Pub Date : 2017-04-01DOI: 10.21088/IJNNS.0975.0223.10218.5
Ravi L.A, D. Anand
INTRODUCTION: Breath holding spells, otherwise called as “Infantile syncope”, are well recognized, common clinical entity characteristically seen in infants and younger children aged 6 months to 5 years. Syncope – derived from the Greek word “Synkoptein”, meaning “to cut” or “to break” - is defined as a sudden loss of consciousness and postural tone, because of transient cerebral hypoperfusion, followed by spontaneous recovery. Transient interruption of cerebral blood flow is followed by loss of consciousness within 8 to 10 seconds. Less than 30 ml blood per 100 grams of brain tissue per minute results in syncope. The critical threshold of cerebral hypoperfusion at which syncope ensues is 50% below baseline mean cerebral flow velocity. OBJECTIVE: The aim of the study was to determine the EEG abnormalities in the intervals of Breath-Holding Spells in children from 6 months to 5yrs. METHODS: An observational prospective study was done at Institute of Child Health and Hospital for Children between May 2016 and October 2016, on children diagnosed as having Breath Holding Spells by clinical history and laboratory evaluation, including complete blood count (CBC), ECG, Echocardiography and Electroencephalography (EEG). RESULTS: A total of 100 children (63 boys, 37 girls) with breath holding spells comprised the study group compared with similar age and sex group of 100 children with simple febrile convulsions served as controls. We found that mean age of onset was 12.7 months. Cyanotic spells (62%) were predominated over pallid spells (26%). There were positive family history (26%) and consanguinity (13%) in the study patients. Mean haemoglobin values was significantly lower in children with BHS (9.978±0.925 g/dl) than with controls (10.276±0.947). Electroencephalographic study in children with BHS showed no significant abnormality except for one child which had slow wave. CONCLUSION: Electroencephalographic study in combination with detailed history and clinical observation is of value in differentiating breath holding spells from convulsive disorders. Routine referral of children with clinical diagnosis of breath holding spells to paediatric neurology clinics is unnecessary and routine EEG is not appropriate investigation in the initial evaluation of breath holding spells.
{"title":"Electroencephalographic Study in Children with Breath-Holding Spells in a Tertiary Care Hospital in South India","authors":"Ravi L.A, D. Anand","doi":"10.21088/IJNNS.0975.0223.10218.5","DOIUrl":"https://doi.org/10.21088/IJNNS.0975.0223.10218.5","url":null,"abstract":"INTRODUCTION: \u0000Breath holding spells, otherwise called as “Infantile syncope”, are well recognized, common clinical entity characteristically seen in infants and younger children aged 6 months to 5 years. \u0000Syncope – derived from the Greek word “Synkoptein”, meaning “to cut” or “to break” - is defined as a sudden loss of consciousness and postural tone, because of transient cerebral hypoperfusion, followed by spontaneous recovery. \u0000Transient interruption of cerebral blood flow is followed by loss of consciousness within 8 to 10 seconds. Less than 30 ml blood per 100 grams of brain tissue per minute results in syncope. The critical threshold of cerebral hypoperfusion at which syncope ensues is 50% below baseline mean cerebral \u0000flow velocity. \u0000OBJECTIVE: \u0000The aim of the study was to determine the EEG abnormalities in the intervals of Breath-Holding Spells in children from 6 months to 5yrs. \u0000METHODS: \u0000An observational prospective study was done at Institute of Child Health and Hospital for Children between May 2016 and October 2016, on children diagnosed as having Breath Holding Spells by clinical history and laboratory evaluation, including complete blood count (CBC), ECG, Echocardiography and Electroencephalography (EEG). \u0000RESULTS: \u0000A total of 100 children (63 boys, 37 girls) with breath holding spells comprised the study group compared with similar age and sex group of 100 children with simple febrile convulsions served as controls. We found that mean age of onset was 12.7 months. Cyanotic spells (62%) were predominated over pallid spells (26%). There were positive family history (26%) and consanguinity (13%) in the study patients. Mean haemoglobin values was