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  • 1
    Electronic Resource
    Electronic Resource
    Hämodynamisch bedingte transitorische ischämische Attacken Eine Differentialdiagnose fokaler motorischer Anfälle? (1998)
    Springer
    Der Nervenarzt 69 (1998), S. 901-904 
    Details
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Verschluß der A. carotis interna ; Transitorische ischämische Attacken ; Zerebrovaskuläre Reservekapazität ; Fokale motorische Anfälle ; Key words Carotid occlusive disease ; Cerebral reserve capacity ; Transient ischemic attacks ; Limb shaking
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary This case report intends to focus attention on hemodynamic TIAs as cause of repetitive involuntary movements (RIMs) as differential diagnosis of simple partial motor seizures. We report two patients with episodic unilateral limb shaking lasting up to several minutes and which could be triggered by orthostasis, heat or physical exertion. Repeated EEG recordings revealed no epileptic discharges. In both patients, duplex ultrasonography revealed an occlusion of the internal carotid artery (ICA) contralateral to the side of the RIMs. Blood flow velocities in the middle cerebral artery ipsilateral to ICA occlusion were reduced and vasomotor reactivity to hypercapnia was absent. After elevation of blood pressure both patients became asymptomatic. We suggest that in patients with episodes of RIMs, Doppler sonography and tests of cerebral vascular reserve capacity should be performed to search for a hemodynamic origin of these symptoms.
    Notes: Zusammenfassung Transitorische ischämische Attacken imitieren in seltenen Fällen einfache fokale motorische Anfälle. Am Beispiel von 2 Patienten wird die differentialdiagnostische Abgrenzung und Therapie solcher hämodynamisch bedingter TIA diskutiert. Beide Patienten litten seit mehreren Monaten unter paroxysmalen einseitigen Extremitätenzuckungen, die durch Orthostase, Hitze oder körperliche Anstrengung ausgelöst wurden. Im EEG fand sich kein Hinweis auf eine fokale Erregungssteigerung. Die farbkodierte Duplexsonographie ergab einen Verschluß der A. carotis interna kontralateral zu den Extremitätenzuckungen. Auf der Seite des Verschlusses waren die Blutflußgeschwindigkeiten in der A. cerebri media erniedrigt und die im Doppler-CO2-Test bestimmte zerebrovaskuläre Reservekapazität erschöpft. In beiden Fällen führte eine Anhebung des Blutdrucks zu Beschwerdefreiheit.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001150050361
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  • 2
    Electronic Resource
    Electronic Resource
    Repetitive transkranielle Magnetstimulation (1997)
    Springer
    Der Nervenarzt 68 (1997), S. 778-784 
    Details
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Repetitive transkranielle Magnetstimulation ; Zerebraler Blutfluß ; Epilepsie ; fMRI ; Therapie ; Depression ; Key words Repetitive transcranial magnetic stimulation ; Cerebral blood flow ; Epilepsy ; fMRI ; Therapy ; Depression
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Repetitive magnetic stimulation (rTMS) is a non-invasive, painless method to induce transient activation in circumscript regions of the human cortex. In contrast to TMS with single pulses rTMS allows a more effective stimulation of association cortex and temporary interference with the proper functioning of stimulated areas. Possible applications for examination of the functional anatomy of language lateralisation, memory functions and visual perception are discussed. Possible therapeutic for movement disorders and depression are discussed. On the basis of theoretical considerations and current experience rTMS induced epileptogenic effects are discussed and safety recommendations are given.
    Notes: Zusammenfassung Die repetitive transkranielle Magnetstimulation (rTMS) ist ein nichtinvasives, schmerzloses Verfahren, mit dem beim Menschen in umschriebene Kortexareale temporäre Reizeffekte ausgelöst werden können. Im Unterschied zur Stimulation mit Einzelreizen kann mit der rTMS effektiver mit Funktionen des Assoziationskortex interferiert werden. Neue Anwendungen für funktionell-anatomische Fragestellungen zu Sprachlateralisierung, Gedächtnisfunktionen und visueller Wahrnehmung werden dargestellt. Mögliche therapeutische Effekte für die Behandlung von Bewegungsstörungen und Depression werden beschrieben. Aufgrund theoretischer Überlegungen und bisheriger Erfahrungen wird das Risiko rTMS-induzierter epileptogener Effekte diskutiert und Empfehlungen zur Anwendungssicherheit gegeben.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001150050194
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  • 3
    Electronic Resource
    Electronic Resource
    Medikamentöse Therapie des Ballismus Literaturübersicht und eigene Beobachtungen (1997)
    Springer
    Der Nervenarzt 68 (1997), S. 990-995 
    Details
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Hemiballismus ; Krankheitsverlauf ; Pharmakotherapie ; Key words Hemiballism ; Natural course ; Treatment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Hemiballism is a rare hyperkinetic disorder which is characterized by irregular vigorous rotatory movements of the limbs of one side of the body. The disabling and exhausting movements with their high risk of severe injuries require an acute drug treatment. However, there are no common guidelines for the treatment of this disorder. Therefore we reviewed the available literature to establish a concept for a rational symptomatic drug treatment. Furthermore, own observations in 6 patients with hemiballism of different origins are reported.
