Revisit Spinal Shock: Pattern of Reflex Evolution during Spinal Shock / 대한신경손상학회지

When the spinal cord is suddenly severed, all the fundamental functions of the spinal cord below the level of injury including the spinal cord reflexes are immediately depressed, which is referred to as spinal shock. The resolution of spinal shock occurs over a period of days to months, and spinal shock slowly transitions to spasticity. The definition of spinal shock and the pattern of reflex recovery or evolution remains as an issue of debate and controversy. The identification of clinical signs that determine the duration of spinal shock is controversial. The underlying mechanisms of spinal shock are also not clearly defined. Various authors have defined the termination of spinal shock as the appearance of the bulbocavernosus reflex, the recovery of deep tendon reflexes, or the return of reflexic detrusor activity. However, many questions remain to be answered, such as: When should we define spinal shock as the end? What types of reflexes appear first among polysynaptic cutaneous reflexes, monosynaptic deep tendon reflexes, and pathological reflexes? Should it include changes in autonomic reflexes such as a detrusor reflex?

Efeito do bilinguismo no resgate automático das palavras nos anos iniciais do ensino fundamental / Effect of bilingualism on automatic word retrieval in the first years of elementary school

RESUMO Objetivo Investigar, em escolares das séries iniciais do ensino fundamental (EF), efeitos do bilinguismo na velocidade e precisão do acesso ao léxico mental, conforme o tempo de exposição ao segundo idioma. Métodos Participaram 83 crianças entre 6 e 8 anos de idade, matriculadas nos dois primeiros anos do EF de escolas particulares, uma bilíngue (Português/Inglês), outra monolíngue (Português), com currículos pareados. Os professores indicaram os participantes que não apresentavam problemas sensoriais, motores, neurológicos, ou psiquiátricos. Todos tinham, como língua materna, o Português Brasileiro. Foram agrupados por escola e ano escolar (1o e 2o). Constituíram-se dois grupos: Grupo Bilíngue - GB - 43 escolares (53,3% meninas) com, pelo menos, dois anos de exposição ao Inglês, média de idade = 6,6 e Grupo Monolíngue - GM - 40 escolares (46,7% meninas), média de idade = 6,9. Foram avaliados em prova de nomeação rápida de objetos, quanto à velocidade e precisão de acesso ao léxico mental. O GB foi avaliado em Português e Inglês (um mês de intervalo) e o GM, em Português. As distribuições foram comparadas pelo teste Qui-quadrado e as médias corrigidas pelo teste de Bonferroni (nível de significância fixado em p<0,05). As comparações entre GB e GM foram feitas por análise de variância. Resultados As amostras pareadas apresentaram, nas condições de nomeação rápida (Português ou Inglês), efeito geral para grupo e ano escolar, quanto à velocidade e precisão. A ANOVA mostrou melhor desempenho em tempo do GM, somente na comparação com GB, em Inglês. Conclusão A exposição ao Inglês não interferiu na velocidade ou precisão de nomeação em Português, no GB. A progressão escolar influenciou positivamente os grupos.

ABSTRACT Purpose Investigate the effects of bilingualism on the speed and accuracy of access to the mental lexicon, according to the time of exposure to the second language, in students of the first years of elementary school. Methods Eighty-three children between six and eight years old (M = 6.8y, SD = 0.72), in the first two years of elementary school in private schools with matching curricula, were assessed: bilingual (Portuguese/English), monolingual (Portuguese). Teachers indicated that they did not present sensory, motor, neurological, or psychiatric problems. Participants had Brazilian Portuguese (L1) as their native language and were grouped by school and grade (1st and 2nd). Bilingual Groups (BG: schoolchildren with at least two years of exposure to English; N = 44, 57% girls) and Monolingual Groups (MG: N = 40, 52.5% girls) were considered. A Rapid Automatized Naming task was used to evaluate the speed and accuracy of access to the mental lexicon. BG was evaluated in Portuguese and English (01 month interval); MG, in Portuguese. A MANOVA was conducted, and Wilks lambda (l) used to verify the effect of each variable (significance level: p <0.05). Results The paired samples (c2 (1) = 0.310, p = 0.577) showed a general effect for group and grade (L1 or L2) for speed and accuracy. Differences in speed were observed between MG and BG for L2. Conclusion L2 exposure did not interfere with the speed or accuracy in rapid naming of L1 in BG. School progression had a positive influence on both groups.