significantly lower in \u0000children with BHS (9.978±0.925 g/dl) than with controls (10.276±0.947). Electroencephalographic study in children with BHS showed no significant abnormality except for one child which had slow wave. \u0000CONCLUSION: \u0000Electroencephalographic study in combination with detailed history and clinical observation is of value in differentiating breath holding spells from convulsive disorders. Routine referral of children with clinical diagnosis of breath holding spells to paediatric neurology clinics is unnecessary and routine EEG is not appropriate investigation in the initial evaluation of breath \u0000holding spells.","PeriodicalId":14163,"journal":{"name":"International journal of neurology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72678261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-03-20DOI: 10.17554/J.ISSN.2313-5611.2017.03.62
J. Dushanova, Mario Christov
Cognitive decline and symptoms of attention deficits, executive dysfunction, and memory impairments describe dementia in the elderly. This review focuses on particular frequency oscillations that occur within the affected brain regions which could be used to classify some idiopathic dementias as specific diseases and could contribute additional information to the clinical data in evaluating age changes that are of benefit for a treatment of cognitive alterations. The main question, whether the changes of event-related potentials (ERPs) and frequency band responses (ERBRs) for sensory stimuli are related to plasticity in neural recruitment during stabilization of sensory/cognitive mechanisms accompanying aging or are underlying pathological changes, remains unknown. We review the effect of aging on low (δ, θ, α) and high (β1, β2, γ1, γ2) ERBRs in an auditory discrimination sensorimotor tasks (low–frequency – right hand movement, high–frequency tone – left movement) at frontal, central, parietal and occipital cortical locations at short latency (post–stimulus interval 0–250 ms; putative sensory processing period) and long latency (250–600 ms; putative cognitive period). High tone stimulation and movement requirements lead to a delay of ERP components in elderly subjects and their amplitudes diminish with increasing age. The amplitudes of β2, γ, and low-frequency activity are more pronounced with progressive age, but the β1 component is less affected by age during the sensory processing. The age difference with respect to scalp distribution is tone-independent for δ/θ, but not for α-activity. Age- and tone-dependent α-changes are focused on frontal and sensorimotor areas. The low- and high-frequency amplitudes during the cognitive processing diminish with increasing age, except for the frontal β2 and γ high tone responses, while the β1 activity is more widespread than in the shorter latency period. This age difference increases in fronto–parietal direction more expressed after high tone stimulation. The age influences more the cognitive processes than the sensory ones.
{"title":"Do the Changes of Event-Related Potentials and Frequency Band Responses to Sensory Stimuli Correlate to Age Cognitive Decline?","authors":"J. Dushanova, Mario Christov","doi":"10.17554/J.ISSN.2313-5611.2017.03.62","DOIUrl":"https://doi.org/10.17554/J.ISSN.2313-5611.2017.03.62","url":null,"abstract":"Cognitive decline and symptoms of attention deficits, executive dysfunction, and memory impairments describe dementia in the elderly. This review focuses on particular frequency oscillations that occur within the affected brain regions which could be used to classify some idiopathic dementias as specific diseases and could contribute additional information to the clinical data in evaluating age changes that are of benefit for a treatment of cognitive alterations. The main question, whether the changes of event-related potentials (ERPs) and frequency band responses (ERBRs) for sensory stimuli are related to plasticity in neural recruitment during stabilization of sensory/cognitive mechanisms accompanying aging or are underlying pathological changes, remains unknown. We review the effect of aging on low (δ, θ, α) and high (β1, β2, γ1, γ2) ERBRs in an auditory discrimination sensorimotor tasks (low–frequency – right hand movement, high–frequency tone – left movement) at frontal, central, parietal and occipital cortical locations at short latency (post–stimulus interval 