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Biomedical subjects

V Ramani

Publications and source records attributed to V Ramani.

13 recordsLinked to original sources
PubMed1992

The role of dominant premotor cortex and grapheme to phoneme transformation in reading epilepsy. A neuroanatomic, neurophysiologic, and neuropsychological study.

We studied a 24-year-old man who had reading epilepsy after removal of a left frontal arteriovenous malformation. Lesion analysis by means of a neuroanatomic template placed a 2-cm region of encephalomalacia anterior to the left central sulcus in premotor cortex (Brodmann's area 6). Lexical and nonlexical reading activation tests demonstrated seizures during reading and increased discharge rates when the patient was reading aloud or silently articulating. Seizures (perceived or actual jaw clicking) were electrographically characterized by brief left frontocentral epileptiform transients. Grapheme to phoneme transformation, not linguistic complexity, appears to be the critical stimulus in some reading epilepsies. The case adds anatomic relevance to the phonologic component of reading and supports the putative role of dominant premotor cortex in activation of precise sequences of motor linguistic output in reading and writing. Reading epilepsy may be a reflex or action myoclonus syndrome localized to Brodmann's area 6 (Exner's area).

Adult↗
PubMed1985

Cortical blindness following ictal nystagmus.

Both ictal nystagmus and cortical blindness may occur transiently in acute cerebral disorders and therefore escape clinical detection, particularly in confused, agitated patients. The following case report describes a young woman with chronic myelogenous leukemia who became progressively ill following bone marrow transplantation. During the course of her illness, acute ictal nystagmus developed from focal right occipital ischemia; postictally she remained cortically blind with possible visual hallucinations for 48 hours.

Adult↗
PubMed1985

Ictal characteristics of pseudoseizures.

The spontaneous pseudoseizures resembling tonic-clonic seizures in 25 patients were recorded on simultaneous videotape and electroencephalograms and were compared with the seizures recorded from 25 patients with true tonic-clonic epileptic events. The goal of the comparison was to identify bedside clinical criteria to assist in differentiating between the two groups. The variables of age, sex, and selected physical manifestations of the events were compared for the two groups by appropriate statistical methods, including a multivariate step-wise discriminate analysis. Significant differences between the two groups of seizures were identified for several variables, and most strikingly for the character of upper and lower extremity movements, the time of vocalization during the event, the character of pelvic movements, and the nature of body tone during the events. Useful bedside criteria for distinguishing a pseudoseizure from a tonic-clonic seizure were identified.

Adolescent↗
PubMed1985

Brainstem auditory evoked potentials in atypical facial neuralgia.

Atypical facial neuralgia is an ill-defined syndrome of obscure etiology characterized by chronic facial pain. The diagnosis is one of exclusion, made only after carefully ruling out a variety of conditions that may cause orofacial pain. The present study detected brainstem abnormalities on the side of the facial pain through examination of brainstem auditory evoked potentials in two out of 12 patients who were clinically diagnosed as having atypical facial neuralgia. The recording of brainstem auditory evoked potentials provides a simple, well-standardized, noninvasive test that may be of value in the investigation of patients who have chronic facial pain.

Adult↗
PubMed1984

Critical frequency of photic driving in the diagnosis of multiple sclerosis.

Pattern visual evoked response (PVER) and critical frequency of photic driving (CFPD) to repetitive flash stimuli were studied in 68 consecutive patients suspected of multiple sclerosis (MS) and 15 normal controls to assess the diagnostic value of combined PVER-CFPD testing. Clinically, 38 qualified for the diagnosis of MS while 30 did not. The CFPD was found to be unreliable for detecting optic nerve dysfunction (OND) in MS, since well-defined photic driving at all frequencies above 40 flashes per second was not present in 14 patients without MS (47%) and in three normal control subjects (20%). The PVER, on the other hand, was highly sensitive and specific for OND, being abnormal in 12 patients with definite MS (92%) but in none of the normal controls. It is concluded that PVER by itself is a valuable test for the diagnosis of OND in MS and additional CFPD testing is uninformative and may even be misleading.

Adolescent↗
PubMed1983

Primary reading epilepsy.

In a case of primary reading epilepsy, seizures were consistently triggered by reading, and the associated EEG abnormalities were clearly lateralized to the dominant hemisphere. On the basis of detailed EEG and activation studies, it is concluded that seizures in this patient were evoked by higher cognitive processes associated with language functions and not by simple visual or proprioceptive stimuli.

Adult↗
PubMed1982

Management of hysterical seizures in epileptic patients.

Intensive behavioral psychotherapy for hysterical seizures was carried out in nine epileptic patients, after video-EEG confirmation of diagnosis, during four to nine weeks of hospitalization in a specialized seizure unit. During a four-year follow-up, a significant reduction in hysterical seizures was noted in seven patients. Only one patient remained refractory to treatment and was hospitalized a number of times for hysterical seizures. One patient was lost to follow-up. Four patients showed significant and two patients showed slight improvement in psychosocial status. There was no behavioral improvement in one patient while another patient, who was severely retarded, showed temporary worsening of behavior, with decrease in frequency of hysterical seizures. Principles of managing hysterical seizures emphasize early diagnosis and vigorous supportive-reed-ucative psychotherapy.

Adolescent↗
PubMed1982

Intensive monitoring of interictal psychosis in epilepsy.

Ten epileptic patients developed interictal psychosis while being treated in hospital for seizure control. They were subjected to intensive behavioral, video-electroencephalographic, and serum anticonvulsant monitoring for an average of 7.1 weeks in a specialized epilepsy unit. In 9 patients, the interictal psychosis was indistinguishable from acute schizophrenia. Only 5 of these patients had complex partial seizures; the other 4 showed evidence of generalized epilepsies. Thus a "unique" association between schizophreniform psychosis and complex partial seizures, noted by previous authors, could not be confirmed. Only 1 patient showed normalization of the electroencephalogram during psychosis and an inverse relationship between psychosis and seizure frequency. In most cases the emergence of psychosis could not be explained. Interictal psychosis in epilepsy appears to be a spectrum of disorders that may be multifactorially determined.

Adolescent↗
PubMed1981

Intensive monitoring of epileptic patients with a history of episodic aggression.

Nineteen epileptic patients with significant history of episodic aggressive behavior were subjected to intensive behavioral and electrophysiologic monitoring for an average period of six weeks in a specialized inpatient facility. Numerous seizures were recorded in these patients but none disclosed ictal aggression. Only two patients showed episodic aggressive behavior but in neither case could seizures be implicated causally. The majority of patients showed a remarkable progressive improvement in aggressive tendencies during hospitalization. It is concluded that ictal aggression is rare and that, in most cases, the aggressive behavior in epileptics is a multifactorially determined interictal phenomenon.

Adolescent↗