Tradição clínica da psiquiatria, psicanálise e práticas atuais em saúde mental / Psychiatry's clinical tradition, psychoanalysis and tradition clinique de la psychiatrie, psychanalyse et pratiques actuelles en santé mentale / Tradición clínica de la psiquiatría, psicoanálisis y prácticas actuales en salud mental / Psychiatry's clinical tradition, psychoanalysis and current practices in mental health

Este artigo aborda a clínica da psicose no campo da saúde mental propondo uma retomada de categorias da psiquiatria clássica pela psicanálise, especialmente o automatismo mental. Seu objetivo é demonstrar a utilidade do que pode ser considerado um programa de trabalho para o campo de tratamento da psicose na saúde mental, polarizado hoje entre o reducionismo biológico e a atenção psicossocial. A riqueza clínica dessas descrições psiquiátricas clássicas, em sua releitura pelo viés da teorização lacaniana, possibilita reconhecer o funcionamento complexo da psicose e, em particular, o trabalho do sujeito para fazer face às dificuldades impostas por essa condição. Como conclusão, o automatismo mental de Clérambault é analisado visando a demonstrar a dependência estrutural de todo sujeito em relação à linguagem e ao significante, fato primeiro do qual deriva a subjetividade como efeito.

L'article discute la clinique de la psychose dans le domaine de la santé mentale proposant un repris par la psychanalyse des catégories de la psychiatrie classique tel que l'automatisme mental. Son objectif est de démontrer l'utilité de ce qu'on peut considérer un programme de travail pour le champ du traitement de la psychose dans la santé mentale, polarisé aujourd'hui entre le réductionnisme biologique et la réhabilitation psychosociale. La richesse clinique de ces descriptions psychiatriques classiques, repris par le biais de la théorie lacanienne, permet de reconnaître la complexité de la psychose et surtout le travail du sujet pour faire face aux difficultés imposées par cette condition. En conclusion, l'automatisme mentale de Clérambault est analysé pour démontrer la dépendance structurelle de tous les sujets par rapport au langage et au signifiant, fait premier duquel la subjectivité dérive comme un effet.

Este texto trata de la clínica de la psicosis y propone que se retomen, a través del psicoanálisis, las categorías de la psiquiatría clásica, principalmente el automatismo mental. El objetivo es demonstrar la utilidad de este programa de trabajo para el tratamiento de la psicosis en los servicios de salud mental, hoy polarizado entre el reduccionismo biológico y la rehabilitación psicosocial. La riqueza clínica de tales descripciones clásicas, desde la teoría de Lacan, permite reconocer el funcionamiento complejo de la psicosis y el trabajo hecho por el sujeto para enfrentar las dificultades impuestas por esta condición. A modo de conclusión, se analiza el automatismo mental de Clérambault con el fin de demostrar la dependencia estructural de todo sujeto en cuanto al lenguaje y al significante, hecho que produce la subjetividad como efecto.

The paper analyzes the clinic of psychosis in the mental health field by revisiting classical psychiatry categories through psychoanalysis, especially mental automatism. This paper aims to demonstrate the usefulness of what may be considered a working plan for the clinic of psychosis, which is today polarized into biological reductionism and psychosocial care. The accuracy of these classical psychiatric descriptions, revisited through Lacan's theory, enables the recognition of the complexity of psychosis and especially the subject's efforts to tackle the difficulties that result from this condition. In the conclusion, we analyze Clérambault's syndrome called "mental automatism" so as to demonstrate every subject's structural dependency on language and on the signifier, from which the subjectivity as an effect is derived.

