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T Nakahori

Publications and source records attributed to T Nakahori.

7 recordsLinked to original sources
PubMed2001

Electroencephalographic changes and their regional differences during pediatric cardiovascular surgery with hypothermia.

Monitoring brain function by EEG is an important means of preventing cerebral insults in pediatric cardiovascular surgery. We studied intraoperative EEG changes and their regional differences associated with hypothermia and brain ischemia. The subjects of this study consisted of 13 children ranging in age from 4 months to 4 years and 6 months. Multi-channel EEGs were recorded using a portable digital EEG system, and the EEG changes were examined by visual inspection and computerized analyses. The results were as follows. (1) During cooling, a discontinuous EEG pattern was transiently observed in four patients, and this phenomenon indicated rapid suppression of cerebral function and subsequent adaptation. (2) Regarding the patterns of change in equivalent potentials induced by hypothermia, there were two different patterns depending on the degree of hypothermia, and the borderline rectal temperature was found to be around 32 degrees C. (3) During cooling, regional differences in the changes in equivalent potentials were observed in nine patients. A decrease in slow waves was marked in the occipital head area, and a decrease in fast waves was prominent in the anterior head area. (4) Arterial hypotension caused transient EEG abnormalities. Of them, bilaterally synchronous rhythmic high voltage slow waves were remarkable and exhibited bifrontal or bicentral dominance. (5) The EEG changes induced by hypothermia were influenced not only by the rectal temperature itself, but also by the rate of change in rectal temperature, and we speculated that this phenomenon was a result of adaptation. In intraoperative EEG monitoring, these findings constitute the basis for early detection of a cerebral hypoxic-ischemic state during pediatric cardiovascular surgery.

Body Temperature↗
PubMed2001

Combined use of sphenoidal electrodes and the dipole localization method for the identification of the mesial temporal focus.

UNLABELLED: We attempted to sub-classify four cases who show temporal spikes on standard scalp electroencephalogram (EEG), using sphenoidal electrodes and the dipole localization METHOD: In a case with mesial temporal epilepsy, spikes showed phase reversal in a sphenoidal electrode, and the spike dipoles were estimated to be in the mesial temporal lobe. In a case with lateral temporal epilepsy, spikes showed no phase reversal in a sphenoidal electrode, and the spike dipoles were estimated to be in the lateral temporal lobe. In two cases out of four, spikes showed phase reversal in sphenoidal electrodes, whilst the dipoles were estimated to be in the frontal lobe. Clinical features also suggested a diagnosis of frontal lobe epilepsy. In one of the two cases in which frontal lobe epilepsy was suspected, ictal dipoles as well as interictal spike dipoles indicated participation of the frontal lobe in the genesis of seizures. Nevertheless, only mesial temporal lobectomy was performed based on results obtained by invasive subdural electrodes. As a result, seizures were not controlled. Although sphenoidal electrodes were useful for differentiating between mesial and lateral temporal lobe foci, it is advisable to use them in combination with the dipole localization method to identify frontal lobe foci.

Action Potentials↗
PubMed1999

Dipole analysis in a case with tumor-related epilepsy.

In order to evaluate the effectiveness of presurgical dipole analysis of interictal spikes as a non-invasive technique for the determination of epileptogenic area, we compared the results of this method with those of electrocorticography (ECoG) localization in the diagnosis of a patient with tumor-related epilepsy. A preoperative MRI revealed a temporal lobe tumor on the right side. The individual dipoles estimated from the interictal spikes were located mainly in the anterolateral region of the right temporal lobe, although some were located in the mesial side. The ECoG recorded frequent spikes in the anterolateral region of the right temporal lobe consistent with the location estimated by dipole analysis. After surgery, the patient suffered from residual seizures. Therefore, the residual epileptogenic area was examined by dipole analysis using a four-layered head model instead of the previous three-layered head model. As a result, the dipole analysis was able to pinpoint the epileptic focus in the area directly adjacent to the resected area, and in the mesial temporal lobe. In conclusion, EEG dipole analysis appears to hold promise as a non-invasive presurgical evaluation technique for locating epileptogenic areas as well as for postsurgical evaluation of residual epileptic focus.

Adolescent↗
PubMed1999

Isolation of epileptiform discharges from unaveraged EEG by independent component analysis.

OBJECTIVE: We propose a method that allows the separation of epileptiform discharges (EDs) from the EEG background, including the ED's waveform and spatial distribution. The method even allows to separate a spike in two components occurring at approximately the same time but having different waveforms and spatial distributions. METHODS: The separation employs independent component analysis (ICA) and is not based on any assumption regarding generator model. A simulation study was performed by generating ten EEG data matrices by computer: each matrix included real background activity from a normal subject to which was added an array of simulated unaveraged EDs. Each discharge was a summation of two transients having slightly different potential field distributions and small jitters in time and amplitude. Real EEG data were also obtained from three epileptic patients. RESULTS: Through ICA, we could isolate the two epileptiform transients in every simulation matrix, and the retrieved transients were almost identical as the originals, especially in their spatial distributions. Two epileptic components were isolated by ICA in all patients. Each estimated epileptic component had a consistent time course. CONCLUSION: ICA appears promising for the separation of unaveraged spikes from the EEG background and their decomposition in independent spatio-temporal components.

Algorithms↗