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Biomedical subjects

R W Frith

Publications and source records attributed to R W Frith.

13 recordsLinked to original sources
PubMed1992

Pattern visual evoked potential luminance and multiple sclerosis.

Pattern visual evoked potentials (PVEPs) were recorded from 111 patients classified as having possible, probable or definite multiple sclerosis. Patients were stimulated with a checkerboard pattern using high and low luminances in order to test the hypothesis that an attenuated pattern luminance increases the detection rate of PVEP abnormalities. With increasing certainty of diagnosis, there was a concomitant increase in the incidence of PVEP abnormalities. However, there was no evidence that stimulating with a lower luminance pattern enhanced the sensitivity of the test. The same findings were also apparent when the patient data was analyzed according to the presence or absence of a history of optic neuritis or other visual symptoms. It is concluded that, within the luminance limits used in this study, the role of varied luminance in detecting demyelinating lesions in the optic nerves using the PVEP is minimal, although there was some limited evidence that a high level of luminance may be more appropriate than a low level.

Adolescent↗
PubMed1991

A comparison between electroencephalography and somatosensory evoked potentials for outcome prediction following severe head injury.

The value of somatosensory evoked potentials (SEPs) for the prediction of outcome following severe head injury (HI) is established. The role of the electroencephalogram (EEG) in this setting is uncertain. In this comparative study, SEPs and EEGs were recorded within 3 days of severe HI in 90 patients, and the results related to outcome at 6 months. Patients with an isoelectric EEG or an EEG with repeated isoelectric intervals died. Reactivity of the EEG to external stimulation tended to be associated with favorable outcome. Grading of the EEGs on the basis of frequency composition otherwise provided no prognostic information. The presence of SEP scalp potentials bilaterally predicted favorable outcome, particularly if the central conduction times were normal. Conversely, the absence of one of both scalp potentials was associated with unfavorable outcome. EEGs thus provided useful prognostic information in only a minority of patients. By comparison, SEPs allowed prediction of both favorable and unfavorable outcomes in a much larger number of patients, and were therefore prognostically superior.

Adolescent↗
PubMed1989

The relationship of eyelid movement to the blink reflex.

Although the blink reflex is a standard neurophysiological investigation its relationship with eyelid movement has not been clearly established. We studied normal subjects and patients with unilateral facial paralysis to define the pattern of eyelid movement following glabellar tap, supraorbital nerve stimulation, facial nerve stimulation and direct corneal stimulation. We found that eyelid closure did not necessarily occur in a single movement. Following glabellar tap the first component of a two-stage movement was initiated by levator palpebrae relaxation while with supraorbital nerve stimulation orbicularis oculi contraction produced the first movement. The compound muscle action potential following direct facial nerve stimulation produced only minimal eyelid movement, the major closure being associated with a longer latency orbicularis oculi reflex. Corneal stimulation elicited a single component eyelid movement. Thus, the pattern of eyelid movement differed for each stimulus reflecting variations in orbicularis oculi contraction and levator palpebrae inhibition.

Adult↗
PubMed1989

Uvulopalatopharyngoplasty in severe idiopathic obstructive sleep apnoea syndrome.

Eleven patients with severe obstructive sleep apnoea syndrome, which was fully reversed by treatment with nasal continuous positive airways pressure, underwent uvulopalatopharyngoplasty. All patients were followed for at least 12 months after surgery. One patient with large tonsils was cured. Of the remaining 10 patients, two showed minimal objective improvement at 12 months and the rest were unchanged. Four patients subsequently developed cardiac failure due to obstructive sleep apnoea. Thus uvulopalatopharyngoplasty was not effective in these patients with severe idiopathic obstructive sleep apnoea syndrome.

Adult↗
PubMed1988

Origin of reprint requests.

One thousand consecutive reprint requests were classified according to their countries of origin. One third came from the United States of America and over 70% originated in six countries (USA, Czechoslovakia, France, West and East Germany and Canada). When reprint requests were adjusted for population size, a different order became apparent with Czechoslovakia requesting proportionally the most, followed by Israel, East Germany, Canada, Switzerland and Belgium. Approximately half of the reprint requests came from European countries with the overall rates for western and eastern European nations being similar. There were comparatively few requests received from Third World nations. The analysis questions several of the reasons commonly given for honouring reprint requests.

Humans↗
PubMed1988

Somatosensory evoked potentials following severe head injury: loss of the thalamic potential with brain death.

The thalamic component (P17) of the short-latency somatosensory evoked potential (SEP) was assessed to determine its usefulness in patients with severe head injury. Subjects were a group of patients admitted to the Auckland Hospital Critical Care Unit who subsequently died from head injury. In all instances where brain death was unequivocally established and a SEP recording made in close temporal proximity to the time of brain death the P17 potential was absent. When there was evidence of continuing brainstem activity and particularly where prolonged survival occurred following the last SEP recording the P17 potential remained intact bilaterally. This study shows that the presence or absence of the thalamic component of the short-latency SEP provides a reliable electrophysiological measure of brainstem function in patients where brain death has been suspected.

Adolescent↗
PubMed1986

Somatosensory evoked potentials in syringomyelia.

The two types of upper limb somatosensory evoked potential abnormality observed in nine patients with syringomyelia were reduced amplitude or absent cervical potentials and an abnormal central conduction time. Although this pattern of abnormalities resembles that observed in other intrinsic spinal cord lesions, it differs from peripheral nerve diseases and cervical radiculopathy in which the central conduction time is normal.

Adolescent↗
PubMed1986

Stationary waves recorded at the shoulder after median nerve stimulation.

A new recording method with a reference electrode on the stimulated arm defined two discrete far-field potentials just before the propagated near-field nerve action potential was recorded at Erb's point. Both potentials were stationary waves with the same latency at all recording sites. The first potential had the same onset and peak latencies as the propagated wave at the axilla; it corresponded to the first component of the P9 far-field potential recorded with scalp to noncephalic reference montages. The latency of the second potential coincided with that of the propagated wave entering the neck and corresponded to the peak of the P9 potential. The occurrence of these potentials where there are significant changes in the morphology of the volume conductor suggests that the P9 far-field potential is due to a change in the conducting medium that surrounds the nerve.

Action Potentials↗
PubMed1985

Obstructive sleep apnoea in Auckland: diagnosis and treatment.

In 1982 facilities for investigation of patients with sleep disorders were established at Auckland Hospital on a trial basis. Twenty patients with the obstructive sleep apnoea syndrome had been investigated and treated by the end of 1983. All were advised to avoid alcohol and sedatives and the obese patients were encouraged to lose weight. In the more severely affected patients either nasal continuous positive airway pressure or tracheostomy was used. The method of diagnosis and treatment are discussed.

Adult↗
PubMed1985

Severe obstructive sleep apnoea treated with long term nasal continuous positive airway pressure.

Seven patients with the severe obstructive sleep apnoea syndrome were treated with nasal continuous positive airway pressure for from three to 22 months. This treatment reversed all symptoms due to the syndrome in every patient and continued to be used in five patients. One patient stopped treatment after eight months and subsequently remained incapacitated and another underwent tracheostomy at the time of transphenoidal hypophysectomy. Nasal continuous positive airway pressure is a safe, non-invasive treatment, which may be used in the presence of cardiac and respiratory failure. It is able fully to reverse upper airway obstruction and can be used at home on a long term basis.

Adult↗