4-19-08 Brain-stem auditory evoked potentials (BAEPs) in premature neonates. Late maturation of...
1
Headache S239 14-l 9-05 1 The influence of stress over evoked potentials in humans L.A.L. Resende, C.V. Faria, P.A.T. Kimaid, M.D. Silva, A.O. Schelp. Hospital das Clinicas Rubi Junior, Cx. P 566, Botucatu, SF: Brazil There are still many questions of how functional events interfere with evoked potentials in humans. It was studied the cortical evoked potentials of 14 medicin students from the last year of graduation course. The potentials were obtained before and after a 24 hours awake and stressful service in emergency room. The responses were compared with a control group of 9 sleepless students without stress. In the group submited to stress was registered an increase in latency of cortical evoked responses (PlOO visual wave; Ill, IV and V, brainstem response waves; P/N13, N19 and P22, somato-sensorial waves). The authors comment the possibility of temperature and sleepless influences over evoked responses. The results point to a clear interference of stress in cortical evoked potentials. The study contribute to the knowledge of insalubrtty of medical assistence in prolonged stressful situations. L-l 4 19 06 Event related potentials and reaction time in Cortical Dementia and Benign Senescent Forgetfulness M.J. Segura, C. Mangone, Silvia Pereyra, Ana De Pascale, Maria R. Nunez, R.E.P. Sica. Cortical Physiology Lab., Neurology, Ramos Mejia Hospital, Buenos Aires, Argentina Objective: To compare the diagnostic sensitivity of Simple (SRT) and Choice Reaction Time (CHRT), are Event Related Potentials (ERPs) in Cortical De- mentia of the Alzheimer Type (CDAT) and Bening Senescent Forgetiulness (BSF). Methods: We studied 11 controls (mean age: 61.27 f 9.65 years; MMS: 29.36 f 0.92), 16 patients with CDAT (mean age: 69.12 f 8.68 years; MMS: 19.73 f 4.81), and 6 patients with BSF (mean age: 66.86 f 9.01 years; MMS: 28.83 f 0.98). SRT stimuli were 3.5 Khz tones, while in CHRT an 80/20 merge of target (3.5 Khz) and standard tones (1.5 khz) was employed. Subjects had to press a button’ after each target tone and 25 succe&fdl responses were recorded in each trial. During the CHRT study auditory ERPs were recorded from Fz, Cz, and Pz (analysis time: 1000 ms; band-pass: 0.15 to 30 Hz). Results: CDAT patients showed delayed responses in the SRT (p c 0.02), CHRT (p < 0.003), N2 latency (p < 0.03) and P3 latency (p < 0.005). On the contrary BSF patients exhibited normal SRT and CHRT responses though half of them showed delayed P3 latencies. Conclusions: Our results suggest that CHRT (abnormal in 81% of patients) is more sensitive than ERPs (abnormal in 54%) to detect cognitive impairment in CDAT. Conversely BSF exhibits a different pattern of abnormalities with preserved Reaction Times but frequently abnormal ERPs. 14-l 9-07 1 Brainstem auditory evoked potentials in different types of brainstem ischemlc lesions M. Szolics, M. Szab6, A. Kondacs, 2. Szolnoki. Pdndy K&man County Hospital, Gyula, Hungary The aim of our study was to investigate brainstem auditory evoked potentials (BAEP) results in patients with different types of brainstem ischemic lesions. Methods: BAEPs were recorded with conventional method in 22 normal subjects and 221 patients with brainstem ischemic disease. Patients had dorso- lateral, oaramedian, multifocal lacunar stroke and permanent ischemic distur- bances: The absolute and interpeak latencies, (IPi I-V, I-III, Ill-V), amplitude ratios (V/I, V/III, Ill/l), Shape ratio SQRT (IV-V peak amplitude)/lll,-V, IPL x 10 and planar vect&s of BAEP were evaliated &atisticaily. Results: Significant differences were found between control and patient groups in I-V, III-V, I-III IPL, Shape ratio, Ill, V wave amplitudes and the lengths of the Ilp, Illn, Vn vectors. In the patient group normal BAEPs were found in 5% of cases (11). In 6.8% of cases (15) only latencies and 33.9% (75) only amplitude changes were abnormal. In 49.8% of cases (110) amplitude and latency abnormalities were found. The wave morphology, amplitudes, interpeak latencies, the shape ratio and vector lengths of BAEPs were different in dorsolateral, paramedian and basal vascular lesions. Conclusions: Our results showed that BAEP with planar vector analysis is a sensitive electrophysiological method in diagnosis of brainstem ischemic disturbances and can be useful in distinguishing between different types of brainstem vascular lesions. 