Display of the epileptogenic zone on the frontal cortical surface using dynamic voltage topography of ictal electrocorticographic discharges.

To evaluate the usefulness of computerized brain-surface dynamic voltage topography (DVT) of ictal electrocorticographic (ECoG) discharges to localize and identify epileptogenic areas, 3 patients with intractable frontal lobe epilepsy who underwent epilepsy surgery after chronic subdural electrode recording were assessed. Cortical surfaces and subdural electrodes were photographed during initial surgery to create an electrode map that could be superimposed onto a picture of the brain surface. DVT was performed by calculating sequential amplitudes of ictal ECoG discharges, which were then superimposed onto the cortical and electrode maps. In all cases, DVT clearly identified the ictal onset zone and the early propagation area on the operative field. DVT allowed recognition of spatial relationships between the epileptogenic area and structural abnormalities, functional cortex, and cortical veins; and was useful to decide on the resection area.

[Study on abuse and neglect of the disabled elderly living at home].

To obtain basic information on elderly abuse and neglect in order to provide for its early discovery and prevention, a questionnaire survey about the present situation regarding abuse and neglect of the disabled elderly living at home was performed on health/medical service/welfare professions. Forty-two cases were analyzed. The major results were as follows; 1. Victims were 13 men and 29 women, approximately 1/3 of whom were in their 70's and another 1/3 in their 80's. Approximately 1/4 of the abusers were either sons or daughters of the victims. 2. Verbal abuse was the most frequent type of abuse with a rate of 69.0%. The percentage of psychological abuse was 61.9, passive neglect was 57.1%, active neglect was 50.0%, physical abuse was 47.6%, passive self-neglect was 28.6%, financial/material exploitation was 23.8%, active self-neglect was 16.7% and the others was 11.9%. The average number of abuse and neglect that an elderly received was 3.5. 3. The main causes of abuse and neglect did not appear to be simple but was complicated by related causes, many of both victims and abusers had elements in their personality, developmental history and interpersonal relationships that over a period of years formed the basis for the problematic behavior. Many abuse or neglect cases arose from caregiving burden of family caregivers or insufficient social systems for support to meet the needs of caring for the elderly. 4. The results suggest that for prevention and countermeasures for elderly abuse, there is an urgent need to arrange for expansion of health and welfare services to reduce burden of caregivers, provide for education of professionals of health/medical service/welfare for early discovery and proper handling of abuse problems, development of a checklist for early discovery, expansion of opportunities of improving care skill for family caregivers and establishment of consultation system for the elderly and caregivers, and organizing emergency shelter for victims of elderly abuse.