Abstract:
:Effective surgical treatment of patients with intractable complex partial seizures depends on accurate preoperative seizure focus localization. We evaluated seizure localization with interictal and immediate postictal single photon emission computed tomographic images of cerebral perfusion using technetium-99m-hexamethyl-propyleneamineoxime (99mTc-HMPAO) in comparison with conventional ictal electroencephalographic (EEG) localization. Thirty-two patients with intractable complex partial seizures were studied. The mean delay from seizure onset to injection was 6.3 +/- 5.3 (SD) minutes. Independent blinded observers assessed the scans for interictal hypoperfusion and postictal focal hyperperfusion. Interictal scans alone were unreliable, indicating the correct localization in 17 patients (53%) and an incorrect site in 3 (9%). When interictal and postictal scans were interpreted together, the focus was correctly localized in 23 patients (72%). There was 1 false-positive study, and 8 patients had inconclusive changes, including 2 with inconclusive depth EEG studies. Postictal hyperperfusion was predominantly mesial temporal and frequently associated with hypoperfusion of lateral temporal cortex. Secondarily generalized seizures tended to show focal hyperperfusion less often than complex partial seizures did (Fisher's exact test p = 0.09). Combined interictal and immediate postictal single photon emission computed tomography with 99mTc-HMPAO is a useful noninvasive technique for independent confirmation of electrographic seizure localization. It may provide a suitable alternative to the use of depth electrode studies for confirmation of surface EEG findings in many patients with complex partial seizures.
journal_name
Ann Neuroljournal_title
Annals of neurologyauthors
Rowe CC,Berkovic SF,Sia ST,Austin M,McKay WJ,Kalnins RM,Bladin PFdoi
10.1002/ana.410260512subject
Has Abstractpub_date
1989-11-01 00:00:00pages
660-8issue
5eissn
0364-5134issn
1531-8249journal_volume
26pub_type
杂志文章abstract::Urinary urgency and frequency are common in α-synucleinopathies such as Parkinson disease, Lewy body dementia, and multiple system atrophy. These symptoms cannot be managed with dopamine therapy, and their underlying pathophysiology is unclear. We show that in individuals with Parkinson disease, Lewy body dementia, or...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.24430
更新日期:2015-07-01 00:00:00
abstract::Mutations in genes encoding the NADH ubiquinone oxidoreductase, complex I of the respiratory chain, cause a diverse group of diseases. They include Leber hereditary optic neuropathy, Leigh syndrome, and mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes. There is no effective treatment for t...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.20175
更新日期:2004-08-01 00:00:00
abstract::A subset of human immunodeficiency virus (HIV)-infected patients develop persistent CD8 hyperlymphocytosis and a Sjogren's syndrome-like syndrome associated with multivisceral CD8 T-cell infiltration, known as the diffuse infiltrative lymphocytosis syndrome (DILS). Patients with DILS tend to have higher CD4 cell count...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410410406
更新日期:1997-04-01 00:00:00
abstract::The prevalence of migraine is much greater in female than male individuals. Cortical spreading depression (CSD) is thought to be a fundamental mechanism of migraine, and CSD in rodents is used as a model for migraine. We used optical intrinsic signal imaging and electrophysiological techniques to investigate CSD in C5...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.21138
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVE:Antiepileptic drugs (AEDs) are important for the treatment of epilepsy, psychiatric diseases, and pain syndromes. Small studies have suggested that AED treatment reduces serum levels of folate and vitamin B12. METHODS:This prospective monocenter study aimed at testing the hypothesis that AED treatment is ass...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.22229
更新日期:2011-02-01 00:00:00
abstract::Using two-color flow cytometric analysis, we studied peripheral blood lymphocyte subsets in 15 patients with human T-cell lymphotropic virus type I-associated myelopathy. The percentage of CD4+ 4B4+ cells (helper inducer T cell) was significantly increased in the patients with the myelopathy, compared with 16 healthy ...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410260212
更新日期:1989-08-01 00:00:00
