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Cerebral electrical activity and spatial concepts acquisition in deaf girl
Abstracts of the 5th Latin American Congress of Clinical Neurophysiology / Clinical Neurophysiology 119 (2008), S143–S177 between trophism and binocular P2 (p=0.04); age and N2 right (p=0.04), N2 left (p=0.03), and binocular N2 (p=0.008); older children did not presented shorter latencies. No statistically significant differences of VEP were observed with gender, condition at birth and encephalopathy type. Discussion: The age and trophism at birth had influences on VEP, variability was observed in the latencies of visual responses. No reduction of latencies of VEP were found as children aged (as reported in the literature), probably due by the influence of the PE. Relevance. The VEP in children that suffer some type of neurological damage in the perinatal stage has demonstrated to be useful to evaluate the functional compromise. Keywords: Visual evoked potentials; Light emitting diodes; Goggle; Perinatal encephalopathy; Development; Children
P02.3 Quantitative electroencephalogram (QEEG) and gender identity disorders (GID) L. Rojas, L. Aquino-Cías, R. Aneiros-Riba, L. Hernández-Coterón, P. Cañizares Hospital Universitario Especializado en Psiquiatría Infanto-Juvenil “Clínica del Adolescente”, Ciudad de la Habana, Cuba, Jefe de Departamento de Neurofisiología Clínica, 5ta Ave, No. 3804 entre 38 y 40, Miramar, Playa, Ciudad de la Habana, Cuba Objective: To evaluate QEEG from children and adolescents with GID diagnosed. To compare results from normative data obtained from statistical software (made ad hoc for this purpose), and between subgroups of patients. Methods: The QEEG of 58 subjects between 6 and 19 years old with GID diagnosed by two different psychiatric according to DSM-IV were analyzed and compared with the normal standard data of MEDICID software, significant values were 2SD above or below Z transformed. According to the specialist who diagnosed them, were separated in two subgroups. To evaluate differences t-student test with p values less than 0.05 was applied. Results: We observe a smooth of the power spectrum measures with alpha frequency peak inverse. Broad band analysis showed total absolute and alpha powers globally diminished. Statistical differences between subgroups were not found. Conclusions: Disturbs in QEEG of child and adolescents with GID could be related with maturational process in cerebral electrogenesis or other unknown factors. Significance: Quantitative electroencephalogram brings elements to support a neurobiological essence in GID patients. Keywords: Quantitative electroencephalogram; Gender identity disorders; Cerebral differences
P02.4 Alpha rhythm during generation of visual afterimages L.A Uresti-Cabrera 1 , D. Granados-Ramos 1 , G. Romero-Esquiliano 2 , V.M. Alcaraz-Romero 1 , A. Contreras-Martínez 1 , V.H. Gálvez-Zúñiga 1 1 Laboratorio de Psicobiología, Facultad de Psicología-Xalapa, Universidad Veracruzana; 2 Universidad Autónoma Metropolitana-Xochimilco Objective: To identify changes in the cerebral electrical activity in visual afterimages in healthy adult subjects. Material and methods: Experimental study with 8 masculine right subjects of 18 to 22 years old. 3 visual stimuli were showed: green, red and blue, putting white screens before and blacks later. When closing eyes indicated generation (AG) and suppression of afterimage (AS). Absolute power (AP) was analyzed using ANOVA. Results: We found significant differences in stimuli green and red comparing AG and AS. Green stimulus in Pz (p < 0.04), O1 (p < 0.02), O2 (p < 0.02) and Oz (p < 0.02). Red stimulus in C4 (p < 0.04), P4 (p < 0.04), O1 (p < 0.04), T3 (p < 0.02) and T5 (p < 0.05). In Cerebral Mapping (CM) greater left voltage was observed during AG, in red C3, P3; in blue O1, T3, T5; in green P3, T5. During AS in red P3, O1, T5; in blue C3, T3; in green P3. Discussion: Desynchronization of alpha rhythm could be observed in AP of cortical posterior regions and greater left voltage in CM during afterimages.
