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[Significance of electroencephalography in the physical examination of children with encopresis].

At an one time transversal examination 28 of 36 children with encopresis exhibited abnormal findings, increased incidence of sharp waves, a back ground that was too slow for their age and subcortical dysfunctions was striking. The abnormalities are approached as constitutional risks and maturational retardation with increased environmental propensity. Increased frequency of enuresis and encopresis in premature craniosynostosis was found. Electroencephalography should be used in paediatric and child psychiatric examination as a not burdening screening method for clarifying the aetiologic conditions of encopresis and getting hints of brain maturation, constitutional disorders and may be signs of brain damage.

Adolescent↗

Conventional electroencephalography as a diagnostic tool: possibilities and limits.

After a short historical review, the Author describes some relevant new acquisitions supplied by the Electroencephalography in the latest years. In particular, some of the most typical EEG patterns observed in inflammatory and degenerative diseases, in seizure disorders and in sleep disturbances are reviewed. The Author underlines the importance of the EEG as a tool of diagnosis and functional investigation of CNS and the specific fields in which EEG may be supported by the more recent computer-assisted techniques.

Central Nervous System Diseases↗

Electroencephalography should not be routine in the evaluation of syncope in adults.

We reviewed the reports of all electroencephalograms obtained at the Nashville (Tenn) Veterans Administration Hospital from September 1987 to August 1989. Seventy-three patients were referred for evaluation of syncope or near syncope. Of these 73 patients, 10 (13.7%) had abnormal findings. Twenty-six patients were referred for other complaints similar to syncope (ie, blackouts, loss of consciousness, falling out, passing out, and fainting). Of these 26 patients, five (19.2%) had abnormal findings. We reviewed the medical records of the patients with abnormal findings and found that the final diagnosis or treatment of the syncope was affected by electroencephalogram in only one patient. These findings suggest that routine electroencephalography is not of significant value in the evaluation of syncope in adults.

Adult↗

[A new computerized system for electroencephalography at the Kochi Medical School Hospital: the present status and problems of electroencephalogram data filing systems].

The usual electroencephalography (EEG) recording consumes great amounts of paper, considerable storage space for records and much time and energy for their search and retrieval. In addition, we can not perform digitized analyses of the records with the present method. To solve these problems, our laboratory developed a new computerized system for EEG, in which data are retained in optic disks, and which has been in service for routine examination since December, 1988. The functions of the system and EEG filing system, include the collection, retention, retrieval, transmission and analyses of data with the reproduction of the original EEG and editing function of summary reports to be filed in the medical records. The summary report consists of summary, characteristic wave patterns picked up and edited from EEG, and spectral array and topographical mapping by digitized analyses of EEG. The condition for the collection of EEG data was 200 Hz/8 bit, and the reproduced wave patterns were accepted by all clinicians. The merits of the system include; (i) saving of paper, space and time needed for EEG, (ii) enabling the comparison of the wave patterns in the form of summary reports and (iii) the capability of digitized analyses of EEG by retaining the EEG data in the data base. The problems remaining to be improved for the system are the longer time required for examination (5-10 min) and the higher running cost (yen 460/order). Regarding the latter problem, a revised method which dispenses with recording paper is under consideration. That is, in the case of screening examinations, summary reports for medical records alone would be delivered to clinicians. This idea has been accepted by some clinicians. To realize the revised system, we presently are planning to establish a method to display EEG on CRT.

Data Collection↗

[Electroencephalography and brainstem auditory evoked potential in brain death].

