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

BACKGROUND: The clinical and electroencephalographic differentiation of the mesial temporal lobe epilepsy (MTLE) and neocortical temporal lobe epilepsy (NTLE) may have a practical value. Until now, a few comparative studies reported some relatively minor differences between the two groups. We investigated the clinical history, interictal and ictal electroencephalographic (EEG) patterns to differentiate NTLE from MTLE. METHODS: Twenty two patients with medically refractory MTLE and fourteen patients with isolated neocortical lesions were recruited. The interictal and ictal scalp EEG patterns were compared in terms of the interictal EEG distribution patterns of epileptiform discharges, focal slow waves (ipsilateral/contralateral refers to side of pathology), and the frequencies of ictal discharges on EEG at seizure onset. RESULTS: Interictal EEG patterns of epileptiform discharges and focal slow waves were recorded most often at the ipsilateral or bilateral sphenoidal electrodes in both groups without significant differences. Ictal EEG onset with rhythmic theta waves was significantly more frequent in MTLE (72.3%) than in NTLE (36.7%), but ictal EEG onset with rhythmic alpha waves and those with rhythmic beta waves were significantly more frequent in NTLE (33.3%, 20.0%, respectively) than in MTLE (10.8%, 1.2%, respectively). Initial ictal EEG patterns appeared more frequently at the sphenoidal electrodes in both groups (MTLE:73.5%, NTLE:60.0%). Initial ictal EEG patterns of the bilateral hemisphere, ipsilateral hemisphere or ipsilateral diffuse temporal area were seen only in NTLE (16.7%, 3.3%, 10% respectively), but not in MTLE. CONCLUSIONS: This study showed that the initial ictal patterns and the frequency of ictal onset were significantly different in MTLE and NTLE. These differences could give a practical help in diagnosing MTLE and NTLE.
Electrodes ; Electroencephalography ; Epilepsy, Temporal Lobe* ; Humans ; Scalp* ; Seizures ; Temporal Lobe*

Niopam is a newer, nonionic, watersoluble contrast medium used predominately in cisternographic and myelographic studies with metrizamide lately. The former has fewer, less severe and shorter adverse reactions than the latter. Until now there were no reports on meningitis complicating Niopam CT cisternography or myelography. Now we present a case of aseptic purulent meningitis complicating Niopam CT cisternography.
Iopamidol* ; Meningitis* ; Metrizamide ; Myelography

Recent studies have revealed that mossy fiber(MF) axons of dentate granule cells undergo synaptic reorganization in both electrical kindling models of temporal lobe epilepsy (TLE) and human TLE. This synaptic reorganization has been demonstrated by Timm histochemistry which selectively labels synaptic terminals of MF because of unusually high zinc content. Of MF. In electrical kindling model and human TLE Timm granules were distributed throughout the supragranular layer of dentate gyrus where they are not normally present. These supragranular Timm granules are regarded as MF synaptic reorganization. Kindling model of generalized epilepsy can be made by repeated intraperitoneal injections of subconvulsive dosage of pentylenetetrazol (PTZ). The present study is designed to test the hypothesis that MF synaptic reorganization might be developed in PTZ kindling model In this study, the supragranular Timm granules by Timm histochemistry were scored and depth EEG was recorded in dentate gyrus of various stages of PTZ kindling rats. The scores of supragranular Timm granules were 0. 33+0.17 in stage I seizure (n=9) ; 0. 38 + 0. 14 in stage II seizure (n=13) ; 0. 44 + 0. 18 in stage III seizure (n=9) ; 1. 40+0.16 in 3 consecutive or total 5-7 stage TV or V seizure (n=10) ; 1. 86+ 0.26 in 7-10 consecutive or total 10-15 stage IV or V seizure (n=7) ; 2.50+0.22 in 1215 consecutive or total 20-30 stage IV or V seizure (n=6) ; and 0. 30+0.15 in salinen controls (n=lo). Statistical analysis showed the supragranular Timm scorwere significantly higher in stage IV or V seizure than in control and in stage 1, I or, I seizure (p<0.05 ), and tended to increase with increasing numbers of stage IV or V seizure. Depth EEG recording from dentate gyrus showed 6-9Hz rhythmic waves in saline injected control, single or polyspikes or normal waves during stage I seizure, 4-6Hz slow waves or spike-waves complexes lasting 1-2 seconds during stage II seizure, 4-6Hz slow waves or spike-waves complexes lasting 3-6 seconds during stage III seizure, 8-15Hz spikes lasting over 10 seconds during stage IV seizure and 10-30HZ spikes lastmg over 20 seconds durmg stage V seizure The results demonstrate the development of MF synaptic reorganization and a sound correlation between MF synaptic reorganization and the progression of the kindlmg phenomenon in PTZ kindling models. These findings suggest that MF synaptic reorganization might be a critical event underlying the development and . Maintenance of kindling phenomenon and epileptic state.
Animals ; Axons ; Dentate Gyrus* ; Electroencephalography ; Epilepsy, Generalized ; Epilepsy, Temporal Lobe ; Humans ; Injections, Intraperitoneal ; Pentylenetetrazole* ; Presynaptic Terminals ; Rats* ; Seizures ; Zinc

