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W Klostermann

Publications and source records attributed to W Klostermann.

At least 19 recordsLinked to original sources
PubMed2001

[Electromyography of the infrahyoid muscles - part 1: normal findings].

BACKGROUND: The infrahyoid muscles (IHM) are very useful as a neurovascular myofascial flap in plastic reconstructive surgery of the upper aerodigestive tract, especially for restoration of the muscular component in larger tongue defects. As a base for further postoperative investigations on the function of transferred IHM this first part of the study describes the physiological function and the electromyographical features of the IHM. METHODS: In 17 patients with cancer of the upper aerodigestive tract the sternohyoid and sternothyroid muscles and in additionally eight patients the upper part of the omohyoid muscle were studied electromyographically. Muscular activity was recorded at various movements and maximal voluntary innervation. In ten healthy volunteers the motor unit potentials (MUP) during light voluntary innervation of these muscles were studied. RESULTS: In both muscles we found the steadist and strongest muscular activity at isometric head bending and yaw opening, in the omohyoid muscle also at head rotation. At swallowing and breathing in (2/3) of the cases muscular activity could be recorded. Amplitudes and electromyographic charge pattern in comparison were diminished. Phonation und tongue movements showed no noticable muscular activity. Analysis of the MUP in 10 healthy volunteers showed a mean amplitude of 274 +/- 59 microV and a mean duration of 8.5 +/- 0.6 ms. CONCLUSIONS: The presented study demonstrates that EMG of the IHM are recorded best while head bending, yaw opening and head rotation. Since there is no interchange of nerve fibres between the hypoglossal nerve and the cervical ansa it should be possible to differentiate between original tongue muscles and transferred muscles in electromyographic studies of myofascial flaps after tongue reconstruction.

Deglutition↗
PubMed2001

[Electromyography of the infrahyoid muscles - part 2: pathological findings].

BACKGROUND: The infrahyoid muscles (IHM) can easily be used as a neurovascular myofascial flap for reconstructive surgery in the oral cavity and pharynx and especially for functional tongue reconstruction following tumor ablation. METHODS: In order to detect neurogenic lesions caused by neck pathologies, in particular lymph node metastasis, we studied ten patients (nine patients suffering from tongue carcinoma and one patient after traumatic tongue ablation) by preoperative electromyography of the IHM. These results were compared to ten healthy controls. RESULTS: We found no pathological spontaneous activity with the EMG at rest in any patient. During light voluntary innervation, the motor unit potentials (MUP) were normal in controls and in patients with normal ultrasound, CT scans and histologic examination after neck surgery. When pathologic lymph nodes were found in the neck, the number of polyphasic MUP in the ipsilateral IHM was increased in some cases (n = 6), and normal in others (n = 5). Traumatic or radiogenic lesions clearly resulted in pathological EMG findings (n = 6). Maximal innervation of the IHM was obtained during head bending and jaw opening. We found no difference in the discharge pattern of both groups. CONCLUSIONS: Due to their extent lymph node metastasis can lead to neurogenic lesions of the cervical ansa of the IHM. Neurogenic damages are most clearly present after traumatic lesions of the neck (prior operations, radiotherapy). EMG at maximal voluntary contraction instead revealed no lesions. The clinical impact of these demonstrated neurogenic lesions need to be studied by measuring the muscle strength of the IHM.

Adult↗
PubMed2001

[Electromyography of the infrahyoid muscles - part 3: findings after transposition as a myofascial flap in tongue reconstruction].

BACKGROUND: Due to the preservation of its nerval supply the neurovascular infrahyoid muscle flap in tongue reconstruction enables to prevent atrophy of the musculature. In this study the integrity of the infrahyoid muscles (IHM) after transposition into the oral cavity was examined by means of electromyography. METHODS: 17 patients after partial or complete reconstruction of the tongue with IHM were studied at varied times after surgery. The IHM in the oral cavity was inserted by a concentric needle electrode and activity at rest as well as the discharge pattern at maximal voluntary innervation was evaluated. During light voluntary activity a motor unit potential (MUP) analysis were performed. RESULTS: 13 of 17 patients (76,5 %) in total revealed electromyographic activity in the transfered IHM flaps. Within the first 6 months after surgery 71,5 % of the patients or 77,8 % of the IHM flaps showed activity. After 6 months in 61,5 % of the patients or 64,7 % of the IHM flaps muscular activity was demonstrated. In 84,6 % of the patients or 88,2 % of the flaps we could detect neurogenic lesions at least once. Maximal voluntary contraction showed a discrete activity pattern in 63 %. In 26 % of all cases we found a discrete to reduced interference pattern and in 10 % a reduced interference pattern. CONCLUSIONS: Functioning muscle tissue could be demonstrated in the most IHM flaps, but almost all of the studied muscles showed neurogenic lesions with a loss of motor units due to the traumatic surgery. Maybe bioelectrical stimulation of the Ansa cervicalis with implantable amplifiers will lead to better flap contractility in the future.