The usefulness of electrophysiologic examination in the diagnosis of brain death has been a controversy. This study was undertaken to examine the role of electroencephalography (EEG) and brainstem auditory evoked potential (BAEP) in the brain death diagnosis. From March to November 1986, EEG and BAEP were studied in 21 patients (14 males, 7 females; aged 26-73 years) fulfilling the diagnostic criteria of brain death proposed by a special committee organized by the Department of Health, R.O.C. All the EEG and BAEP were performed within 24 hours after the diagnosis of brain death. Of the 15 patients who underwent EEG test, isoelectric tracing (less than 2.5 microV) was found in 5 (33%), low-potential record (less than 5 V) in 3 (20%), and obvious residual activity in 7 (47%). Of the 20 patients who had BAEP examination, absence of all waveforms was noted in 11 (55%), and Wave-I only was preserved in 9 (45%; 6 unilateral, and 3 bilateral). Half of the preserved Wave-I were of prolonged latency (greater than 1.97 msec). Regardless of the EEG and BAEP findings, all of the 21 patients developed cardiac asystole within 77 hours after the diagnosis of brain death. During the study period, we observed 2 patients with absence of auditory evoked responses; both were deaf, but were not brain death victims. From this study, it is obvious that the EEG findings do not correlate well with the diagnosis of brain death. The reason is understandable since EEG is essentially a test of cortical function, while brain death can be diagnosed on the basis of irreversible loss of brainstem function.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Computerized tomography and electroencephalography findings in post-traumatic brain edema].

The reduction in size of the ventricular areas in the computer tomogram as a morphological substrate of a generalised cerebral edema in 43 patients correlated better with the vigilance than with the EEG findings. This fact as well as the representation possibility of additional intracranial haemorrhages favour the computer tomography in the posttraumatic acute phase as compared to the electroencephalography, which should be employed in the subacute phase.

Adolescent↗

[Role of electroencephalography in the diagnosis of acute cerebral diseases].

It appears from a study of 100 cases of acute cerebral disease that electroencephalography is valuable as part of the diagnosis strategy and not only to establish the correct final diagnosis. This examination therefore plays a non-negligible role in neurological practice. In a number of diseases it provides information that no other examination can provide, being a dynamic, functional method of brain tissue analysis.

Acute Disease↗

Diagnosis and subtyping of depressive disorders by quantitative electroencephalography: III. Discriminating unipolar from bipolar depression.

One hundred fifty-two inpatient major depressives fulfilled the Research Diagnostic Criteria for unipolar (N = 111) or bipolar (N = 41) affective disorder. After at least seven days drug-free, all patients had a thyrotropin releasing hormone stimulation test (TRHST), a dexamethasone suppression test (DST) and quantitative electroencephalography (QEEG). Multivariate analysis of variance was used to compare post-dexamethasone cortisol, delta TSH, six regional QEEG measures of interhemispheric symmetry and six focal measures of QEEG frequency. Age, sex and diagnosis were included in the analysis. Unipolar depressives were discriminated from bipolar depressives by age, delta TSH and QEEG fast wave abnormalities in the alpha and beta frequency bands. Unipolar depressives were significantly older, had lower mean delta TSH, showed excessive alpha activity and deficient beta activity. Bipolar depressives were younger, had higher mean delta TSH, showed a deficit of alpha activity and excessive beta activity. Unipolar might be discriminable from bipolar major depression by the use of two objective procedures--TRHST and QEEG. The two disorders appear to be biochemical and electrophysiological opposites. Treatment implications are discussed.

Adolescent↗

Diagnosis and subtyping of depressive disorders by quantitative electroencephalography: IV. Discriminating subtypes of unipolar depression.

Of 216 symptomatic adult depressives who underwent comprehensive inpatient biomedical assessment of their illness, 111 met Research Diagnostic Criteria for primary unipolar depressive disorder. Seventy of these patients were segregated into two groups having different frequency analysis profiles as determined by quantitative electroencephalography (QEEG). The following variables were assessed and tabulated for each of the seventy patients: age and sex; presence of endogenous, nonendogenous or atypical symptoms, cognitive impairment, anxiety, obsessive-ruminative thinking, panic and/or phobic symptoms; abnormalities of the dexamethasone suppression test (DST) and the thyrotropin releasing hormone stimulation test (TRHST). Frequency of occurrence of each variable was compared between groups. Two variables were significant--age and TRHST abnormalities. The patients in group 1, characterized electrophysiologically by beta deficit with or without slow wave excess, were older and had more TRHST abnormalities than the patients in group 2, who were characterized electrophysiologically by having slow wave excess only. The implications of these preliminary findings for objective diagnostic subtyping of depression are discussed.

