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Psychophysiological characteristics of patients with alcohol epileptic syndrome
304
Posters session 3 / International Journal of Psychophysiology 69 (2008) 276–316
Clinical and psychophysiological algorithm for the diagnosis of intoxication episyndrome A.G. Soloviev a, T.V. Elistratova b a Northern State Medical University, Institute of Psychology and Psychiatry, Arkhangelsk, Russia b Central Medical-Sanitary Unit № 58, Severodvinsk, Russia The tendency for increased use of strong drinks results in increased number of alcohol-associated somatic and neurological disorders including increased frequency of epileptic syndrome (ES) occurrence. With the goal to increase effectiveness of ES differential diagnosis, the algorithm of evaluation of results of clinical and psychophysiological examination has been presented. Hereditary epileptic taint in anamnesis, attacks during sleep (more often at 4 and 8 a.m.), epiphenomena: disorders of falling asleep, «deja vu», «meja vu», dreadful stereotypic colorful dreams, speaking in dreams, walking in dreams, febrile convulsions in childhood, a changed personality of epitype (circumstantiality, emotional viscosity, unbalance) wee most peculiar to persons with idiopathic epilepsy, and a previous craniocerebral injury allowed to suspect symptomatic epilepsy. For intoxication ES, it was typical that patients who abused alcohol, were registered at a narcologist's and had only daytime primary generalized attacks (attacks during sleep exclude intoxication genesis). During clinical examination of patients with ES with suspected intoxication, focal and meningeal symptoms were not detected, and polyneuropathy of lower extremities and abstinent syndrome occurred in 90% of cases. Alcoholic ES laboratory markers were increased activity of gammaglutamylpeptidase, aspartate and alanintransferase, if the level of bilirubin was allowable and liquor was not changed. EEG epileptic activity without focal symptoms said for idiopathic epilepsy, and presence of focal symptoms revealed symptomatic epilepsy; brain low bioelectric activity, diffusive changes, overlapping of muscular tremor, plural artifacts connected with frequent sialophagia and winking occurred in 95% of cases of intoxication ES. Cysts, gliosis, tumors, hemorrhages detected with the method of computer tomography showed symptomatic epilepsy; mixed hypotrophic hydrocephalus was diagnosed in 85% of cases of intoxication ES. Thus, the presented consistent study of clinical and psychophysiological diagnostic criteria gave a possibility of early detection of intoxication ES for improvement of emergency care quality. The work has been supported by the Russian Humane Scientific Fund (RHSF), Project № 07-06-48618а/c. doi:10.1016/j.ijpsycho.2008.05.304
Psychophysiological characteristics of patients with alcohol epileptic syndrome T.V. Elistratova, P.I. Sidorov Central Medical-Sanitary Unit № 58, Severodvinsk, Russia Epileptic attacks in alcohol withdrawal syndrome (AWS) appear in connection with cancellation of alcohol use in the first 12–72 h of abstinence. Differential diagnosis of alcohol epileptic syndrome (AES) with idiopathic and symptomatic is very urgent. The goal of the study was to examine the electroencephalogram (EEG) of patients with AES, 251 persons (18–76 years old): I group included 89 patients with AES — with primary generalized attacks of wakefulness and ААS symptoms without brain limited organic injuries in anamnesis; in II group — with non-alcoholic ES: II-а subgroup included 22 persons with — symptomatic — with primary generalized and secondary generalized attacks of sleep and wakefulness and brain
organic limited injuries (cerebrocranial injuries, insults, tumors in anamnesis) with ААS symptoms; in II-b — 56 — with idiopathic — with primary and secondary generalized attacks of sleep and wakefulness without АWS symptoms; III gr. — comparisons — 84 neurological patients without ES and АWS. EEG of all the patients in I gr. had the following characteristics: lowamplitude alpha-rhythm with absent zonal differences and modulations as well as regular dominating activity; diffuse changes in the form of slow waves from the delta range above both brain hemispheres, high frequency beta-rhythm primarily in frontal abductions; record of several artifacts; overlapping of “muscular tremor” and “floating electrodes” as AAS manifestation; epileptic and focal slow wave activity was not present on any EEG, but reduced activation after hyperventilation, photo- and phonostimulation has been detected. Thus, EEG of the patients with AES besides the change of the amplitude-frequency indices towards slowing, applanation and irregularity of the main rhythm, diffuse onset of excessive number of slow waves, were characterized by rarely occurring paroxysmal activity, absence of epileptic activity, decreased activation reaction to hyperventilation, photo- and phonostimulation, overlapping of “muscular tremor” and artifacts, that did not occur practically in patients with idiopathic and symptomatic epilepsies, this can be used as an additional criterion of AES differential diagnosis. The work has been supported by the Russian Humane Scientific Fund (RHSF), Project № 07-06-48618а/c. doi:10.1016/j.ijpsycho.2008.05.305
