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Biomedical subjects

S Dikmen

Publications and source records attributed to S Dikmen.

At least 37 records · Page 2Linked to original sources
PubMed1983

The behavioral sequelae of head injury.

Twenty patients with mild and, in a few cases, moderately severe head injuries were examined 3 days and 1 month postinjury. The results indicate that these patients, as compared to appropriate controls, show significant neuropsychological difficulties at 3 days, but not at 1 month postinjury. Postconcussional symptoms are endorsed, on the other hand, at both 3 days and 1 month. Absence of significant neuropsychological findings at 1 month is contrary to some of the previous reports. A number of reasons for this discrepancy were discussed. Some of these included: (a) inappropriate controls used in previous research; (2) failure to screen for pre-existing conditions in prior studies, therefore confounding the effects of the injury with pre-injury factors; (3) possible practice effects in our research; and (4) differences in the neuropsychological measures used across different studies.

Adolescent↗
PubMed1983

Validity of the Minnesota Multiphasic Personality Inventory (MMPI) to psychopathology in patients with epilepsy.

Information regarding the sensitivity of the Minnesota Multiphasic Personality Inventory (MMPI) to psychopathology and the meaning of MMPI elevations in neurological patients, particularly in those with epilepsy, is of both theoretical and clinical concern. Such information has a particular relevance to the temporal lobe epilepsy-psychopathology controversy. In order to investigate evidence for increased psychopathology as a function of complex partial seizures (temporal lobe epilepsy in the old nomenclature), three groups of epilepsy patients differing in seizure type were compared on the MMPI. No supportive evidence was present for such an association. Second, the sensitivity of the MMPI to psychopathology was examined by comparing three groups of epilepsy patients differing in history of psychiatric problems. The results clearly indicated that the MMPI is sensitive to psychopathology in patients with epilepsy. Finally, the Sc scale was examined in relation to items descriptive of "disease-related experiences" and the psychiatric implications of endorsing such items. About one third of the items were identified as descriptive of "real experiences." Nevertheless, patients with psychiatric histories endorsed more of such items. In conclusion, the MMPI appears to be sensitive to psychopathology in epilepsy. Therefore, insensitivity of this instrument cannot be advanced as an explanation for the results of many studies that have not supported the temporal lobe epilepsy-psychopathology controversy.

Adult↗
PubMed1983

Head injury in the Pacific Northwest.

This report describes 451 consecutive patients admitted to a regional trauma center with head injury over 1 year's time. Our results replicate findings from other hospital- and population-based studies of head trauma. Males exceeded females by 3 to 1; the most frequent age of patients was between 15 and 24 years; and motor vehicles were the most common cause of injuries. Mortality was related inversely to Glasgow coma scale (GCS) scores and directly to age. This study also points out two current problems in head trauma research. One is the difficulty in using the GCS in a community with highly sophisticated emergency medical services. In 38% of the patients, one or more GCS components could not be assessed directly. In 17% of cases, GCS scores could not be confidently assigned. This was principally because endotracheal tubes were in place before arrival at the hospital, precluding determination of the verbal response. A second problem is the influence of chronic pre-existing central nervous system conditions on head outcome. Twenty-nine per cent of our patients had one or more such conditions at the time of their injury. Minimal estimates of prevalence ranged from 1% (mental retardation) to 18% (alcoholism).

Adolescent↗
PubMed1982

Increased psychopathology associated with multiple seizure types: fact or artifact?

Previous investigations have reported that individuals with complex partial seizures (CPS) who also have experienced other types of seizures manifested more psychopathology than individuals with CPS who experienced only that type of seizure. These previous studies failed to match their seizure subgroups on important variables known to bear significant relationships with psychopathology, and the possibility that the previous results were due to artifact cannot be excluded. Thirty-three individuals with CPS only were compared to 34 individuals with both complex partial and secondarily generalized attacks (CPS/SG). The groups were closely matched on several potentially confounding variables and compared on Minnesota Multiphasic Personality Inventory (MMPI) measures of overall psychopathology, aggression, and psychosis. The CPS/SG group manifested significantly more psychopathology on all the MMPI measures and it was concluded that the multiple seizure type effect is real and robust. These findings were related to the larger epilepsy/ psychopathology literature.