abstract::The mechanisms responsible for early prenecrotic ischemic brain edema were investigated in rats by comparing brain metabolism, tissue water (HOH) content, and sodium and potassium ion concentration in brain during ischemia induced by decapitation, by the Pulsinelli-Brierley technique, and by carotid embolization. Alth...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410090310
更新日期:1981-03-01 00:00:00
abstract:OBJECTIVE:The effect of prestroke aspirin use on initial severity, hemorrhagic transformation, and functional outcome of ischemic stroke is uncertain. METHODS:Using a multicenter stroke registry database, patients with acute ischemic stroke of three subtypes (large artery atherosclerosis [LAA], small vessel occlusion ...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.24602
更新日期:2016-04-01 00:00:00
abstract::Previous imaging studies using 11C-flumazenil in patients with mesial temporal lobe epilepsy and neocortical partial seizure disorders have found focal decreases in gamma-aminobutyric acid type A/benzodiazepine receptor binding. These studies used subjective visual assessment and a region of interest approach to quant...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410400210
更新日期:1996-08-01 00:00:00
abstract::Emotional blunting can be found after cerebellar lesions. However, the mechanism of such a modification is not clear. We present a patient with emotional flattening and increased risk taking after left cerebellar infarct who had an impaired autonomic reactivity to negative as compared with positive reinforcement. This...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.10549
更新日期:2003-05-01 00:00:00
abstract:OBJECTIVE:Nonketotic hyperglycinemia is a neurometabolic disorder characterized by intellectual disability, seizures, and spasticity. Patients with attenuated nonketotic hyperglycinemia make variable developmental progress. Predictive factors have not been systematically assessed. METHODS:We reviewed 124 patients stra...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.24485
更新日期:2015-10-01 00:00:00
abstract::The need for novel, efficacious, antiseizure therapies is widely acknowledged. This study investigates in humans the feasibility, safety, and efficacy of high-frequency electrical stimulation (HFES; 100-500 Hz) triggered by automated seizure detections. Eight patients were enrolled in this study, which consisted of a ...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.20377
更新日期:2005-02-01 00:00:00
abstract::Multiple sclerosis patients who become pregnant experience a significant decrease in relapses that may be mediated by a shift in immune responses from T helper 1 to T helper 2. Animal models of multiple sclerosis have shown that the pregnancy hormone, estriol, can ameliorate disease and can cause an immune shift. We t...
journal_title:Annals of neurology
pub_type: 临床试验,杂志文章
doi:10.1002/ana.10301
更新日期:2002-10-01 00:00:00
abstract::Mutations of copper,zinc-superoxide dismutase (cu,zn SOD) are found in patients with a familial form of amyotrophic lateral sclerosis. When expressed in transgenic mice, mutant human cu,zn SOD causes progressive loss of motor neurons with consequent paralysis and death. Expression profiling of gene expression in SOD1-...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.1252
更新日期:2001-12-01 00:00:00
abstract:OBJECTIVE:Blunted tachycardia during hypotension is a characteristic feature of patients with autonomic failure, but the range has not been defined. This study reports the range of orthostatic heart rate (HR) changes in patients with autonomic failure caused by neurodegenerative synucleinopathies. METHODS:Patients eva...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.25170
更新日期:2018-03-01 00:00:00
abstract::Fresh brain weight, gestational age, body weight, sex, and race were collected from autopsy records of 782 newborns over a 10-year period. The brain weight of the mature newborn does not differ between males and females or between white and black infants. For the premature, however, brain weight is heavier in white ma...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410100308
更新日期:1981-09-01 00:00:00
abstract::Fourteen children with brain tumors received endocrine evaluations at least one year following completion of cranial irradiation. Treatment consisted of operation (13 patients), craniospinal irradiation (6), whole brain irradiation (5), posterior fossa irradiation (3), and chemotherapy (10). Endocrine evaluation inclu...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410140506
更新日期:1983-11-01 00:00:00
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journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.24134
更新日期:2014-05-01 00:00:00