A paixão pelo autômato: a clínica para o cuidado em saúde no templo da tecnologia / The passion for the automaton: clinics for health care in the technology temple

A paixão pelo autômato é a expressão que procura problematizar a cultura contemporânea a partir dos efeitos da tecnologia e da ciência no modo de vida capitalista. Inspirado nos trabalhos da atividade de extensão universitária coordenada pelos autores em 2013, na Universidade Federal do Rio Grande do Sul (UFRGS), em que clássicos cinematográficos de ficção científica operavam como mote para as problematizações, este ensaio procura desenvolver o recorte acerca da escuta e do tratamento clínico no contexto de práticas contemporâneas do cuidado em saúde. Ao final, ao trabalhar o problema de saber o que parece elevar o autômato ao status de ideal humano, procura-se traçar uma diferenciação entre técnica e tecnologia para encaminhar série de estudos acerca da automatização nas práticas e relações humanas.

The passion for the automaton is the expression that tries to problematize contemporary culture from the effects of technology and science in the capitalist mode of life. Inspired by the works of university extension activities coordinated by the authors in 2013, at the Federal University of Rio Grande do Sul (UFRGS), in which science fiction classic films were theme for problematization, this essay brings the clipping of listening and clinical treatment questionings regarding the context of health care practices. At the end, when working the problem of knowing what seems to elevate the status of the automaton as a human ideal, it traces the differentiation between technique and technology to route series of studies on the automation practices and human relations.

Acessibilidade crônica e agenda setting: interface entre a psicologia e a comunicação no estudo da beleza / Accesibilidad crónica y agenda setting: interface entre la psicología y la comunicación en el estudio de la belleza / Chronic accessibility and agenda setting: interface between psychology and communication in a study about beauty

O objetivo deste trabalho foi estudar o automatismo e a acessibilidade crônica, por meio da comparação entre a comunicação formal (mídia) e a informal (discurso verbal), testando a hipótese do agenda setting como uma possibilidade de investigação. O Estudo 1 foi realizado por meio de entrevistas semiestruturadas a grupos diferentes de mulheres. O Estudo 2 foi de análise de conteúdo de revistas femininas baseado nas categorias encontradas no Estudo 1. Os resultados suportam parcialmente a proposta teórica de agendamento e sugerem três dimensões discursivas: Finalidades da Beleza, Aspectos que Impactam no Cuidado, Tipos de Cuidado. A mídia não influenciou como se esperava. As frequências são diferentes entre o discurso midiático e o verbal.

El objetivo de este trabajo es estudiar el automatismo y la accesibilidad crónica, mediante la comparación entre la comunicación formal (medios de comunicación) y la informal (discurso verbal), testando la hipótesis del agenda setting como una posibilidad de investigación. El Estudio 1 fue realizado con entrevistas semiestructuradas a grupos diferentes de mujeres. El Estudio 2 fue de análisis de contenido de revistas femeninas, embasado en las categorías encontradas en el Estudio 1. Los resultados corroboraran parcialmente la propuesta teórica del agendamiento y sugirieran tres dimensiones discursivas: Finalidades de la Belleza, Aspectos que impactan el Cuidado y Tipos de Cuidado. Los medios de comunicación no influenciaran como se esperaba. Las frecuencias son diferentes entre el discurso verbal y el de los medios de comunicación.

The present research aims to investigate automatism and chronic accessibility, through a comparison between formal (media) and informal (verbal discourse) communication styles, providing evidences for the agenda setting as mean for investigation. In Study 1, semi-structured interviews were made in different groups of women. In the second study, the content of feminine magazines was analyzed, based on the categories found in the latter. Results partially support the theoretical proposal of agenda setting, and suggest three discursive dimensions: Beauty Finality, Aspects that impact in Care, Types of Cares. Results also suggest that media does not have the expected influence. Different frequencies were found for the meiotic and verbal discourses.

