An aggressive seizure and behavioural disorder following trivial head injury

We report on a normal 6-year-old boy in whom a trivial head injury triggered a severe seizure, behavioural and cognitive disorder. Complete recovery occurred within 6 months. An aetiology such as trivial head injury is significant for prognosis as the outcome is invariably excellent

F chronodispersion: A new electrophysiologic method

We have introduced the term F chronodispersion to denote the scatter or dispersion of the relative latencies of statistically significant numbers of consecutively recorded F waves. Five patients with chronic renal failure and five control subjects were studied. The two groups were matched for age, sex, proximal and distal motor conduction velocity, and latency of fast F waves plotted against distance traveled. We found that the extent of F chronodispersion of the deep peroneal nerve did not exceed 7.5 msec in control subjects, while it was longer than this value in all uremic patients studied. Measurements of this type may prove to be a useful diagnostic tool for cases in which traditional electrophysiologic measurements are normal. Copyright © 1979 Houghton Mifflin Professional Publisher

F‐wave conduction velocity in the deep peroneal nerve: Charcot‐marie‐tooth disease and dystrophia myotonica

The F‐wave has been used to estimate the motor nerve conduction velocity (MNCV) along the proximal segment (spinal cord to knee) of the axons of the deep peroneal nerve in patients with Charcot‐Marie‐Tooth disease and those with dystrophia myotonica. A new, modified method has been applied to estimate proximal MNCV in patients in whom F‐waves or M‐responses cannot be obtained from the small muscles of the foot. Terminal latencies and MNCV along the distal nerve segment (knee to ankle) have also been estimated using conventional techniques. The results have been compared with those obtained for control subjects. Proximal MNCV was severely slowed in every patient with Charcot‐Marie‐Tooth disease; the degrees of proximal and distal MNCV decreases were related. In patients with dystrophia myotonica, distal and proximal MNCVs were significantly reduced in comparison with control subjects; the MNCV slowing was not related to the degree of muscle atrophy. This is consistent with the hypothesis that the nerves and muscles are independently affected in dystrophia myotonica. It is concluded that the F‐wave MNCV technique is as useful as, and may be more sensitive than, the conventional MNCV method. Copyright © 1978 Houghton Mifflin Professional Publisher

A study of photosensitive epilepsy with particular reference to occipitial spikes induced by intermittent photic stimulation

This thesis is the result of an attempt to find means of diagnostic value and understand the underlying mechanisms of photosensitive epilepsy which is a variety of epilepsy where seizures are provoked by photic stimuli. A detailed review of the relative literature has been endeavoured. The aspects dealt with were mainly concerned with electroencephalographic responses to intermittent photic stimulation. It has been found that intermittent photic stimulation is more effective on "eye-closure" than in any other eye state and more abnormalities are induced when the eyes are open than when they are closed. The significance of light in the provocation of "eye-closure" induced discharges has been emphasized. The characteristics of the occipital spikes induced by intermittent photic stimulation have been studied. The majority of photosensitive epileptic patients and those with epilepsy who are not clinically photosensitive but in whom E.G. abnormalities are provoked by intermittent photic stimulation, show occipital spikes alone or preceding photoconvulsive responses, during photic stimulation. Tbe occipital spikes were compared with the visual evoked responses of the same patients and of normal subjects. This showed that there was no simple relation between occipital spikes and components of visual evoked responses. The characteristics of the negative occipital spike show striking similarities to those of the recruiting response evoked by electrical stimulation of the non-specific thalamic nuclei as described by other authors. This may indicate that the non-specific thalamocortical system is responsible for the genesis of the "epileptogenic" occip:ital spikes and therefore implicated in the pathogenesis of photosensitive epilepsy. The intermittent photic stimulation showed an increased effectiveness when combined with patterns and this may be due to an increased susceptibility of the occipital cortex. It is suggested that seizures in photosensitive epilepsy are the result of discharges arising from abnormally activated,by photic stimuli, non-specific thalamic system and impinging upon a hypersensitive occipital cortex

X-linked spinal and bulbar muscular atrophy of late onset (Kennedy-Stefanis disease?)

X-linked spinal and bulbar muscular atrophy of late onset is a rare variety of motor neuron disease. In this report a Greek family with 2 affected brothers is described. It is interesting that all Greek cases of this disease originate from a small group of Greek islands. Transient fatigue is an additional feature of the disease which is manifested sometimes before other symptoms are apparent. The progression of the disease appears to be faster than in spinal muscular atrophy of Wohlfart-Kugelberg-Welander. Regarding the name of this disorder, we propose the descriptive term, 'X-linked spinal and bulbar muscular atrophy of late onset' or 'Kennedy-Stefanis disease'

Myopathy or Neuropathy in Thyrotoxicosis

To the Editor: Thyrotoxicosis is very often associated with weakness and wasting of muscles, and 80 to 90 per cent of the patients show abnormal electromyographic features1, 2 characteristic of a myopathy. These findings have been attributed to a metabolic myopathy that is fully reversible with adequate treatment of the thyrotoxicosis. The myopathic concept of the disorder has recently been challenged by McComas and his colleagues,3 who attributed the disease to a defect at the motoneuron level, as they also did for all myodystrophies.4, 5 The “neurogenic hypothesis” of the above authors was mainly based on findings obtained with use of a. © 1973, Massachusetts Medical Society. All rights reserved