S169
Significance: In perception of auto-generated images could be observed changes of alpha activity in healthy subjects this allow to evaluate differences in diverse conditions of disease. Keywords: Visual afterimages; Cerebral electrical activity; Visual perception.
P02.5 Value of early sequential electroencephalogram (EEG) in neonates with hypoxic ischemic encephalopathy (HIE) C. Díaz Martínez “Dr. Agostinho Neto” General Hospital, Guantánamo, Cuba Objectives: To perform early sequential EEGs in neonates with HIE and compare the findings with neurodevelopmental outcome. Methods: 15 full-term neonates with HIE had polygraphic studies within 12 h of birth. The EEG was repeated at 24 h intervals. All surviving infants had a neurodevelopmental assessment at 1 year. Results: 4 infants had a normal or mildly abnormal EEG within 12 h of birth and neurodevelopmental outcome was normal. 13 infants had severely depressed background activity in the first 12 h of life. In 6 of these infants the EEG activity recovered within 24h showing continuous activity with no or only minor abnormalities. All these infants had a normal outcome. The remaining 7 infants subsequently developed severe background abnormalities. At follow-up, 1 infant had died and the remainder developed major neurological sequelae. Conclusions: Early EEG is an excellent prognostic tool in HIE. If it is normal within the first 12 h is indicator for a favourable outcome. If it continues clearly abnormal beyond 24 h of life the outcome is poor. Significance: Rapid detection of neonates at neurological risk leads to implementation of early neurological rehabilitation strategies to prevent nervous system complications. Keywords: EEG; Hipoxic-ischemic encephalopathy; Neurodevelopment
P02.6 Early electrophysiological evaluation of central auditory pathway and peripheral nerves in patients with alcoholism C. Díaz Martínez “Dr. Agostinho Neto” General Hospital, Guantánamo, Cuba Objectives: There are few reports exploring objectively the effect of alcoholism over nervous system (NS) at the first stages of alcoholism. Methods: 50 alcoholic patients with a recent diagnosis of alcoholism and without clinical signs of central or peripheral NS lesions were evaluated. Brain Auditory Evoked Potential (BAEP) and Nerve Conduction Studies (NCS) on median, ulnar, peroneal and sural nerves were performed. The results were compared to those obtained in 50 normal controls. Descriptive statistic and ANOVA test were carried out. Results: 24 cases (48%) showed a significant I-V interpeak latency prolongation. 41 % of nerves showed at least one pathological parameter. Axonal alterations predominated. The motor and sensitive nerves were damaged but the alterations were most remarkable in sensitive nerves. 19 patients (38%) were diagnosed with light polyneuropathy. Conclusions: Toxic effects of alcohol affect significantly the activity of central auditory via and peripheral nerves even at the first stages of alcoholism. Relevance: Electrophysiological techniques could be very useful to reveal early NS dysfunctions when clinical signs are difficult to identify. Key words: Alcoholism; Nervous system; Brain auditory evoked potentials; Nerve conduction studies
P02.7 Cerebral electrical activity and spatial concepts acquisition in deaf girl A. Olivera-Ventura 1 , D. Granados-Ramos 1 , G. Romero-Esquiliano 2 , V.M. Alcaraz-Romero 1 , R. Martínez-Aguirre 1 , A. Uresti-Cabrera 1 1 Laboratorio de Psicobiología, Facultad de Psicología-Xalapa, Universidad Veracruzana; 2 Universidad Autónoma Metropolitana-Xochimilco Objective: To describe cerebral electrical activity and acquisition of spatial concepts in congenital deaf girl.