Adult↗

[A direct problem of electroencephalography using the spherical approach].

A solution of the direct problem of electroencephalography was carried out within the framework of multilayer sphere model consisting of homogenous omic spherical kernel covered with five omic layers modelling epicortical liquor, three-layer bone of the skull, scalp. Solutions of more simple models cited in literature are particular variants of this general one. By means of numerical simulation solutions of multilayer spheres of different complexity are compared and a notion of the simplest adequate model is worked out.

Electroencephalography↗

Somatosensory evoked potentials, electroencephalography and CT scans in the assessment of the neurological sequelae of decompression sickness.

Decompression sickness can lead to neurological complications. Recovery may be studied by somatosensory evoked potentials (SEPs), which are more sensitive than normal methods of neurological examination, and by electroencephalography (EEG). The combination of EEG and SEP may be useful in differentiating among spinal, brainstem and cortical pathology.

Adult↗

Diagnosis and subtyping of depressive disorders by quantitative electroencephalography: II. Interhemispheric measures are abnormal in major depressives and frequency analysis may discriminate certain subtypes.

Seventy-six inpatient RDC major depressives (51 primary and 25 secondary), drug free for at least ten days, and 93 normals were examined by quantitative electroencephalography (QEEG). Multivariate analyses of variance were performed on several diagnostic subgroups using QEEG variables identified in an earlier study as discriminators. Decreased interhemispheric coherence in the delta and/or theta frequency bands was present to a statistically significant degree in depressed subjects. Secondary major depressives showed a lesser decrease than did primary major depressives in both anterior and posterior brain regions. Depression secondary to organic brain syndrome was distinguished from other secondary depressions by the presence of significant slow wave excess in the former only. The ability of beta activity to discriminate unipolar from bipolar major depression was confirmed.

Beta Rhythm↗

A comparative study of electroencephalography and computed axial tomography in recent cerebral infarction.

In order to re-assess the present role of electroencephalography in the investigation of cerebral infarct, we prospectively studied 50 adults with recent supratentorial cerebral infarction over a ten-month period. All 50 patients had EEG's and CT scans within the first two weeks of the apoplectic event. The time span between the two procedures was one week or less in all patients. We monitored the following EEG parameters: characteristics of alpha rhythm (depressed, unchanged, or enhanced); prevalence, type, rhythmicity, and topography of focal slowing; and presence or absence of FIRDA. We grouped the patients on the basis of CT findings as follows: depth of the infarct (cortical-subcortical, deep white matter, or lacunar); size of the infarct (large, medium, or small); and presence or absence of mass effect. Statistical analysis revealed no differences with regard to the EEG parameters between the groups. However, when patients were categorized according to topography of the infarct, the group with parietal infarct showed a significantly higher incidence of depressed alpha rhythm compared with the groups with frontal or occipital infarct. Of the 50 patients, four patients whose history and clinical presentation suggested infarct had normal CT scans despite the presence of EEG abnormality. On the contrary, in two patients, the EEG was normal, whereas the CT confirmed the infarct. Our data suggested that physiological factors may play a major role in the pathogenesis of EEG abnormalities in cerebral infarct, thus accounting for the discrepancies between the EEG parameters and CT findings observed in our population. It was also suggested that EEG's be included routinely in the investigation of cerebral infarct.

Adult↗

Experimental carbon dioxide laser brain lesions and intracranial dynamics: Part 1. Effect on intracranial pressure, systemic arterial pressure, central venous pressure, electroencephalography, and gross pathology.