Expertise in automatism study: An application in the consumption of esthetics / Expertise no estudo de automatismo: Uma aplicação em consumo de estética / Expertise en el estudio de automatismo: Una aplicación en el consumo de estética

Expertise is one of the ways one can make one’s behaviors become automatic, and with consumption it is no different. Explanatory models of this sort of behavior described in the literature up to now have considered only conscious or rational buying, and do not apply to automatic buying. The model proposed here is inspired by, and adapted from, the behavior analyses, integrating variables that have typically been neglected in the traditional models, such as contextual variables. This study aimed to describe the relationship between the reports of behavior linked to the consumption of esthetics (operationalized in four variables: commenting, getting information, using cosmetic products and services) and the individual variables and those of the setting where purchases related to beauty were made. In order to do so, 953 Brazilian women responded to an online questionnaire. The model was tested and partially confirmed. Contextual social-psychological variables were the only ones to predict routine buying. Demographic and individual variables did not account for the variance explanation of the behaviors measured. It is suggested that further studies should use and contribute to this model to enhance the understanding of automatic buying...

A rotina é uma das formas de automatizar comportamentos e em consumo não é diferente. Os modelos explicativos de compra descritos na literatura partem de compras conscientes ou racionais e não se aplicam às automáticas. O modelo proposto aqui é inspirado e adaptado da análise do comportamento e trata de integrar outras variáveis tipicamente negligenciadas nos modelos tradicionais, incluindo variáveis contextuais. O objetivo deste estudo foi descrever a relação entre os relatos de comportamentos ligados ao consumo de beleza (operacionalizados em quatro variáveis: comentar, informar-se, usar produtos e serviços cosméticos) e as variáveis individuais e de cenário de compra direcionadas à beleza. Para isso, responderam a um questionário online 953 mulheres brasileiras. O modelo foi testado e parcialmente confirmado. As variáveis psicológicas contextuais sociais foram as únicas que predisseram os comportamentos de compra rotineira. As variáveis demográficas e as individuais não entraram como variáveis explicativas em nenhum dos comportamentos mensurados. Sugere-se que novos estudos utilizem e contribuam para este modelo no intuito de auxiliar no entendimento da compra automática...

La rutina es una de las formas de automatizar la conducta y en consumo no es diferente. Los modelos explicativos de compra descritos en la literatura son de compras conscientes o racionales y no se aplican a las automáticas. El modelo propuesto aqui es inspirado y adaptado de la análise de la conducta y trata de integrar otras variables tipicamente negligenciadas en los modelos tradicionales, incluyendo variables contextuales. La finalidad de este estudio fue describir la relación entre los relatos de conductas vinculadas al consumo de estética (operacionalizadas en cuatro variables: comentar, informarse, usar productos y servicios cosméticos) y las variables individuales y de contexto de compra dirigidas a la estética. Contestaron a un cuestioário online 953 mujeres brasileñas. El modelo fue testado y parcialmente confirmado. Las variables psicológicas contextuales sociales fueron las únicas que predijeron las conductas de compra rutinera. Las variables demograficas e individuales no entraron como variables explicativas en ninguno de las conductas medidas. Sugiérese que nuevos estúdios utilicen y contribuyan para este modelo en el intuito de auxiliar en el entendimento de compra automática...

Tratamento cirúrgico para automatismos sexuais em crises parciais complexas: relato de caso e revisão da literatura / Surgical treatment for sexual automatisms in complex partial seizures: case report and literature review

Relatamos caso raro de crises parciais complexas com automatismos genitais secundárias a tumor temporal. Paciente foi submetida à lobectomia temporal direita com remissão completa dos sintomas. Após revisão da literatura, fica evidenciado que crises podem ser originadas tanto no lobo frontal quanto temporal.