Development of music perception by patients with cochlear implants Je.A. Ogorodnikova a, I.V. Koroleva b, Ja. Ross c a Pavlov Institute of Physiology, Psychophysiology Language Behavior Department, St. Petersburg, Russia b Herzen University, Human Anathomy and Physiology Department, St. Petersburg, Russia c University of Tartu, Tartu, Estonia Cochlear implantation is the most effective method in the rehabilitation of deaf patients. The surgically implantable device provides hearing sensation by substitute of damaged sensory cells and transforming sound energy into electrical energy that will initiate impulses in the auditory nerve. The devise of cochlear implants (CI) have been designed primarily to enhance speech recognition, but have some limitations for processing melodic characteristics of sounds, which is based on subjective measurement of fundamental frequency (F0) that is the objective correlate of the pitch. Not completely auditory estimation of the F0 determines difficulties in perception of intonation and melody in speech prosody and in music performance. But rehabilitation of CI patients directed mainly on the development of speech recognition. It is a very important communicative function, but there are many other sounds in our acoustical environment. Among them music plays special role and many patients anticipate enjoying music following the implantation. Obviously the development of music perception with CI should be directed on testing and training of skill to perceive some basic features in complex sounds for their discrimination and correct recognition. It should actuate the study of music perception with CI and the development of training procedures for auditory analysis of musical signals. The aim of experiments is the comparative study of CI-perception of pitch, timbre and rhythmic pattern of musical signals. The study was conducted at the Institute of ENT and Speech in St. Petersburg with participation of 25 patients with CI (Combi 40/40+ or Opus-2 by MED-EL). Psychophysical procedure (by means of the computerized
Posters session 3 / International Journal of Psychophysiology 69 (2008) 276–316
Clinical and psychophysiological algorithm for the diagnosis of intoxication episyndrome A.G. Soloviev a, T.V. Elistratova b a Northern State Medical University, Institute of Psychology and Psychiatry, Arkhangelsk, Russia b Central Medical-Sanitary Unit № 58, Severodvinsk, Russia The tendency for increased use of strong drinks results in increased number of alcohol-associated somatic and neurological disorders including increased frequency of epileptic syndrome (ES) occurrence. With the goal to increase effectiveness of ES differential diagnosis, the algorithm of evaluation of results of clinical and psychophysiological examination has been presented. Hereditary epileptic taint in anamnesis, attacks during sleep (more often at 4 and 8 a.m.), epiphenomena: disorders of falling asleep, «deja vu», «meja vu», dreadful stereotypic colorful dreams, speaking in dreams, walking in dreams, febrile convulsions in childhood, a changed personality of epitype (circumstantiality, emotional viscosity, unbalance) wee most peculiar to persons with idiopathic epilepsy, and a previous craniocerebral injury allowed to suspect symptomatic epilepsy. For intoxication ES, it was typical that patients who abused alcohol, were registered at a narcologist's and had only daytime primary generalized attacks (attacks during sleep exclude intoxication genesis). During clinical examination of patients with ES with suspected intoxication, focal and meningeal symptoms were not detected, and polyneuropathy of lower extremities and abstinent syndrome occurred in 90% of cases. Alcoholic ES laboratory markers were increased activity of gammaglutamylpeptidase, aspartate and alanintransferase, if the level of bilirubin was allowable and liquor was not changed. EEG epileptic activity without focal symptoms said for idiopathic epilepsy, and presence of focal symptoms revealed symptomatic epilepsy; brain low bioelectric activity, diffusive changes, overlapping of muscular tremor, plural artifacts connected with frequent sialophagia and winking occurred in 95% of cases of intoxication ES. Cysts, gliosis, tumors, hemorrhages detected with the method of computer tomography showed symptomatic epilepsy; mixed hypotrophic hydrocephalus was diagnosed in 85% of cases of intoxication ES. Thus, the presented consistent study of clinical and psychophysiological diagnostic criteria gave a possibility of early detection of intoxication ES for improvement of emergency care quality. The work has been supported by the Russian Humane Scientific Fund (RHSF), Project № 07-06-48618а/c. doi:10.1016/j.ijpsycho.2008.05.304
