No abstract available.
Stroke*

To consider current concepts of epilepsy further, the brief review begins with a discussion of what is epilepsy, discribes multifactorial nature of epileptic disorders, and ends with a presentation of current classifications. A combination of the standard antiepielptic drugs(AEDs) may be necessary to treat intractable seizures, but no studies have been done to indicate an optimal combination. The new AEDs provide alternative choices, but questions remain about the optimal timing and manner of administration. AEDs selection must individualized, no drug of choice can be named for all patients.
Anticonvulsants* ; Classification ; Epilepsy* ; Humans ; Seizures

The knowledge about nutritional, toxic, and metabolic causes of dementia is particularly important, because they may be reversible. Central pontine myelinolysis(CPM) is one of these causes. CPM is a well known but rare metabolic disease of unknown etiology linked to overly aggressive correction of hyponatremia. We report a 74-year-old woman who developed disorientation, memory disturbance, and behavioral problem following intensive care unit management for pneumonia. Mini-mental status examination-Korean version(MMSE-K) study revealed severe cognitive dysfunction. Brain magnetic resonance imaging showed changes consistent with CPM and extrapontine myelinolysis. After supportive care, patient's clinical status was significantly improved. We suggest that a metabolic problem such as CPM should be considered in the diagnosis of acute or subacute cognitive deterioration in elderly patients.
Aged ; Brain ; Dementia ; Diagnosis ; Female ; Humans ; Hyponatremia ; Intensive Care Units ; Magnetic Resonance Imaging ; Memory ; Metabolic Diseases ; Myelinolysis, Central Pontine* ; Pneumonia ; Problem Behavior

Current treatment strategies for levodopa-induced psychosis in advanced Parkinson's disease have had limited success. Reduction or discontinuation of levodopa and coadministration with dopamine-blocking neuroleptics may attenuate the psychotic symptoms, but these strategies are associated with worsening of parkinsonian symptoms. Administration of 5-HT3 receptor antagonist ; ondansetron, a newer strategy to attenuate psychosis of Parkinson' disease without motor deterioration was introduced. A 41-year-old young-onset male, who was diagnosed as Parkinson's disease 7 years ago, was treated with levodopa therapy, and had levodopa-induced psychosis(delusion, hallucination, paranoid, insomnia). After trial of ondansetron, he showed improvement in the Brief Psychiatric Rating Scale(from 21 points to 9 points) in spite of increasing the dosage of levodopa. With ondansetron, we could increase the dosage of levodopa without psychotic complications(esp, hallucination), and he showed improvement in the motor fluctuation.
Adult ; Antipsychotic Agents ; Hallucinations ; Humans ; Levodopa ; Male ; Ondansetron ; Parkinson Disease ; Psychotic Disorders* ; Receptors, Serotonin, 5-HT3

BACKGROUND AND PURPOSE: Valproic acid (2-propylpentanoic acid) which enhances GABA synthesis and blocks it's degradation has been useful treatment of migraine and may activate GABA receptors to modulate trigeminal nociceptive neurons innervating the meninges. But the mechanism and action of sodium valproate in headache is not clear. To investigate the mechanism of valproic acid action in headache model, we compared the change of dural plasma protein extravasation in both substance-P neurogenic inflammation rats with valproic acid pretreatment and without valproic acid pretreatment. METHOD: Sprague-Dawely rats were pretreated with valproate 30 minutes prior to substance-P administration in order to test the effects of sodium valproate on dural plasma protein extravasation by detecting the amount of extravasated Evans blue in the dura matter. To examine the abilities of either bicuculine (GABAA antagonist) and phaclofen (GABAB antagonist) to reverse the effect of valproate, they were administered 5 min before valproate administration. After then we also test the effect of muscimol (GABAA agonist) and bicuculine (GABAA antagonist) in substance-P induced neurogenic inflammation rats. RESULTS: Intraperitoneal injection of sodium valproate and muscimol reduced dural plasma protein extravasation after intravenous substance-P administration. The GABAA antagonist bicuculine completely reversed the effect of valproate and muscimol on plasma extravasation following substance-P administration, whereas the GABAB receptor antagonist, phaclofen, did not. CONCLUSION: We concluded that the attenuation of dural plasma protein extravasation by valproate and muscimol is mediated by via GABAA receptors within the meninges. Agonists and modulators at the GABAA receptor may become useful for the development of selective therapeutic agents for migraine headache.
Animals ; Evans Blue ; gamma-Aminobutyric Acid ; Headache* ; Injections, Intraperitoneal ; Meninges ; Migraine Disorders ; Muscimol ; Neurogenic Inflammation ; Nociceptors ; Plasma ; Rats* ; Receptors, GABA ; Sodium* ; Valproic Acid*