Experimental brain lesions were created in the left parietooccipital cortex of the albino rabbit through the intact dura mater with high radiating carbon dioxide laser energy (40-watt impacts of 0.5-second duration for a total of 4 seconds on a 12.5-mm surface). Behavior, intracranial pressure (ICP), systolic arterial pressure (SAP), central venous pressure (CVP), electroencephalography (EEG), and gross pathology were studied at 2, 6, and 24 hours after the insult at a constant PaCO2 (38-42 torr). Disruption of the blood-brain barrier (Evans blue extravasation) was uniformly seen extending from the impact crater into the surrounding white matter in all groups. The ICP was elevated in sham-operated animals at 2 hours after the impact, and it remained elevated at 6 and 24 hours. The EEG revealed severe slowing with high voltage waves in the insulted left hemisphere. There was no change in mean SAP or CVP when compared to the sham-operated group. In the dexamethasone-pretreated group, there was a reduction of ICP when compared to the untreated group at 24 hours after the insult (P less than 0.005), but no changes in the gross pathology were noted.

Animals↗

Mumps meningitis: electroencephalography and leukocyte migration inhibition by basic myelin protein.

In 20 patients with mumps meningitis, electroencephalography and leukocyte migration inhibition tests with basic myelin protein were carried out. Fourteen patients had mild or moderate EEG abnormalities indicative of encephalitis as well. Cellular reactivity to basic myelin protein was found in 4 cases only. The observations support the concept that mumps meningoencephalitis is a consequence of a direct viral impact onto the nervous tissue, i.e. no neuroallergic mechanisms are involved.

Cell Migration Inhibition↗

[Value of quantitative electroencephalography in psychiatry].

Computerized quantitative EEG processes the signal in four sequential steps: 1) EEG sampling with rejection of artefacts; 2) Fourier analysis (power spectrum according to frequency); 3) data reduction with computation of spectral parameters in five-minute recordings on at least four EEG channels (mean frequencies, mean amplitudes in microvolts and %, with standard deviations for delta, theta, alpha and beta frequency bands); 4) data base and multivariate statistical analyses. Five main results are obtained by computerized quantitative EEG analysis in psychiatry and clinical pharmacology: 1) longitudinal studies of patients before and after treatment; 2) transversal studies of homogeneous EEG groups (discrimination between tracings of residual-type or paranoid-type schizophrenic patients) comparatively with control groups (high and low alpha subjects); 3) study of psychotropic drugs: profiles, prediction of action, dose-effect curves, pharmacokinetic studies, biodisponibility, correlations with plasmatic levels and behavioural or clinical psychiatric rating scales; 4) typologic classification and discrimination by multivariate analysis, studies of functional activities: functional interhemispheric lateralisation of amplitudes and its variations during the course of psychotic processes; 5) new techniques: computerized topo-electroencephalography (CT-EEG, BEAM technique) based on 16 EEG recordings, comparison with other imaging techniques.

Computers↗

[Comparison between the informative value of electroencephalography and cranial computer tomography in childhood epileptic seizures].

Using electroencephalography and cranial computerized tomography, the authors examined 100 infants and young children suffering from epileptic attacks. The children were divided into three groups: the first one comprised children with grand mal epilepsy, the second those with focal fits and the third those with paroxysms of myoclonic convulsions. The EEG and CT findings were coded according to their diagnostic value as to the presence of the epileptic process. It was demonstrated that in contrast to the EEG which yields information about the presence of cerebral pathology in 92% of all observations, CT provides such information in only 35% while giving no evidence about substantial differences between various forms of epileptic attacks. Focal changes detected by the EEG were compared with local changes shown by CT.

Adolescent↗

[Comparative results of neuropsychological investigations, computer tomography and electroencephalography in post-traumatic epilepsy (author's transl)].

Clinical-neurological and neuropsychological investigations, as well as cranial computerized tomography (CT) and electroencephalography (EEG) were performed in 33 patients suffering from verified post-traumatic epilepsy. The purpose of this study was to compare the neuropsychological test scores (dementia, psycho-organic syndrome, decreased vigilance) with the results of CT and EEG. There was no significant correlation between the neuropsychological scores and the EEG results. On the other hand, a significant correlation was found between decreased vigilance (measured by CFF) and the results of CT, both in the case of focal lesions or diffuse brain atrophy.

Adolescent↗