14-l 9-08 1 Brain-stem auditory evoked potentials (BAEPs) in premature neonates. Late maturation of descending auditory pathways? Yuri Takeuchi, Hernln CNZ, Liliana Mayor, Luz M. Alzate. Servicio de Neurologia, Laboraforio de Neurofisioogla Clinica, Unidad de Recidn Nacidos, Fundacidn Valle de/ Lili, Cali, Colombia BAEPs have two important pediatric application: hearing assessment in neona- tal populations and determining brain stem function in newborn and children. The BAEPs demonstrates very definite maturational changes in newborns, and particularly in preterm infants. Age has proven not to be the sole determinant of newborn BAEPs latency, and it has been postulated that the BAEPs may actually be a measure of other critical factors influencing neurophysiological function and development. These maturing variables include wave form, wave latency, interpeak intervals, and relative Wave IN amplitude. BAEPs were recorded from 130 premature neonates (82 males, 48 fe- males), with conceptional ages between 32 weeks and 41 weeks. Integrity of peripheral auditory function was assumed by the presence of wave V of BAEPs at 20-30 dB nHL (referred to the click hearing threshold of normal adults). No significant difference was found in relation to ear side. Differences between two sex groups were altogether not significant. Age maturational changes were inconsistent; however, we found statistical significant differences between newborn with birth weight over and under 1500 gr. In our work, the amplitude of Ill wave appears as the most stable and consistent of the BAEPs (significant Pearson’s correlation coefficient between three independent observers). These findings has been reported in multiple sclerosis patients and suggest that the descending auditory pathways (cortico- olivary, p.e.) postnatal development occurs later than the ascending auditory pathways. 21 Headache 14-21-01 I Effectiveness of lamotrigine in the prophylaxis of migraine with aura. An open pilot study Giovanni D’Andrea, Franc0 Granella I. Dept. of Neurology, Este Hospital, Este (PD), Ita/,: ’ Institute of Neurology, University of Parma, Parma, ltaly Background and Objectives: It has been hypothesised that migraine aura could be due to a spreading depression related to an increased turnover of CNS glutamate. Lamotrigine, a new potent antiepileptic drug, seems to act blocking voltage-gated sodium channels, thus inhibiting glutamate release. Aim of this study was to assess the usefulness of lamotrigine in the prophylaxis of migraine with aura (MA). Methods: We selected 11 patients (IO female, 1 male; mean age 37.7 f 16.4 years) affected by MA with a high frequency of attacks. After a one- month run-in period, during which only symptomatic drugs were allowed, we administered lamotrigine (dosage: 25-50 mg bid) for 3 months. We evaluated frequency and intensity of the attacks and duration of both aura and pain phase by means of headache diaries. Results: One patient withdrew from the study because of the occurrence of a cutaneous rash. In the remaining IO patients, lamotrigine determined a significant (sign test: p = 0.004) reduction of attacks frequency (run-in: 5.4 f 4.5 attacks/month: 3” treatment month: 0.7 f 0.5 attacks/month). In 7 patients the aura completely disappeared, in 3 its duration was markedly reduced (run-in: 18.6 f 14.8 min; 3” treatment month: 10.9 f 6.5 min). The intensity of pain and the duration of headache of residual attacks remained unchanged. A marked somnolence was noted in one patient, while another had a weight increase. Conclusions: This small open pilot study suggests that lamotrigine could be an useful dNg in the treatment of the unusual MA with high frequency of attacks. Moreover, the results of our study seem to confirm the glutamatergic hypothesis of the pathophysiology of the aura. I 4 21 02 Efficacy and tolerability of sumatriptan tablets 50 mg in patients naive to sumatriptan A. Fazekas for the Study Group. Neurology Department, Szt lstvan Metropolitan Hospifal, Nagyvarad sq. l., Budapest, Hungary Objective: This double-blind, placebo-controlled, parallel-group study evalu- ated the efficacy and tolerability of sumatriptan 50 mg tablets in the acute treatment of migraine in patients naive to sumatriptan.