S170
Abstracts of the 5th Latin American Congress of Clinical Neurophysiology / Clinical Neurophysiology 119 (2008), S143–S177
Material and methods: Cerebral Mapping (CM) and evaluation of spatial concepts were made in two moments (difference of 8 months) to 9 years 4 months girl with secondary deep deafness to gestational rubella, auditory prosthesis and learning of signs at 4 years old. Results: First CM: Greater absolute power (AP) Delta and Theta in left parietal and greater relative power (RP) Theta in left parietal and Delta in frontals and occipitals. Second CM: Greater AP Delta and Theta in right frontal, left occipital and central; greater RP in bilateral frontal. From eight concepts she expressed: high-low, in-on, up-down; in second evaluation increased open-close. Discussion: It was observed different cerebral organization. In spatial concepts she showed delay because in the deaf child has been shown these are acquired at 6 years old. The cerebral electrical activity in auditory alteration and the delayed signs learning could influence in concepts acquisition. Significance: Know about functional expression of brain in auditory deprivation and its relation with learning. Keywords: Cerebral mapping; Absolute power; Relative power; Deaf; Spatial concepts
P02.8 Electromyographic alterations of swallowing muscles in amyotrophic lateral sclerosis M.L. Rengifo-Varona Clinica Universitaria Teleton, Universidad de la sabana, Chia, Colombia Amyotrophic lateral sclerosis (ALS) is associated with oropharyngeal dysphagia (OD) when the onset is bulbar or at the late stages of the disease, being a risk factor to respiratory complications, principal cause of mortality in ALS. Methods: A descriptive study was realized with the purpose to evaluate the condition of the swallowing muscles (SM) in ALS patients. After signing the consent form; a needle electromyography of SM (EMGSM) was realized to eleven patients of the Clínica Universitaria Teletón, between January/06 and march/08, with a confirmed ALS diagnosis of less than 3 months. Results: 9 out of 11 patients presented alteration of the EMGSM tested at rest and during swallowing, with reduced interference pattern, positive sharp waves, fibrillations, fasciculations, decreased recruitment and polyphasic motor unit potentials. Where 3 of these patients reported OD symptoms, and 2 of them had ALS with bulbar onset. Discussion and Significance: These findings suggest that ALS patients have compromise of the SM since the initial stages of the disease, with a subclinic OD; therefore the EMGSM should be an important part of the electrodiagnosis study that facilitates early diagnosis, aiming to delay respiratory complications with the aid of the proper rehabilitation treatment to improve patients’ quality of life. Keywords: Electromyography; Swallowing muscles; Amyotrophic lateral sclerosis
P02.9 Hearing disability in newborns discharged from an intensive care unit A.E. Díaz Riverol Facultad de Ciencias Médicas, Hospital Pediátrico Provincial “José Martí”, Sancti Spíritus, Cuba Objectives: The objective was to describe the clinical-epidemiological characteristics and lab results from patients discharged from the UCI service. Methods: The sample was made up of 154 newborns discharged from Intensive Therapy, who met the inclusion criteria established. Informed consent was obtained in all cases. The study variables were age at the time of screening, sex, type and intensity of hearing loss, affected ear and risk factors of hearing disability. Results: The most common period of screening was before the third month of life (77.9%). Male sex prevailed over the female. According to the distribution of hearing losses by type and intensity, the greatest percent was found in mild conductive hypoacusias for a 65.6%, and the bilateral ones occupied a 43.7% when related to the affected ear. The most common risk factors were prematurity, use gentamycin, sepsis and hyperbilirrubinemia, and in regard to the results of the PEATC positivity was obtained in 32 cases,
with 3 of them being neurosensorial hypoacusias, one moderate and two bilateral. Conclusions: Through this research it can be concluded that the early detection of this pathology is the most important aspect to be taken into account. Keywords: Hypoacusia; Newborn; Risk factors; Auditory evoked potentials