0–250 ms; putative sensory processing period) and long latency (250–600 ms; putative cognitive period). High tone stimulation and movement requirements lead to a delay of ERP components in elderly subjects and their amplitudes diminish with increasing age. The amplitudes of β2, γ, and low-frequency activity are more pronounced with progressive age, but the β1 component is less affected by age during the sensory processing. The age difference with respect to scalp distribution is tone-independent for δ/θ, but not for α-activity. Age- and tone-dependent α-changes are focused on frontal and sensorimotor areas. The low- and high-frequency amplitudes during the cognitive processing diminish with increasing age, except for the frontal β2 and γ high tone responses, while the β1 activity is more widespread than in the shorter latency period. This age difference increases in fronto–parietal direction more expressed after high tone stimulation. The age influences more the cognitive processes than the sensory ones.","PeriodicalId":14163,"journal":{"name":"International journal of neurology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78253434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-03-20DOI: 10.17554/J.ISSN.2313-5611.2017.03.57
J. Jaster
Medical investigators in the 21 st century have increasingly focused on neurotransmitter abnormalities in the medulla oblongata as the primary etiology of Sudden Infant Death Syndrome(1) and also as the etiology of sudden unexpected deaths that occur in adults with Multiple System Atrophy(2) – serotonin is the problem in both instances.Investigators have also reported numerous cases in which the presence of a very small anatomical medullary brain lesion, like a plaque of demyelinated white matter(3), was associated with sudden unexpected death(4,5) – and in all cases the lesions were without mass effect or hemorrhage(6). Many such medullary lesions have otherwise produced only minor clinical symptoms and have in themselves been previously considered relatively harmless – in cases where they have been known to be present.Many victims have been considered healthy prior to sudden death, and the medullary brain lesions were often incidental discoveries at autopsy, with no other causes of death identified.
{"title":"Phrenic nerve stimulation – and chorda tympani nerve stimulation – may prevent lethal cardiac arrhythmias during sleep apnea with heart failure","authors":"J. Jaster","doi":"10.17554/J.ISSN.2313-5611.2017.03.57","DOIUrl":"https://doi.org/10.17554/J.ISSN.2313-5611.2017.03.57","url":null,"abstract":"Medical investigators in the 21 st century have increasingly focused on neurotransmitter abnormalities in the medulla oblongata as the primary etiology of Sudden Infant Death Syndrome(1) and also as the etiology of sudden unexpected deaths that occur in adults with Multiple System Atrophy(2) – serotonin is the problem in both instances.Investigators have also reported numerous cases in which the presence of a very small anatomical medullary brain lesion, like a plaque of demyelinated white matter(3), was associated with sudden unexpected death(4,5) – and in all cases the lesions were without mass effect or hemorrhage(6). Many such medullary lesions have otherwise produced only minor clinical symptoms and have in themselves been previously considered relatively harmless – in cases where they have been known to be present.Many victims have been considered healthy prior to sudden death, and the medullary brain lesions were often incidental discoveries at autopsy, with no other causes of death identified.","PeriodicalId":14163,"journal":{"name":"International journal of neurology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85361865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-03-20DOI: 10.17554/J.ISSN.2313-5611.2017.03.65
Rajib Paul, Swagat A Sasane
We present a case of 75 year old male patient who was brought to the hospital with history of unconsciousness, 6 hours, following viper bite. CT scan of brain showed multiple infarcts in right temporal and in cerebellar hemisphere. Neurological manifestations following snake bite is mainly to hemorrhagic complications. Presentation with infarction is rare and it can be attributed to various factors such as vasculitis, vasospasm, endothelial damage; toxin induced procoagulant effect and disseminated intravascular coagulation.
