In order to observe the effects of various click polarity and stimulus rate on brainstem auditory evoked potentials (BAEPs), we measured the absolute latency, interwave latency and amplitude. Variations of IV-V wave complex in different stimulus rate and polarity were also observed. Observations were made on 50 normal subjects(32 males and 18 females) aged 8 to 56. The results are summarized as follows, 1. With rarefaction click stimulation, the absolute latencies of wave I and wave V were shortest, and wave I and wave III amplitudes were most increased as compared with condensation or alternating-polarity. 2. The absolute latencies of wave I and wave V were most prolonged and wave V amplitude was highest with condensation clicks. 3. I - III, III -V and I - V interwave latencies were not significantly changed between any of polarities. 4. By increasing stimulus rate from 10 click / sec to 50 click / sec, absolute and interwave latencies were significantly prolonged. Except wave V amplitude at condensation and alter-nating-polarity clicks, all wave amplitudes were decreased significantly. 5. The waveforms were classified into 5 types according to configuration of IV - V wave complex. At any conditions, type A and B were present most frequently. We proposed that if one is to employ only a single stimulus polarity, rarefaction clicks should be used because this will produce the earliest and largest wave I. Condensation can be used in those cases in whom rarefaction does not produce clar waveforms, or when wave V appears absent. The use of alternating-polarity clicks as the only mode of stimulation is discouraged because of the possibility of phase cancellations.
Brain Stem* ; Evoked Potentials, Auditory, Brain Stem* ; Humans ; Male

This study was undertaken to evaluate the clinical usefulness of magnetic motor evoked potential (MEP) in the diagnosis of stroke and predicting the motor improvement following stroke. The cortical, cervical and lumbar stimulations were performed in the case of 24 healthy controls and 24 to a target muscle between after transcranial stimulation and after cervical or lumbar stimulation. There was no case showing no response in controls. But in 11 out of 24 ischemic patients, we could not get cortical MEP. Mean CMCT of abductor pollicis brevis muscle was not significantly different in controls and stroke patients in whom MEPs were recorded. There were significant differences between mean CMCT of normal controls and that of stroke patients showing MEPs in AH Muscle. MEP Results from testing the stroke patients were correlated with site of lesion, degree of motor weakness and motor improvement after 1 to 2 months. These results suggest that magnetic MEP is easy and useful in electrophysiological test of central motor pathway and is useful indicator for representing the motor weakness and predicting the motor outcome in acute ischemic stroke patients.
Diagnosis ; Evoked Potentials, Motor* ; Humans ; Stroke*

BACKGROUND AND PURPOSE: This study was undertaken to compare the sensitivity of the Repetitive Nerve Stimulation Test (RNST) between the upper and lower extremity muscles in myasthenia gravis(MG) patients. MATERIALS AND METHODS: The study population consisted of 20 normal persons(control group) and 10 MG patients(MG group). Using Stalberg's method. RNST was systemically performed in orbicularis oculi muscle. upper extremity muscles(flexor carpi ulnaris. abductor digiti quinti), and lower extremity muscles(tibialis anterior. extensor digitorum brevis. vastus medialis). RESULTS: There were statistical differences of decremental response(mean+/-SD) in orbicularis oculi and upper extremity muscles between the control and MG groups(p<0.05 or p<0.01). However, there was no statistical difference of decremental response(mean+/-SD) to RNST in lower extremity muscles between the control and MG groups. There were highersensitivity in orbicularis oculi and upper extremity muscles than lower extremity muscles. Although positive reponse were detected in the lower extremity muscles, the positive response rates of lower extremity muscles were lower than o.oculi and upper extremity muscles. CONCLUSIONS: When the response rates of RNST in facial and upper extremity muscles are normal, may not be required RNST in lower extremity muscles.
Humans ; Lower Extremity* ; Muscles* ; Myasthenia Gravis* ; Upper Extremity