The development of pentylenetetrazol (PTZ) kindling has been controversial, authors confirmed the development of kindling phenomenon in experimental rats following every second or third day intraperitoneal administration of PTZ(20-25mg/kg) to experimental rats and same amount of saline to control rats. The developmental stage of motor seizure could be categorized into five stages (stage I; clonic seizure of face and neck, stage II; clonic seizure of face, neck and forelimbs, stage III; clonic seizure of forelimbs and body with brief rearing, stage IV; falling and generalized clonic seizure, stage V; falling and generalized tonic-clonic seizure with tonic extension of hindlimbs). Linear regression analysis showed that the stages of motor seizure were increased with the number of PTZ injections (Y=0.1361X + 0.1943, p < 0.05). The persistence of kindling state was also observed after a 5-months pause of PTZ injection. This study suggested that PTZ kindling model in rats could be a good animal model of generalized epilepsy.
Animals ; Epilepsy, Generalized ; Forelimb ; Linear Models ; Models, Animal ; Neck ; Pentylenetetrazole* ; Rats* ; Seizures

Although some cases of benign positional vertigo are associated with a chronic ipsilateral sensorineural hearing loss, an association with simultaneous ipsilateral sudden deafness is rare. We report a 53-year old woman with sudden deaf-ness with simultaneous positional vertigo in the same ear characterized by benign paroxysmal positional vertigo of pos-terior semicircular canal type. After a modified Epley particle-repositioning maneuver, the patient's vertigo was resolved. Clinical and neuro-otologic evaluations suggested that the lesion responsible for this patient was probably located within inner ear rather than within the vestibulocochlear nerve. (J Korean Neurol Assoc 19(4):410~412, 2001)
Ear ; Ear, Inner ; Female ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden* ; Humans ; Middle Aged ; Semicircular Canals ; Vertigo* ; Vestibulocochlear Nerve

This study was performed to evaluate the effects of acute withdrawal of antiepileptic drugs in epileptic patients during continuous BEG monitoring. One hundred sixty-five withdrawals in 134 patients who were candidates for epileptic surgery were included for this study. Clinical features and frequency of seizure were observed after drug withdrawal with daily monitoring of serum drug level. The phases after withdrawal of antiepileptics were divided into phase of therapeutic drug level, phase of falling drug level, and phase of subtherapeutic or undetectable(zero) drug level. There were significant increase in frequency of seizure and seizure of secondary generalization after acute withdrawal of antiepileptic drugs. Number of seizure during the period of drugs withdrawals was not correlated with onset age of epilepsy, duration of epilepsy, duration of medication, and number of administrated antiepiteptic drugs. The number of frequency of seizure before drug withdrawal was correlated with the number of frequency of withdrawal seizure. The number of seizure frequency after carbamazepine withdrawal was significantly higher during the phase of subtherapeutic or zero drug level, and not during phase of rapid falling antiepileptic drug level.
Age of Onset ; Anticonvulsants* ; Carbamazepine ; Epilepsy ; Generalization (Psychology) ; Humans ; Seizures*