We report a rare case of sexual automatism in complex partial seizures secondary to temporal tumor. Patient underwent a right temporal lobectomy with complete remission of symptoms. After reviewing the literature, it is evident that the crisis can arise in both the frontal and temporal.

La repetición y lo real: de Aristóteles a Lacan / Repetition and real: from Aristotle to Lacan

El presente trabajo tiene por fin indagar la referencia que introduce Lacan en El Seminario 11, aquella relacionada con las causas accidentales propias de la teoría aristotélica. Es el interés que las mismas revisten el que le permite conceptualizar de un modo inédito el estatuto de la repetición. Fundamentalmente en lo que respecta a esta última, es pasible afirmar que tanto tyché como automatón posibilitan dilucidar de manera innovadora las coordenadas problemáticas que comporta el concepto freudiano de repetición, al abordarla no sólo desde la insistencia significante, marcada por la lógica que rige la dimensión simbólica, sino precisamente a partir de lo real puesto allí en juego.

Reflex seizures induced by micturition: A pediatric case and ictal EEG finding / 소아과

Reflex seizures induced by micturition are rare, and there have been few reports on ictal electroencephalogram (EEG) findings. Here, we report a 7-year-old boy with secondarily generalized partial seizures induced by micturition. The seizures occurred every time he urinated. A few seconds after micturition begun, he toppled down with hand automatism followed by a secondarily generalized tonic posture and loss of consciousness. Ictal video-EEG recording during urination was performed. An ictal EEG demonstrated a polyspike wave discharge onset from the left frontotemporal region, with rapid spread to the right frontotemporal region. He was treated with the antiepileptic drug valproate sodium, which improved seizure control. He remained seizure-free until the last followup for a period of 2 years.

Postoperative Electroclinical Features in Epilepsy Patients With Seizures After Anteromesial Temporal Resection

BACKGROUND: Anteromesial temporal resection (AMTR) is well established as effective in patients with intractable mesial temporal epilepsy. However, little electroclinical information is available relevant to poor surgical outcome after AMTR. We examined the postoperative electroclinical features based on postoperative MRI and video-EEG monitoring (VEM) in patients with poor surgical outcome. METHODS: We reviewed clinical features and postoperative VEM results in 20 patients with failure in AMTR. According to the postoperative electroclinical features, we classified them into mesial temporal (MT), bitemporal (BT), extramesial temporal (XMT), combined (C), and unclassified groups. The postoperative VEM results were compared among the groups. Surgical outcome was assessed in five patients who underwent reoperation. RESULTS: Patients comprised 6 MT, 2 BT, 6 XMT, 1 C, and 6 unclassified. Aura and automatism were more frequent in MT (50.0%, 83.3%) than in XMT (16.7%, 33.3%). Theta to delta rhythm, during the ictal onset and build-up period, was more frequent in MT (83.3%, 66.7%) than in XMT (33.3%, 33.3%). The ictal onset and build-up pattern of ictal EEG were most frequently localized to the frontotemporal region in MT (66.7%, 100.0%), while there was no predominantly localized region in XMT. The surgical outcome after reoperation was better in MT group than in XMT and C groups. CONCLUSIONS: Postoperative MRI and VEM are useful to assess the postoperative electroclinical features in failed AMTR. Reoperation of the residual mesiotemporal structures after confirming epileptogenic foci may have good surgical outcome.

Estrutura, memória e a emergência da lei no Seminário sobre A carta roubada / Structure, memory and the emergence of the law in the Seminar on The purloined letter

Apesar de o Seminário sobre A carta roubada ser um dos escritos mais claros de Lacan, em uma parte importante e densa do texto um formalismo lógico-matemático sinteticamente apresentado torna a leitura de difícil acesso à maioria dos leitores. Além disto, hipóteses não explicitamente assumidas por Lacan neste trecho de seu escrito induzem o leitor a considerar como absolutos resultados que, infelizmente, possuem restrições quanto à generalização. Este artigo se propõe a analisar detidamente estes trechos obscuros e informais do texto e trazer à luz, não só as hipóteses assumidas por Lacan, mas, além disto, as conseqüências para sua própria teoria. Adicionalmente, uma discussão sobre os processos de auto-organização, segundo a moderna teoria da complexidade, se abre para atualizar as idéias de Lacan sobre a formação da estrutura do simbólico

