ABSTRACT
INTRODUCTION: The reversible electrochemical effects of electroconvulsive therapy (ECT) on specific areas of the brain enable the neuroanatomical bases of some cognitive functions to be studied. In research carried out on memory systems, a selective alteration of the declarative ones has been observed after treatment with ECT. Little work has been done to explore the differential alteration of the memory subsystems in patients with a high number of ECT sessions. AIM. To study the declarative and non declarative memory system in psychiatric patients submitted to maintenance ECT treatment, with a high number of previous ECT sessions. PATIENTS AND METHODS: 20 patients submitted to treatment with ECT (10 diagnosed as having depression and 10 with schizophrenia) and 20 controls, who were paired by age, sex and psychopathological diagnosis. For the evaluation of the declarative memory system, the Wechsler Memory Scale (WMS) logical memory test was used. The Hanoi Tower procedural test was employed to evaluate the non declarative system. RESULTS: Patients treated with ECT performed worse in the WMS logical memory test, but this was only significant in patients diagnosed as suffering from depression. No significant differences were observed in the Hanoi Tower test. CONCLUSIONS: A selective alteration of the declarative systems was observed in patients who had been treated with a high number of ECT sessions, while the non declarative memory systems remain unaffected.
Subject(s)
Electroconvulsive Therapy/adverse effects , Memory/physiology , Adolescent , Adult , Aged , Depression/therapy , Humans , Middle Aged , Neuropsychological Tests , Schizophrenia/therapyABSTRACT
Cortical laminar necrosis (CLN) is radiologically defined as high intensity cortical lesions on T1 weighted MRI images following a gyral distribution. Histopathologically, CLN is characterised by pannecrosis of the cortex involving neurones, glial cells, and blood vessels. It has been reported to be associated with hypoxia, metabolic disturbances, drugs, and infections. We present two patients who developed CLN and permanent neurological deficits after prolonged and repeated focal status epilepticus. The possible mechanisms leading to CLN in these patients are discussed, together with the implications of prompt and aggressive treatment in similar cases.
Subject(s)
Cerebral Cortex/pathology , Necrosis/etiology , Necrosis/pathology , Status Epilepticus/complications , Status Epilepticus/physiopathology , Adult , Anticonvulsants/therapeutic use , Aphasia, Wernicke/diagnosis , Aphasia, Wernicke/etiology , Brain Diseases/diagnostic imaging , Brain Diseases/etiology , Brain Diseases/pathology , Cerebral Cortex/diagnostic imaging , Functional Laterality , Hemianopsia/diagnosis , Hemianopsia/etiology , Humans , Levetiracetam , Magnetic Resonance Imaging , Male , Middle Aged , Necrosis/diagnostic imaging , Paresis/diagnosis , Paresis/etiology , Phenytoin/therapeutic use , Piracetam/analogs & derivatives , Piracetam/therapeutic use , Status Epilepticus/drug therapy , Tomography, Emission-Computed, Single-PhotonABSTRACT
Complex motor behaviors differing from typical automatisms were found in 12 of 502 patients with temporal lobe epilepsy. Movements involved proximal limb segments (6) or body axis (6) and were often preceded by auras and followed by automatisms. Seven of 12 patients are seizure free after surgery. The other 5 patients declined surgery.