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Biomedical subjects

Y Futagi

Publications and source records attributed to Y Futagi.

At least 19 recordsLinked to original sources
PubMed2001

Diminished plantar grasp response as an additional indicator of a shunt malfunction in a case of congenital hydrocephalus.

A male infant with congenital hydrocephalus who had undergone ventriculoperitoneal (VP) shunting at 3 days of life exhibited a diminished plantar grasp response (PGR) from 2 months of age, which had clearly recovered 3 months after a shunt revision at 6 months of age. The diminished PGR was the only overt neurological sign in this patient. The precipitous decrease in PGR that occurs during early infancy in a hydrocephalic infant with VP shunting is a possible indicator of a prespastic condition caused by a shunt malfunction.

Equipment Failure↗
PubMed2001

[Neurodevelopmental outcome of children with idiopathic toe-walking].

Twenty-six children with idiopathic toe-walking (ITW) were evaluated as to their neurodevelopmental outcome by means of a follow-up study. The ages of the subjects at the last follow-up ranged from 3 years and 4 months to 14 years and 10 months (mean: 7 years and 4 months). The neurodevelopmental outcome in the subjects was normal intelligence in 22 (of which 5 were clumsy and 4 were hyperkinetic), and borderline intelligence in 4 (of which 2 were clumsy). Thus, 13 of the 26 cases (50%) had neurodevelopmental problems including clumsiness and hyperkinesia. It is noteworthy that there was a high rate of the neurodevelopmental problems among the children with ITW. The clinical course of children with ITW should be carefully followed-up, and the appropriate care and intervention should be given to them, when the children are found to have these problems.

Adolescent↗
PubMed1999

Serum and CSF neuron-specific enolase in patients with West syndrome.

OBJECTIVE: To determine whether frequent seizures and/or hypsarrhythmia may cause neuronal injury in West syndrome. BACKGROUND: West syndrome is an age-related epileptic syndrome of infancy characterized by clusters of epileptic spasms, a peculiar interictal EEG pattern of hypsarrhythmia, and mental deterioration. Recent clinical studies demonstrated that serum and CSF neuron-specific enolase (NSE)-a marker of neuronal injury-were increased after status epilepticus. METHODS: The authors examined serum and CSF NSE levels in 18 newly diagnosed infants (8.4 +/- 2.2 months) with West syndrome (3 cryptogenic, 15 symptomatic). In patients who showed complete resolution of spasms and disappearance of hypsarrhythmia (responders), additional serum NSE levels were determined several weeks after cessation of seizures. Serum NSE levels were obtained from 28 age-matched infants with normal neurologic development (control group), and 10 infants with an acute neurologic insult. RESULTS: There were no significant differences (p > 0.05) in serum NSE levels between the group with West syndrome (12.9 +/- 3.4 ng/mL) and the control group (13.2 +/- 3.1 ng/mL). The serum NSE value in the group with an acute insult (100.3 +/- 67.4 ng/mL) was significantly higher (p < 0.0001) than that for the West syndrome and the control groups. The mean +/- SD CSF NSE level was 7.3 +/- 3.6 ng/mL, which is similar to the reported CSF NSE levels of Japanese infants without neurologic disease. Thirteen responders showed no significant (p > 0.05) change in serum NSE after cessation of epileptic spasms. CONCLUSION: Normal serum and CSF neuron-specific enolase levels provided no evidence that seizures and/or hypsarrhythmia induced neuronal injury in West syndrome.

Adolescent↗
PubMed1999

Neurodevelopmental outcomes of infants with birth weights of less than 1000 g: comparison between periods before and after the introduction of surfactant.

In order to assess the effect of surfactant therapy on the neurodevelopmental outcome of infants with a birth weight of less than 1000 g, we evaluated the outcome of 169 infants in the period after introduction of the surfactant (January 1989 to May 1993) by a follow-up of 6 years on the average, and compared these results to those of 107 infants in our previous study before the surfactant period (October 1981 to March 1986) by a follow-up of 7.5 years on the average. Nursery survival rate was significantly increased from 69.3% in the presurfactant period to 80% in the surfactant period (P < 0.05). However, there were no substantial differences in the neurodevelopmental outcomes between the two periods. This enhanced survival rate without the improvement of outcome resulted in a proportionate increase in normal and impaired survivors.