Ischemic stroke is among the principal causes of death and disability in the elderly. Although control of blood pressure, decreased cigarette smoking, and modified dietary habits are among important reasons for stroke decline, the use of antithrombotic therapy, rigorously prescribed. Several antiplatelet agents are approved to reduce the risk of recurrent stroke. Aspirin is the best-studied and most widely used antiplatelet agent for stroke prevention; it provides approximately 15% to 25% relatively risk reduction for secondary prevention of stroke or the major vascular death. Combining 2 antiplatelet agents with different mechanism of action was demonstrated to provide a substantial increase in efficacy in several studies. Anticoagulation should be considered first with potential cardiac sources of embolism. Heparin reduces development of erythrocyte-fibrin thrombi that form in regions of vascular stasis especially within the heart, in severely stenosed arteries sometimes engrafted on white thrombi, in acute arterial occlusion. Heparin should not be indiscriminately given to all acute brain ischemia patients, but may contribute to treatment of large artery occlusion and severe stenosis, cardiogenic embolism with a high acute recurrence risk, and dural sinus and cerebral venous thromobosis.
Aged ; Anticoagulants ; Arteries ; Aspirin ; Blood Pressure ; Brain Ischemia ; Cause of Death ; Constriction, Pathologic ; Embolism ; Food Habits ; Heart ; Heparin ; Humans ; Platelet Aggregation Inhibitors ; Recurrence ; Risk Reduction Behavior ; Secondary Prevention ; Smoking ; Stroke*

We evaluated the performance of activities of daily living by using Barthel ADL index and the factors affecting the quality of life were also analyzed in 82 survivors who suffered from single cerebral infarction in MCA territory and followed for more tham 3 months. The results were as follows: 1. Among the patients, 56(68.3%) patients regained functional indepeadency.but they were not necessarily normal or socially independent. 2. They improved markedly in first 4 weeks after onset of the stroke. 3. Functional recovery in the left hemiplegic patients was better than the right, but there was no difference in functional recovery related to sex and etiologic factors. 4. There was no correlation between age and ADL score 5. The major determinants for long term quality of life were the initial neurologic signs and the size of infarcted area demonstrated by Computed Tomography.
Activities of Daily Living* ; Cerebral Infarction ; Humans ; Neurologic Manifestations ; Quality of Life ; Stroke* ; Survivors ; Tromethamine

To evaluate the intractability of partial epileptic patients by variables, the author studied 113 patients (uncontrolled: 45, controlled: 68) who were admitted to the Department of Neurology, College of Medicine, Yeungnam University from January, 1991 to August, 1993. The results were as follows. The items related to complex partial seizures, multiple seizure types and a histories of status epilepticus or clusters of seizures were significantly associated with drug-refractoriness (p<0.01). A high frequency of seizures before evaluation was associated with a poor outcome(p<0.01). The presences of known etiology of seizures, neurologic abnormalities and psychiatric disturbance were associated with limited treatment responses(p<0.01, p<0.05, p<0.01). An abnormal EEG findings such as background slowing, focal slowing, epileptiform discharges or secondarily bilateral synchrony were statistically significant (p<0.01). Age at onset, sex, distribution of epileptic foci, duration of seizure before evaluation, family history and abnormal neuroradiologic findings were not statistically significant. By these results, it was suggested that having at least four factors of the above variables were associated with limited treatment response.
Electroencephalography ; Epilepsies, Partial* ; Humans ; Neurology ; Risk Factors ; Seizures ; Status Epilepticus

Idiopathic hypoparathyroidism is frequeutly associated with intracranial calcification and neuropsychiatric abnormalities. The most commonly recognized central nervous system manifestations of chronic hypoparathyroidism are seizure, alteration of mental function and extrapyramidal signs. We present a care of hypoparathyroidism, demonstrating extensive intracranial calcification, not only basal ganglia, but also outside the extrapyramidal system. An 58-year-old woman presented with 30 year history of seizure and memory disturbance. The physical examination and several laboratory studies disclosed normal. However hypocalcemia, hyperphosphatemia with hypocalciuria and decreased parathormone level were demonstrated. Clinical symptoms and signs showed improvement after supplementary calcium and Vit D3 therapy.
Female ; Humans

