Biomedical subjects

P D Moyes

Publications and source records attributed to P D Moyes.

13 recordsLinked to original sources

PubMed1988

Results of anterior corpus callosum section in 24 patients with medically intractable seizures.

Twenty-four medically refractory seizure patients, who did not qualify for excisional surgery, had anterior two-thirds corpus callosum section. Three to 11 years' postoperative follow-up suggests that this procedure can (1) lateralize a frontal lobe focus, which may lead to subsequent localized excision and (2) significantly reduce seizure frequency and severity in 75% of the patients without giving any permanent neurologic deficits. Patients with an ictal focus confined to one frontal lobe did best (8/8 improved), followed by patients with secondarily generalized seizures and multifocal bilateral foci (5/6 improved). Patients with mental retardation benefited less frequently (5/10 improved), but 4/4 from this group with ictal falls associated with Lennox-Gastaut syndrome did benefit. In this series, the improvements following the anterior partial section were lasting if present at 1 year of follow-up. Anterior corpus callosum section should be considered as a diagnostic (lateralizing) and therapeutic option in appropriately defined medically refractory patients who do not qualify for excisional surgery.

Adolescent↗

PubMed1982

Long-term follow-up after cerebral hemispherectomy: neurophysiologic, radiologic, and psychological findings.

Eight patients were studied 3 to 16 years (mean, 10 years) after cerebral hemispherectomy. Seven have infantile hemiplegia, and one had Sturge-Weber disease. Preoperative assessment included EEG responses to intracarotid drug injections. Postoperative complications occurred in seven patients. The operation was followed by a marked reduction in seizure frequency and improvement in behavior, with little change in intellect or hemiplegia. Neuropsychological assessment performed in four patients showed that they were not aphasic, but nonverbal spatial abilities were poor. CT showed marked shift of the remaining hemisphere in five of six patients scanned.

Adolescent↗

PubMed1980

Dandy-Walker syndrome: analysis of 21 cases.

During the years 1950 to 1978, a total of 21 cases of Dandy-Walker syndrome were seen at the Vancouver General Hospital. Apart from hydrocephalus, the associated brain anomalies included agenesis of the corpus callosum in four cases, occipital meningocele in two and aqueductal stenosis in one patient. Systemic malformations were present in four patients and included two cases of cleft palate, one of polycystic kidneys and one of congenital rubella syndrome. The over-all mortality was 48 per cent, but has declined since 1965. Of the 12 cases treated surgically, only four have died. The number of shunt revisions was high (about two per patient). Of the 11 survivors, three have normal intelligence, four show mild mental retardation, and four are moderately to severely retarded. The differential diagnosis, clinical course and surgical therapy are discussed. It is recommended that double shunting of a lateral ventricle and of the enlarged fourth ventricle should be the primary procedure in cases associated with aqueductal stenosis or occlusion, and should be the secondary procedure in patients who exhibit recurrence of increased pressure in the posterior fossa after simple shunting of a lateral ventricle.

Cerebrospinal Fluid Shunts↗

PubMed1970