Age Factors↗
PubMed1999

Clinical significance of plantar grasp response in infants.

The present study was undertaken to delineate the clinical significance of the plantar grasp response in infants. All 834 normal control infants had a positive response within the first 6 months of age, and most of them had a marked response at 1-4 months of age. The authors attempted to evaluate the neurologic outcomes of infants who had negative or diminished responses in these respective periods. Ninety-three infants examined from 1982 to 1992 fulfilled these criteria, and their prognoses were reviewed. The outcomes consisted of cerebral palsy in 75 (69 spastic, four athetoid with spasticity, one athetoid, and one ataxic); mental retardation in seven; borderline intelligence in two; motor delay in one; and eight were considered normal. These outcomes indicate that the negative or diminished response of this primitive reflex during early infancy is highly suggestive of neurologic abnormalities, especially for spasticity. Infants with such findings should be carefully observed for possible development of neurologic abnormalities.

Central Nervous System Diseases↗
PubMed1999

Neurologic outcomes of infants with tremor within the first year of life.

The neurologic outcomes of 24 infants with no other overt neurologic signs except for tremor that lasted through or began after the neonatal period were evaluated during a follow-up period of 3-10.2 years (mean = 6.8 years). Twenty patients had normal outcomes, three had borderline intelligence, and the remaining patient had cerebral palsy (to a minimum degree). The duration, incidence, persistence, and type of tremor were not related to the neurologic outcomes in this group. The outcomes of the 10 children with no perinatal complications were good. In contrast, among the 14 children with perinatal complications, four had mild neurologic deficits, as previously mentioned. The neurologic outcomes of infants with no other neurologic signs except for tremor seem to be generally good, especially when the infants have no perinatal complications. It appears that tremor in neonates and infants is a functional sign that can be caused by a variety of factors, and the neurologic outcomes are related directly to the underlying brain damage induced by perinatal insults.

Asphyxia Neonatorum↗
PubMed1999

Ictal video-EEG recording of three partial seizures in a patient with the benign infantile convulsions associated with mild gastroenteritis.

PURPOSE: In infants, benign convulsions can be triggered by febrile illness or mild diarrhea such as Rotavirus gastroenteritis. The triggering mechanism of these convulsions is still unknown. In spite of several reports concerning clinical features, the ictal EEG recordings were rarely analyzed by a video-EEG monitoring system. To reveal a clue for the triggering mechanism of these convulsions, we analyzed the correlation of clinical manifestations and the EEG discharges during the ictal events and compared with previous reports. METHODS: The ictal EEG of a cluster of three afebrile convulsions associated with mild gastroenteritis was recorded by an EEG closed-circuit TV (EEG-CCTV) monitoring system in a 6-month-old healthy female infant. RESULTS: All seizures began as complex partial seizures (CPSs), which exhibited a motionless stare with or without leftward deviation of both eyes, and evolved to secondarily generalized tonic-clonic seizures (SGTCSs) for approximately 90 s. Each of three ictal discharges began from the right occipital, right centroparietotemporal, and left occipital regions, respectively. CONCLUSIONS: Although initiating sites of ictal discharges of benign infantile convulsions associated with mild gastroenteritis (BICE) were previously reported to be variable among patients, these results indicated that those differ among seizures even in a same infant.

Cerebral Cortex↗
PubMed1999

[Prognostic value of SPECT in newly diagnosed symptomatic West syndrome].

