-90 in four sets, changes in oxygenated (O2Hb) and deoxygenated (HHb) hemoglobin, tissue oxygenation index (TOI), and cerebral blood volume (CBV) were measured by near-infrared spectroscopy. During the first test set, designed as a short-attention task, the children with ADHD showed significant increases in O2Hb and CBV, whereas the controls showed no significant changes. During the 4 task cycles in which extended attention was demanded, both groups showed increases in O2Hb and CBV, but only the controls showed an additional increase in HHb in the left prefrontal region. In the ADHD group only, TOI showed an increase mainly on the left side. NIRS is a sensitive tool for measuring differences in hemodynamic changes between boys with ADHD and normal controls. Overall, the normal controls showed lateralized oxygen consumption in the left prefrontal cortex during an extended-attention task, whereas the boys with ADHD showed an imbalance between oxygenated and deoxygenated hemoglobin during the short- and extended-attention tasks.

Age Factors↗

PubMed2005

Sudden unexplained death in children with epilepsy: a cohort study with an eighteen-year follow-up.

AIM: Sudden unexplained death is a significant cause of mortality in adults with epilepsy. Only a few data exist about this risk in childhood. METHODS: Cases of sudden unexplained death in epilepsy (SUDEP) up to the age of 18 y occurring at our hospital between 1984 and 2001 were identified. The incidence rate was calculated on the basis of diagnosed epileptics registered with a statutory disability insurance scheme. RESULTS: Four cases of SUDEP were identified during the 18-y period. The incidence of SUDEP was 4.3 per 10,000 patient-years. All children showed polytherapy-refractory epilepsy, developmental retardation and early-onset epilepsy. Two witnessed cases had shown no previous signs of seizure. CONCLUSION: SUDEP is rare in childhood. Children with uncomplicated epilepsy seem not to be at risk.

Anticonvulsants↗

PubMed2004

Attention-induced frontal brain activation measured by near-infrared spectroscopy.

In eight right-handed healthy males aged 9.6-12.9 years, changes in the frontal cerebral concentrations of oxygenated, deoxygenated, and total hemoglobin, as well as in tissue oxygenation index and cytochrome oxidase aa(3) were measured by near-infrared spectroscopy. The males were evaluated using a trail-making test with four test cycles interrupted by relax breaks. During the first cycle of this task, a significant increase in deoxygenated hemoglobin was documented in the left frontal region. In the extended course of the test, a significant increase in oxygenated and total hemoglobin was observed on both sides, indicating an increase in cerebral blood volume. However, only on the left side was an increase in deoxygenated hemoglobin documented. In children, changes in cerebral oxygenation induced by a cognitive task could be measured by near-infrared spectroscopy. In a short and extended attention task, a lateralized increase in oxygen consumption was documented by an increase in deoxygenated hemoglobin. In an extended attention task, an increase in oxygenated and total hemoglobin was recorded additionally in both frontal brain regions, indicating a compensatory increase in cerebral perfusion. Further studies are required to examine the significance of this technique in testing differences in children with neurobehavioral disabilities.

Attention↗

PubMed2002

Methylphenidate treatment.

Methylphenidate is the psychotropic drug most commonly used to treat individuals suffering from developmental attention-deficit-hyperactivity disorder. Additional attention deficit is part of numerous neurologic diseases in childhood. Despite the vast extent of scientific research on methylphenidate, the use of this stimulant in the treatment of cognitive and behavioral dysfunction in children with epilepsy, brain tumor, leukemia, closed brain injury, encephalitis, meningitis, or mental retardation continues to be controversial. Only few data exist about the efficacy and side effects of methylphenidate treatment in children with this neurologic illness or history. The aim of the present study is to provide a review of this important clinical topic and perhaps to stimulate further controlled investigations.

Attention Deficit Disorder with Hyperactivity↗