All issues
Volume 17, Issue 4
Displaying 1-18 of 18 articles from this issue
- |<
- <
- 1
- >
- >|
-
[in Japanese]1985 Volume 17 Issue 4 Pages 286
Published: 1985
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (143K) -
Akashi Ishikawa1985 Volume 17 Issue 4 Pages 287-292
Published: 1985
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThree hundred and sixty-eight cases were examined by a child neurologist of Sapporo Child Welfare Center during the three-year period. The diagnoses at the first visit were mental retardation, Down's syndrome, epilepsy, speech delay, cerebral palsy, congenital heart disease and many others. The numbers of children examined by the child neurologist increased 1.5 times for three years. Children who took medical advice every several months also increased. Repeated medical care was necessary in 61 cases (17%). Only 23 patients caught up on the psychomotor development.
It was pointed out that the role of the child neurologist in Sapporo Child Welfare Center became more important every year.View full abstractDownload PDF (678K) -
Hiroyoshi Koide1985 Volume 17 Issue 4 Pages 293-300
Published: 1985
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe neuropathology of brainstem was studied on 27 patients, with ages rainging from 2 to 26 years 23 patients with cerebral palsy due to perinatal asphyxia (15), kernicterus (4), and encephalitis or encephalopathy (4), and 4 mentally retarded patients without cerebral palsy. Their clinical findings were confirmed by histological lesions in the brainstem, cerebrum, thalamus, basal nuclei and cerebellum.
The brainstem lesions were common among patients with severe cerebral palsy. The most common brainstem lesions of the perinatal asphyxia were found in the inferior olivary nucleus, vestibular nucleus, vagus nucleus, and pontine nucleus, with secondary degeneration of the pyramidal tract. There were less common damages in the reticular formation of medulla, superior colliculus, inferior colliculus, substantia nigra, red nucleus, oculomotor nucleus, trigeminal nucleus and hypoglossal nucleus.
The reactive astrocytosis was found even in the area of mild nerve cell damages.
These neuropathologic findings support Ozawa's and Torok's results that vestibular dysfunction was relatively common among cerebral palsy patients.View full abstractDownload PDF (2839K) -
Toyoko Kanda, Etsuko Arii, Mariko Yuge, Yuriko Yamori, Junko Suzuki, E ...1985 Volume 17 Issue 4 Pages 301-306
Published: 1985
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDisorders of postural control are considered as an integral component of neural dysfunction in many forms of cerebral palsy. There is no report about the development of abnormal postural reactions in patients with brain damage at the neonatal period.
We studied Landau reaction on 100 infants with disturbance of central coordination. Fourteen cases developed cerebral palsy (CP), 40 cases were treated for more than 6 months (treated) and 46 cases were normalized without treatment or if with, less than 6 months (normalized). All patients visited the St. Joseph Hospital before 13 weeks of age.
Head lifting originally described by Landau was not observed in 50% of the CP patients, 15.0% of treated patients and 21.7% of normalized patients at the first examination. Their responses resembled those in newborn infants.
The CP patients showed 4 types at the first examination and then gradually showed the typical pattern of hypotonic trunk and extension of lower extremities without lifting the head.
All treated and normalized patients showed 4 types initially and then showed the normal development of Landau reaction as Vojta reported.
Three patients with minimal CP after a long-term treatment showed initially the typical pattern, which persisted for 1 1/2 years. However, the pattern of mature newborn infants has been observed recently with lack of head lifting, truncal hypotonia and flexion of lower extremities.
It was concluded that development of Landau reaction was closely associated with the prognosis of subsequent psychomotor development.View full abstractDownload PDF (8212K) -
Clinical Analysis of Functional Prognosis in 24 CasesShizuo Oi, Hiroshi Yamada, Kuniaki Fukuda, Shoko Ando, Yasunori Tamura ...1985 Volume 17 Issue 4 Pages 307-313
Published: 1985
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe cerebrovascular accident in children is a rare clinical entity, epidemiologic studies of which are very scarce in Japan. This study analyzed 13, 131 sick children, admitted to a children's general hospital, with regard to the incidence of cerebrovascular accident and specific characteristics. In this paper, cases of cerebral infarction are analyzed with special reference to developmental outcome.