In 19 cases with newly diagnosed symptomatic West syndrome, we assessed interictal regional cerebral blood flow (rCBF) before ACTH therapy with single photon emission computed tomography (SPECT). Based on the SPECT findings, we divided these cases into 3 groups: normal rCBF (Group A, 7 cases), abnormal rCBF corresponding to cerebral lesions on MRI and CT (Group B, 6 cases), and abnormal rCBF in areas different from lesions on MRI and CT (Group C, 6 cases). We compared clinical features, response to initial treatment, and short-term outcome among these 3 groups. No significant differences were found in clinical characteristics (sex, age of onset, prior seizures before onset of spasms, EEG findings). Four cases in Group B (67%) and 5 in Group C (83%) showed complete cessation of spasms after initial treatment (high dose vitamin B6-->zonisamide-->ACTH therapy), while in Group A only 2 patients (29%, p > 0.05; compared to Group B or Group C) responded. Although not statistically significant, short-term prognosis (both seizures and development) after a mean follow-up of 2 years and 8 months was also worst in Group A. Our results suggest that normal SPECT findings may be predictive of unfavorable prognosis in infants with symptomatic West syndrome.

Female↗
PubMed1998

Theta rhythms associated with sucking, crying, gazing and handling in infants.

In order to specify the locations and to clarify the electrophysiological significance of the transitory rhythmic theta activities detected on scalp electrodes in infants, we performed simultaneous EEG and video recording with power spectral map analysis in 29 normal infants of less than 1 year of age. The rhythmic theta activities appeared in posterior temporal regions with sucking or crying, in the parietal region with gazing, and in the frontal region with handling. Each specific location of the theta rhythm seemed to correspond to the functional localization in the infant's brain. We thus concluded that these rhythmic theta activities might originate from direct cortical activation, or from the cortical activation driven by the neuronal impulses from the limbic system through the connection between that system and the cortex.

Brain Mapping↗
PubMed1998

[Neurologic outcomes for infants weighing less than 1,000 grams at birth].

We evaluated the neurologic outcomes of 107 infants with birth weights of less than 1,000g who had been admitted to our hospital from October 1981 to March 1986. Their outcomes were confirmed during a follow-up period of 20-39 years (mean: 75 years). The diagnoses were normal in 71, cerebral palsy in 13, mental retardation in 11, borderline intelligence in 11, and spinal palsy due to birth injury in 1. Only 3 infants with cerebral palsy had developed epilepsy. Among the infants with birth weights of less than 1,000g hospitalized in this tertiary care center, about one-third still had some major or minor neurologic abnormalities.

Brain↗
PubMed1998

[A case of congenital toxoplasmosis confirmed by detection of Toxoplasma gondii in placenta].

We report a case of congenital toxoplasmosis with a prenatal diagnosis of fetal hydrocephalus. A CT scan performed at birth revealed ventricular dilation with calcification. The serum and CSF Toxoplasma specific IgM were elevated. The diagnosis was confirmed by the presence of Toxoplasma cysts in the placenta, and detection of the Toxoplasma SAG1 gene by a polymerase chain reaction (PCR) (placenta, positive; CSF, negative). Signs of active central nervous system infection, such as the decreased CSF glucose, and elevated CSF protein, neuron specific enolase and LDH, resolved after initiation of treatment with pyrimethamine and sulfazoxine. A PCR test using the placental tissue may be useful for the rapid diagnosis of congenital toxoplasmosis.

Adult↗
PubMed1997

Prognosis of infants with ankle clonus within the first year of life.

The present study was undertaken to clarify how we should assess the necessity of close follow-up in each case, when we first examine an infant with ankle clonus within the first year of life. The neurologic prognoses of 169 infants who had exhibited ankle clonus at least once during the first year of life were reviewed in relation to the age at examination for positive response, degree of response, and coexisting neurologic signs other than ankle clonus. Ninety-seven of them (57.4%) were normal, while the rest had diverse pathologic outcomes: cerebral palsy in 49, mental retardation in 12, borderline intelligence in 9, and motor delay in 2. The neurologic prognoses in infants whose ankle clonus was more than ten beats at any age within the first year of life, and ten or less beats over 8 months of age were always abnormal. In the subjects whose neurologic signs other than ankle clonus appeared within 4 months of age and persisted after 5 months of age, prognoses were generally poor. In infants with such findings, their clinical courses should be closely observed for the possible development of neurologic abnormalities.