Electromyography↗
PubMed1998

Lateralized human cortical activity for shifting visuospatial attention and initiating saccades.

Lateralized human cortical activity for shifting visuospatial attention and initiating saccades. J. Neurophysiol. 80: 2900-2910, 1998. The relation between shifts of visual attention and saccade preparation was investigated by studying their electrophysiological correlates in human scalp-recorded electroencephalogram (EEG). Participants had to make saccades either to a saliently colored or to a gray circle, simultaneously presented in opposite visual hemifields, under different task instructions. EEG was measured within the short interval between stimulus onset and saccade, focusing on lateralized activity, contralateral either to the side of the relevant stimulus or to the direction of the saccade. Three components of lateralization were found: 1) activity contralateral to the relevant stimulus irrespective of saccade direction, peaking 250 ms after stimulus onset, largest above lateral parietal sites, 2) activity contralateral to the relevant stimulus if the stimulus was also the target of the saccade, largest 330-480 ms after stimulus onset, widespread over the scalp but with a focus again above lateral parietal sites, and 3) activity contralateral to saccade direction, beginning about 100 ms before the saccade, largest above mesial parietal sites, with some task-dependent fronto-central contribution. Because of their sensitivity to task variables, component 1 is interpreted as the shifting of attention to the relevant stimulus, component 2 is interpreted as reflecting the enhancement of the attentional shift if the relevant stimulus is also the saccade target, and component 3 is interpreted as the triggering signal for saccade execution. Thus human neurophysiological data provided evidence both for independent and interdependent processes of saccade preparation and shifts of visual attention.

Adult↗
PubMed1997

Slow saccades and other eye movement disorders in spinocerebellar atrophy type 1.

In order to study the relation between genotype and phenotype, a detailed study of the course of oculomotor deficits was performed in three patients with autosomal-dominant cerebellar ataxia, subtype spinocerebellar atrophy type 1 (SCA 1) using clinical testing and electrooculography. DNA analysis revealed a CAG repeat expansion of 65 in the SCA 1 gene on chromosome 6p in all patients. A progressive disorder of the saccadic system became obvious, leading to a marked slowing of saccadic eye movements and loss of pathological and physiological nystagmus. An upward gaze palsy developed early, followed by horizontal and downward gaze palsy at a later state of the disease. Smooth pursuit eye movements were disturbed to a lesser extent; the vestibulo-ocular reflex was reduced. As an additional feature, severe loss of visual acuity developed due to progressive optic nerve atrophy. The oculomotor deficits can be explained by progressive damage to the brain stem rather than to the cerebellum. Each combination of oculomotor deficits with or without optic atrophy may occur irrespective of the gene locus of the disease, making a correlation between clinical signs and genetic findings difficult.

Adult↗
PubMed1997

Basilar branch disease presenting with progressive pure motor stroke.

OBJECTIVES: Isolated infarcts of the pons cause well definable neurological syndromes with distinct pathomechanism, clinical course and prognosis. PATIENTS AND RESULTS: We report 8 cases suffering from a pure motor hemiparesis that was severely progressive within the 1st 3 days and unresponsive to aspirin. A relatively good recovery was observed in all patients, however, stroke recurrence occurred in 2 cases within 3 months and resulted in pseudobulbar paralysis and tetraparesis. MRI displayed unilateral (n=6) and bilateral (n=2) ventromedial pontine infarctions (VPI). Angiographic evaluation (n=4) or color Duplex examination (n=4) revealed atherosclerotic lesions but no basilar artery occlusion. CONCLUSION: Although VPI due to basilar branch disease may clinically mimic a classical lacunar syndrome, it is related to a particular pathogenetic mechanism different from microangiopathy or embolism. In contrast to the MRI feature of lacunes, VPI typically extend to the basal surface of the pons. The progressive pattern, ending up in a relative uniform clinical picture, is probably caused by propagating thrombosis.

Aged↗
PubMed1997

Apraxia of eyelid opening after bilateral stereotaxic subthalamotomy.

