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Comparative Study 2009; 30(4): 487-490 PubMed PMID: 20010487 Citation  Keywords:  Adult, Binomial Distribution, Child, Electroencephalography:standards, Epilepsy:diagnosis, Humans, Magnetic Resonance Imaging:standards, Reproducibility of Results, Retrospective Studies, Risk Factors, Tomography, X-Ray Computed:standards,.   

BACKGROUND: The occurrence of the first unprovoked epileptic seizure always requires thorough examination. The risk of incorrect diagnosis is high, non-epileptic seizures represent 20-33% of newly diagnosed cases. The aim of the study is to evaluate findings of various modifications of EEG examination in the group of patients who experienced solitary unprovoked epileptic seizure and compare benefits of CT and MRI examination of the brain of these patients.

MATERIAL AND METHODS: The group involved 84 patients hospitalized at the 1st Department of Neurology , Faculty of Medicine, Comenius University in Bratislava between January 1997 and January 2007 after experiencing unprovoked epileptic seizure. It is a retrospective analysis of information from medical records and clinical documentation. For statistic comparing of benefits of various modifications of EEG examination and between CT and MRI examination of the brain binomic test of proportion was used.

RESULTS: Interictal epileptiform EEG graphoelements in native EEG was recorded only in 14.29% of patients. Statistically significantly more epileptiform graphoelements comparing EEG and EEG after sleep deprivation of the patient (SD) with one- hour recording was recorded with 24-hour 8 channels EEG monitoring after SD, EEG after SD with one- hour recording was of no significance comparing to native EEG. MRI examination of the brain was statistically more significant comparing to CT examination.

CONCLUSION: Low catchment of epileptiform EEG graphoelements in patients with solitary unprovoked seizure shows the importance of precise history in diagnostics of these patients. Though EEG is a very important examination it is an auxiliary one. We confirmed that MRI examination in patients who experienced solitary unprovoked epileptic seizure is undoubtedly the first choice method....

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Case Reports 2008; 29(1): 67-68 PubMed PMID: 18283251 Citation  Keywords:  Brain:blood supply, Creutzfeldt-Jakob Syndrome:diagnostic imaging, Diagnosis, Differential, Female, Fluorodeoxyglucose F18:metabolism, Humans, Middle Aged, Positron-Emission Tomography:methods, Radiopharmaceuticals:metabolism, Regional Blood Flow, Tomogra.   

: Creutzfeldt-Jakob disease (CJD) is a subacute spongiform encephalopathy. This fatal prion disease is characterized by rapidly progressive dementia with a variety of neurological disorders. Diagnostic methods provided by nuclear medicine might be helpful for evaluation of patients with probable CJD as additional diagnostic tools to MRI and cerebro-spinal fluid evaluation. The experience with FDG-PET and brain perfusion SPECT is presented....

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Case Reports 2007; 28(3): 255-258 PubMed PMID: 17627258 Citation  Keywords:  Adult, Brain:pathology, Dandy-Walker Syndrome:pathology, Humans, Kallmann Syndrome:pathology, Male, Tomography, X-Ray Computed,.   

BACKGROUND & AIM: Dandy-Walker malformation, a rare congenital brain malformation, is described as a triad of cystic dilatation of the fourth ventricle, complete or partial agenesis of the cerebellar vermis, and an enlarged posterior fossa with elevated tentorium. We aimed to report an association of Kallmann's syndrome and Dandy-Walker malformation.

CASE: A fifteen years old boy was referred to endocrinology department due to delayed puberty. Stages of male genital development according to Marshall and Tanner, was stage G1 and P1 respectively. In the LHRH test, peak LH level was 40th min.:15.3 IU/ml. Peak growth hormone with insulin tolerance test was 14.5 microg/L. Olfactory test revealed light anosmia. With these findings the patient was accepted as isolated gonadotropin deficiency (Kalmann's syndrome). In computed tomography of the brain, cerebellar vermis was found to be hypoplastic and 4th ventricle was large and in posterior fossa broad hypodens area with cerebrospinal fluid density were seen (Dandy-Walker malformation).

CONCLUSION: We reported an association of Kallmann's syndrome and Dandy-Walker malformation. This is second reported case probably....

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Letter 2007; 28(3): 250-251 PubMed PMID: 17627256 Citation  Keywords:  Adult, Brain Stem Neoplasms:diagnostic imaging, Female, Glioma:diagnostic imaging, Humans, Indium Radioisotopes, Receptors, Somatostatin:analysis, Somatostatin:analogs & derivatives, Tomography, Emission-Computed, Single-Photon,.   

: In diffuse brainstem gliomas often surgical biopsies cannot be obtained. The diagnosis relies upon imaging criteria, first line being MRI. Gliomas generally express somatostatin receptors (SSTR), which might enable receptor imaging. We present the case of a female adolescent with acute onset of hallucinations, dysphagia and diplopia. MRI detected a suggestive large pontine glioma. This lesion presented with marked In-111-pentreotide tracer uptake. SSTR-scan provided information about SSTR-expression, tumour viability and extension. Radiopeptide therapy for selected patients might be discussed....

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Clinical Trial 2007; 28(1): 53-59 PubMed PMID: 17277726 Citation  Keywords:  Adult, Brain Mapping, Case-Control Studies, Cognition:physiology, Female, Fluorodeoxyglucose F18, Hallucinations:diagnostic imaging, Humans, Male, Positron-Emission Tomography, Prefrontal Cortex:diagnostic imaging, Psychotic Disorders:diagnostic imaging, .   