Adolescent↗
PubMed1997

Hypomelanosis of Ito associated with hemimegalencephaly: a clinicopathological study.

A girl with hypomelanosis of Ito was studied both clinically and at postmortem examination. She manifested severe epilepsy early after birth. Magnetic resonance imaging demonstrated left-sided hemimegalencephaly. The seizures were secondarily generalized or unilateral initially, followed by infantile spasms with asymmetrical hypsarrhythmia at 1.5 months of age. Frequent complex partial seizures, refractory to anti-epileptic drug treatments appeared at 4 months of age. She died of pneumonia at the age of 14 months. Postmortem examination revealed marked asymmetry of the cerebrum and gyral abnormalities in the left cerebral hemisphere. Histopathologically, severe disorganization of the neuronal cytoarchitecture was evident. Absence of delineation between cortical gray and white matter was evident, as was increase and hypertrophy of the neurons and glial cells. We believe that the association of skin and brain lesions was not one of chance; that is, they may share a common pathogenetic mechanism.

Cerebral Cortex↗
PubMed1996

Growth suppression in children receiving acetazolamide with antiepileptic drugs.

To clarify the effect of the clinical dosage of acetazolamide on growth in children with epilepsy or febrile convulsion, the standard scores of height and weight in 17 subjects receiving acetazolamide as an adjunct to unchanged monotherapy of antiepileptic drug were compared longitudinally through four phases: before antiepileptic drug administration, with monotherapy of antiepileptic drug, with acetazolamide in addition to monotherapy, and after acetazolamide discontinuation. The standard scores of both height and weight in the subjects were significantly reduced during the phase of acetazolamide administration. During this period, serum concentrations of potassium and total CO2 decreased while that of chloride increased, suggesting the existence of metabolic acidosis in the subjects. For both height and weight, there was no correlation between the degree of standard score reduction during acetazolamide administration and age at the time of acetazolamide initiation, duration of acetazolamide administration, dosages of acetazolamide, and variety of antiepileptic drugs concomitantly administered with acetazolamide. We speculate that metabolic acidosis induced by acetazolamide suppressed the growth of the subjects and that there were large individual differences in the susceptibility to acetazolamide for growth suppression among patients receiving acetazolamide.

Acetazolamide↗
PubMed1996

[Clinical and electroencephalographic studies in children with hemimegalencephaly].

Clinical and electroencephalographic (EEG) studies were performed in two children with hemimegalencephaly. The ages of seizure onset were 44 hours after birth in one infant and 33 days of postnatal life in the other patient. In both children, infantile spasms (IS) associated with hemihypsarrhythmia, developed at 1.5 months and 4 months, respectively. The subsequent clinical courses in these children were notable for frequent, intractable seizures. The seizures consisted of either generalized or partial seizures which originated from not only the hemimegalic hemisphere but also the contralateral one. Later, the clinical and EEG findings in one child indicated the development of Lennox-Gastaut syndrome (LGS). These findings suggested that the lesions of epileptogenesis in patients with hemimegalencephaly involved not only the pathological hemisphere, but also the contralateral hemisphere and subcortical structures. A detailed neurophysiological investigation in hemimegalencephaly could help the elucidation of the pathophysiology of intractable epilepsies, such as IS or LGS.

Brain↗
PubMed1996

[SPECT, MRI and EEG in infants with lissencephaly].

Single photon emission tomography (SPECT), MRI and EEG were studied in two infants with lissencephaly. One infant had generalized tonic convulsions at 7 month of age and continuous high voltage fast activities on EEG. The other infant developed infantile spasms at the age of 2.5 months, and showed low voltage disorganized background with pseudorhythmic high voltage sharp waves on EEG. Cranial CT and MRI in both infants revealed abnormally thick cortex, dilatation of the lateral ventricles, and smooth or relatively smooth cerebral surface. In SPECT studies, a diffuse increase of tracer uptake was shown at the cerebral cortex compared with the basal ganglia or cerebellum in both infants. The SPECT finding might reflect the abnormal cortical architectures in this cerebral malformation.

Brain↗