One hundred and twenty children (0.85 percent of all sick children) had cerebrovascular accidents documented both in the clinical pictures and CT scans. 2.5% of the 4, 738 CT examinations were performed for these sick children. There were 79 cases of intracranial hemorrhage (65.0%), 24 of cerebral infarction (20.0%) and 17 of vascular anomalies (14.2%).
Of the children with cerebral infarction, eleven (45.8%) had occlusion of the middle cerebral artery, four (16.5%) had occlusion of the internal carotid artery, six (25.0%) had occlusion of multiple arteries or diffuse lesions, two (8.4%) had lacunar type occlusions and another (4.2%) had anterior cerebral arterial occlusion. Stroke onset in these children was assumed to have occurred before one year of age in 16 cases, the cause remaining essentially unknown in the majority. With regard to mental prognosis for the children with cerebral infarction, nine of the 21 cases investigated (42.8%) had severe psychomotor retardation, with IQs below 20.
In conclusion, it should be emphasized that cerebral infarction occurring at a young age could cause severe insult to immature brain development.View full abstractDownload PDF (6077K) -
Stimulation in Juvenile Diabetes MellitusToshiaki Hashimoto, Masanobu Tayama, Kuniaki Fukuda, Shoichi Endo, Ets ...1985 Volume 17 Issue 4 Pages 314-317
Published: 1985
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSShort latency somatosensory evoked potentials (SSEP) to peroneal nerve stimulation were studied on juvenile onset diabetes mellitus.
In juvenile onset diabetes mellitus, peripheral nerve conduction velocity, spinal conduction velocity and each peak latencies per meter of body length without Ni were slower. Interpeak latencies per meter of body length were normal. The wave pattern of SSEP was not different between patients with juvenile onset diabetes mellitus and normal controls. However, some patients without clinical evidence of neurological involvements showed abnormalities of SSEP.
It was concluded that SSEP was useful in the diagnosis of neurological disorders associated with juvenile onset diabetes mellitus.View full abstractDownload PDF (507K) -
Clinical Features and the Findings of Nerve PathologyNobutada Tachi, Yukitoshi Ishikawa, Akiko Tsuzuki, Mutsuko Watanabe, R ...1985 Volume 17 Issue 4 Pages 318-324
Published: 1985
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESS4 cases of hereditary motor and sensory neuropathy (HMSN) type I were studied clinically and pathologically. Motor development was delayed and gait was ataxic in all cases. Superficial sensation was normal, but deep sensation (especially of position) was impaired in lower extremities. Deep tendon reflexes were absent in all cases. Cerebellar signs were not seen. Motor nerve conduction velocity was slow (less than 20m/sec in the ulnar nerve).View full abstractDownload PDF (7690K) -
Tohru Ueda, Ryosuke Murata, Kimiko Takeda, Gen Isshiki, Katsuhiro Kage ...1985 Volume 17 Issue 4 Pages 325-329
Published: 1985
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThere is a general agreement that ACTH is most beneficial for the treatment of infantile spasms. However, it has been found that transient brain shrinkage demonstrated by computed tomography occurs during ACTH therapy. A decrease in the water content of the brain may be one of the causative factors. In this study we examined the effect of ACTH on the water content of rat brains, by a gas chromatographic determination.
Rats with ACTH injections at the early neonatal period showed a significant decrease of the brain water content (P<0.01).
This study indicated that ACTH might interfere with the growth of the neonatal brain, and reconsideration of ACTH therapy was suggested.View full abstractDownload PDF (587K) -
Junichi Satoh1985 Volume 17 Issue 4 Pages 330-340
Published: 1985
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSNeuropathological findings in twenty- two autopsy cases with history of infantile spasms were studied. Eleven cases were considered to be of prenatal origin; five cases with gross malformations of the pallium, in-cluding two of pachgyria and one of congenital hydrocephalus, and six cases without gross cerebral lesions except minor dysgenesis or slight glial proliferation demonstrated only by immunohistochemistry of glial fibrillary acidic protein (GFAP). Eleven other cases were considered to have suffered from anoxic encephalopathies in peri-or early postnatal periods; six cases with severe destructive lesions in the pallium, especially of marked fibrillary gliosis of the cerebral white matter. Some common pathological findings of the brainstem tegmentum were noticed throughout the cases despite their various etiologies; 1) a small size of the tegmentum, 2) spongy state in and around the central tegmental tract, 3) localized periaqueductal glial scar.
