PubMed · 7137298
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E Trefler. 1982. Arm restraints during functional activities.. https://doi.org/10.5014/ajot.36.9.599
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This paper investigates the prognostic value of flash visual evoked potentials (VEPs) recorded in preterm infants at birth and at term age with respect to severe neurological outcome. Flash VEPs were recorded in 81 preterm infants at birth (i.e. <35 weeks' gestation) and repeated in 56 of these infants at term age. The preterm infants were assigned to either a healthy or at-risk subgroup based on clinical birth factors. Normal ranges of flash-VEP latencies, amplitudes, and number of components present were obtained from the subgroup of healthy preterm infants and from 68 term infants tested postnatally. The flash-VEP results of the entire preterm group were compared with the normal ranges and any abnormalities noted. Seven preterm infants in the at-risk group died, six of whom had abnormal flash VEPs before term age. Of the five infants from the at-risk group diagnosed with cerebral palsy (CP), three had abnormal flash VEPs before term age. Thus the sensitivity and specificity of the flash VEP with respect to survival was 86% and 89% respectively, and with respect to the development of CP was 60% and 92%. The abnormal features of the flash VEP associated with adverse outcomes comprised a delayed N3 component before term age and the absence of a positive component (P2) at term age.
Listeria neuromeningitis presents as febrile rhombencephalitis in half the patients, often with persistent sequelae such as cranial nerve palsy. We report the case of a man who developed central apnea with simultaneous consciousness impairment subsequent to an infectious disease. Magnetic resonance imaging showed low signal intensities in T1 and T2, particularly in the medulla. Neither acidosis, hypoxia nor hypercapnea stimulated the respiratory centers during episodes of apnea; ventilation started again only with strong voluntary stimulation. Pons and medulla lesions of the reticular formation were probable as well as lesions of the automatic respiratory system and could explain the central origin of the apnea in this patient.
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