Psychophysiological characteristics of patients with alcohol epileptic syndrome T.V. Elistratova, P.I. Sidorov Central Medical-Sanitary Unit № 58, Severodvinsk, Russia Epileptic attacks in alcohol withdrawal syndrome (AWS) appear in connection with cancellation of alcohol use in the first 12–72 h of abstinence. Differential diagnosis of alcohol epileptic syndrome (AES) with idiopathic and symptomatic is very urgent. The goal of the study was to examine the electroencephalogram (EEG) of patients with AES, 251 persons (18–76 years old): I group included 89 patients with AES — with primary generalized attacks of wakefulness and ААS symptoms without brain limited organic injuries in anamnesis; in II group — with non-alcoholic ES: II-а subgroup included 22 persons with — symptomatic — with primary generalized and secondary generalized attacks of sleep and wakefulness and brain
organic limited injuries (cerebrocranial injuries, insults, tumors in anamnesis) with ААS symptoms; in II-b — 56 — with idiopathic — with primary and secondary generalized attacks of sleep and wakefulness without АWS symptoms; III gr. — comparisons — 84 neurological patients without ES and АWS. EEG of all the patients in I gr. had the following characteristics: lowamplitude alpha-rhythm with absent zonal differences and modulations as well as regular dominating activity; diffuse changes in the form of slow waves from the delta range above both brain hemispheres, high frequency beta-rhythm primarily in frontal abductions; record of several artifacts; overlapping of “muscular tremor” and “floating electrodes” as AAS manifestation; epileptic and focal slow wave activity was not present on any EEG, but reduced activation after hyperventilation, photo- and phonostimulation has been detected. Thus, EEG of the patients with AES besides the change of the amplitude-frequency indices towards slowing, applanation and irregularity of the main rhythm, diffuse onset of excessive number of slow waves, were characterized by rarely occurring paroxysmal activity, absence of epileptic activity, decreased activation reaction to hyperventilation, photo- and phonostimulation, overlapping of “muscular tremor” and artifacts, that did not occur practically in patients with idiopathic and symptomatic epilepsies, this can be used as an additional criterion of AES differential diagnosis. The work has been supported by the Russian Humane Scientific Fund (RHSF), Project № 07-06-48618а/c. doi:10.1016/j.ijpsycho.2008.05.305
Development of music perception by patients with cochlear implants Je.A. Ogorodnikova a, I.V. Koroleva b, Ja. Ross c a Pavlov Institute of Physiology, Psychophysiology Language Behavior Department, St. Petersburg, Russia b Herzen University, Human Anathomy and Physiology Department, St. Petersburg, Russia c University of Tartu, Tartu, Estonia Cochlear implantation is the most effective method in the rehabilitation of deaf patients. The surgically implantable device provides hearing sensation by substitute of damaged sensory cells and transforming sound energy into electrical energy that will initiate impulses in the auditory nerve. The devise of cochlear implants (CI) have been designed primarily to enhance speech recognition, but have some limitations for processing melodic characteristics of sounds, which is based on subjective measurement of fundamental frequency (F0) that is the objective correlate of the pitch. Not completely auditory estimation of the F0 determines difficulties in perception of intonation and melody in speech prosody and in music performance. But rehabilitation of CI patients directed mainly on the development of speech recognition. It is a very important communicative function, but there are many other sounds in our acoustical environment. Among them music plays special role and many patients anticipate enjoying music following the implantation. Obviously the development of music perception with CI should be directed on testing and training of skill to perceive some basic features in complex sounds for their discrimination and correct recognition. It should actuate the study of music perception with CI and the development of training procedures for auditory analysis of musical signals. The aim of experiments is the comparative study of CI-perception of pitch, timbre and rhythmic pattern of musical signals. The study was conducted at the Institute of ENT and Speech in St. Petersburg with participation of 25 patients with CI (Combi 40/40+ or Opus-2 by MED-EL). Psychophysical procedure (by means of the computerized