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H reflex and S1 radiculopathy
B-3.06 H REFLEX AND SI RADICULOPATHY. ruah (Milwaukee, Wis, USA)
J.K. Ba-
It is known that in SI radiculopathy, the H reflex latency is prolonged but in a small percentage of cases remains normal. We have analysed the amplitudes, duration and configuration of the reflex in thelattergroup. Twenty-one patients (25-65 years; 12M, 9F) clinically suggestive of unilateral Sl radiculopathy, were studied. The values were compared with the H reflexes from the unaffected lower extremities and from a control group. In all these groups the H reflex latencies were However, the duration of the reflexes normal. was markedly prolonged (16 2 1.5 msec) as comoared to the oooosite limb (13 f 0.9 msec) in the same individual or to the controls (12 f. The amplitudes (3 ;t 0.5 mV) of the 1.3 msec). H reflexes were found to be significantly different from the opposite limbs (6 + 0.9 mV) or the controls (7 f 1.1 msec). The configuration of the H reflexes were also very helpful; on the affected side the reflexes showed one of the following abnormalities-notched, wavy or polyAll these patients were confirmed to phasic. have SI radiculopathy by radiology (CT scan & Thus,from this study myelogram) and surgery. it could be concluded that besides the latencies, the morphology of H reflexes is often helpful in the diagnosis of SI radiculopathy. B-18.02 CUTANEOUS REFLEX RESPONSES AND CENTRAL NERVOUS LESIONS IN MAN. B.H.G. Choa and J.A. Stephens (London, G.B.) Cutaneous reflex responses have been recorded from first dorsal interosseous and tibialisanterior muscles by stimulating the index finger and first and second toes respectively. In normal subjects the response in first dorsal interosseous muscles is triphasic, consisting of early excitation (El) and inhibition (11) at spinal latency followed by late excitation (E2) with a latency compatible with a transcortical pathway being involved. In the lower limb the pattern is more variable. The early components (El and 11) are usually not visible and E2 mav be followed bv inhibitorv and excitatory components at even longer latenc-ies. In patients with multiple sclerosis, upper limb cutaneous reflexes show three general types of change. First, there may be prolongation of the latency to the onset of E2 attributable to central conduction delay. Secondly, E2 may be attenuated or absent, typically in association with an exaggerated El, a pattern seen with increasing pyramidal involvement. Finallv, no reflex mav be elicitabTe. attributable perhaps to central desynchronisation. In the lower limb latency changes have been less consistently observed, but the presence of a prominent El is a reliable guide to pyramidal dysfunction. In severe pyramidal lesions this
is the only component
present.
C-14.02 EEG AND CLINICAL FOLLOW-UP OF EPILEPTIC PATIENTS AFTER TEMPORAL'LOBECTOMY. L. Karaguiosov, S. Avramov, K. Karaguiosov (Sofia, Bulgaria) Thirty-one patients with different forms of temporal lobe epilepsy, confirmed by investigations in clinical conditions, have been submitted to In all cases the dynamics temporal lobectomy. of pre- and postoperative EEG activity were Intraoperative electrocorticography studied. and subcorticography was applied. Preoperative investigations and observation on the best medication continued for at least 3 months, and postoperatively in the hospital for 2 months. Then they underwent control examinations every 3 months, for an average period of 2 years. Total EEG records were 346, averaging more than 10 per patient, 116 of them after the operation (averaging 4.5per patient). All records were submitted to visual and some to amplitude and Comparison of.the clinical frequency analysis. and EEG results led us to formulate the following preliminary conclusions: 1. About 36% of the operated are seizure-free and 24% have considerable improvement. 2. A significant improvement in the organization of electrical activity is observed after temporal lobectomy, in some patients within the normal range for their age. 3. The clinical and EEG data correlate highly, mainly in seizure-free and improved groups of patients.
C-8.01 EEG DEVELOPMENT DURING THE FIRST YEAR OF SPECTRAL AND COHERENCE ANALYSIS. C. FaiLIFE. enza and C. Capone (Parma, Italy) Five polygraphic records in normal babies aged from 33 wks of conceptional age to 12 months were studied by means of spectral and coherence analysis, to estimate the development of electrical brain activity. Spectral Analysis: at the age of 33 wks only one significant peak, at delta frequency (0.7-1.05 c/set), can be seen. During older ages, significant peaks appear at different frequencies: delta (1.5-3.5 c/set), theta (3.5-7.5 c/set), alpha 1 (7.5-9.5 c/set). Coherence Analysis: at the age of 33 wks the value of the coherence factor is lowest in all frequency bands, both in sleep stages 1 and 2. At the age of 40 and 50 wks the coherence factor increases progressively, especially in delta activity. It is also possible to recognize the two different stages of sleep. At 5 and I2 months the coherence factor appears high in all frequencies with significant peaks in delta and theta activity and 13-14 c/set (spindles); the whole period of sleep is differentiated in 4 phases of non-REM and REM activity. The spatial coordinates of tridimensional plots are: time, horizontal axis; frequency fields, oblique axis; coherence factor, vertical axis.