The significance of these tegmental lesions of the brainstem was emphasized in relation to some clinical features of patients with infantile spasms, s ch as mental retardation and disturbance of the circadian rhythm.View full abstractDownload PDF (2941K) -
Masutomo Miyao1985 Volume 17 Issue 4 Pages 341-347
Published: 1985
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe spinal and scalp somatosensory evoked potentials induced by left posterior tibial nerve stimulation were recorded from 49 normal children of 1 to 16 years of age. The point of stimulation to spine (PCV: peripheral conduction velocity), spine to spine (SVC: spinal conduction velocity) and spine to scalp propagation velocities (CCV: central conduction velocity) were calculated. Three surface spine bipolar channels (L4-L2, T12-T10, C7-C5) and 1 scalp bipolar channel (Cz'-Fz) were performed. This method was then investigated in 41 patients with diseases of peripheral nerve and spinal cord, and diffuse or multifocal leasions of the central nervous system. C7 and scalp potentials were absent in a case of Guillain-Barré syndrome; spine and scalp potentials absent in transverse myelitis (T10), Friedreich ataxia and Leigh's syndrome (one case each); scalp potentials absent in C1-C2 dislocation, Tay-Sachs disease and congenital muscular dystrophy (Fukuyama type) (one case each). PCV and SCV were slow in one of five cases with diabetic neuropathy; PCV and CCV slow in a case of globoid cell leukodystrophy; CCV slow in opsoclonus-polymyoclonia syndrome, spike and wave stupor (Lennox syndrome) and Wilson's disease (one case each). The technique described in this report gave useful information on pathological lesions involving the afferent pathways throughout the peripheral and central nervous systems.View full abstractDownload PDF (860K) -
Hiroshi Matsuura, Shozo Nakazawa1985 Volume 17 Issue 4 Pages 348-351
Published: 1985
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA ten-year-old girl with interhemispheric subdural empyema was reported. She was admitted to the hospital complaining of headache, fever and seizures. Lumbar puncture showed leukocytosis (428/3) in CSF and she was given antibiotics for pulurent meningitis. EEG showed slow waves in the right side but CT scan revealed no abnormal findings at the time of admission. She developed left hemiconvulsion and sensory loss in the left toe. CT scan performed 15 days after the onset showed a low density area in the right parafalx region and the enhancement of its margin following contrast medium injection. Craniotomy was performed under the diagnosis of subdural empyema, and the pus was aspirated because total removal of the capsule was not possible. The patient was discharged 13 days after the operation without neurological dificits and seizures. Value of serial CT scan for diagnoses of subdural empyema was stressed. The beneficial effects of surgical treatment through an ample craniotomy were discussed.View full abstractDownload PDF (2690K) -
Takushi Utsunomiya, Yasushi Yamawaki, Yoshiaki Abe, Morimi Shimada1985 Volume 17 Issue 4 Pages 352-356
Published: 1985
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA full term female infant was born to a healthy woman and was found to have severe microcephaly at birth. CT and renal arteriography showed lissencephaly with cystic dilatation of the posterior horn of the lateral ventricle and hypoplasia of the left kidney. Laboratory examinations disclosed remarkable thrombocytosis.
Since this infant was a product of a twin pregnancy with a stillborn macerated fetus, various abnormal manifestations including lissencephaly were considered to be caused by multiple intravascular coagulation.View full abstractDownload PDF (5911K) -
Akiko Kimura, Seizo Kyoya, Akihiro Matsushima, Hideki Irimichi, Yoshik ...1985 Volume 17 Issue 4 Pages 357-362
Published: 1985
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe patient was a 4-month-old boy, the first child of healthy, non-consanguineous patient. He was mildly asphyxiated at birth and developed severe convulsions at two days of age. At 4 months of age, he was referred to us because of infantile spasms and motor retardation. The EEG showed hypsarhythmia, ACTH and anticonvulsants were started, but his seizures were not controlled completely.