Epilepsy, Temporal Lobe↗
PubMed1982

Interictal psychopathology in patients with ictal fear: a quantitative investigation.

We assessed the hypothesis that psychopathology is overrepresented in patients with temporal lobe epilepsy (TLE) who experience ictal fear. Eleven such patients were matched with two control groups: patients who had TLE without ictal fear and patients who had generalized epilepsy. On several MMPI scales, the TLE-ictal fear group scored significantly higher than the two control groups, which did not differ significantly from each other. Furthermore, the TLE-ictal fear group had more MMPI clinical scales that were pathologically elevated, had significantly more patients with histories of admission to psychiatric hospitals, and had more MMPI profiles that were psychotic than either of the control groups.

Adult↗
PubMed1981

Psychological effects of general anesthesia on five- to eight-year-old children.

Thirty-six five- to eight-year-old children undergoing routine myringotomy procedures and maintained with halothane-N2O general anesthesia (mean duration = 17.9 min) were administered a series of psychological performance measures prior to and at about two hours after surgery. A control group of 30 children not experiencing anesthesia or surgery was tested at comparable intervals. In addition, 16 of the anesthesia group and 15 of the control group subjects were retested again the next day, about 24 h postsurgery. The anesthesia group demonstrated impairment on tests of reasoning, motor and memory functions at two hours postanesthesia. There was no evidence for continued impairment 24 h later. The effects at two hours postanesthesia did not appear related to induction medication or group differences in discomfort/symptomatology.

Adaptation, Psychological↗
PubMed1980

Neuropsychological factors related to employability and occupational status in persons with epilepsy.

The relationship between neuropsychological abilities and employment and occupational status was examined in 108 epilepsy patients. The performances of each subject on a wide range of neuropsychological measures were grouped into six conceptually meaningful ability categories. Highly significant differences were obtained between groups of patients with epilepsy differing in employment status and occupational status across both the range of individual measures and the composite neuropsychological ability areas utilized. The relative importance of the six ability scores was then examined with respect to employment status and occupational status. The results suggest that generalized neuropsychological dysfunction characterizes groups of persons who are unemployed and/or who have held low occupational level jobs. Within this context of general impairment, however, memory and alertness and flexibility in thinking appear to be relatively important abilities with respect to these general employment variables. Implications of the results for vocational and rehabilitation efforts were discussed.

Adult↗
PubMed1978

Neuropsychological performance in posttraumatic epilepsy.

Performances on the Wechsler-Bellevue Intelligence Scale and on Halstead's neuropsychological measures were investigated in two groups of adult subjects with posttraumatic seizures. One of the groups, in addition to seizures, had abnormal and persistent focal cortical signs. The other group had seizures only and no other known deficits or complications. The results suggest that posttraumatic epilepsy, whether or not accompanied by abnormal and persistent focal cortical signs, is associated with significant psychological impairment. Patients with posttraumatic epilepsy alone perform somewhat better than those whose epilepsy is accompanied by independent evidence of cortical damage. However, the performance difference between such patients is not major, nor is it statistically significant on most measures such as those used in the present study. Possible reasons for the performance deficit in this group were discussed.

Adult↗
PubMed1977

Emotional sequelae of head injury.

The emotional after-effects of head injury in relation to acuteness versus chronicity of the injury and neuropsychological deficits were studied. The results indicate that there is a decline in emotional distress over time after the injury and show that patients with significant initial and residual neuropsychological deficits experience greater emotional distress than those with negligible difficulties.

Adaptation, Psychological↗
PubMed1977

MMPI correlates of adaptive ability deficits in patients with brain lesions.

