The aim of study was to examine how to the Somatosensory evoked potentials ( SEPs) are affected in patients with cerebrovascular thalamic lesions and to correlate the findings with sensory abnormalities

Gorgoska, E

Ilievska, Liljana

UGD Academic Repository

4-H1 KOHrpec Ha HeBpOfl03HTe Ha MaKeAoHVlja co HHTepHa4V10HaflHO Y4ecTBO . - ,­KJH.1HVl4Ka CJlVlKa n03V1TVlBHVlOT HaO,ll Ha CIK O,llVl BO npVlJlor Ha nocTeHlIecj:>aJlVlTVl4eH napKVlHcoHVl3aM co aBToVlMYHa eTVlonorVlja.¢aKToT 3a cna6a peaKTVlBHoCT Ha ~-Aona O,ll cTpaHa Ha nallVleHToT e YWTe e,lleH ,llOKa3 3a eTVlonorVljaTa Ha TaKoB nm Ha ceKyH,llapeH napKVlHcoHVl3aM. P52 SOMATOSENSORY EVOKED POTENTIALS IN DEAFERENTATION PAIN tlievska Lj, Gorgoska E. Clinic of neurology, Skopje, Macedonia The aim of study was to examine how to the Somatosensory evoked potentials ( SEPs) are affected in patients with cerebrovascular thalamic lesions and to correlate the findings with sensory abnormalities. Methodology: Changes in SEPs are studed in 36 pateints with unilateral cerebrovascular Lesions. All of patients had a central post stroke pain and abnormal sensibility of the all modality. Main age was 66 years and was studied in relation to age-mached control group 50-80 years. Two-thirds of the lesions were on right side of the brain. The SEP obtained in median nerve and posterior nerve stimulation_ Results: In brainstem lesions SEP had a normal configuration and latency od single components with absence of P15 wave in majority ad cases. In supratentorial lesions with thalamic involvement, SEP shoved marked abnormalities with absence ad all or single components on the affected side. We could differentiate severaL kinds ad abnormalities: a) absence of all waves after P15 ( 4 cases) ; b) presence of N20 and N40 which showed marked amplitude reduction but other components were absent ( 3 cases) and; c) presence of P40 only but other componets are absent ( 3 cases); and d) presence of early and absence of late SEP components after 40 ms ( 2 cases). SEP have shown significant prolongation ad N20 and P25 on the side of the Lesion in patients with cortical lesions ( p<0,05 ). SEP obtained over the non- affected side did not show latency changes, however, SEP amplitudes showed significant increase, especially of N60 in median or N75 wave in tibial nerve stimulation, which was particulary discussed in the paper. Conclusion: The results of our SEP examination in patients with thalamic cerebrovascular lesions were in accordance with sensory loss. It ist based on the hypotheses that the transmited activity is dispersed or abolished trough an insured zone. Key words: thalamic pain, somatosensory evoked potentials, cerebrovacular lesions 4-th Congress of Neurologists of Macedonia International Participation Page 98 4-TV1 l{oHrpec Ha HeBpO!l03~Te Ha MaKeAoH~ja co ~HTepHal\~OHa!lHO Y4ecTBo HajHoBa