Albeit the Seminar on The purloined letter is one of the clearest of the writings of Lacan, in a especially dense part of the text a logical-mathematical formalism makes the rationale difficult for the understanding of the majority of the readers. In addition, some hypothesis not explicitly assumed by Lacan in this part of his paper lead the reader to consider as absolute some conclusions that unfortunately can not be considered as such. This paper aims to analyse carefully these specific obscure parts of the text, bringing light, not only over Lacan’s subsumed hypothesis, but also on the consequences over his own theory. Some results from the theory of complexity, specially the self-organization phenomena, are used to update Lacan ideas about the genesis of the symbolic structure of the unconscious

Clinico-electrical Characteristics of Lateral Temporal Lobe Epilepsy; Anterior and Posterior Lateral Temporal Lobe Epilepsy

BACKGROUND AND PURPOSE: This study aimed to determine whether there are clinicoelectrical differences between anterior lateral temporal lobe epilepsy (ALTLE) and posterior lateral temporal lobe epilepsy (PLTLE), taking medial temporal lobe epilepsy (MTLE) as a reference. METHODS: We analyzed the historical information, ictal semiologies, and ictal EEGs of temporal lobe epilepsy patients with a documented favorable surgical outcome (Engel class I or II) at follow-up after more than one year. LTLE was defined when a discrete lesion on MRI or an ictal onset zone in invasive study was located outside the collateral sulcus. LTLE was further divided into ALTLE and PLTLE by reference to the line across the cerebral peduncle. Total 107 seizures of 13 ALTLE, 8 PLTLE and 21 MTLE patients were reviewed. RESULTS: Initial hypomotor symptom was frequently observed in PLTLE (P<0.001). Oroalimentary automatism (OAA) was not observed initially in PLTLE. Generalized tonic-clonic seizures occurred significantly earlier in PLTLE than in ALTLE or MTLE (P< 0.001). Ictal scalp EEG was not helpful in differentiating between ALTLE and PLTLE. CONCLUSIONS: Frequent hypomotor onset, the absence of initial oroalimentary automatism, and early generalization are characteristic findings of PLTLE, although they are insufficient to differentiate it from ALTLE or MTLE.

Clinical Characteristics of Temporal Lobe Epilepsy in Childhood / 대한소아신경학회지

PURPOSE:Temporal lobe epilepsy(TLE) is now recognized as a distinct syndrome in adults. The seizure evolution in adult patients is well characterized, manifesting initially with an aura, behavioral arrest, automatism, and secondary generalized tonic-clonic seizures. In contrast, relatively few studies are available for the pediatric age group. In the present study, we investigated children undergoing temporal lobectomy for refractory seizures and correlated the pathologic findings with clinical presentations. METHODS:The records of the pediatric patients admitted at the Seoul National Children's Hospital for epilepsy surgery between January 1995 and December 2005 were reviewed. Then, eighteen patients were included in this study. The clinical records were reviewed in terms of the patient profiles imaging findings, surgical techniques, and pathologic findings. The seizure outcomes were described according to the Engel's classification. RESULTS:The postsurgical outcomes were favorable. Lateral temporal epilepsy was more common in childhood than in adulthood. Dual pathology was commonly found. Arm dystonia or tonic arm elevation have a lateralizing value. Head turning may have a lateralizing value based upon a time sequence. The brain MRI was less predictable for pathologic findings. The ictal EEG cannot always have a localizing value. Delta beginning in the ictal rhythm may suggest lateral lobe epilepsy. Anterior temporal beginning of the ictal location may suggest mesial temporal lobe epilepsy. Ganglioglioma tends to cause rhythmic beta activities at the beginning of the ictal event. CONCLUSION:TLE in childhood shows more complex and atypical clinical manifestations and have more variable etiologies. No single presurgical investigation can be a good predictable value to localization or lateralization.