BACKGROUND AND OBJECTIVES: Qualitative oculomotor abnormalities have been reported in parkinsonian patients for many years, but conflicting results have been obtained. This study was performed to evaluate the correlation between the severity of the disease and the abnormalities of the ocular movements in idiopathic parkinson's disease. METHODS: We gave the vestibular function tests in patients with idiopathic parkinson's disease and normal controls. Eye movement recordings were made with automated electronystagmography and rotation test was performed. A total of 46 patients (mean age : 61.2+/-6.7) and 24 controls (mean age : 60.5+/-4.3) were studied. The severity of the disease was divided into two groups by modified Hoehn & Yahr staging ; H-Y stage 1 and 2 as a mild group and stage 3 and 4 as a severe group. RESULTS: Saccadic latency and accuracy, pursuitic gain and velocity, vestibulo-ocular reflex (VOR) suppression by vision were significantly altered in patients, whereas mean velocity of optokinetic nystagmus (OKN) and VOR gain in darkness were normal. Alteration of saccadic latency and accuracy, pursuitic gain and velocity, VOR suppression by vision were profound in the severe group compared with a mild group and controls, but the above parameters did not differ between a mild group and controls. In a hemiparkinson's group, saccadic latency and accuracy, pursuitic gain, OKN mean velocity and gain was not different between the both sides. CONCLUSION: The results indicate that severe Parkinson's disease damages nigrostriatal or other specific pathways which were involved in the regulation of the saccadic, pursuitic and pursuitic-mediated visual fixation system. In a hemiparkinson's group asymmetric damage of dopaminergic innervation which was involved in the regulation of ocular movements was not found.
Darkness ; Electronystagmography ; Eye Movements ; Humans ; Nystagmus, Optokinetic ; Parkinson Disease* ; Reflex, Vestibulo-Ocular ; Vestibular Function Tests

After subarachnoid hemorrhage, transient hypoglycorrhachia is not unusual but prolonged hypoglycorrhachia has been reported rarely. We report a 67-year-old woman who show prolonged hypoglycorrhachia for more than one month after subarahnoid hemorrhage without evidences of infection and malignancy.
Aged ; Female ; Hemorrhage ; Humans ; Subarachnoid Hemorrhage*

We studied the effects of botulinum A toxin in 101 patients with hemifacial spasm and 11 patients with blepharospasm in an open trial and double blind manner. All patients in the open trial and 6 patients in the double blind trial improved after the first injection of botulinum toxin. There was no improvement with placebo. The peak effect ranged from one to 6 days after injection and mean peak effect was 3.6 days in blepharospasm, and 4 days in hemifacial spasm. Of 144 treatments, 98.6% had excellent results, (below grade I). The duration of beneficial effect ranged 11 to 40 weeks (mean 16.5 weeks) in hemifacial spasm and 9 to 30 weeks (mean 14.2 weeks) in blepharospasm. Complications were encountered in 63.4% in hemifacial spasm and 72.7% in blepharospasm. The common side effects were dry eyes, mouth droop, ptosis and lid edema in order of frequency. These side effects were mild and resolved spontaneously in 1 to 3 weeks. Botulinum A toxin therapy is effective and convenient, and the treatment of choice for patients with hemifacial spasm and blepharospasm.
Adult ; Aged ; Blepharospasm/*drug therapy ; Botulinum Toxins/adverse effects/*therapeutic use ; Double-Blind Method ; *Facial Muscles ; Female ; Humans ; Male ; Middle Aged ; Spasm/*drug therapy