Transcript of 4-19-08 Brain-stem auditory evoked potentials (BAEPs) in premature neonates. Late maturation of...
Headache S239
14-l 9-05 1 The influence of stress over evoked potentials in humans
L.A.L. Resende, C.V. Faria, P.A.T. Kimaid, M.D. Silva, A.O. Schelp. Hospital das Clinicas Rubi Junior, Cx. P 566, Botucatu, SF: Brazil
There are still many questions of how functional events interfere with evoked potentials in humans. It was studied the cortical evoked potentials of 14 medicin students from the last year of graduation course. The potentials were obtained before and after a 24 hours awake and stressful service in emergency room. The responses were compared with a control group of 9 sleepless students without stress. In the group submited to stress was registered an increase in latency of cortical evoked responses (PlOO visual wave; Ill, IV and V, brainstem response waves; P/N13, N19 and P22, somato-sensorial waves). The authors comment the possibility of temperature and sleepless influences over evoked responses. The results point to a clear interference of stress in cortical evoked potentials. The study contribute to the knowledge of insalubrtty of medical assistence in prolonged stressful situations.
L-l 4 19 06 Event related potentials and reaction time in Cortical Dementia and Benign Senescent Forgetfulness
M.J. Segura, C. Mangone, Silvia Pereyra, Ana De Pascale, Maria R. Nunez, R.E.P. Sica. Cortical Physiology Lab., Neurology, Ramos Mejia Hospital, Buenos Aires, Argentina
Objective: To compare the diagnostic sensitivity of Simple (SRT) and Choice Reaction Time (CHRT), are Event Related Potentials (ERPs) in Cortical De- mentia of the Alzheimer Type (CDAT) and Bening Senescent Forgetiulness (BSF).
Methods: We studied 11 controls (mean age: 61.27 f 9.65 years; MMS: 29.36 f 0.92), 16 patients with CDAT (mean age: 69.12 f 8.68 years; MMS: 19.73 f 4.81), and 6 patients with BSF (mean age: 66.86 f 9.01 years; MMS: 28.83 f 0.98). SRT stimuli were 3.5 Khz tones, while in CHRT an 80/20 merge of target (3.5 Khz) and standard tones (1.5 khz) was employed. Subjects had to press a button’ after each target tone and 25 succe&fdl responses were recorded in each trial. During the CHRT study auditory ERPs were recorded from Fz, Cz, and Pz (analysis time: 1000 ms; band-pass: 0.15 to 30 Hz).
Results: CDAT patients showed delayed responses in the SRT (p c 0.02), CHRT (p < 0.003), N2 latency (p < 0.03) and P3 latency (p < 0.005). On the contrary BSF patients exhibited normal SRT and CHRT responses though half of them showed delayed P3 latencies.
Conclusions: Our results suggest that CHRT (abnormal in 81% of patients) is more sensitive than ERPs (abnormal in 54%) to detect cognitive impairment in CDAT. Conversely BSF exhibits a different pattern of abnormalities with preserved Reaction Times but frequently abnormal ERPs.
14-l 9-07 1 Brainstem auditory evoked potentials in different types of brainstem ischemlc lesions
M. Szolics, M. Szab6, A. Kondacs, 2. Szolnoki. Pdndy K&man County Hospital, Gyula, Hungary
The aim of our study was to investigate brainstem auditory evoked potentials (BAEP) results in patients with different types of brainstem ischemic lesions.
Methods: BAEPs were recorded with conventional method in 22 normal subjects and 221 patients with brainstem ischemic disease. Patients had dorso- lateral, oaramedian, multifocal lacunar stroke and permanent ischemic distur- bances: The absolute and interpeak latencies, (IPi I-V, I-III, Ill-V), amplitude ratios (V/I, V/III, Ill/l), Shape ratio SQRT (IV-V peak amplitude)/lll,-V, IPL x 10 and planar vect&s of BAEP were evaliated &atisticaily.
Results: Significant differences were found between control and patient groups in I-V, III-V, I-III IPL, Shape ratio, Ill, V wave amplitudes and the lengths of the Ilp, Illn, Vn vectors. In the patient group normal BAEPs were found in 5% of cases (11). In 6.8% of cases (15) only latencies and 33.9% (75) only amplitude changes were abnormal. In 49.8% of cases (110) amplitude and latency abnormalities were found. The wave morphology, amplitudes, interpeak latencies, the shape ratio and vector lengths of BAEPs were different in dorsolateral, paramedian and basal vascular lesions.
