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

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

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

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

BACKGROUND: Parkinson's Disease (PD) is a progressive neurodegenerative disorder characterized by resting tremor, rigidity, and bradykinesia. L-3,4-dihydroxyphenylalanine (L-dopa) has been used for over last 3 decades to treat this disorder, however, its usage is limited due to the reducing effectiveness on time and severe side effects. The best strategy for treating this disorder without serious side effects would be to keep a constant level of dopamine in the brain. This could be achieved by gene or cell therapy using gene(S) involved in dopamine biosynthesis or cells from other individual. For Parkinson's gene therapy, however, there still are controversies on which gene In what combination will yield the best result. In this report, we propose a biochemical background for using GTP cyc]ohydrolase I (GTPCH I) in addition to TH for higher and/or more stable expression of TH. METHODS: TH and GTPCH I cDNA were subcloned into retroviral vectos and resulting recombinant retrovirus packaged in BOSC 23 cells were used to infect NIH-3T3. Confirming successful infections by westers blot analysls, the new cell lines were used to examine steady state TH expression level and TH activity. Furthermore, the effect of ectopic expression of BH4 to the proliferation of these cells were studied. RESULTS: NIH-3T3 cells expressing both TH and GTPCH I showed approximately 10 fold higher expression of TH protein than the cells expressing TH alone. The activity of KNTH2GC6 was approximately 4-6 fold higher than that of striatal tissue and 60 fold higher than KNTH2. Furthermore, growth rate of KNTH2GC6 was strikingly reduced by inhibiting the biosynthesis of BH4. CONCLUSIONS: We showed that the use of GTPCH I in addition to TH not only increased the stability and/or expression of TH protein but also the activity of the enzyme. These improved characteristics of TH protein are very likely due to the expression of BH4 and should be very seriously considered for Parkinson's gene therapy.
Brain ; Cell Line ; Cell- and Tissue-Based Therapy ; DNA, Complementary ; Dopamine ; Genetic Therapy ; GTP Cyclohydrolase* ; Guanosine Triphosphate* ; Hypokinesia ; Levodopa ; Neurodegenerative Diseases ; NIH 3T3 Cells ; Parkinson Disease ; Retroviridae ; Tremor ; Tyrosine 3-Monooxygenase* ; Tyrosine* ; Zidovudine

This study was retrospectively undertaken to evaluate clinical manifestations, electroencephalographic findings, response to antiepileptic drugs and prognosis of 80 benign childhood epilepsy with centrotemporal spikes (BCECT) patients seen between 1967 and 1993 and followed up for more than 2 years. The age of onset ranges from 3 to 15 years. In 93 percent of patients, seizures appeared between 4 to 12 year-old, with peak of 5 year-old. The main manifestations of partial seizure were hemifacial spasm (53%) and oropharygeal signs (52%) with hypersalivation, abnormal sensation of mouth, gutteral sounds, swallowing difficulty and feeling of suffocation. The types of seizure consist of partial seizure(66%) and partial seizure with secondary generalization (34%). Distributions of seizure attack were nocturnal sleep (83%), diurnal sleep state(4%) and waking state (13%). The typical EEG findings were slow diaphasic high voltage centrotemporal spikes with unilateral (94%) and bilateral foci(6%) with normal background. In addition to typical EEG findings, there were associated with multifocal independent sharp-waves (8.9%) and generalized sharp-wave discharges (7.8%). BCECT patients were well controlled by antiepileptic drugs and had good prognosis. During the follow-up period (2-17years), we observed that all patient were well adapted to school and society. Seizures did not occur after adolescent period.
Adolescent ; Age of Onset ; Anticonvulsants ; Asphyxia ; Child ; Child, Preschool ; Deglutition ; Electroencephalography ; Epilepsy ; Epilepsy, Rolandic* ; Follow-Up Studies ; Generalization (Psychology) ; Hemifacial Spasm ; Humans ; Mouth ; Prognosis ; Retrospective Studies ; Seizures ; Sensation ; Sialorrhea

Kindling, induced by repeated subconvulsive electrical or chemical stimulations, leads to progressive and permanent amplification of seizure activity, resulting in permanent brain changes. It is a good animal model of epilepsy and neural plasticity. C-fos has been proposed as the gene responsible for turning on molecular events for these permanent brain changes underlying epilepsy and neural plasticity. But the role of c-fos in the development of kindling is controversial. This study was undertaken to investigate the role of c-fos mRNA in the plastic changes underlying kindling. Among 66 adult male Sprague-Dawley rats, 29 rats were kindled by repeated administrations of subconvulsive doses (IS-25 mg/kg) of pentylenetetrazol (PTZ), 25 rats experienced convulsions induced by a single injection of convulsive dose(30-60 mg/kg) of PTZ, and 12 rats experienced convulsions by a single electroconvulsive shock (ECS), Twelve control rats received normal saline only. Animals were sacrificed at various seizure stages. C-fos mRNA levels in the hippocampus were quantified using slot-blot hybridization analysis. In the experiment of PTZ kindling, c-fos mRNA expression 30 min after convulsion was elevated about 2-4 times at stage 1, 2 and 5, but wasn't increased at stage 3 and 4, compared with controls. C-fos mRNA expression 60 min after convulsion was elevated about 2 times at stage 1 and 5, but wasn't increased at stage 2, 3 and 4. In the experiment of PTZ-induced seizures, c-fos mRNA expression 30 min after convulsion was elevated 2.5, 2.2 and 6 times stage 1-2, 3-4, and 5, respectively. C-fos mRNA expression 60 min after convulsion was elevated 3.6 times at stage 3-4, but wasn't increased at stage 2 and 5. In the experiment of ECB-induced seizures, c-fos mRNA expression 1 min after mild convulsion was elevated 3,3 times, but wasn't increased generalized tonic-clonic seizure. C-fos mRNA expression 60 min after convulsion wasn't increased at any stage of convulsion. These results show that c-fos mRNA levels have no meaningful relationship with the stages of PTZ kindling, and PTZ or ECS-induced seizures, and that c-fos mRNA does not seem to play the crucial role in turning on a molecular program underlying kindling.
Adult ; Animals ; Brain ; Electroshock ; Epilepsy ; Hippocampus* ; Humans ; Male ; Models, Animal ; Pentylenetetrazole* ; Plastics ; Rats* ; Rats, Sprague-Dawley ; RNA, Messenger* ; Seizures ; Stimulation, Chemical

BACKGROUND: It is debatable whether psychiatric problems are overrepresented in the epileptic patient population. In addition, the significance of MMPI elevations in epileptic patients is still uncertain. This study attempted to find out MMPI profile characteristics of patients with medically refractory epilepsy (MRE). METHODS: MMPI was administered to 172 MRE patients and 139 normal controls. RESULTS: In terms of the mean value of MMPI scales, the MRE patients group had normal mean values comparable to the normal control group. However, the MRE patients could be classified into three subgroups by a multivariate cluster analysis, which include a subgroup with normal profile group (41% of patients), neurotic profile group (elevated Hs-D-Hy scales; 19% of patients), and psychiatric profile group (elevated Pa-Pt- Sc & Hs-D-Hy scales; 40% of patients). CONCLUSIONS: This study shows that the majority of MRE patients have abnormal MMPI profiles and suggests that psychiatric disorders or problems might be common in MRE patients. (J Korean Neurol Assoc 19(3):226~231, 2001)
Epilepsy* ; Humans ; MMPI* ; Psychotic Disorders ; Weights and Measures