At 8 months of age, the CT scan demonstrated a cerebral atrophy with enlarged ventricles and a diffuse low density of cerebral white matter, and lactic acidosis was first noticed. The glucose, glucagon, fructose, and alanine tolerance tests revealed almost normal responses in blood glucose levels and elevation of lactate levels above the initial value. Enzyme studies revealed a severe deficiency of pyruvate dehydrogenase complex and pyruvate dehydrogenase (E1), and a normal activity of pyruvate carboxylase in liver obtained by biopsy. In biopsied muscle, mitochondria appeared normal. Treatment with thiamine, lipoic acid and anticonvulsants was not effective.
The clinical picture of PDC deficiency has been correlated with the amount of the residual activity, and this case confirmed to the “severe” category. Several pathologic entities may be associated with PDHC deficiency, and CT findings in our case demonstrated the demyelinating condition. The precise relationship between the defect and the pathogenesis remains to be elucidated.View full abstractDownload PDF (3014K) -
Shota Miyake, Hiroshi Tada, Michiko Hayashi, Hiroko Iwamoto, Yoichiro ...1985 Volume 17 Issue 4 Pages 363-368
Published: 1985
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSRomano-Ward syndrome is important for us because it can be easily misdiagnosed as epilepsy. The association of a prolonged QT interval without cardiac organic changes and syncopal attacks is known as main symptomes. We reported two cases of this syndrome.
A 12-year-old girl developed frequent syncopal attacks with convulsive movements. She felt sudden fullness in the chest when she was playing basketball, and lost consciousness. Thereafter tonic convulsion occurred for a few minutes. She was diagnosed and treated as epilepsy at a local doctor without any effect.
The second case was a male patient of 7 years of age. During swimming, tonic-clonic convlusions occurred for a few minutes. Ten months later, when his teacher told him to walk in the pool, he rose to the surface of the water and the same attack occurred. EEG revealed a few spike discharges at right posterior temporal lesion and antiepileptics were started without any effect.
Two cases were referred to our clinic. Their physical and neurological examinations were normal. No seizure discharge was found on EEG. ECG showed marked prolonged QT interval. They were diagnosed as Romano-Ward syndrome. ECG revealed the prolonged QT interval also in their family.View full abstractDownload PDF (769K) -
Takuji Takagi, Takashi Matsumoto, Yoichiro Kasuga, Masayo Horie, Hidek ...1985 Volume 17 Issue 4 Pages 369-373
Published: 1985
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSMajor forms of intracerebral hemorrhage include cortical, white matter and subependymal hemorrhages. Subependymal hemorrhage arises in general from the head of the caudate nucleus and rupture into the lateral ventricle.
However, a massive hematoma is formed in the basal ganglia sometimes, although its mechanism is unknown. Recently, hematoma of the left basal ganglia was treated conservatively with success in our clinic.
The female baby was born on May 27, 1983, by spontaneous cephalic delivery after 41 weeks of normal gestation. Birth weight was 3, 850 g. Apgar score was 9 at one minute after birth. The patient did well for the first 18 hours. Nineteen hours after birth, generalized convulsion occurred. On the 2nd postnatal day, CT was performed as the tense anterior fontanel suggested an intracranial hemorrhage. CT revealed a massive hematoma in the left basal ganglia with intraventricular hemorrhage (IVH) and moderate ventricular dilation. The patient was treated by removing cerebrospinal fluid with repeated lumbar punctures for 30 days. On the 19th day after birth, the hematoma disappeared but moderate ventricular dilation was still observed without an increased intracranial pressure. Thereafter, acetazolamide (20 mg/kg/day) and furosemide (1 mg/kg/day) were given orally for 6 months. She is now 16 months old and moderate ventricular dilation is noted on CT. But, she shows normal physical development and DQ is 94.
We consider that the massive hematoma of the basal ganglia with IVH should be treated at first by repeated lumbar punctures and then by administration of acetazolamide and furosemide.View full abstractDownload PDF (2608K) -
[in Japanese], [in Japanese], [in Japanese], [in Japanese]1985 Volume 17 Issue 4 Pages 374-375
Published: 1985
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESS -
[in Japanese], [in Japanese]1985 Volume 17 Issue 4 Pages 376-377
Published: 1985
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESS -
[in Japanese], [in Japanese], [in Japanese], [in Japanese]1985 Volume 17 Issue 4 Pages 378-379
Published: 1985
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESS
- |<
- <
- 1
- >
- >|