P02.10 Electromagnetic tomography methods for epileptogenic zone localization in pharmacoresistant focal epilepsy patients L. Morales-Chacón, O Trapaga Quincoses, M.A. Bobes, J. Iglesias, Y. Santos, R. Rodríguez, I. Garcia, J. Bender, B. Estupiñán, A. Sánchez, M. Zaldivar Internacional Center for Neurological Restoration, Cuban Neuroscience Center, Havana, Cuba Purpose: The aim of the present study was to determine the usefulness of electromagnetic tomography methods, using individual Magnetic Resonance Imaging (MRI) in pharmacoresistant focal epilepsy in order to localize the epileptogenic zone. Methods: Electrographic seizure onsets were recorded in 14 focal epilepsy patients (8 with temporal lobe seizure and 6 with extratemporal one). Video EEG was recorded during 7-18 days of telemetry monitoring). Ictal EEG patterns were categorized according to morphology, frequency and topography. We applied a time-frequency analysis and EEG inverse solutions using LORETA and BAYESIAN methods. The patient’s volumetric MRI was used in order to create the volume space where the inverse solutions were adjusted. These methods were developed in the Cuban Neuroscience Center. The correctness of the source localization results was determined by comparing them with those of other neuroimaging and postoperative outcome data (Engel Scale). We also presented the relationship with histopathology findings in operated patients. Results: Different patterns of electrical activity at the onset of seizures were observed. In temporal lobe epilepsy patient the ictal EEG pattern was characterized by rhythmic activity in delta and theta/alfa frequency band, as well as repetitive discharges, whereas the extratemporal epilepsy patients exhibited a rhythmic alpha-beta pattern. The results of time-frequency analysis based on wavelets morlet and Source Spectral was determined in the time for each electrode. The inverse solution calculated on each individual brain in the frequency domain allowed the localization of the intracerebral generators from the scalp EEG in each point of time of the window analysis. In TLE we observed mesial and mesiolateral generators with correct lateralization and localization in 88.8% and 55.6% respectively. In patients with histopathological diagnosis of microscopic temporal dual pathology, the generators were located mesiolateral and lateral. A correct lateralization and localization were obtained in 100% of the patients with extratemporal pharmacoresistant epilepsy. Conclusion: The methods of electromagnetic tomography applied to ictal EEG patterns, adjustedfittings on individual MRI provides excellent localization information in pharmacoresistant focal epilepsy, especially for extratemporal epilepsy.
P02.11 Incidence of the Carpal Tunnel Syndrome in patients with fibromyalgia L. Acevedo González Hospital General, Caracas, Venezuela The Carpal Tunnel Syndrome (CTS) is an entity that can be found with frequency in patients with fibromyalgia (FM), to verify this, double blind, prospective, comparative study was made in the National Medical Rehabilitation Institute in Caracas, Venezuela, between May and September 2005. Results: From 31 female patients, between 18 and 65 years old, physical exam and median nerve conduction was applied. There were 18 with FM and 13 without it. The CTS was found in 44.44% from fibromyalgia patients and 69% from patients without FM. Conclusions: The CTS was found in fibromyalgia patients with non significative frequency in comparison with general population. Keywords: Fibromyalgia; Carpal Tunnel Syndrome
P02.3 Quantitative electroencephalogram (QEEG) and gender identity disorders (GID) L. Rojas, L. Aquino-Cías, R. Aneiros-Riba, L. Hernández-Coterón, P. Cañizares Hospital Universitario Especializado en Psiquiatría Infanto-Juvenil “Clínica del Adolescente”, Ciudad de la Habana, Cuba, Jefe de Departamento de Neurofisiología Clínica, 5ta Ave, No. 3804 entre 38 y 40, Miramar, Playa, Ciudad de la Habana, Cuba Objective: To evaluate QEEG from children and adolescents with GID diagnosed. To compare results from normative data obtained from statistical software (made ad hoc for this purpose), and between subgroups of patients. Methods: The QEEG of 58 subjects between 6 and 19 years old with GID diagnosed by two different psychiatric according to DSM-IV were analyzed and compared with the normal standard data of MEDICID software, significant values were 2SD above or below Z transformed. According to the specialist who diagnosed them, were separated in two subgroups. To evaluate differences t-student test with p values less than 0.05 was applied. Results: We observe a smooth of the power spectrum measures with alpha frequency peak inverse. Broad band analysis showed total absolute and alpha powers globally diminished. Statistical differences between subgroups were not found. Conclusions: Disturbs in QEEG of child and adolescents with GID could be related with maturational process in cerebral electrogenesis or other unknown factors. Significance: Quantitative electroencephalogram brings elements to support a neurobiological essence in GID patients. Keywords: Quantitative electroencephalogram; Gender identity disorders; Cerebral differences
