Future directions in the neuropsychology of epilepsy

Two important themes for future clinical research in the neuropsychology of epilepsy are proposed: (1) the neurobiological abnormalities that underlie neuropsychological impairment in people with epilepsy, and (2) neuropsychological status of persons with new-onset epilepsy.     

Neurocognitive sequelae of a giant arachnoid cyst: case study

We conducted a comprehensive neuropsychological evaluation of a normally functioning man with a giant arachnoid cyst encompassing much of the space normally occupied by the left hemisphere. Although of solidly average intellectual ability, the patient demonstrated neurocognitive deficits only revealed upon neuropsychological assessment. Despite the remarkable left hemisphere lesion, the pattern of cognitive dysfunction suggested right hemisphere pathology. We review the arachnoid cyst literature and discuss the possibility of a crowding phenomenon by which language function relocates to the more viable hemisphere. This case illustrates striking preservation of higher cognition in the presence of substantial structural abnormality.     

Feverfew as a preventive treatment for migraine: a systematic review

Background : Feverfew is a popular herbal remedy advocated for the prevention of migraine. Aim : The aim of this systematic review was to look at the evidence for or against the clinical effectiveness of feverfew in migraine prevention. Data sources : Literature searches were performed using the following databases: Medline, Embase, Biosis, CISCOM, and the Cochrane Library (all from their inception to April 1998). Study selection : Only randomized, placebo-controlled, double-blind trials were included. Data extraction : All articles were read by two independent reviewers. Data were extracted in a predefined, standardized fashion. The methodological quality of all trials was evaluated using the Jadad score. Main results : Five trials met the inclusion/exclusion criteria. The majority favor feverfew over placebo. Yet important caveats exist. Conclusion : The clinical effectiveness of feverfew in the prevention of migraine has not been established beyond reasonable doubt.     

SEASON OF BIRTH IN DOWN'S SYNDROME

SUMMARY Previous studies have found a summer peak in the birth of individuals with Down's syndrome but have not tended to examine them into adulthood. The aims of this study were to look for evidence of a seasonal effect in birth and to uncover any differences in adulthood between those born in different seasons. The casenotes of all adults with Down's syndrome from the catchment area of a hospital for people with learning disability were examined. A summer peak in births was confirmed. Only 6% of births took place during January and February compared with the 17% expected (P=0.019); birth during these 2 months was associated with female sex (P=0.047). There was a trend for those born in December to March not to develop epilepsy (P=0.053).     

Bony inlet stenosis as a cause of nasal airway obstruction

Two cases of congenital bony stenosis of the nasal piriform aperture (anterior nares) are presented. Both patients experienced episodes of respiratory distress and clinical symptoms similar to those seen in patients with posterior choanal atresia. The underlying anatomic abnormalities in congenital bony inlet stenosis are quite different from those in choanal atresia and require different surgical approaches for correction. Computed tomography demonstrates in detail the underlying anatomic abnormality and allows differentiation of bony inlet stenosis from choanal atresia.