Neurologic Impairment (neurologic + impairment)

Distribution by Scientific Domains

Selected Abstracts

Bilirubin as a determinant for altered neurogenesis, neuritogenesis, and synaptogenesis

Adelaide Fernandes
Abstract Elevated levels of serum unconjugated bilirubin (UCB) in the first weeks of life may lead to long-term neurologic impairment. We previously reported that an early exposure of developing neurons to UCB, in conditions mimicking moderate to severe neonatal jaundice, leads to neuritic atrophy and cell death. Here, we have further analyzed the effect of UCB on nerve cell differentiation and neuronal development, addressing how UCB may affect the viability of undifferentiated neural precursor cells and their fate decisions, as well as the development of hippocampal neurons in terms of dendritic and axonal elongation and branching, the axonal growth cone morphology, and the establishment of dendritic spines and synapses. Our results indicate that UCB reduces the viability of proliferating neural precursors, decreases neurogenesis without affecting astrogliogenesis, and increases cellular dysfunction in differentiating cells. In addition, an early exposure of neurons to UCB decreases the number of dendritic and axonal branches at 3 and 9 days in vitro (DIV), and a higher number of neurons showed a smaller growth cone area. UCB-treated neurons also reveal a decreased density of dendritic spines and synapses at 21 DIV. Such deleterious role of UCB in neuronal differentiation, development, and plasticity may compromise the performance of the brain in later life. © 2009 Wiley Periodicals, Inc. Develop Neurobiol 2009 [source]

Ictal Pattern of EEG and Muscular Activation in Symptomatic Infantile Spasms: A Videopolygraphic and Computer Analysis

EPILEPSIA, Issue 12 2002
Francesca Bisulli
Summary: ,Purpose: To investigate ictal muscular phenomena characterizing symptomatic infantile spasms (ISs) and their relation to ictal EEG. Methods: Four children with severe encephalopathy, neurologic impairment, and refractory ISs related to different dysplastic lesions, underwent videopolygraphic recordings collecting surface electromyogram (EMG) activity from several cranial and limb muscles to evaluate the pattern of muscular recruitment, duration, and side-to-side asymmetry of ISs. Acquired data were stored for off-line analysis by a computerized polygraphic system. Results: Spasms were characterized by a complex pattern of muscular activation. A constant or rostrocaudal propagation pattern was lacking in all patients. Intervals between the onset of EMG activity in different muscles in each spasm were very long: ,100,200 ms. Two patients, with hemispheric cortical dysplasia and agenesis of the corpus callosum, had asymmetric and asynchronous spasms in which the EMG onset of the muscles contralateral to the affected hemisphere constantly anticipated that of the ipsilateral ones. Backaveraging of EEG activity disclosed a high-amplitude EEG complex on the same side as the dysplastic lesion, preceding or succeeding the contralateral muscle activity onset. In the other two patients with diffuse cortical dysplasia, no EEG transient was related to EMG activity onset. Conclusions: Despite clinical similarity between spasms in the same patient, our data demonstrate the complexity and heterogeneity of these motor phenomena. Our findings cannot be explained simply in terms of cortical or reticular generators like other motor phenomena such as cortical myoclonus or startle reflex. [source]

Continuous venovenous hemodiafiltration to treat controlled-release carbamazepine overdose in a pediatric patient

Summary Carbamazepine (CBZ) intoxication is an important issue in acute poisoning practice. Highly protein-bound, CBZ is not removed efficiently through conventional hemodialysis. We describe the use of continuous venovenous hemodiafiltration (CVVHDF) in a 2-year-old boy who developed general tonic clonic seizure and respiratory depression due to controlled-release formula of CBZ overdose (peak drug level of >20 ,g·ml,1, therapeutic range: 5,10 ,g·ml,1). Serum CBZ concentrations fell to 0.25 ,g·ml,1 at the end of hemodiafiltration. The patient recovered rapidly and was discharged from hospital 4 days from the time of ingestion with no complications or neurologic impairment. [source]

Determinants of prognosis of acute transverse myelitis in children

Reiko Miyazawa
Abstract Background: Acute transverse myelitis (ATM) is a severe disorder; recovery requires several months and often leaves neurologic residua. To determine what features of patients with acute transverse myelitis significantly influence prognosis, the authors reviewed reports of ATM in Japanese children published in the last 15 years (from 1987 to 2001). Methods: The authors studied reports of 50 Japanese patients (17 boys, 26 girls, 7 children of unspecified sex; mean age ± SD, 8.0 ± 3.8 years). Acute-phase and demographic features including age, increased deep tendon reflexes, Babinski reflex, sex, preceding infection, decreased deep tendon reflexes, time course of peak neurologic impairment, treatment with prednisolone and/or high-dose methylprednisolone, and the day of illness when treatment was started were used as independent variables in a regression analysis. The dependent variable was long-term persistence of neurologic deficits. Results: Younger patients and those without increased deep tendon reflexes or a Babinski reflex were more likely to have residual neurologic deficits such as paraplegia or tetraplegia, sensory loss and sphincter disturbance. No relationship was seen between prognosis and sex, preceding infections, decreased deep tendon reflexes, time course of peak neurologic impairment, treatment with prednisolone or high-dose methylprednisolone, or timing of treatment initiation. Conclusions: Age at onset and neurologic features were important for outcome prediction in ATM. Steroid therapy did not associate with better outcome. [source]

