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  • 1
    Electronic Resource
    Electronic Resource
    Iktuale Synkopen Kardiale sympathische Innervationsstörung als Ursache? (1998)
    Springer
    Der Nervenarzt 69 (1998), S. 712-716 
    Details
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Iktuale Asystolie ; Kardiale Innervations- störung ; Synkope ; Epilepsie ; Heterotopie ; Neuronale Migrationsstörungen ; Key words Ictal sinus arrest ; Cardiac innervation disturbances ; Syncope ; Epilepsy ; Heterotopia ; Neuronal migration disorders
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary We report 3 cases of an ictal sinus arrest. All patients suffered from temporal lobe epilepsy (TLE). Seizures were monitored with simultaneaous video-eeg during preoperative epilepsy diagnosis. One patient with cortical dysplasia, who frequently suffered from long lasting syncopes, had a nearly completely missing cardiac sympathetic innervation in MIBG-SPECT (=Meta-Iodide-Benzyle-Guanidine-single-photon-emission tomography). Cardiac investigation including long-term ECG and echocardiography had shown normal findings. After epilepsy surgery the syncopal events in all patients disappeared. A dominant parasympathetic ictal stimulus following excitation of the reticular formation might cause the ictal bradycardia and sinus arrest. A missing sympathetic innervation, possibly occurring as fehlbildung together with cortical dysplasia, which makes autoregulation impossible, might then be the explanation for sudden cardiac ictal death.
    Notes: Zusammenfassung Wir berichten über 3 Patienten mit iktualer Asystolie. Alle Patienten litten an einer Temporallappenepilepsie (TLE). Die Anfälle wurden im Rahmen der prächirurgischen Epilepsiediagnostik mit simultaner Video-EEG-Ableitung aufgezeichnet. Bei einer Patientin mit kortikaler Heterotopie, die häufig und besonders lang an Synkopen litt, konnte eine nahezu fehlende kardiale sympathische Innervation im MIBG-SPECT (Meta-Iodid-Benzyl-Guanidin-Single-Photon-Emissions-Computer-Tomographie) des Herzens nachgewiesen werden. Eine kardiologische Untersuchung, inkl. Langzeit-EKG und Echokardiographie, hatte normale Befunde gezeigt. Nach einem epilepsiechirurgischen Eingriff verschwanden die synkopalen Ereignisse bei allen Patienten. Ein epileptogen hervorgerufener dominanter parasympathischer Stimulus nach Erregung der Formatio reticularis wird als Ursache der iktualen Bradykardie und Asystolie diskutiert. Eine sympathische Innervationsstörung des Herzen, möglicherweise als Fehlbildung im Zusammenhang mit kortikalen Migrationsstörungen auftretend, die eine reflektorische Autoregulation unmöglich macht, wird als mögliche Ursache für eine besonders lang andauernde Asystolie und damit auch als Ursache des plötzlichen Herztodes während eines epileptischen Anfalls erörtert.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001150050334
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    99m-Tc-HMPAO-SPECT in diagnosis of early cerebral vasculitis (1996)
    Springer
    Rheumatology international 16 (1996), S. 37-42 
    Details
    ISSN: 1437-160X
    Keywords: Systemic vasculitis ; CNS involvement ; Neurologic symptoms ; 99m-Tc-HMPAO-SPECT imaging ; Early detection and prevention
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The objective of this study was to evaluate whether mild neurological symptoms suggestive of neuropsychiatric involvement may be associated with cerebral perfusion defects as detected by functional brain imaging with 99m-Tc-HMPAO-SPECT (single photon emission computed tomography). SPECT analysis for the early detection of central nervous system (CNS) involvement was evaluated in 40 consecutive patients with systemic vasculitis or with Sneddon's syndrome. Of these, 18 patients showed overt neuropsychiatric symptoms, so-called major symptoms (e.g. motoric or sensible defects); 6 had mild symptoms like headache or cognitive disorders, so-called minor symptoms; 16 patients did not present with any of these symptoms. SPECT abnormalities were detected in 16 of the 18 patients with overt neuropsychiatric symptoms (89%). Five of the 6 patients with minor symptoms (83%) and 5 of the 16 patients without neurological symptoms (31 %) also had SPECT abnormalities. There was no relation to disease activity or duration. We concluded that the high sensitivity of SPECT (87.5%) in detecting perfusion abnormalities among the evaluated group of patients indicates its suitability for early diagnosis of vasculitic CNS involvement.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01419953
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Investigation of parasympathetic and sympathetic cardiac innervation in diabetic neuropathy: Heart rate variation versus meta-iodo-benzylguanidine measured by single photon emission computed tomography (1994)
    Springer
    Clinical autonomic research 4 (1994), S. 117-123 
    Details
    ISSN: 1619-1560
    Keywords: Autonomic diabetic neuropathy ; Heart rate variation ; MIBG-SPECT ; Thermal thresholds
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In diabetic neuropathy disturbed autonomic cardiac innervation is associated with shortened life expectancy. Sympathetic dysfunction is likely to play a role in cases of cardiac death. The quantitative uptake of the radiopharmaceutical iodine-123-meta-iodo-benzylguanidine (MIBG) can be measured by single photon emission computed tomography (SPECT). It is an index of the functional integrity of sympathetic neurones in the heart. The respiratory heart rate variation—as assessed by a computerized device—reflects mainly parasympathetic cardiac innervation. In 25 diabetic patients and 19 healthy subjects MIBG-SPECT and heart rate variation tests were carried out. MIBG scans in all normal subjects showed homogeneous uptake of activity. In 12 out of 25 patients at least two heart rate variation tests were abnormal. MIBG-SPECT was more sensitive (abnormal in 17 out of 25). The lack of correlation between MIBG-SPECT results and spectral analysis of heart rate variation suggest that spectral analysis alone should not be regarded as an indicator of sympathetic cardiac innervation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01845775
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    Paper (German National Licenses)
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