Psychomotor status: case reports and proposal for classification

Two cases with psychomotor status were reported. Case 1 is considered to have been seized with subjective seizure status which lasted 10 hours. Case 2 most likely suffered the typical psychomotor status which satisfies all of Heintel's criteria. The relationship between ictal patterns and EEG recordings was discussed and the classification proposed.     

A proposal for a five-dimensional patient-oriented epilepsy classification.

The recent proposal by the ILAE Task Force for Epilepsy Classification consists of a multi-axial syndrome-oriented approach. Epilepsy syndromes, as defined by the ILAE, group patients according to various, poorly defined parameters. The resulting syndromes have frequently no biological significance, with overlap among different syndromes and syndromes changing with age. Additionally, only a minority of patients can be classified syndromatically, and the axes of this classification system convey redundant information. We propose a five-dimensional, patient-oriented approach to classifying epilepsies. This approach shifts from the syndrome-oriented approach to a standard, neurological, methodological, patient-oriented approach, using independent criteria in each of the five dimensions. Similar to general neurology, the first step in each patient-physician encounter in epileptology is to take a history of the presenting symptoms and generate a hypothesis regarding the localization and etiology of the symptom within the nervous system. Therefore, the main dimensions of this classification consist of: 1) localization of the epileptogenic zone, 2) seizure semiology classified according to the semiological seizure classification, 3) etiology, 4) seizure frequency, and 5) related medical conditions. These dimensions characterize all of the information necessary for patient management, are independent parameters, and include more pertinent information with regards to patient management than the ILAE axes. All patients can be classified according to this five-dimensional system even at the initial patient encounter when no detailed test results are available. Information from clinical tests, such as MRI and EEG, are translated into the best possible working hypothesis at the time of classification, allowing for increasing precision of the classification as additional information becomes available. This patient-oriented classification envisions an epileptic seizure as an independent symptom of a central nervous system dysfunction due to different causes, with various cortical localizations, occurring at various frequencies, and in conjunction with other diseases and clinical symptoms.     

Acquired brain injury: a proposal for its definition, diagnostic criteria and classification

Acquired brain injury is a heterogeneous clinical concept that goes beyond the limits of the classical medical view, which tends to define processes and diseases on the grounds of a single causation. Although in the medical literature it appears fundamentally associated to traumatic brain injury, there are many other causes and management is similar in all of them, during the post-acute and chronic phases, as regards the measures to be taken concerning rehabilitation and attention to dependence. Yet, despite being an important health issue, today we do not have a set of diagnostic criteria or a classification for this condition. This is a serious handicap when it comes to carrying out epidemiological studies, designing specific care programmes and comparing results among different programmes and centres. Accordingly, the Extremadura Acquired Brain Injury Health Care Plan working group has drawn up these proposed diagnostic criteria, definition and classification. The proposal is intended to be essentially practical, its main purpose being to allow correct identification of the cases that must be attended to and to optimise the use of neurorehabilitation and attention to dependence resources, thereby ensuring attention is provided on a fair basis.     

Denial of pregnancy as a reproductive dysfunction: a proposal for international classification systems

OBJECTIVE: To propose a new Diagnostic and Statistical Manual (DSM) and International Classification of Diseases (ICD) category concerning reproductive dysfunctions not caused by organic disorder. METHODS: Forensic (n=93) and obstetrical cases (n=78) of denied and concealed pregnancies are compared and discussed. RESULTS: Denied pregnancies occur with a ratio of 1:475 births. An overwhelming phenomenological agreement is demonstrated between obstetrical and forensic cases. The findings were similar for denial and concealment of pregnancy, probably representing two different types of reproductive dysfunction that can be classified psychosocially together under the heading "negated pregnancy". CONCLUSIONS: Analogous to the phenomenology of "sexual dysfunctions", "reproductive dysfunctions" could be distinguished by the extraordinariness of both reproductive experience and behavior (as part of human sexuality) and psycho-physiological changes, which characterize the reproductive course of events and cause obvious suffering and interpersonal complications. It is therefore suggested to include these entities as categories in their own right under the appropriate existing headings in DSM and ICD.     

The fallopian canal: a comprehensive review and proposal of a new classification

Introduction

The facial nerve follows a complex course through the skull base. Understanding its anatomy is crucial during standard skull base approaches and resection of certain skull base tumors closely related to the nerve, especially, tumors at the cerebellopontine angle.

Methods

Herein, we review the fallopian canal and its implications in surgical approaches to the skull base. Furthermore, we suggest a new classification.

Conclusions

Based on the anatomy and literature, we propose that the meatal segment of the facial nerve be included as a component of the fallopian canal. A comprehensive knowledge of the course of the facial nerve is important to those who treat patients with pathology of or near this cranial nerve.     

神经元形态分类和命名的机制研究

The morphological and functional characteristics of neurons are quite varied and complex. There is a need for a comprehensive approach for distinguishing and classifying neurons. Similar to the biological species classification system, this study proposes a morphological classification system for neurons based on principal component analysis. Based on four principal components of neuronal morphology derived from principal component analysis, a nomenclature system for neurons was obtained. This system can accurately distinguish between the same type of neuron from different species.     

Epilepsy is a neurological and a systemic disorder

The basic pathophysiology of epilepsy is still not fully understood. Epidemiological evidence for epilepsy seems to suggest that it may not only be the propensity for seizures to occur. The high prevalence of comorbidity and the finding that premature mortality is still increased in those who are in long-term remission, suggest that there is a systemic component to the condition. This systemic component is an additional shared risk factor that can explain an important proportion of the comorbidities of epilepsy as well as how an individual with inactive epilepsy remains at an elevated risk of premature mortality. This systemic component can be viewed from the perspective of a number of fundamental pathophysiological processes: inflammation, oxidative stress, glycation, and methylation capacity. These processes are associated with all-cause mortality and there is also a growing understanding of their impact on seizure processes. We propose that epilepsy be considered as the sum of seizures and comorbidities caused by systemic dysfunction, and that the comprehensive management of epilepsy should also include the management of the systemic dysfunction.