CTYAl-1ja, r,ll,H$ XpOHI-14HO 61-111 npV1MaH npeKY I-1HTpaBeHTpl-1KynapHI-1 I-1nl-1 nYTaMeH nYMnV1, BOAejKI-1 KOH 61-1naTepanHI-1 3roneMYBal-ba BO Hl-1rpanHaTa AOnaMI-1HeprV14Ha HeBpoHcKa Kenl-1CKa rOneMI-1Ha, 6pOjOT Ha Hl-1rpanHI-1Te Kenl-1l-1 61-1n 3roneMeH na4ejKI-1 Tl-1p03V1H xV1APoKCVlna3a V1 3roneMeHVI AonaMV1H MeTa60nV1THI-1 HV1Boa BO CTpV1jaTYMoT VI nanVlAYMoT. nOKpaj Toa, r,ll,H$ npV1MaTenVlTe nOKa>Kane cl-1rHV1qmKaHTHo VI nOAAP>KaHO nOA06PYBal-be Ha CI-1MnrOMV1Te, VlMaa 3roneMYBal-ba BO AonaMV1HcKoTO HVIBO 1-1 6pOjOT Ha TVlP03V1H xVlAPoKcVlna3a. KOI-1 ce npeAHocn1Te Ha reHCKaTa TepanHja BO TpeTMaHoT Ha nEi? 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I-1HTep,LIl-1Cl\l-1nJlJ1HapeH l\eHTap 3a COMHOJlOrl-1ja, Kliniki NUrnberg (J1H,LIPOMOT Ha HeMl-1pHl-1 H03e (RLS) ce KapaKTepl-13J1pa co napeCTe3J1J1 J1 ,LIJ13eCTe3l-1J1 Ha ,LIOJlHl-1Te l-1JlJ1/J1 rOpHl-1Te eKCTpeMJ1TeTl-1. napeCTe3J1I-1Te 1-1 ,LIJ13eCTe3l-1l-1Te ce jaBYBaaT 4-th Congress of Neurologists of Macedonia with International Participation Page 32 l-1 4'T!-1 KOHrpeC Ha HeapOfl03V!Te Ha MaKe,lloHV!ja co V!HTepHa4HOHaflHO Y4eCTBO L\epe6paflHa xeMOparl-1ja 3a naL\l-1eHm KOl-1 pa3Bl-1BaaT ICH, SAH, SDH . BO TeK Ha aKYTHl-10T nepl-10A (HajMaflKY 1-2) ce npeKl-1HYBa AKT l-1 ATT l-1 BeAHaw ce aHTarOHVl3l-1pa aHTl-1KOarYflaHTHl-10T ecpeKT co COOABeTHVI areHCl-1 (BVtT.K, CBe}l{a cMp3HaTa nfla3Ma) (K-III, N-C). nOcfle 3-4 HeAeflVt MO}l{e Aa ce BOBeAaT OAT, co PVtroP03HO MOHVtTOpVlpal-be l-1 OAP}l{YBal-be Ha INR Ha AOfleH Tepanl-1CKVt paHr (K-lIb, N-Cl. 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TKAC e l-1HAVtL\l-1paHa 3a AeTeKTl-1pal-be Ha Y1HTpaKpaHY1jaflHaTa CTeH03a Vtfll-1 OKflY3Vtja Kaj l-1CXeMY14eH M0304eH YAap; AeTeKTVtpal-be Ha Ba30cna3MOT nOpaAl-1 cy6apaXH0Y1AaflHa xeMoparVtja; AeTeKmpal-be Ha apTepl-10BeHCKVI MaflcpopMaL\l-1Y1; AeTeKmpal-be Ha KOflaTepaflHl-1Te naTVtWTa. V1CTOTaKa Haora npY1MeHa Kaj Y1HTpaKpaHY1jaflHaTa xeMOparl-1ja, xY1APOL\ecpaflycoT, M0304HVtOT eAeM, MeHVtHrOeHL\ecpam1TY1COT Y1 CflVt4Hl-1 cocToj6l-1 KOY1 ro MeHYBaaT npocpY1flOT Ha L\epe6paflHVloT npoToK. npVt TKAC nperfleAoT, YflTpa3BY4HVlOT CHon ce nponYWTa HVt3 npl-1pOAHY1Te KpaHVtjaflHVt OTBOPY1 KOVI ce OApeAeHVt nOflY1l-ba Ha KpaHVtYMOT KaAe KOCKaTa e HajTeHKa. Toa ce: TpaHCTeMnopafleH, TpaHCOp6Y1TafleH l-1 TpaHCOKL\l-1nVtTafleH np030peL\. YflTpa3BY4HaTa Al-1jarHocmKa BO nOCfleAHO BpeMe 6efle)f{Y1 3Ha4ajHo nOA06pYBal-be BO HeBpOCOHOflOrl-1jaTa. OBa ce AOIl)f{l-1 Ha: nOBY1COK KBafll-1TeT Ha CIll-1KaTa, MYIlTl-1Al-1MeH3l-10HaflHa BY13yefll-13aL\Y1ja (3A, 4A)' VtMel-1I,ll-1Hr KOj ja KOM6VtHl-1pa CTPYKTypHaTa l-1 npOTOYHaTa Bl-13yelll-13aL\Vlja l-1 m-mode Aonnep 3a AeTeKL\l-1ja Ha Y1HTpaKpaHl1janHVloT npOTOK Ha nOBeKe HVtBOa VI AeTeKL\l-1ja Ha eM6oflYCl-1. V1CTOTaKa, HOBI1Tem ce HVtCKO­eHepreTCKI1Te COHAl-1, nOMafll1 l-1 nopTa6fl CY1CTeMl-1 l-1 pa3Boj Ha pa3nl-1YHl-1 YllTpa3BYYHl-1 