    Notes: Zusammenfassung Beim Hemiballismus handelt es sich um eine seltene hyperkinetische Bewegungsstörung mit irregulären, kraftvollen proximal betonten rotatorischen schleudernden Arm- und Beinbewegungen einer Körperhälfte. Die Schwere des Krankheitsbildes mit körperlicher Erschöpfung und Verletzungsgefahr machen in der Regel eine akute medikamentöse Behandlung erforderlich, für die es jedoch keine allgemein anerkannten Richtlinien gibt. In diesem Beitrag wurde deshalb mit dem Ziel, ein Konzept zur symptomatischen Therapie zu erstellen, die vorliegende Literatur unter Berücksichtigung der Bewegungsstörung ausgewertet. Daneben werden eigene Erfahrungen bei 6 Patienten mit Hemiballismus unterschiedlicher Ätiologie mitgeteilt.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001150050228
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  • 4
    Electronic Resource
    Electronic Resource
    Transcranial magnetic stimulation of the human brain: responses in muscles supplied by cranial nerves (1988)
    Springer
    Experimental brain research 71 (1988), S. 623-632 
    Details
    ISSN: 1432-1106
    Keywords: Magnetic stimulation ; Motor cortex ; Corticonuclear tract ; Cranial nerves
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The present investigation demonstrates that time-varying magnetic fields induced over the skull elicit distinct types of responses in muscles supplied by the cranial nerves both on the ipsilateral and the contralateral side. When the center of the copper coil was positioned 4 cm lateral to the vertex on a line from the vertex to the external auditory meatus, bilateral responses in the masseter, orbicularis oculi, mentalis, and sternocleidomastoideus muscles with a delay of about 10 to 14 ms after the stimulus occurred. Similar to the transcranially evoked muscle responses in hand muscles, the responses in the cranial muscles can be influenced in latency and amplitude by background excitation. It is concluded that these responses are induced by excitation of the face-associated motor cortex followed by multiple I-waves in the corticonuclear tract with both ipsilateral and contralateral projections to the corresponding motoneurones. Additionally, at higher stimulation strengths “short-latency” ipsilateral responses in muscles supplied by the trigeminal, facial, and accessory nerves occurred which we suggest are induced by direct stimulation of the peripheral cranial nerves in their intracisternal course. The present study confirms the bilateral projection of corticonuclear tracts in awake unanesthetised human subjects which has been observed by electrical stimulation on the exposed cortex during surgical procedures already decades ago. The present investigation will serve as a basis for the assessment of pathophysiological mechanisms involving the corticonuclear system or the peripheral cranial nerves in their proximal parts in awake humans.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00248756
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  • 5
    Electronic Resource
    Electronic Resource
    Reorganisation of descending motor pathways in patients after hemispherectomy and severe hemispheric lesions demonstrated by magnetic brain stimulation (1991)
    Springer
    Experimental brain research 83 (1991), S. 419-426 
    Details
    ISSN: 1432-1106
    Keywords: Magnetic brain stimulation ; Hemispherectomy ; Corticospinal tract ; Cortico-reticulospinal pathways ; Human
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Numerous clinical studies on patients after hemispherectomy (HS) have provided clear evidence that two distinct groups can be recognized on the basis of the quality of their motor functions after operation. One of these consists of cases where HS was performed after normal brain maturation, the other of patients where the removed hemisphere was damaged early in life. The post-operative motor function has been found to be much better in the latter group. In the present paper it is demonstrated that in contrast to normal subjects ipsilateral compound muscle action potentials (CMAPs) induced by magnetic stimulation of the one intact motor cortex are present in patients after HS. The amplitudes of ipsilateral CMAPs in the muscles roughly correlate with their individual residual motor capacities and show a proximo-distal gradient. In patients with early brain damage prior to HS, CMAPs had short latencies and large amplitudes, whereas in patients with later acquired brain damage prior to HS, CMAPs had long latencies and small amplitudes. It is suggested that reinforcement of the ipsilateral corticospinal pathway may be responsible for residual motor functions in patients with early brain damage, whereas in patients with later acquired brain damage cortico-reticulospinal pathways may play a dominant role in ipsilateral motor control.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00231167
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  • 6
    Electronic Resource
    Electronic Resource
    Functional organisation of corticonuclear pathways to motoneurones of lower facial muscles in man (1994)
    Springer
    Experimental brain research 101 (1994), S. 465-472 
    Details
    ISSN: 1432-1106
    Keywords: Magnetic stimulation ; Single motor units ; Lower facial muscles ; Corticobulbar connexions ; Human
