颞叶癫痫患者磁共振质子波谱与脑电图的关系

目的 探讨颞叶癫痫患者的磁共振质子波谱(1H-MRS)与动态脑电图和MRI之间的关系.方法 对入组的38例颞叶癫痫患者均行1H-MRS、常规MRI和动态脑电图检测,以16例健康儿童作为对照.根据MRI结果进行分组:单、双侧海马硬化组及非海马硬化组,计算各组病灶侧和病灶对侧的NAA/(Cr+Cho)、NAA/Cr和NAA/Cho并进行比较,同时分析脑电图中癫痫样放电情况.结果 38例患者中有14例MRI发现海马硬化(比例 为36.8%),31例1H-MRS异常(比例为81.6%),双侧、单侧海马硬化组病灶侧和病灶对侧及非海马硬化组病灶侧的上述3个指标均高于正常对照组(P＜0.05);38例患者中有27例动态脑电图异常,27例动态脑电图异常中有17例与1H-MRS的定位一致,二者的符合率为62.9%.结论 1H-MRS较MRI诊断海马硬化及对癫痫灶定侧的敏感性高;1H-MRS和动态脑电图在癫痫灶的定位中具有一致性.     

慢性酒精中毒患者的脑电图分析

目的 分析慢性酒精中毒患者的脑电图表现.方法 对38例慢性酒精中毒患者按国际标准10～20系统头皮电极放置法进行常规脑电图检查.结果 76%存在脑电图异常,其中轻度异常16例(55%),中度异常12例(41%),重度异常脑电图1例.脑电图异常改变特征为波形不规则,调节、调幅差,θ、δ慢活动呈弥散性分布.结论 慢性酒精中毒对脑功能影响和脑组织损害是弥散性的.     

脑血栓形成的脑电图诊断

目的 分析脑电图在形成诊断中的意义.方法 使用ND-82B型8导脑电图机,对我院2008-02～2010-02收治的脑血栓形成125例患者进行脑电图分析.结果 本组125例,脑电图正常36例(28.8%),异常89例(71.2%),且脑电图异常侧和临床病变侧均相一致.结论 脑血栓形成时的脑电图异常虽有慢波波幅低、较局限、波形较规则、背景活动的异常程度轻等特点,但非特异性,而脑电图的动态观察还是诊断及鉴别诊断的最好方法.另外,进行性脑血栓时,脑电图改变比临床症状先出现,有利于对进行性脑血栓形成的早期发现.     

尿毒症患者肾移植前后的脑电图分析

目的 探讨尿毒症患者肾移植前后脑电图变化与临床的关系.方法 对38例尿毒症患者肾移植前、术后1个月及1年的脑电图进行分析,并结合相关文献讨论.结果 尿毒症患者肾移植前脑电图异常率71.1%,肾移植术后1个月脑电图异常率为42.1%,术后1年脑电图异常率为7.9%.结论 尿毒症患者行肾移植术后,随着肾功能逐渐恢复,血中代谢产物清除,脑组织和脑脊液内环境稳定,脑电图逐渐恢复正常     

轻度认知损害老年患者脑干听觉反应、P300及脑电图的研究

目的 探讨轻度认知损害(MCI)患者的脑干听觉反应(BAEP)、事件相关电位(ERP)P300和脑电图(EEG)的特点,为早期痴呆的诊断提供帮助。方法 对38例MCI患者(MCI组)、26例阿尔茨海默病(AD)患者(AD组)进行BAEP和P300、EEC检查,并与20名健康老年人(健康组)作比较。结果 BAEP检查:MCI组与AD组左侧Ⅰ、Ⅱ波的差异均有显著性,P<0.05;MCI组与健康组比较,左、右侧Ⅳ、Ⅴ波的差异有显著性,P<0.05;AD组与健康组比较,左侧Ⅰ-Ⅳ波及右侧Ⅳ、Ⅴ波的差异均有非常显著性(P<0.01),右侧Ⅰ波差异有显著性(P<0.05)。P300检查,MCI组与AD组只在潜伏期的Pz点差异有显著性(P<0.05);MCI组与健康组在潜伏期Cz点差异有显著性(P<0.05);AD组与健康组比较,潜伏期的Fz、Cz、Pz点差异均有非常显著性(P<0.01),波幅的Cz点差异有显著性(P<0.05)。EEG显示,MCI组未见明显异常的18例,轻度异常17例,中度异常3例;AD组未见明显异常的1例,轻度异常8例,轻-中度异常9例,中度异常8例。结论 P300潜伏期的Pz点的改变可能有助于区分MCI和AD,而右侧Ⅳ、Ⅴ波的延长提示MCI患者可能有早期痴呆;EEG左侧颞部θ波增多提示MCI患者可能有早期AD。     

