Clinical Neuroscience

[Hemispherical tuberculoma]

SZABÓ Gyula1

MARCH 11, 1954

Clinical Neuroscience - 1954;7(01)

[Its frequency is shown differently by statistics of different authors. Their ratio to total tumors of the brain, according to Anglo-Saxon authors (1), is 1.5% -3.6%. In data from Soviet neurosurgical institutes (2), 2.1–3.4% of all brain tumors were tuberculoma. The reason for the differences in the statistics is that tuberculoma often does not undergo neurosurgery but is detected only by autopsy.]

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  1. Budapesti Orvostudományi Egyetem Ideg-elmeklinikája Idegsebészeti Intézet

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Clinical Neuroscience

[Data on the symptoms of damage to the gyrus cinguli and the medial cerebral sulcus]

GERÉB Tibor

[Clinical symptoms of the medial surface of the left hemisphere were analyzed in connection with an astrocytoma destroying the cingulitis of the left gyrus and the contiguous part of the medial surface of the forehead and wall lobe. Some of the epileptic seizures were introduced by euphoria as an aura. This can be interpreted based on the internal organ projection relationships of the medial brain surface, which is also supported by anatomical and experimental data. The onset of epileptic seizures in the hand, resp. his appearance there alone — with anatomically proven sparing of the fibers from the arm center of preecentral cortical representation — can be traced back to the excitement of the additional motor area described by Penfield, just as the speech inhibition observed once. Disorders of personal consciousness (Kleist) were not detectable.]

Clinical Neuroscience

[Brain tumour and pregnancy]

MAJERSZKY Klára

[1. Data from the literature differ on the association between brain tumor and pregnancy. Some say in animal experiments that pregnancy delays or has no effect on tumor growth, others say it specifically accelerates it. Few cases have been reported in humans in which pregnancy did not adversely affect brain tumor symptoms. In 80% of adverse events, childbirth exacerbated brain tumor symptoms. 2. In 14 years among 221 women with brain cancer , 17 pregnant, resp. we observed patients who already had a brain tumor during the last pregnancy. 3. In six cases, pregnancy and childbirth had no detectable effect on the tumor. With the onset of cancerous symptoms, resp. pregnancy can be directly related to pregnancy in 6 cases and childbirth in 2 cases (47%). In three cases, the co-occurrence of pregnancy and cancer symptoms is apparently an accidental encounter. 4. Based on our own cases, the essence of the issue of the relationship between pregnancy and brain tumor is not the growth retardation or in the problem of acceleratio, but the cases are approx. half of it is seen in the upset of intracranial hydrodynamic balance due to gestational disorders. 5. Things to do change from time to time. Radical neurosurgery or, if this is not possible, subtemporal or posterior scala decompression. In the latter case, cesarean delivery may be recommended. In previously operated cases, if the surgery was not radical or the tumor is prone to recurrence, an abortion is warranted if the patient's condition has not deteriorated. If you have already had threatening tumor symptoms, reoperation is the right solution. In the case of pituitary adenoma, artificial abortion must be performed when the tumor symptoms worsen.]

Clinical Neuroscience

[Experimental data on the mechanism of the tetanus inhibitory reflex]

KIBÉDI Tibor, DIRNER Zoltán

[1. Our various tetanus interventions: During max. flexion, extension, trunk flexion, and slight compression of the chest, one or more muscle groups are always stretched. Prolongation of muscle or tendon is an adequate stimulus of proprioceptive receptors. Proprioceptive stimuli trigger the tetanus reflex. 2. Tetanus inhibition lasts only as long as the muscle is kept stretched. 3. During inhibition, the animal is capable of appropriate reflex movement. 4. The anti-tetanus reflex, when properly affected, also develops in the spinal cord of an incised animal during transection. 5. Clonus spasms caused by Cardiazol cannot be reduced by effects based on muscle or muscle elongation. 6. If the spinal cord is cut at the height of one of the dorsal segments and then the animal is poisoned with strychnine, the known effect on the pharmacy develops weaker and later during the incision.]