abstract::We report on a 12-year-old girl with a severe subacute to chronic bifrontal leukoencephalopathy. By clinical, biochemical, radiological, and neuropathological criteria, a diagnosis of inflammatory myelinoclastic diffuse sclerosis was reached. This is the third fully documented case. ...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410230422
更新日期:1988-04-01 00:00:00
abstract::The developmental sequence of sleep cycles has been found to be a useful index of central nervous system maturation in premature infants. To determine the effects of severe reversible stress on the maturation of sleep cycles, 6- to 8-hour sleep studies were done on 10 premature infants with severe hyaline membrane dis...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410060610
更新日期:1979-12-01 00:00:00
abstract::We analyzed the prion protein gene (PRNP) region in patients with transmissible spongiform encephalopathy associated with the PRNP D178N mutation. The results suggest that the D178N chromosomes had independent origins in each affected pedigree or apparently sporadic case. A de novo spontaneous PRNP mutation was observ...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.10267
更新日期:2002-09-01 00:00:00
abstract:OBJECTIVE:Ischemic injury of axons is a feature of periventricular leukomalacia, a pathological correlate of cerebral palsy. Recent evidence suggests that axons are damaged before they receive the first layer of compact myelin. Here we examine the cellular mechanisms underlying ischemic-type injury of premyelinated cen...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.21767
更新日期:2009-11-01 00:00:00
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journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410060614
更新日期:1979-12-01 00:00:00
abstract::Cerebrospinal fluid (CSF) lymphocytes from three young patients undergoing acute exacerbations of multiple sclerosis were studied by flow cytometry. Using a new method that simultaneously measures cell-surface antigens and the cell-cycle phase, we determined that the CSF lymphocytes in these patients were activated. T...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410180617
更新日期:1985-12-01 00:00:00
abstract::After unilateral cortical lesions in neonatal rats, the spared unablated hemisphere is known to demonstrate remarkable neuroanatomical plasticity in corticofugal connectivity. This same type of structural plasticity is not seen after similar lesions in adult rats. One possibility for the lack of such a plastic respons...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/1531-8249(199906)45:6<778::aid-ana12>3.0.c
更新日期:1999-06-01 00:00:00
abstract::Regional patterns of cerebral glucose utilization (rCMRglc) and blood flow (rCBF) were examined in the early recovery period following transient forebrain ischemia in order to correlate early postischemic physiological events with regionally selective patterns of ischemic neuropathology. Wistar rats were subjected to ...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410180410
更新日期:1985-10-01 00:00:00
abstract:OBJECTIVE:To examine changes in the response properties of meningeal nociceptors that might lead to migraine pain and examine endogenous processes that could play a role in mediating them using a clinically relevant model of migraine triggering, namely infusion of the nitric oxide (NO) donor nitroglycerin (NTG). METHO...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.23873
更新日期:2013-06-01 00:00:00
abstract::Adult GM2 gangliosidosis is a rare disorder that often presents with both neurological and psychiatric syndromes. Effective treatment of the psychotic and affective symptoms associated with this disorder has been complicated by poor treatment response and the concern that many psychotropic agents may worsen the underl...
journal_title:Annals of neurology
pub_type: 杂志文章,评审
doi:10.1002/ana.410310320
更新日期:1992-03-01 00:00:00
abstract::Thirty patients in whom the initial diagnosis of multiple sclerosis was clinically entertained underwent cranial magnetic resonance imaging (MRI) in close temporal relationship to cranial x-ray computed tomography (CT), electrodiagnostic studies (visual evoked responses, brainstem auditory evoked responses, and somato...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410170509
更新日期:1985-05-01 00:00:00
abstract:OBJECTIVE:To examine the association between odor identification deficits and future mortality in a multiethnic community cohort of older adults. METHODS:Participants were evaluated with the 40-item University of Pennsylvania Smell Identification Test (UPSIT). Follow-up occurred at 2-year intervals with information on...
journal_title:Annals of neurology
pub_type: 杂志文章,随机对照试验
doi:10.1002/ana.24447
更新日期:2015-09-01 00:00:00