There has been quite a number of research regarding the role of dopamine in epilepsy and it has been still very controversial, In this study, the effect of dopaminergic deafferentation on kainic acid induced seizures was evaluated with behavioral study and molecular biologic method. We produced unilateral dopaminergic deafferentation via injection of 6-hydroxydopamine at the location of right substantia nigra in the Spague- Dawley rats (250-300gm) using the stereotaxic technique under pentobarbital anesthesia. Four weeks after this procedure, kainic acid (10m9/kg) was injected into the peritoneal cavity for induction of seizures. Observations of seizure pattern and mRNA expression of c-fos, dynorphin and enkephalin were obtained in the lesion group and were compared with those in the non-lesion group in terms of behavior characteristics and in situ hybridization histochemistry. In behavior study, the results demonstrated that more severe seizure patterns (rearing, falling, tonic-clonic seizure and status epilepticus) and more fast seizure evolution time(from onset to stage V) in the lesion group than those in the non-lesion group, which may indicated statistically significant (16.21+/-12.84 min. vs 35.88+/-16.55 min., p(0.05) The results of in situ hybridization revealed that the expression of c-fos, dynorphin and enkephalin mRNAs in certain areas of brain was higher in the lesion group than that in non-lesion group; c-fos in cerebral cortex, dynorphin in dentate gyrus, enkephalin in the entorhinal cortex and amygdala nuclei. Although the lesion was unilateral, the mRNA expression patterns appeared symmetrical shape. The characteristic behavior and molecular biologic study results are suggested that the dopamine may plays a important role in control of kainic acid induced seizures.
Amygdala ; Anesthesia ; Animals ; Brain ; Cerebral Cortex ; Dentate Gyrus ; Dopamine ; Dynorphins ; Enkephalins ; Entorhinal Cortex ; Epilepsy ; In Situ Hybridization ; Kainic Acid* ; Oxidopamine ; Pentobarbital ; Peritoneal Cavity ; Rats* ; RNA, Messenger ; Seizures* ; Stereotaxic Techniques ; Substantia Nigra

Huntington's disease is an autosomal dominant neurodegenerative disorder that usually begins in mid-life and is characterized by a progression of involuntary choreiform movements, personality change, and dementia. 4 specific unstable trinucleotide (CAG) repeat expansion in a gene on the short arm of chromosome 4 was recently identified as the pathogenic mutation for this disease. We have analysed the CAG expansion in peripheral leukocyte from a woman suspected with Huntington's disease and her family. A 40-year-old woman visited for the 6 years history of progressing intractable involuntary hyperkinetic movement and antagonistic personality. She showed bilateral caudate nucleus atrophy with mild enlargement of both frontal horn at brain MRI and showed the decrement of glucose metabolism in both basal ganglia at 18F-FDG PET scan. We also studied about the clinical manifestations of her family. Her younger brother also showed mild cognitive impairment and dysarthria. She and her relatives (n = 6) were tested for the existence of high risk allele of Huntington's disease by polymerase chain reaction method. The high risk allele (above 40 CAG repeat) in the 1715 gene was confirmed in 6 persons including the patient. The CAG repeat variance was 46 to 54. Only one person showed the normal range of CAG repeat.
Adult ; Alleles ; Animals ; Arm ; Atrophy ; Basal Ganglia ; Brain ; Caudate Nucleus ; Chorea ; Chromosomes, Human, Pair 4 ; Dementia ; Diagnosis* ; Dysarthria ; Female ; Fluorodeoxyglucose F18 ; Genes, vif ; Glucose ; Horns ; Humans ; Huntington Disease* ; Hyperkinesis ; Leukocytes ; Magnetic Resonance Imaging ; Metabolism ; Mild Cognitive Impairment ; Neurodegenerative Diseases ; Polymerase Chain Reaction* ; Positron-Emission Tomography ; Reference Values ; Siblings

BACKGROUND & OBJECTIVES: Depression is one of the most common neuropsychiatric sequelae of stroke, and depression is a serious disorder that can compromise the quality of life and overall rehabilitating process. The aim of this study was to investigate the frequency of depression in acute stroke patient and to compare with nondepressive patients in terms of demographic data, lesion site, pathology and the days of hospitalization. METHOD: Total 200 stroke patients admitted in Korea university hospital from Jan. 1993 to Dec. 1994 were included in this study. Data was collected from the medical records retrospectively and analyzed by means of statistics. RESULT: The frequency of depressive episode was 17% (34/200). The pathologic lesion was more frequently located in the right hemisphere (no statistical significance) and patients with depressive episode showed a higher frequency of lesions in anterior areas of the left hemisphere and posterior areas of the right hemisphere. The hospitalization days of depressive group was longer than that of non-depressive group (student t-test, p<.05). The age of depressive group was younger than that of non-depressive group (student t-test, p<.05). There was a positive correlation between the hospitalization days and the severity of depression(r=0.41). There also was a positive correlation between NIH stroke scale and the severity of depression (r=0.4988). CONCLUSION: In patients with depressive episode after acute stroke, it was more frequently developed in right posterior hemispheric lesion and their hospitalization days was longer in the depressive group than in nondepressive patients.
Depression* ; Hospitalization ; Humans ; Korea ; Medical Records ; Pathology ; Quality of Life ; Retrospective Studies ; Stroke

Recently protective and supportive functions of neurotrophic factors on dopaminergic neurons have been reported. In this study, in situ hybridization histochemistry with "S-labeled oligonucleotide probes for brain-derived factor (BDNF) and neurotrophin-3 (NT-3) mRNAs was performed to determine the effect of unilateral deafferentation of midbrain dopaminergic cells with 6-hydroxydopam'me (6-OHDA) on the expression of niRNAs of the above neurotrophic factors in the hippocampal areas. The deafferentation of midbrain dopaminergic cells induced changes of expression of BDNF mRNAs and NT-3 mRNAs. Although the reduction of NT-3 MRNA is limited to dentate gyrus of the lesion side, the induction of BDNF MRNA was observed in the lesion side firstly and then showed in the contralateral side conseqently. These results support the suggestion that these neurotrophic factors may protect or support dopaminergic neurons. In addition, these data propose the possibility that neurotrophic factors may be related with degenerative diseases such as Parkinson's disease.
Brain-Derived Neurotrophic Factor ; Dentate Gyrus ; Dopaminergic Neurons ; In Situ Hybridization ; Mesencephalon ; Nerve Growth Factors* ; Oligonucleotide Probes ; Parkinson Disease ; RNA, Messenger*

No abstract available.
Blood Platelets* ; Monoamine Oxidase* ; Selegiline*