{"title":"Rare Ischemic Stroke Presentation after Viper Bite-A Case Report","authors":"Rajib Paul, Swagat A Sasane","doi":"10.17554/J.ISSN.2313-5611.2017.03.65","DOIUrl":"https://doi.org/10.17554/J.ISSN.2313-5611.2017.03.65","url":null,"abstract":"We present a case of 75 year old male patient who was brought to the hospital with history of unconsciousness, 6 hours, following viper bite. CT scan of brain showed multiple infarcts in right temporal and in cerebellar hemisphere. Neurological manifestations following snake bite is mainly to hemorrhagic complications. Presentation with infarction is rare and it can be attributed to various factors such as vasculitis, vasospasm, endothelial damage; toxin induced procoagulant effect and disseminated intravascular coagulation.","PeriodicalId":14163,"journal":{"name":"International journal of neurology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85555639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.21088/IJNNS.0975.0223.9217.17
G. Balasubramaniam, V. Babu, S. S. Kumar, P. M. Vincy, K. Rama
{"title":"Giant Intraosseous Angiolipoma of Skull: A Case Report and Review of the Literature","authors":"G. Balasubramaniam, V. Babu, S. S. Kumar, P. M. Vincy, K. Rama","doi":"10.21088/IJNNS.0975.0223.9217.17","DOIUrl":"https://doi.org/10.21088/IJNNS.0975.0223.9217.17","url":null,"abstract":"","PeriodicalId":14163,"journal":{"name":"International journal of neurology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75042775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.21088/IJNNS.0975.0223.9217.13
M. Singaravelu, S. S. Kumar
{"title":"Spinal metastases of Intracranial Glioblastoma – Can Immunohistochemical Features Explain the Mechanism of Spread?","authors":"M. Singaravelu, S. S. Kumar","doi":"10.21088/IJNNS.0975.0223.9217.13","DOIUrl":"https://doi.org/10.21088/IJNNS.0975.0223.9217.13","url":null,"abstract":"","PeriodicalId":14163,"journal":{"name":"International journal of neurology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76710126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.21088/IJNNS.0975.0223.9217.16
Rajesh Singh Pukhrambam, Abuno Thepa, Nukshimenla Jamir, Limamanen Phom, S. C. Yenisetti
{"title":"Parkinson’s Disease and Therapeutic Strategies","authors":"Rajesh Singh Pukhrambam, Abuno Thepa, Nukshimenla Jamir, Limamanen Phom, S. C. Yenisetti","doi":"10.21088/IJNNS.0975.0223.9217.16","DOIUrl":"https://doi.org/10.21088/IJNNS.0975.0223.9217.16","url":null,"abstract":"","PeriodicalId":14163,"journal":{"name":"International journal of neurology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84152932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.21088/IJNNS.0975.0223.9217.1
Amresh S Bhaganagare, V. Naik, B. Pai, S. Nagesh, P. Rathod, Nanditakujur
{"title":"Surgical Outcome in 65 Patients of Pituitary Adenoma: Our Institutional Experience","authors":"Amresh S Bhaganagare, V. Naik, B. Pai, S. Nagesh, P. Rathod, Nanditakujur","doi":"10.21088/IJNNS.0975.0223.9217.1","DOIUrl":"https://doi.org/10.21088/IJNNS.0975.0223.9217.1","url":null,"abstract":"","PeriodicalId":14163,"journal":{"name":"International journal of neurology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79219736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.21088/IJNNS.0975.0223.9217.14
G. Chand, Kulwant Singh, R. Prasad, S. Pandey, S. Nalin
{"title":"Cauda equina Syndrome in Pregnancy Due to Herniated Lumber Disc: A Case Report and Review","authors":"G. Chand, Kulwant Singh, R. Prasad, S. Pandey, S. Nalin","doi":"10.21088/IJNNS.0975.0223.9217.14","DOIUrl":"https://doi.org/10.21088/IJNNS.0975.0223.9217.14","url":null,"abstract":"","PeriodicalId":14163,"journal":{"name":"International journal of neurology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87401367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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