Clinical Neuroscience

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Clinical Neuroscience

The yield of electroencephalography in syncope

NALBANTOGLU Mecbure, TAN Ozturk Ozlem

Introduction - Syncope is defined as a brief transient loss of consciousness due to cerebral hypoperfusion. Although the diagnosis of syncope is based on a thorough history and examination, electroencaphalography (EEG) is also an important investigational tool in the differential diagnosis in this group of patients. In this study we aimed to identify the diagnostic value of EEG in patients with syncope. Methods - We retrospectively examined EEG recordings of 288 patients with the diagnosis of syncope referred to the Cankiri State Hospital EEG laboratory, from January 2014 to January 2016. The EEG findings were classified into 6 groups as normal, epileptiform discharges (spike and sharp waves), generalized background slowing, focal slowing, hemispherical asymmetries, and low amplitude EEG tracing. The EEGs were separated according to gender and age. Results - Total of 288 patients were included in this study, 148 were females (51.4%) and 140 (48.6%) were males. Among all the EEG reports, 203 (70.5%) were normal, 8 of them (2.8%) showed generalized background slowing and 7 (2.4%) demonstrated focal slow waves. Epileptiform discharges occured among 13 patients (4.5%). Hemispherical asymmetries were detected in 10 patients (3.5%) and low amplitude EEG tracing in 47 patients (16.3%). There was no significant difference between age groups in EEG findings (p=0.3). Also no significant difference was detected in EEG results by gender (p=0.2). Discussion - Although the diagnosis of syncope, epilepsy and non-epileptic seizures is clinical diagnosis, EEG still remains additional method

Clinical Neuroscience

[Surgically cured resistant epilepsy - caused by hemispherical dysgenesis - Case report]

HEGYI Márta, SIEGLER Zsuzsa, BARSI Péter, RUDAS Gábor, LENGYEL Zsolt, SZAKÁLL Szabolcs, BOGNÁR László, KOZÁK Lajos Rudolf, NEUWIRTH Magdolna, FOGARASI András

[A part of patients with the therapy resistant epilepsy can be cured by surgical interventions. The more concordant the presurgical evaluation data, the better prognosis the patient has postoperatively. In case of discordant examination data, multimodal evaluation or case-specific decision might be successful. We report on a five-year-old boy with bilateral (left-dominated) cortical dysplasia and therapy resistant epilepsy. The ictal EEG did not help to localize the seizure onset zone, semiology had little lateralization value; however, FDG-PET showed left hemispherial hypermetabolism. The child became almost seizure-free and showed improved development after left-sided hemispherotomy.]

Clinical Neuroscience

[Periodic paroxysmal discharges with occlusion of the middle cerebral artery]

HALÁSZ Péter, GŐDÉNY Sára, HIDASI János

[Cerebral aneurysms due to a hemispherical occlusion of the middle cerebral artery develop a specific EEG activity, consisting of alternating discharges, some of which are single periodic paroxysmal discharges and others which are a series of discharges connected by flat segments. Based on the functional specificity of the electrical phenomena and the electropathological correlations, the two types of alternating activity observed in this patient can be analogized with the two main types of periodic paroxysmal phenomena; suppression-burst activity showing periodic complexes (panencephalitis-like) and cortical denervation pattern. A common pathomechanism can be discerned in these EEG phenomena, in which the specific metabolic state of the vascularly damaged and denervated cortex plays a crucial role. ]

Clinical Neuroscience

[EEG and ocular aspects of hemihypertrophy]

TOMKA Imre, REMENÁR László

[Authors found the following ophthalmologic, neurologic and EEG abnormalities in an 8 and a half year old boy with hemihypertrophy of the whole right side of the body: Developmental defects of the tissues of the right eye of neroepithelial origin (sphincter, dilator pupillae lesion, peripapillary and macular coloboma, Bergmeister pupil). Segmental skin tumours common in phakomatosis. Imbecility; rare left side facio-brachial clonal epileptic seizures with loss of consciousness. On PEG, the hemihypertrophic side of the lateral ventricle was wider and protruded in the parietal direction. On awake EEG. recordings, sinusoidal delta activity with a constant amplitude of 2.5-3 c/s in the temporal, parietal and occipital areas of the right side was inhibited by eye opening. When evipan sodium was administered, diffusely periodically recurring complete depression phases "electrical silences" developed over the right hemisphere at 0.35-0.38 g evipan sodium, which began to develop in the right side only 0.20 g.times later at 0.55-0.58 g evipan sodium, i.e. the impaired right hemisphere showed an increased barbiturate sensitivity by more than 50%. The ocular developmental abnormalities suggest that hemihypertrophy is a true embryopathy that develops at a very early stage of development. In the present case, developmental damage to the central nervous system was continuous throughout intrauterine life on the hemihypertrophic side. The clinical signs and literature data also point to the role of a hemispherical lesion of the autonomic nervous system. ]