J.K. Ba-
It is known that in SI radiculopathy, the H reflex latency is prolonged but in a small percentage of cases remains normal. We have analysed the amplitudes, duration and configuration of the reflex in thelattergroup. Twenty-one patients (25-65 years; 12M, 9F) clinically suggestive of unilateral Sl radiculopathy, were studied. The values were compared with the H reflexes from the unaffected lower extremities and from a control group. In all these groups the H reflex latencies were However, the duration of the reflexes normal. was markedly prolonged (16 2 1.5 msec) as comoared to the oooosite limb (13 f 0.9 msec) in the same individual or to the controls (12 f. The amplitudes (3 ;t 0.5 mV) of the 1.3 msec). H reflexes were found to be significantly different from the opposite limbs (6 + 0.9 mV) or the controls (7 f 1.1 msec). The configuration of the H reflexes were also very helpful; on the affected side the reflexes showed one of the following abnormalities-notched, wavy or polyAll these patients were confirmed to phasic. have SI radiculopathy by radiology (CT scan & Thus,from this study myelogram) and surgery. it could be concluded that besides the latencies, the morphology of H reflexes is often helpful in the diagnosis of SI radiculopathy. B-18.02 CUTANEOUS REFLEX RESPONSES AND CENTRAL NERVOUS LESIONS IN MAN. B.H.G. Choa and J.A. Stephens (London, G.B.) Cutaneous reflex responses have been recorded from first dorsal interosseous and tibialisanterior muscles by stimulating the index finger and first and second toes respectively. In normal subjects the response in first dorsal interosseous muscles is triphasic, consisting of early excitation (El) and inhibition (11) at spinal latency followed by late excitation (E2) with a latency compatible with a transcortical pathway being involved. In the lower limb the pattern is more variable. The early components (El and 11) are usually not visible and E2 mav be followed bv inhibitorv and excitatory components at even longer latenc-ies. In patients with multiple sclerosis, upper limb cutaneous reflexes show three general types of change. First, there may be prolongation of the latency to the onset of E2 attributable to central conduction delay. Secondly, E2 may be attenuated or absent, typically in association with an exaggerated El, a pattern seen with increasing pyramidal involvement. Finallv, no reflex mav be elicitabTe. attributable perhaps to central desynchronisation. In the lower limb latency changes have been less consistently observed, but the presence of a prominent El is a reliable guide to pyramidal dysfunction. In severe pyramidal lesions this
is the only component
present.
C-14.02 EEG AND CLINICAL FOLLOW-UP OF EPILEPTIC PATIENTS AFTER TEMPORAL'LOBECTOMY. L. Karaguiosov, S. Avramov, K. Karaguiosov (Sofia, Bulgaria) Thirty-one patients with different forms of temporal lobe epilepsy, confirmed by investigations in clinical conditions, have been submitted to In all cases the dynamics temporal lobectomy. of pre- and postoperative EEG activity were Intraoperative electrocorticography studied. and subcorticography was applied. Preoperative investigations and observation on the best medication continued for at least 3 months, and postoperatively in the hospital for 2 months. Then they underwent control examinations every 3 months, for an average period of 2 years. Total EEG records were 346, averaging more than 10 per patient, 116 of them after the operation (averaging 4.5per patient). All records were submitted to visual and some to amplitude and Comparison of.the clinical frequency analysis. and EEG results led us to formulate the following preliminary conclusions: 1. About 36% of the operated are seizure-free and 24% have considerable improvement. 2. A significant improvement in the organization of electrical activity is observed after temporal lobectomy, in some patients within the normal range for their age. 3. The clinical and EEG data correlate highly, mainly in seizure-free and improved groups of patients.
C-8.01 EEG DEVELOPMENT DURING THE FIRST YEAR OF SPECTRAL AND COHERENCE ANALYSIS. C. FaiLIFE. enza and C. Capone (Parma, Italy) Five polygraphic records in normal babies aged from 33 wks of conceptional age to 12 months were studied by means of spectral and coherence analysis, to estimate the development of electrical brain activity. Spectral Analysis: at the age of 33 wks only one significant peak, at delta frequency (0.7-1.05 c/set), can be seen. During older ages, significant peaks appear at different frequencies: delta (1.5-3.5 c/set), theta (3.5-7.5 c/set), alpha 1 (7.5-9.5 c/set). Coherence Analysis: at the age of 33 wks the value of the coherence factor is lowest in all frequency bands, both in sleep stages 1 and 2. At the age of 40 and 50 wks the coherence factor increases progressively, especially in delta activity. It is also possible to recognize the two different stages of sleep. At 5 and I2 months the coherence factor appears high in all frequencies with significant peaks in delta and theta activity and 13-14 c/set (spindles); the whole period of sleep is differentiated in 4 phases of non-REM and REM activity. The spatial coordinates of tridimensional plots are: time, horizontal axis; frequency fields, oblique axis; coherence factor, vertical axis.