Laughter as an epileptic phenomenon is very uncommon. The introduction of the term gelastic epilepsy by Daly and Mulder (1957) may have resulted in less precision in diagnosis. Laughter does not necessarily include Mirth (gelos). Smiling may be volumtary or barely perceptible, whereas the laryngeal and respiratory components of laughter are more likely to be involuntary and are definite. To this time the loction of this epilepsy is said to be related with temporal lobe and hypothalamus. This case which we present with reviewing of the literature has paroxysmally a burst of loud, high-pitched laughter without any emotional expression. It suggests that at the production of this laughter some fasciorespiratory pathways might be involved, and that the start of this epileptic discharge is probably from a lesion of the orbito-frontal area.
Diagnosis ; Epilepsies, Partial* ; Epilepsy ; Hypothalamus ; Laughter ; Smiling ; Temporal Lobe

To obtain the basic data of prognosis of acute carbon monoxide (CO) intoxication, one hundred and sixteen cases of CO intoxication defined by carboxyhemoglobin (COHb) and admitted via emergency room of Yeungnam University Hospital from Oct. '85 to April' 89 have been clinically analyzed and evaluated, including delayed postanoxic encephalopathy (DPE) and the following results were obtained. 1. The ratio of male to female was 1:1.5 and mental state was drowsy mostly (26.2% of 116 cases) 2. The more disturbed the mental state, the more decreased was the arterial pH and PaCO₂, which may be the result of metabolic acidosis. 3. The early laboratory findings in patients of CO intoxication were as follows: leukocytosis-65.5%, increase of hematocrit-23.3%, hyperglycemia-19.8%, increase of GPT-19.8% increase of creatinine-0.9% and glucosuria-12.1%. 4. The early findings of EKG were abnormal in 35.3%: change of rhythm-25.0%, abnormal ST segment 15.5% (change of rhythm and abnormal ST segment-5.2%) but the conduction disorder was not present. 5. The abnormal EEG above mild degree was 93.1%, of which moderate was most frequent (80.2%). 6. The incidence of DPE was 7.8% among all admitted CO patients. DPE cases had long duration of exposure time (8 hours), severe leukocytosis (20,000) and an abnormal EEG (MA).
Acidosis ; Blood Gas Analysis ; Brain Diseases ; Carbon Monoxide* ; Carbon* ; Carboxyhemoglobin ; Clinical Study* ; Electrocardiography ; Electroencephalography ; Emergency Service, Hospital ; Female ; Humans ; Hydrogen-Ion Concentration ; Incidence ; Leukocytosis ; Male ; Prognosis

Nerve conduction studies help delineate the extent and distribution of the neural lesion. The nerve conduction was studied on upper (median, ulnar and radial nerves) and lower (personal, posterior tibial and sural nerves) extremities in 83 healthy subjects 23 to 66 years of age, and normal values were established (Table 1). The mean motor terminal latency (TL): median, 3.6 (±0.6) milliseconds; ulnar, 2.9 (±0.5) milliseconds; radial nerve, 2.3 (±0.4) milliseconds. Mean motor nerve conduction velocity (MNCV) along distal and proximal segments: median, 61.2 (±9.1) (W-E) and 57.8 (±13.2) (E-Ax) meters per second; ulnar, 63.7 (±9.1) (W-E) and 50.6 (±10.0) meters per second. Mean sensory nerve conduction velocity (SNCV): median, 34.7 (±6.7) (F-W), 63.7 (±7.1) (W-E) and 62.8 (±12.3) (E-Ax) meters per second; ulnar, 38.0 (±6.7) (F-W), 63.4 (±7.5) (W-E) and 57.0 (±10.1) (E-Ax) meters per second; radial, 45.3 (±6.8) (F-W) and 64.2 (±11.0) (W-E) meters per second; sural nerve, 43.4 (±6.1) meters per second. The amplitudes of action potential and H-reflex were also standardized. Mean H latency was 28.4 (±3.2) milliseconds. And, the fundamental principles, several factors altering the rate of nerve conduction and clinical application of nerve stimulation techniques were reviewed.
Action Potentials ; Adult* ; Extremities ; H-Reflex ; Healthy Volunteers ; Humans ; Neural Conduction* ; Radial Nerve ; Reference Values ; Sural Nerve