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract EMG responses were recorded from lower facial muscles (depressor labii inferioris or depressor anguli oris) of 12 normal subjects after magnetic stimulation of the motor cortex. Using a figure-of-eight stimulating coil, the largest responses were obtained from points around 8–10 cm lateral to the vertex. Usually they were bilateral and had the same latency (11–12 ms) on both sides of the face. Patients with complete Bell's palsy had no response in muscles on the same side as the lesion, indicating that the ipsilateral component to cortical stimulation was not the result of recrossing in the periphery of nerve fibres from the contralateral side. Single-unit studies showed that cortical stimulation produced two phases of motoneuronal facilitation: a short-latency (central motor delay from contralateral cortex to the intracranial portion of the facial nerve, 7.6 ms), short-duration (1– to 2-ms duration peak in the post-stimulus time histogram) input, which was more commonly evoked by contralateral than ipsilateral stimulation; and a longer latency (central delay 〉 15 ms), long-duration input evoked equally well from either hemisphere. The former may represent activity in a predominantly contralateral oligosynaptic corticobulbar pathway; the latter, a polysynaptic indirect (e.g. co-rticotegmento-nuclear) bilateral pathway to lower facial muscles.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00227339
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  • 7
    Electronic Resource
    Electronic Resource
    Complex repetitive discharges in the iliopsoas muscle (1988)
    Springer
    Journal of neurology 235 (1988), S. 411-414 
    Details
    ISSN: 1432-1459
    Keywords: Electromyography ; Spontaneous activity ; Iliopsoas muscle ; Diabetic polyneuropathies ; Radiculopathies
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A prospective electromyographic investigation of lower limb muscles in patients with different neurogenic disorders showed that complex repetitive discharges (CRD) were observed predominantly and often only in the iliopsoas muscle. Analysis of the EMG findings in acute and chronic lesions shows that CRD are a feature of a chronic proximal motor axon lesion. Furthermore, the frequently focal occurrence of CRD in the iliopsoas muscle in clinically distal diabetic polyneuropathies suggests that this muscle and its nerves represent a locus minoris resistentiae.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00314483
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  • 8
    Electronic Resource
    Electronic Resource
    Motor responses evoked by magnetic brain stimulation in psychogenic limb weakness: diagnostic value and limitations (1992)
    Springer
    Journal of neurology 239 (1992), S. 251-255 
    Details
    ISSN: 1432-1459
    Keywords: Magnetic brain stimulation ; Psychogenic weakness ; Central weakness ; Corticospinal tract function
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The latencies and amplitudes of responses evoked by magnetic brain stimulation (magnetic evoked potentials, MEP) in the first dorsal interosseus and the anterior tibial (TA) muscles were investigated in 15 patients with psychogenic limb weakness and in 50 patients with limb weakness due to established organic central nervous system disease. Of the patients with psychogenic limb weakness, 3 presented with upper limb monopareses, 2 with lower limb monoparesis, 4 with hemipareses, 4 with parapareses and 2 with paraparesis. All patients with psychogenic weakness had MEP in arm and leg muscles with latencies within the normal range. MEP amplitudes were also normal except for 1 patient in whom the response amplitude in the TA of the plegic limb was reduced. In patients with limb weakness due to established organic disease, MEP were frequently but not invariably abnormal. In patients with plegic (i.e. completely paretic, MRC grade 0) muscles due to organic disease, MEP always were clearly abnormal. Normal MEP were sometimes elicited from paretic muscles, more commonly in association with cerebral hemisphere lesions than with spinal lesions. We conclude that psychogenic limb weakness is associated with normal MEP. However, normal MEP in mildly paretic muscles do not definitely exclude organic pathology.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00810346
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  • 9
    Electronic Resource
    Electronic Resource
    Morphology of acallosal brains as assessed by MRI in six patients leading a normal daily life (1998)
    Springer
    Journal of neurology 245 (1998), S. 106-110 
    Details
    ISSN: 1432-1459
    Keywords: Key words Agenesis of the corpus ; callosum ; Asymptomatic ; Magnetic ; resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The pattern of anatomical features of the brain revealed by magnetic resonance imaging (MRI) is described in six patients incidentally identified as having acallosal brains. The complex of morphological features associated with complete agenesis of the corpus callosum included lateral displacement of slit-like anterior horns of the lateral ventricles (bullhorn-like shape), dilatation of the posterior horns of the lateral ventricles, absence of the septum pellucidum, lateral displacement of the cingulate gyri, complete separation of fornices and the presence of the anterior commissure and longitudinal callosal bundles (Probst’s bundles). No compensatory enlargement of the anterior commissure was seen in the patients. The planimetrically measured cross-sectional areas of the anterior commissures were between 2.0 and 4.2 mm2 (mean 3.1) (in ten normal subjects they were 4.5, SD 0.4; range 3.8–5.2 mm2) and were reduced in four and normal in two patients. Inconstant morphological features were an absence of the posterior commissure and a radial pattern of the sulci and gyri on the medial aspect of the hemispheres. Conventional clinical testing revealed no abnormalities except a slight impairment of walking heel-to-toe in two patients. None of the patients had subjective restrictions of activities of daily life, which shows the efficacy of unknown compensatory processes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004150050187
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  • 10
    Electronic Resource
    Electronic Resource
    Scalp potentials recorded over the sensorimotor region following magnetic stimulation over the cerebellum in man: Considerations about the activated structures and their potential diagnostic use (1995)
    Springer
    Journal of neurology 242 (1995), S. 109-112 
    Details
    ISSN: 1432-1459
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00887826
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