Epidemiology of Helicobacter pylori infection in children: A serologic study of the Kyushu region in Japan

Yasuhiro Yamashita
Background: The prevalence of Helicobacter pylori infection in children varies as a function of socioeconomic development, with low rates in developed countries and high rates in developing countries. The prevalence of H. pylori infection in Japanese children is unknown. Methods: The present study examined the effect of living conditions on the prevalence of H. pylori infection in children. We determined the prevalence of H. pylori infection in healthy children of the Kyushu region in Japan and compared it with the prevalence in institutionalized children with severe neurologic illness. Serum concentrations of anti- H. pylori IgG antibody were measured by an enzyme-linked immunosorbent assay in 336 healthy children and 56 patients with severe neurologic impairment. An antibody concentration >50 units/mL was taken as evidence of infection. Results: The prevalence of H. pylori seropositivity in healthy children increased with age (P<0.0001) and was 29% in children 15,19 years of age. This value is slightly higher than prevalences reported in developed countries (5,15%), but is lower than in developing countries (30,60%). Seropositivity did not vary with respect to gender, water supply or location of housing. Helicobacter pylori seropositivity was more prevalent among institutionalized children aged 5,19 years than their healthy counterparts (P<0.005). Conclusions: The intermediate prevalence of H. pylori seropositivity in healthy children between that measured in developed and developing countries is consistent with the socioeconomic ,westernization' of Japan. [source]

Electroconvulsive Therapy: Issues in the Elderly

Arunava Das
Abstract: The elderly psychiatrically ill constitute a high proportion of the patients who receive electroconvulsive therapy (ECT). There is evidence to say that the efficacy of ECT may be enhanced in the elderly. Clinical and biological markers are increasingly being recognised as predictors of outcome to ECT. The doses of anticholinergic, anaesthetic and relaxant agents may need to be modified in accordance with physiological changes associated with aging. ECT stimulus and ECT technique should be selected against the background of increased seizure threshold and possibility of greater ECT-induced cognitive dysfunction in the elderly, particularly those with pre-existing cognitive or neurologic impairment. New brain-imaging techniques and biochemical measures of brain damage have proved that ECT does not cause brain damage. The physical risk with ECT is considered to be low. There is some evidence to say that cardiovascular complications reported with ECT are related to the nature of pre-existing cardiac disease. Although the short-term response to ECT in the elderly is quite good, post-ECT relapse rates are quite high. Continuation-maintenance ECT has a definite role in minimising relapses and recurrences in the elderly, taking care not to enhance physical and cognitive risks. With increasing administration of outpatient ECT, it is important to refine methods for monitoring patients for adverse effects of treatment. The roles of repetitive trans-cranial magnetic stimulation (rTMS) and vagus nerve stimulation (VNS) in geriatric psychiatry are yet to be established. [source]

Dramatic efficacy of infliximab in cauda equina syndrome complicating ankylosing spondylitis

Divi Cornec
Cauda equina syndrome is an uncommon complication of ankylosing spondylitis (AS) characterized by the slow and insidious development of severe neurologic impairment. Imaging studies usually show a wide lumbar canal with dural ectasia. No medical or surgical treatment has been proven effective. We managed the care of a 66-year-old man who had longstanding AS and clinical features of cauda equina syndrome, including anal incontinence and buttock hypoesthesia. Magnetic resonance imaging demonstrated no cause for these symptoms other than AS. The patient was treated with infliximab, a monoclonal antibody to tumor necrosis factor , that is used for the treatment of active AS. After 3 infliximab infusions, sphincter control and sensation were normal. The treatment was continued, and he was still doing well 1 year later. This is the first report of an effective treatment for cauda equina syndrome complicating AS. Our case report strongly supports an inflammatory mechanism to this condition. [source]

Fragile X syndrome, the Fragile X related proteins, and animal models

André T. Hoogeveen
Abstract The Fragile X syndrome (FraX), which is characterized among other physical and neurologic impairments by mental retardation, is caused by the absence of the product of the FMR1 gene. The Fragile X Mental Retardation Protein (FMRP) is a member of a novel family of RNA-binding proteins. The latter includes two other proteins highly homologous with FMRP: the fragile X related proteins 1 and 2 (FXRP1 and FXRP2). Characterization of FXRPs, including their interaction with FMRP, will provide critical information about the mechanisms of action of FMRP and the role of this group of proteins in FMRP-deficient conditions such as FraX. Genetic manipulations of FMRP and the FXRPs should also provide valuable tools for investigating pathophysiology and gene therapies in FraX. The present review summarizes the strategies used for identifying the FXRPs, their chromosomal localization, molecular structure, and tissue distribution. It also reviews interactions between different members of this family of RNA-binding proteins. Animal models, both knockout and transgenic, of FMRP and the FXRPs are discussed. Phenotypic features of the FMR1 knockout mouse, the FMR1 transgenic rescue mouse, and other novel strategies for manipulating and delivering FMRP and FXRPs to the brain and other tissues are described. Microsc. Res. Tech. 57:148,155, 2002. © 2002 Wiley-Liss, Inc. [source]