Ictal Spitting in a Patient with Dominant Temporal Lobe Epilepsy: Discrepancy between Epileptogenic and Symptomatogenic Areas for Spitting Automatism

Ictal spitting is an unusual manifestation that originates from the non-dominant hemisphere, but rarely from the dominant hemisphere. In the latter case, it has not been well defined as to whether symptomatogenic area for ictal spitting originates from the dominant hemisphere. We present a patient with ictal spitting. Intracranial EEG demonstrated a left hippocampal onset with propagation to the right hemisphere, and subsequent ictal spitting development. Even in dominant hemispheric seizures, the non-dominant hemisphere is a symptomatogenic area for ictal spitting.

Impedidor labial para paciente com seqüela de lesão encefálica adquirida / Lip blocker use for patient with acquired encephalic lesion sequela

A espasticidade é um distúrbio freqüente nas lesões congênitas ou adquiridas do sitema nervoso central e afeta milhões de pessoas. O objetivo deste estudo foi demonstrar a importância da atuação do Cirurgião-dentista na promoção de tratamento adequado a um paciente com seqüela de lesão encefálica adquirida, com a confecção de um impedidor labial. Relatamos um caso de paciente em coma profundo há 130 dias, pós-parada cardiorrespiratória. Apresentava traumatismo recorrente em mucosa interna de lábio inferior, resultado do automatismo oral de natureza reflexa com mordida tônica e interposição do lábio inferior entre as superfícies incisais. Foi indicado um impedidor labial para atuar de forma a distanciar e proteger o lábio inferior dos arcos dentais, evitando a sua interposição entre as superfícies incisais. Foi realizada moldagem com silicona pesada, de condensação, em paciente semi-sentada, apresentando abertura bucal de 5 mm, e mantida com auxílio de garrote de borracha entre molares superiores e inferiores esquerdos. Foi feita a confecção de uma placa de acrílico interoclusal para estabilização da face vestibular do impedidor labial, em acetato. Instalado, respeitaram-se as inserções dos freios e bridas, com indicação de uso contínuo. Sete dias após a instalação do mesmo, notou-se evolução favorável no tocante à cicatrização do local anteriormente traumatizado. É de fundamental impotância a participação do Cirurgião-dentista na equipe transdiciplinar que atua em pacientes sequelados neurológicos, pois apenas este profissional pode entender e modificar a ação deletéria do dano neurológico em cavidade bucal.

Reliability of Semiology Descriptions by Frequent Observers

BACKGROUND: Semiology of epileptic seizure is very important for diagnosis and treatment. However, little is known about the reliability of the observers' description. This study aims to determine the description reliability of seizures in the aspects of classification and lateralization. METHODS: We recorded 72 patients with habitual seizures during video-EEG monitorings. We, then, compared the ictal behaviors described by frequency observers and those recorded on the videotape to compare the accuracy of the observers' descriptions. Finally, we reviewed which aspects of the informants affected the reliability of the data. RESULTS: The classification of seizures based only on the observer-description was somewhat discordant from the videotape (correct classification: 82%) especially in dividing simple partial from complex partial seizures. Description of many ictal behaviors in presumed complex partial seizure such as oroalimentary automatism, motionless staring, tonic/clonic posture and version was accurate except for the hand automatism. A specified direction by the observer has a very high true positive rate. The accuracy of the description was related to the educational status of the observer. CONCLUSIONS: Semiology description by well-educated observers is may be reliable, but every physician should keep its limitation in mind and judge accordingly.