KOHTpaCTHVt cpeACTBa. nOCTojaT HajHOBVt CTYAI1l-1 KOl-1 ce CPOKYCVtpaaT Bp3: aMnnVtcpI1KaL\Y1ja Ha TpeTMaHOT Kaj aKYTHI10T M030yeH YAap, OAHOCHO COHOTpOM60nI13a, I1Mel1l,ll-1Hr Ha 4-th Congress of Neurologists of Macedonia with International Participation Page 41 11 4-TI-1 KOHrpeC Ha HeepOl10311Te Ha MaKeAoHl1ja co V1HTepHaI1110HaIlHO Y4eCTBO M030YHI10T napeHXI1M 11 nepl1cpepHI10T HepB, l1,L1eHTI1cpI1Kal\l1ja Ha BI1COKO-PI13I1YHI1 nal\l1eHTI1 3a pa380j Ha 6011ecTa 111111 nporpecl1ja, M030yeH MOHI1TOpI1Hr, KaKO TelleMe,LII1l\I1HCKa anlll1Kal\l1ja Ha YllTpa38YYHaTa TeXHollorl1ja. He8pocoHollorl1jaTa I1Ma 8036Y,LI1l118a I1,L1HI1Ha 80 ,LIl1jarHocTl1KaTa 11 Tepane8TCKaTa anlll1Kal\l1ja Kaj HespOllOWKI1Te nal\l1eHTI1. SPEECH AND LANGUAGE DISORDERS SECONDARY TO DIFFUSE SUBCORTICAL VASCULAR LESIONS: NEUROllNGUISTIC AND ACOUSTIC ANALYSIS. A CASE REPORT Tom;c Ga, Stojanovic Mb , PavloviC Aa, StankoviC ph, Zidverc Trajkovic.r, Pavlovic Da, Markovic Jovanovic Za, Covickovic SterniC W. a Institute of Neurology, Clinical Center of Serbia, Dr Subotica 6, 11 000 Belgrade, Serbia b Institute of Otorhinolaryngology, Clinical Center of Serbia, Pasterova 2, 11 000 Belgrade, Serbia Background and purpose: Subcortical white matter (WM) plays an important role in speech production and language processing. Most frequently, cerebral WM lesions are secondary to small vessel disease in patients with vascular risk factors. We report a 53­year-old man with history of hypertension and ischemic subcortical lesions, who presented with speech difficulties and memory decline. Methods: language and cognitive assessment included: Boston Diagnostic Aphasia Examination, Boston Naming Test, Ray Auditory-Verbal learning Test, Ray-Osterreith Complex Figure Test, Trail Making Test A and B, Wisconsin Card Sorting Test, Scale for Evaluation of Perceptive Characteristics of Voice and Speech, and Multidimensional Evaluation of Speech and Voice. Results: Brain MRI showed ischemic WM lesions and lacunar infarcts in the brainstem and right cerebellum. Cognitive testing revealed mild cognitive impairment, dominantly affecting attention and executive functions. Speech and language analysis demonstrated, dysarthria, dysphonia with hypophonia, imprecise articulation, short rushes of speech, palilalia and mild subcortical dysphasia. Conclusions: Neurolinguistic and acoustic analysis in patients with ischemic WM lesions can provide additional information in understanding language and speech disturbances and assist in patient management. KEY WORDS: speech disorders; language disorders; white matter lesions; cerebral small­vessel disease; neurolinguistic analysis; acoustic analysis; lacunar infarct 4-th Congress of Neurologists of Macedonia with International Participation Page 42 

Somatosensory evoked potentials in deaferentation pain

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