In the present study the relationship between MMPI variables and adequacy of function in verbal and performance intelligence, concept formation, sensory-perceptual and motor skills was examined in 129 subjects with definite evidence of cerebral lesions. Patients with greater impairment of abilities showed higher elevations on the MMPI variables, suggesting more emotional difficulties. Based on the present results and those of two previous studies by the same authors it was concluded that: a) MMPI variables are more closely related to measures of adequacy of function in adaptive abilities than they are to measures of lesion localization based upon pathoanatomical characteristics of the brain; and b) except for verbal skills the relationship between the MMPI variables and various adaptive skills is relatively minor. Interpretive limitations of the MMPI with brain-damaged patients and the need for devising other tests sensitive to the nuances of emotional difficulties of patients with brain lesions were discussed.

Adaptation, Psychological↗
PubMed1977

Effect of major motor seizure frequency upon cognitive-intellectual functions in adults.

Wechsler Aandult Intelligence Scale and Halstead neuropsychological performances were investigated in three groups of adult subjects with major motor epilepsy classified according to low, moderate, and high seizure frequency. The groups were equated on seizure duration and age at onset variables. On 7 of the 14 psychological measures employed, significant between-group differences were obtained, with poorest, intermediate, and best test scores associated with the high, moderate, and low seizure frequency groups, respectively. Similar performance comparisons were made on two additional groups: a "high risk" group characterized by early onset age, long seizure duration, and high seizure frequency, and a "low risk" group characterized by late onset age, short seizure duration, and low seizure frequency. Highly significant differences were obtained between the high risk and low risk groups on 12 of 14 variables, with the high risk subjects demonstrating severe cognitive and adaptive impairment in comparison to the low risk subjects. The results support the conclusion that increased frequency of major motor seizures is associated with increasing levels of adaptive impairment, and that the probability of severe cognitive-adaptive dysfunction is further and substantially increased when high seizure frequency is accompanied by a history of early onset and long duration of the disorder.

Adult↗
PubMed1977

Effect of early versus late onset of major motor epilepsy on cognitive-intellectual performance: further considerations.

Two groups of adult patients, one with early (0-5 years), the other with late (10-15 years) age of seizure onset, were compared on 14 variables derived from the Wechsler Adult Intelligence Scale (WAIS) and Halstead's neuropsychological measures. The groups were matched for duration of the disorder and seizure frequency, and all subjects (Ss) had unequivocal histories of major motor seizures. The group with early age of onset obtained significantly lower WAIS, Verbal IQ, Performance IQ, and Full Scale IQ values than the group with late age of onset. No significant intergroup differences were obtained on Halstead's measures, although the performances of both groups were impaired vis-a-vis non-neurological control expectancy. The results suggest that early onset age, as operationally defined in this study, has a specifc differential influence which is restricted to psychometric intellectual functions as measured by the WAIS in groups matched for seizure duration and seizure frequency.

Adolescent↗
PubMed1977

Age of onset and psychometric correlates of MMPI profiles in major motor epilepsy.

The purpose of the present study was to examine the MMPI performances of patients with major motor epilepsy and of nonepileptic brain damaged patients in relation to age of onset, duration of brain dysfunction and adequacy of intellectual functions. The present results suggest that MMPI indices of emotional disturbance are more closely associated with the degree of psychometric and cognitive impairment than they are with age of onset or duration of brain dysfunction. This effect is evident both in patients with major motor epilepsy and in nonepileptic brain damaged subjects.

Age Factors↗
PubMed1975

The effect of early versus late onset of major motor epilepsy upon cognitive-intellectual performance.

Performance on the Wechsler Adult Intelligence Scale and Halstead neuropsychological measures were investigated in two groups of adult subjects with major motor epilepsy of early (0 to 5 yr) and later (17 to 50 yr) onset, and in two groups with early and later onset of brain damage without epilepsy. The two groups with early onset earned poorer scores on most tests than did the two groups with later onset. The findings suggest an adverse effect of cerebral dysfunction of early onset, whether accompanied by major motor seizures or not. Subjects with early onset of major motor seizures scored significantly lower on 9 of 14 measures than subjects in any other group, none of which showed significant intergroup differences in the dependent variables employed. The results support the conclusion that early age of onset of major motor seizures is more apt to result in impairment of mental abilities in adult life than is later onset of seizures or early or late onset of brain damage uncomplicated by epilepsy.

Adolescent↗