阿尔茨海默氏病与血管性痴呆临床特点的对照研究

目的比较阿尔茨海默氏病（AD）与血管性痴呆（VD）的临床特点。方法对39例AD和38例VD患者的精神行为症状特点、伴随的躯体疾病、头颅CT检查以及脑电图检查进行比较。结果AD组与VD组在幻觉、妄想等精神病性症状方面无明显差异,在抑郁、焦虑等情绪障碍以及行为脱抑制方面有显著差异;AD组伴随的躯体疾病无明显特异性,VD组多伴发高血压、冠心病;AD组头颅CT多表现为脑萎缩,VD组多表现为脑梗塞;脑电图检查AD组无明显特异性,VD组界限脑电图居多。结论AD与VD患者的BPSD及所伴随的躯体疾病可有不同特点,CT和脑电图的检查等对痴呆的诊断与鉴别诊断均具有重要价值。     

各型注意缺陷多动障碍患者脑电图的改变

目的 探讨各型注意缺陷多动障碍(ADHD)患者脑电图的改变.方法 对152例临床诊断为ADHD患儿进行脑电图检查,采用视听整合连续性测试(IVA-CPT)对ADHD进行分型,分析各型ADHD患儿的脑电图改变.结果 本组患儿脑电图正常108例(71.1％),异常44例(28.9％),脑电图异常改变均为非特异性.IVA-CPT检查示正常18例(11.8％),注意缺陷为主型41例(27.0％),多动/冲动为主型27例(17.8％),混合型40例(26.3％),多动无效26例(17.1％).脑电图异常率在注意缺陷为主型为25.0％,多动/冲动为主型为18.2％,混合型为18.2％;各型患儿的脑电图异常率差别均无统计学意义.结论 ADHD患儿脑电图改变无特殊性;不同亚型间脑电图异常率基本相似.     

50例灭鼠药中毒患者脑电图观察分析

目的 通过对灭鼠中毒患者脑电图的观察、分析,了解灭鼠药对中枢神经系统的损害.方法 选择50例灭鼠药中毒病例的脑电图进行观察、分析.结果 脑电图异常率明显高于正常.结论 灭鼠药对中枢神经系统有影响,脑电图异常程度与临床病情严重程度相符.     

84例病毒性脑炎的脑电图、脑脊液、头颅CT及临床分析

目的　回顾分析脑电图对病毒性脑炎的早期协助诊断价值以及脑电图结合脑脊液、头颅CT及临床资料对病毒性脑炎的早期诊断价值。方法　分析治愈的 84例病毒性脑炎患者住院 2 4h内的脑电图、腰穿结果 (脑压、脑脊液外观、常规、生化检查 )、头颅CT以及复查的腰穿结果及临床资料。结果　 84例病毒性脑炎患者住院 2 4h内的脑电图异常 77例 ,其中 9例腰穿正常 ;同期腰穿异常结果中以脑压增高例数最多 ( 68例 ) ,其EEG均不正常。EEG和腰穿的检出结果比较有非常显著性差异 ( χ2 =7 11,P <0 0 1) ;头颅CT异常 3 2例。 84例CSF的糖和氯化物初查及复查均正常。临床症状以头痛 ( 82例 )、发热 ( 76例 )最常见。结论　脑电图对病毒性脑炎的早期协助诊断有重要价值。以发热头痛为主症而且脑电图异常 ,结合CSF的压力、细胞数、蛋白的增高、氯化物正常、糖正常或偶有轻度增高及典型病史 ,病毒性脑炎的诊断基本可以确定     

感冒后病毒性脑炎28例脑电图分析

目的 研究脑电图检测对感冒后病毒性脑炎在临床诊断中的作用。方法 选择28例均有感冒病史，且出现脑炎症状的患者分别多次进行脑电图检测。结果 28例均为异常，其中轻度异常18例（64．3％），中度异常8例（28．6％），重度异常2例（7．1％），5d后正常6例（21.4％），10d后正常24例（85．7％）。结论 患者临床症状越重，则脑电图异常程度越高，且脑电图检查结果在不同病期，其改变也不同，初期脑电图异常程度较轻，发病期脑电图异常程度重，恢复期脑波逐渐好转，而脑电图恢复比临床好转较慢。脑电图检查对脑炎较敏感，阳性率高。对早期诊断、早期治疗、观察病情、估计预后均有帮助。     

Denervation study of synapses of organ of corti of old world monkeys

Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system.     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

Limits of deinstitutionalization--perspectives of relatives of psychiatric patients

After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.