P02.4 Alpha rhythm during generation of visual afterimages L.A Uresti-Cabrera 1 , D. Granados-Ramos 1 , G. Romero-Esquiliano 2 , V.M. Alcaraz-Romero 1 , A. Contreras-Martínez 1 , V.H. Gálvez-Zúñiga 1 1 Laboratorio de Psicobiología, Facultad de Psicología-Xalapa, Universidad Veracruzana; 2 Universidad Autónoma Metropolitana-Xochimilco Objective: To identify changes in the cerebral electrical activity in visual afterimages in healthy adult subjects. Material and methods: Experimental study with 8 masculine right subjects of 18 to 22 years old. 3 visual stimuli were showed: green, red and blue, putting white screens before and blacks later. When closing eyes indicated generation (AG) and suppression of afterimage (AS). Absolute power (AP) was analyzed using ANOVA. Results: We found significant differences in stimuli green and red comparing AG and AS. Green stimulus in Pz (p < 0.04), O1 (p < 0.02), O2 (p < 0.02) and Oz (p < 0.02). Red stimulus in C4 (p < 0.04), P4 (p < 0.04), O1 (p < 0.04), T3 (p < 0.02) and T5 (p < 0.05). In Cerebral Mapping (CM) greater left voltage was observed during AG, in red C3, P3; in blue O1, T3, T5; in green P3, T5. During AS in red P3, O1, T5; in blue C3, T3; in green P3. Discussion: Desynchronization of alpha rhythm could be observed in AP of cortical posterior regions and greater left voltage in CM during afterimages.
S169
Significance: In perception of auto-generated images could be observed changes of alpha activity in healthy subjects this allow to evaluate differences in diverse conditions of disease. Keywords: Visual afterimages; Cerebral electrical activity; Visual perception.
P02.5 Value of early sequential electroencephalogram (EEG) in neonates with hypoxic ischemic encephalopathy (HIE) C. Díaz Martínez “Dr. Agostinho Neto” General Hospital, Guantánamo, Cuba Objectives: To perform early sequential EEGs in neonates with HIE and compare the findings with neurodevelopmental outcome. Methods: 15 full-term neonates with HIE had polygraphic studies within 12 h of birth. The EEG was repeated at 24 h intervals. All surviving infants had a neurodevelopmental assessment at 1 year. Results: 4 infants had a normal or mildly abnormal EEG within 12 h of birth and neurodevelopmental outcome was normal. 13 infants had severely depressed background activity in the first 12 h of life. In 6 of these infants the EEG activity recovered within 24h showing continuous activity with no or only minor abnormalities. All these infants had a normal outcome. The remaining 7 infants subsequently developed severe background abnormalities. At follow-up, 1 infant had died and the remainder developed major neurological sequelae. Conclusions: Early EEG is an excellent prognostic tool in HIE. If it is normal within the first 12 h is indicator for a favourable outcome. If it continues clearly abnormal beyond 24 h of life the outcome is poor. Significance: Rapid detection of neonates at neurological risk leads to implementation of early neurological rehabilitation strategies to prevent nervous system complications. Keywords: EEG; Hipoxic-ischemic encephalopathy; Neurodevelopment
P02.6 Early electrophysiological evaluation of central auditory pathway and peripheral nerves in patients with alcoholism C. Díaz Martínez “Dr. Agostinho Neto” General Hospital, Guantánamo, Cuba Objectives: There are few reports exploring objectively the effect of alcoholism over nervous system (NS) at the first stages of alcoholism. Methods: 50 alcoholic patients with a recent diagnosis of alcoholism and without clinical signs of central or peripheral NS lesions were evaluated. Brain Auditory Evoked Potential (BAEP) and Nerve Conduction Studies (NCS) on median, ulnar, peroneal and sural nerves were performed. The results were compared to those obtained in 50 normal controls. Descriptive statistic and ANOVA test were carried out. Results: 24 cases (48%) showed a significant I-V interpeak latency prolongation. 41 % of nerves showed at least one pathological parameter. Axonal alterations predominated. The motor and sensitive nerves were damaged but the alterations were most remarkable in sensitive nerves. 19 patients (38%) were diagnosed with light polyneuropathy. Conclusions: Toxic effects of alcohol affect significantly the activity of central auditory via and peripheral nerves even at the first stages of alcoholism. Relevance: Electrophysiological techniques could be very useful to reveal early NS dysfunctions when clinical signs are difficult to identify. Key words: Alcoholism; Nervous system; Brain auditory evoked potentials; Nerve conduction studies
P02.7 Cerebral electrical activity and spatial concepts acquisition in deaf girl A. Olivera-Ventura 1 , D. Granados-Ramos 1 , G. Romero-Esquiliano 2 , V.M. Alcaraz-Romero 1 , R. Martínez-Aguirre 1 , A. Uresti-Cabrera 1 1 Laboratorio de Psicobiología, Facultad de Psicología-Xalapa, Universidad Veracruzana; 2 Universidad Autónoma Metropolitana-Xochimilco Objective: To describe cerebral electrical activity and acquisition of spatial concepts in congenital deaf girl.