OBJECTIVE: The aim of the study was to detect whether the abnormal regional brain activity correlates with auditory verbal hallucination-proneness (AVH) in a group of patients with schizophrenia and schizophrenia-related psychoses.

METHODS: 15 patients with prominent AVH (score for hallucination intensity--item 3 in the PANSS > or =4) and 15 control patients without AVH (item 3 PANSS score < or =2) underwent 18FDG positron emission tomography at rest.

RESULTS: SPM group analysis revealed an increased uptake of 18FDG in the right middle frontal gyrus (BA46) in subjects with high verbal hallucination score compared to non-hallucinating patients (p<0.001, uncorrected). Activation in BA46 positively correlated with the intensity of hallucinations (Spearman r=0.57; p<0.001).

CONCLUSIONS: The observed functional recruitment of the right prefrontal cortex in subjects with high hallucination score may reflect impairment in the integration of intended actions and sensory feedback resulting in misattribution of internal events to an external source. This mechanism may form the cognitive basis for AVH....

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Case Reports 2006; 27(6): 737-739 PubMed PMID: 17187000 Citation  Keywords:  Acute Disease, Akathisia, Drug-Induced:diagnostic imaging, Antipsychotic Agents:adverse effects, Benzodiazepines:adverse effects, Cerebellum:diagnostic imaging, Fluorodeoxyglucose F18, Humans, Male, Middle Aged, Positron-Emission Tomography:methods, Radio.   

OBJECTIVES: Akathisia is a clinical important symptom, frequently induced by neuroleptic treatment. Despite its clinical importance, less is known about its pathophysiology.

METHODS: Using [18]-FDG-PET, imaging patterns of cortical metabolic activity were obtained in a patient during olanzapine-induced akathisia and after recovery.

RESULTS: Akathisia was characterized by a reduced metabolic activity in thalamus and cerebellum. After discontinuing medication akathisia disappeared, reflected by a recovery of metabolic activity in these brain areas.

CONCLUSION: [18]-FDG-PET may be useful to identify cortical regions mediating clinical aspects of drug-induced akathisia, thereby offering a deeper insight into the pathophysiology of this serious side effect....

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Controlled Clinical Trial 2006; 27(5): 587-594 PubMed PMID: 17159818 Citation  Keywords:  Adolescent, Adult, Basal Metabolism, Brain:metabolism, Brain Mapping, Female, Fluorodeoxyglucose F18:metabolism, Frontal Lobe:metabolism, Humans, Male, Middle Aged, Positron-Emission Tomography:methods, Psychomotor Performance, Schizophrenia:metabolism, T.   

OBJECTIVES: With the aim to indicate the functional anatomical substrate of cognitive dysfunction in schizophrenia we evaluated the relationship between resting brain metabolism and performance on the Trail Making Test (TMT). As the prerequisite analysis we compared the performance in Part A and B of the TMT between schizophrenic patients and controls. Resting brain metabolism was investigated by (18)FDG positron emission tomography (PET) as the probe for the relative regional synaptic strength and density.

METHODS: (18)FDG PET data were analyzed by SPM99 with TMT A and B as the covariate (p< or =0.001).

RESULTS: Schizophrenic patients (N=42) had worse performance in both TMT A and B compared to controls (N=42). In schizophrenic subjects (18)FDG PET did not predict the performance on Part A (psychomotor speed) but predicted that for Part B (set-shifting and flexibility) of the TMT. The (18)FDG uptake in the superior, middle and inferior frontal gyruses bilaterally was associated with better performance in the TMT B. The negative covariation between 18FDG uptake and time spent in the TMT B was detected in the temporal and parietal cortices, pre- and postcentral gyruses, precuneus limbic regions (anterior cingulate, uncus) and the pons.

CONCLUSIONS: Our data indicate that hypometabolism in the frontal lobes and hypermetabolism in the temporo-parieto-limbic regions is the neurobiological basis for deficient TMT B performance in schizophrenia....

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Journal Article 2003; 24(5): 314-320 PubMed PMID: 14647003 Citation  Keywords:  Animals, Bone Density, Female, Mandible:diagnostic imaging, Rats, Rats, Wistar, Superior Cervical Ganglion:surgery, Sympathectomy, Tomography, X-Ray Computed, Tooth Eruption:physiology,.   

OBJECTIVE: To assess the effect of local sympathectomy on mandibular bone during tooth eruption in rats.

METHODS: The effect of a unilateral superior cervical ganglionectomy (Gx) on morphometry of ipsi- and contralateral mandible and volumetric bone density (as assessed by peripheral computed tomography) was examined 30 days after surgery.

RESULTS: Only a few mandibular morphometric parameters decreased significantly after denervation in rats subjected to a unilateral Gx and a contralateral sham-operation. Mandibular volumetric bone density decreased significantly after sympathetic denervation. In a second experiment, carried out under conditions of unilateral unimpeded eruption of incisors performed ipsilaterally or contralaterally to a unilateral Gx, a significant interaction "denervation x type of eruption" was found for most morphometric parameters. Further analysis indicated higher morphometric indexes in denervated mandibles than in the innervated ones under impeded incisor eruption conditions, and lower morphometric indexes in denervated mandibles than in the innervated ones under unimpeded incisor eruption conditions. Unimpeded eruption augmented total volumetric bone density providing the innervation was intact and caused opposite effects on cortical volumetric bone density in the presence of innervation (increase) or absence of innervation (decrease). Trabecular volumetric bone density decreased significantly after sympathetic denervation.

CONCLUSION: The results support a role of the sympathetic nervous system in the regulation of bone remodeling....

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