The case of a patient with apraxia of eyelid opening and blepharospasm occurring during the course of idiopathic torsion dystonia and previously treated with stereotaxic subthalamotomy is presented. The anatomic basis of this lid movement disorder is suggested to be located in the rostral brain stem. There was a considerable amelioration after treatment with trihexyphenidyl.

Adult↗
PubMed1995

Crossed R1 response of the blink reflex in peripheral facial palsy.

A patient with regenerated Bell's palsy showed a crossed R1 component of the blink reflex recorded from the healthy side while stimulating the affected side. Our observation supports the hypothesis that a short-circuit trigemino-facial pathway crossing the midline exists in normal subjects which is not activated under normal conditions, but may be engaged following peripheral facial nerve disease.

Adult↗
PubMed1994

The presaccadic cortical negativity prior to self-paced saccades with and without visual guidance.

The presaccadic negativity (PSN) of the scalp EEG potential prior to self-initiated saccades aimed either at a visual target or at the remembered position of that target in total darkness was analysed in 10 normal subjects. Under both conditions a PSN with a negligible EOG contamination was found, showing 4 characteristics: (1) In both conditions, the PSN maximum is localized at the vertex, probably containing the activity of the supplementary motor area. (2) At an electrode placed over the frontal eye field (FEF) contralateral to the saccade direction, there is a temporary, circumscribed maximum prior to saccades to the visual target, thus probably reflecting activity of the FEF. (3) Prior to saccades to the visual target, there is a statistically significant interhemispheric difference of the PSN over the parietal cortex with a larger amplitude over the hemisphere contralateral to the saccade direction; this might be attributed to directed visual attention. (4) Prior to saccades without visual guidance in darkness there is a statistically significant interhemispheric difference of the PSN over the frontal cortex with a larger amplitude over the hemisphere contralateral to the saccade direction. The amplitude of the PSN decreased in the course of the experiment, probably due to psychological factors such as attention and motivation. Our results suggest that the PSN is a readiness potential preceding voluntary saccades, containing activity related both to unspecific psychological processes and to specific movement preparation in the frontal and parietal ocular motor areas.

Adult↗
PubMed1993

[Carbon monoxide poisoning: the importance of computed and magnetic resonance tomographic cranial findings for the clinical picture and follow-up].

Clinical, CT and MR imaging findings of 5 patients are presented who suffered from sudden coma due to carbon monoxide intoxication. Follow-up investigations were done for up to three years. 4 patients recovered with only minor deficits, while one patient survived with a severe choreatic syndrome. Cranial computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated typical lesions in the globus pallidus, the cerebral white matter and the cortex. Initial lesions of the cerebral white matter rather than of the globus pallidus seem to indicate a doubtful clinical prognosis. In the CT of the severe case progressive white matter atrophy was visible still after half a year. In contrast, in two cases with good outcome repeated MRI showed no progressive white matter changes.

Adult↗
PubMed1993

[Unmasking congenital myotonia by hypothyroidism].

A case with the combination of hypothyroidism and true myotonia is reported, in which the latter first became manifest clinically together with the thyroid disorder and improved with L-thyroxine therapy. The hypothyroidism itself caused very few symptoms, and the diagnosis was not made until examination for myotonia. The effect of each disorder on muscle function seems to be additive.

Adult↗
PubMed1992

[Musical pseudo-hallucination in acquired hearing loss].

Auditory hallucinations take various forms including the perception of tinnitus, voices, and, rarely, music. While formed hallucinations are usually ascribed to psychiatric illness, we describe a syndrome of musical hallucinations in mentally sane patients, who are hard of hearing or deaf. 26 cases from the literature are supplemented by 6 own observations, including the first description of two cases in a single family. The different modes of emergence, the spectrum of clinical features and their course are outlined. Differential diagnostic, pathogenetic and therapeutic aspects are discussed.

Aged↗
PubMed1989

Carbon monoxide poisoning: clinical, neurophysiological, and brain imaging observations in acute disease and follow-up.

Five patients (aged 19-52 years) were treated for a midbrain syndrome due to acute carbon monoxide poisoning and had clinical follow-up investigations for up to 18 months. Three patients recovered with minor neurological and neuro-psychological deficits and resumed their premorbid life-style. One patient had normal findings, while the fifth remained in a permanent vegetative state. Initial CT of the brain may fail to detect low-density lesions in the globus pallidus. If present, these lesions may either have disappeared, diminished, or remained unchanged at follow-up. Long-term outcome seems to show a closer link to white matter changes, which are at present best investigated by magnetic resonance imaging. The additional value of determining visual evoked responses at repeated follow-up is suggested by the present investigation.

Adult↗