S170
Abstracts of the 5th Latin American Congress of Clinical Neurophysiology / Clinical Neurophysiology 119 (2008), S143–S177
Material and methods: Cerebral Mapping (CM) and evaluation of spatial concepts were made in two moments (difference of 8 months) to 9 years 4 months girl with secondary deep deafness to gestational rubella, auditory prosthesis and learning of signs at 4 years old. Results: First CM: Greater absolute power (AP) Delta and Theta in left parietal and greater relative power (RP) Theta in left parietal and Delta in frontals and occipitals. Second CM: Greater AP Delta and Theta in right frontal, left occipital and central; greater RP in bilateral frontal. From eight concepts she expressed: high-low, in-on, up-down; in second evaluation increased open-close. Discussion: It was observed different cerebral organization. In spatial concepts she showed delay because in the deaf child has been shown these are acquired at 6 years old. The cerebral electrical activity in auditory alteration and the delayed signs learning could influence in concepts acquisition. Significance: Know about functional expression of brain in auditory deprivation and its relation with learning. Keywords: Cerebral mapping; Absolute power; Relative power; Deaf; Spatial concepts
P02.8 Electromyographic alterations of swallowing muscles in amyotrophic lateral sclerosis M.L. Rengifo-Varona Clinica Universitaria Teleton, Universidad de la sabana, Chia, Colombia Amyotrophic lateral sclerosis (ALS) is associated with oropharyngeal dysphagia (OD) when the onset is bulbar or at the late stages of the disease, being a risk factor to respiratory complications, principal cause of mortality in ALS. Methods: A descriptive study was realized with the purpose to evaluate the condition of the swallowing muscles (SM) in ALS patients. After signing the consent form; a needle electromyography of SM (EMGSM) was realized to eleven patients of the Clínica Universitaria Teletón, between January/06 and march/08, with a confirmed ALS diagnosis of less than 3 months. Results: 9 out of 11 patients presented alteration of the EMGSM tested at rest and during swallowing, with reduced interference pattern, positive sharp waves, fibrillations, fasciculations, decreased recruitment and polyphasic motor unit potentials. Where 3 of these patients reported OD symptoms, and 2 of them had ALS with bulbar onset. Discussion and Significance: These findings suggest that ALS patients have compromise of the SM since the initial stages of the disease, with a subclinic OD; therefore the EMGSM should be an important part of the electrodiagnosis study that facilitates early diagnosis, aiming to delay respiratory complications with the aid of the proper rehabilitation treatment to improve patients’ quality of life. Keywords: Electromyography; Swallowing muscles; Amyotrophic lateral sclerosis
P02.9 Hearing disability in newborns discharged from an intensive care unit A.E. Díaz Riverol Facultad de Ciencias Médicas, Hospital Pediátrico Provincial “José Martí”, Sancti Spíritus, Cuba Objectives: The objective was to describe the clinical-epidemiological characteristics and lab results from patients discharged from the UCI service. Methods: The sample was made up of 154 newborns discharged from Intensive Therapy, who met the inclusion criteria established. Informed consent was obtained in all cases. The study variables were age at the time of screening, sex, type and intensity of hearing loss, affected ear and risk factors of hearing disability. Results: The most common period of screening was before the third month of life (77.9%). Male sex prevailed over the female. According to the distribution of hearing losses by type and intensity, the greatest percent was found in mild conductive hypoacusias for a 65.6%, and the bilateral ones occupied a 43.7% when related to the affected ear. The most common risk factors were prematurity, use gentamycin, sepsis and hyperbilirrubinemia, and in regard to the results of the PEATC positivity was obtained in 32 cases,
