On the problem of supersonic gas flow in two-dimensional channel with the oscillating upper wall

In the present paper we solve the problem of supersonic gas flow in two-dimensional channel with the moving upper wall making oscillations according to the harmonic law. In order to get a numerical solution for gas dynamics equations we have implemented a difference scheme with space and time approximation of the first order and one with space approximation of the second order. Depending on a type of harmonic law and initial gas inflow conditions, the peculiarities of angle-shock wave propagation in moving curvilinear domains have been investigated. It has been determined that the increase of oscillation amplitude causes the increase of shock wave intensity. It has been shown that under particular oscillation amplitude the moving wall has practically no effect on the flow within the domain

Hemiplegic Migraine Presenting with Prolonged Somnolence: A Case Report

Hemiplegic migraine is a rare and complex disease, characterized by migraine with a reversible motor aura. Hemiplegic migraine can be easily misdiagnosed at its first presentation with an atypical severe form of migraine, a stroke, multiple sclerosis, metabolic disorders, conversion disorder or an epilepsy. We present the case of a young 24-year-old male patient, who since the age of 4 years had been having multiple episodes of migraine associated with hemiparesis, paraesthesia, prolonged somnolence, aphasia and confusion. We review the literature and discuss important diagnostic findings in hemiplegic migraine to help establishing a prompt diagnosis

Peripheral (Seventh) Nerve Palsy and Multiple Sclerosis: A Diagnostic Dilemma - A Case Report

During the last decades, only a few cases on the association between peripheral demyelinating diseases and multiple sclerosis (MS) have been reported. We describe the case of a young man who was initially diagnosed with Bell's palsy, and only after performing a brain MRI was the diagnosis of MS made. We review the literature and discuss some pitfalls which may lead to missing the diagnosis of MS

Late heartbeat-evoked potentials, indicators of cortical representation of interoceptive signal processing, are associated with survival after cardiac arrest

Rationale: Cardiac arrest (CA) is a serious condition characterized by high mortality rates, even after initial successful resuscitation, mainly due to neurological damage. Whether brain-heart communication is associated with outcome after CA is unknown. Heartbeat-evoked brain potentials (HEPs) represent neurophysiological indicators of brain-heart communication, as they reflect cortical representation of interoceptive signal processing. The aim of this study was to address the association between HEPs and survival after CA. Methods: HEPs were calculated from resting EEG/ECG in 55 CA patients 24 h after resuscitation. All patients were treated with targeted temperature management and a standardized sedation protocol during assessment. We investigated the association between HEP amplitude (180{320 ms, 455{595 ms, 860{1000 ms) and 6-month survival. Results: Twenty-five of 55 patients (45%) were still alive at 6-month follow-up. Survivors showed a higher HEP amplitude at frontopolar and frontal electrodes in the late HEP interval than non-survivors. This effect remained significant after controlling for between-group differences in terms of age, Fentanyl dose, and time lag between resuscitation and EEG assessment. There were no group differences in heart rate or heart rate variability. Conclusion: Brain-heart communication, as re ected by HEPs, is associated with survival after CA. Cardiovascular autonomic arousal may not be involved in mediating this effect. Adequate cortical representation of interoceptive signals may be essential to preserve cariovascular health and should be in the focus of prevention strategies. Future studies should address the brain-heart axis in CA

Late heartbeat-evoked potentials, indicators of cortical representation of interoceptive signal processing, are associated with survival after cardiac arrest

Rationale: Cardiac arrest (CA) is a serious condition characterized by high mortality rates, even after initial successful resuscitation, mainly due to neurological damage. Whether brain-heart communication is associated with outcome after CA is unknown. Heartbeat-evoked brain potentials (HEPs) represent neurophysiological indicators of brain-heart communication, as they reflect cortical representation of interoceptive signal processing. The aim of this study was to address the association between HEPs and survival after CA. Methods: HEPs were calculated from resting EEG/ECG in 55 CA patients 24 h after resuscitation. All patients were treated with targeted temperature management and a standardized sedation protocol during assessment. We investigated the association between HEP amplitude (180{320 ms, 455{595 ms, 860{1000 ms) and 6-month survival. Results: Twenty-five of 55 patients (45%) were still alive at 6-month follow-up. Survivors showed a higher HEP amplitude at frontopolar and frontal electrodes in the late HEP interval than non-survivors. This effect remained significant after controlling for between-group differences in terms of age, Fentanyl dose, and time lag between resuscitation and EEG assessment. There were no group differences in heart rate or heart rate variability. Conclusion: Brain-heart communication, as reflected by HEPs, is associated with survival after CA. Cardiovascular autonomic arousal may not be involved in mediating this e ect. Adequate cortical representation of interoceptive signals may be essential to preserve cariovascular health and should be in the focus of prevention strategies. Future studies should address the brain-heart axis in CA

First Epileptic Seizure and Epilepsy in Adulthood

Background The manuscript is a current and significantly expanded version of the 2012 German Society of Neurology (DGN) Guidelines for the First Epileptic Seizure and Epilepsy in Adulthood. The goal of these guidelines is to summarize the present situation with regard to diagnostics and therapy along with the available scientific literature and thereby improve the diagnostic and therapeutic procedures and contribute towards their standardization. The guidelines pertain exclusively to those epilepsies in adulthood. Children's epilepsies will not be included, nor will status epilepticus or seizures resulting from an immune-mediated disease of the brain as these types of epilepsies already have their own set of DGN guidelines. Methodology The guideline committee is comprised of neurology experts possessing special expertise in the area of epilepsy, as well as clinicians and independent physicians. In addition to the German Society of Neurology (DGN), the German Society of Neurosurgery (DGNC), the Austrian Chapter of the International League Against Epilepsy, the Swiss League Against Epilepsy as well as the Luxemburg Society of Neurology also participated. Special care was taken to also include younger members on the editorial board. Literature that has been published since the 2012 edition was issued has been examined and incorporated in the current edition. The methodology utilized for guideline development is in accordance with standardized consensus techniques like a modified Delphi process (submission of previously produced text or tables, multi-step written questioning techniques, feedback process, participant information about the group responses, discussion of all comments and, if appropriate, the subsequent revisions; group members are able to examine a comparison of their statements). The consensus process corresponds to the rules of the Association of the Scientific Medical Societies in Germany (AWMF) and the DGN in order to address conflicts of interests. Results The most important new feature is the development of a new epilepsy definition. A substantially new aspect of this definition is the question of whether or not epilepsy can be resolved. Also included is a new version of the classification for seizures and epilepsies which essentially corresponds to the 1989 version. The most important therapeutic development since the 2012 edition has been the significant expansion of the anticonvulsive medication spectrum. New medications have been approved (Perampanel, Brivaracetam) or have extended their approval (Zonisamide, Lacosamide, Eslicarbazepine acetate). The administration of Valproic Acid to women and children is being viewed ever more critically. The guidelines explain, in detail, the problems related to treating women with epilepsy. In addition to drug therapy, operative therapies and stimulation procedures are also covered. Psycho-social aspects, driving ability, education, vocation as well as the problems that arise when discontinuing medication after years of seizure freedom are more extensively discussed. Also, new sections on mortality, first-aid measures, and acute symptomatic seizures have been added. A single chapter has been devoted to pharmacokinetics and addresses the interactive potential of anti-epileptic drugs with other medications as well as the possible influence on vitamin and hormone levels. In particular, therapies for malignant diseases can be critically influenced by interactions