Conclusions: Our results showed that BAEP with planar vector analysis is a sensitive electrophysiological method in diagnosis of brainstem ischemic disturbances and can be useful in distinguishing between different types of brainstem vascular lesions.
14-l 9-08 1 Brain-stem auditory evoked potentials (BAEPs) in premature neonates. Late maturation of descending auditory pathways?
Yuri Takeuchi, Hernln CNZ, Liliana Mayor, Luz M. Alzate. Servicio de Neurologia, Laboraforio de Neurofisioogla Clinica, Unidad de Recidn Nacidos, Fundacidn Valle de/ Lili, Cali, Colombia
BAEPs have two important pediatric application: hearing assessment in neona- tal populations and determining brain stem function in newborn and children. The BAEPs demonstrates very definite maturational changes in newborns, and particularly in preterm infants. Age has proven not to be the sole determinant of newborn BAEPs latency, and it has been postulated that the BAEPs may actually be a measure of other critical factors influencing neurophysiological function and development. These maturing variables include wave form, wave latency, interpeak intervals, and relative Wave IN amplitude.
BAEPs were recorded from 130 premature neonates (82 males, 48 fe- males), with conceptional ages between 32 weeks and 41 weeks. Integrity of peripheral auditory function was assumed by the presence of wave V of BAEPs at 20-30 dB nHL (referred to the click hearing threshold of normal adults).
No significant difference was found in relation to ear side. Differences between two sex groups were altogether not significant. Age maturational changes were inconsistent; however, we found statistical significant differences between newborn with birth weight over and under 1500 gr.
In our work, the amplitude of Ill wave appears as the most stable and consistent of the BAEPs (significant Pearson’s correlation coefficient between three independent observers). These findings has been reported in multiple sclerosis patients and suggest that the descending auditory pathways (cortico- olivary, p.e.) postnatal development occurs later than the ascending auditory pathways.
21 Headache
14-21-01 I Effectiveness of lamotrigine in the prophylaxis of migraine with aura. An open pilot study
Giovanni D’Andrea, Franc0 Granella I. Dept. of Neurology, Este Hospital, Este (PD), Ita/,: ’ Institute of Neurology, University of Parma, Parma, ltaly
Background and Objectives: It has been hypothesised that migraine aura could be due to a spreading depression related to an increased turnover of CNS glutamate. Lamotrigine, a new potent antiepileptic drug, seems to act blocking voltage-gated sodium channels, thus inhibiting glutamate release. Aim of this study was to assess the usefulness of lamotrigine in the prophylaxis of migraine with aura (MA).
Methods: We selected 11 patients (IO female, 1 male; mean age 37.7 f 16.4 years) affected by MA with a high frequency of attacks. After a one- month run-in period, during which only symptomatic drugs were allowed, we administered lamotrigine (dosage: 25-50 mg bid) for 3 months. We evaluated frequency and intensity of the attacks and duration of both aura and pain phase by means of headache diaries.
Results: One patient withdrew from the study because of the occurrence of a cutaneous rash. In the remaining IO patients, lamotrigine determined a significant (sign test: p = 0.004) reduction of attacks frequency (run-in: 5.4 f 4.5 attacks/month: 3” treatment month: 0.7 f 0.5 attacks/month). In 7 patients the aura completely disappeared, in 3 its duration was markedly reduced (run-in: 18.6 f 14.8 min; 3” treatment month: 10.9 f 6.5 min). The intensity of pain and the duration of headache of residual attacks remained unchanged. A marked somnolence was noted in one patient, while another had a weight increase.
Conclusions: This small open pilot study suggests that lamotrigine could be an useful dNg in the treatment of the unusual MA with high frequency of attacks. Moreover, the results of our study seem to confirm the glutamatergic hypothesis of the pathophysiology of the aura.
I 4 21 02 Efficacy and tolerability of sumatriptan tablets 50 mg in patients naive to sumatriptan
A. Fazekas for the Study Group. Neurology Department, Szt lstvan Metropolitan Hospifal, Nagyvarad sq. l., Budapest, Hungary
Objective: This double-blind, placebo-controlled, parallel-group study evalu- ated the efficacy and tolerability of sumatriptan 50 mg tablets in the acute treatment of migraine in patients naive to sumatriptan.