with 3 of them being neurosensorial hypoacusias, one moderate and two bilateral. Conclusions: Through this research it can be concluded that the early detection of this pathology is the most important aspect to be taken into account. Keywords: Hypoacusia; Newborn; Risk factors; Auditory evoked potentials
P02.10 Electromagnetic tomography methods for epileptogenic zone localization in pharmacoresistant focal epilepsy patients L. Morales-Chacón, O Trapaga Quincoses, M.A. Bobes, J. Iglesias, Y. Santos, R. Rodríguez, I. Garcia, J. Bender, B. Estupiñán, A. Sánchez, M. Zaldivar Internacional Center for Neurological Restoration, Cuban Neuroscience Center, Havana, Cuba Purpose: The aim of the present study was to determine the usefulness of electromagnetic tomography methods, using individual Magnetic Resonance Imaging (MRI) in pharmacoresistant focal epilepsy in order to localize the epileptogenic zone. Methods: Electrographic seizure onsets were recorded in 14 focal epilepsy patients (8 with temporal lobe seizure and 6 with extratemporal one). Video EEG was recorded during 7-18 days of telemetry monitoring). Ictal EEG patterns were categorized according to morphology, frequency and topography. We applied a time-frequency analysis and EEG inverse solutions using LORETA and BAYESIAN methods. The patient’s volumetric MRI was used in order to create the volume space where the inverse solutions were adjusted. These methods were developed in the Cuban Neuroscience Center. The correctness of the source localization results was determined by comparing them with those of other neuroimaging and postoperative outcome data (Engel Scale). We also presented the relationship with histopathology findings in operated patients. Results: Different patterns of electrical activity at the onset of seizures were observed. In temporal lobe epilepsy patient the ictal EEG pattern was characterized by rhythmic activity in delta and theta/alfa frequency band, as well as repetitive discharges, whereas the extratemporal epilepsy patients exhibited a rhythmic alpha-beta pattern. The results of time-frequency analysis based on wavelets morlet and Source Spectral was determined in the time for each electrode. The inverse solution calculated on each individual brain in the frequency domain allowed the localization of the intracerebral generators from the scalp EEG in each point of time of the window analysis. In TLE we observed mesial and mesiolateral generators with correct lateralization and localization in 88.8% and 55.6% respectively. In patients with histopathological diagnosis of microscopic temporal dual pathology, the generators were located mesiolateral and lateral. A correct lateralization and localization were obtained in 100% of the patients with extratemporal pharmacoresistant epilepsy. Conclusion: The methods of electromagnetic tomography applied to ictal EEG patterns, adjustedfittings on individual MRI provides excellent localization information in pharmacoresistant focal epilepsy, especially for extratemporal epilepsy.
P02.11 Incidence of the Carpal Tunnel Syndrome in patients with fibromyalgia L. Acevedo González Hospital General, Caracas, Venezuela The Carpal Tunnel Syndrome (CTS) is an entity that can be found with frequency in patients with fibromyalgia (FM), to verify this, double blind, prospective, comparative study was made in the National Medical Rehabilitation Institute in Caracas, Venezuela, between May and September 2005. Results: From 31 female patients, between 18 and 65 years old, physical exam and median nerve conduction was applied. There were 18 with FM and 13 without it. The CTS was found in 44.44% from fibromyalgia patients and 69% from patients without FM. Conclusions: The CTS was found in fibromyalgia patients with non significative frequency in comparison with general population. Keywords: Fibromyalgia; Carpal Tunnel Syndrome