A experiência surrealista da linguagem: Breton e a psicanálise / x

Este artigo apresenta alguns aspectos da experiência surrealista da linguagem nos anos 1920, mostrando que o automatismo surrealista se inspira no funcionamento do inconsciente proposto por Freud. Considerando a linguagem como fundamento da realidade humana, Breton antecipa as formulações de Lacan sobre o eu e a realidade. No entanto, a primeira concepção lacaniana da linguagem, circunscrita exclusivamente ao simbólico, separa Lacan do surrealismo. Apenas nos anos 1970, a teoria da linguagem em Lacan permitirá pensar a prática surrealista da linguagem.

The surrealist experience of language: Breton and the psychoanalysis. This article presents some aspects of the surrealist experience of language in the twenties, showing that the surrealist automatism is inspired by the functioning of the unconscious as described by Freud. Considering language as the foundation of human reality, Breton anticipates Lacan's formulation of the self and reality. Nevertheless, the first Lacanian conception of language, exclusively circumscribed to the symbolic register, separates Lacan from surrealism. Only in the seventies, will Lacan's theory of language allow the interpretation of the surrealist practice of language.

A Case of Juvenile Onset Lennox-Gastaut Syndrome Presenting as Atypical Absence / 대한간질학회지

Atypical absence is less understood than typical absence. Several conditions that produce atypical absence are known including Lennox-Gastaut syndrome, myoclonic astatic epilpsy and epileptic encephalopathy with continuous spike and waves in slow wave sleep. A 17-year-old girl with mental retardation had developed frequent loss of consciousness and occasional falling attack with traumatic facial injury for 2 years. The interictal EEG showed 2 Hz slow spike-and-wave complex with maximum over right frontotemporal area and the brain MRI was normal. Carbamazepin was prescribed initially but the drug seemed to worsen the seizures. Long term video-EEG monitoring showed very frequent atypical absence seizures consisting of sudden hypotonia of head and oral automatism with or without secondary generalization. Generalized 2 to 2.5 Hz slow spike-and-wave complexes with duration of 10 to 40 seconds were seen during ictal period. About 10% to 20% of the non REM sleep was occupied with generalized slow spike-and-wave complex and/or polyspikes or polyspikes-and-wave complex with duration of within 1 second. Valprorate monotherapy had failed, then lamotrigin was added. In spite of polytherapy, the seizure was intractable. We think this intractable atypical absence might be associated with juvenile onset Lennox-Gastaut syndrome.

La Antoniana Margarita de Gómez Pereira y el origen de la controversia sobre el mecanicismo animal entre realismo, idealismo y materialismo: ejercicio de exploración de una vía indirecta de retorno a la escolástica / Gómez Pereiraïs la Antoniana Margarita and the origin of the controversy over the animal mechanicism between realism, idealism and materialism: an exercise in exploring an indirect route back to scholasticism

La Antoniana Margarita y su autor, Gómez Pereira, son bastante desconocidos en el ámbito de la psicología y la psiquiatría, a pesar de que aquel texto es el primero donde se expone una versión mecanicista de la conducta animal. En este trabajo se dan información histórica sobre ambos y se discuten las premisas filosóficas que están en la base de la obra y en el pensamiento del autor. La cabal comprensión de este texto y su discusión, exigen cierto conocimiento de la psicología escolástica, por lo que se exponen un breve compendio de ella

Hamartoma hipotalámico, una causa de pubertad precoz: caso clínico / Hypothalamic hamartoma causing precocious puberty: report of 1 case

Hypothalamic hamartomas are non neoplastic lesions that may cause precocious puberty with or without complex seizures, personality disorders and mental retardation. We report a 14 years old male that had a precocious puberty at the age of 11 and a prolonged episode of altered sensorium with automatism, that was diagnosed as a complex seizure. Physical examination showed a sexual development classified as Tanner stage III-IV, a height of 168 cm and a weight of 61 kg. Neurological examination was normal. A CAT scan showed a 13x13x9 mm mass in the suprasellar cistern, between the infundibulum and the brain stem, without exerting a mass effect over adjacent structures. It was diagnosed as an hypothalamic hamartoma