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1.
J Neurol Neurosurg Psychiatry ; 87(8): 821-30, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27093948

RESUMO

While the past 2 decades have witnessed an increasing understanding of amyotrophic lateral sclerosis (ALS) arising from East Asia, particularly Japan, South Korea, Taiwan and China, knowledge of ALS throughout the whole of Asia remains limited. Asia represents >50% of the world population, making it host to the largest patient cohort of ALS. Furthermore, Asia represents a diverse population in terms of ethnic, social and cultural backgrounds. In this review, an overview is presented that covers what is currently known of ALS in Asia from basic epidemiology and genetic influences, through to disease characteristics including atypical phenotypes which manifest a predilection for Asians. With the recent establishment of the Pan-Asian Consortium for Treatment and Research in ALS to facilitate collaborations between clinicians and researchers across the region, it is anticipated that Asia and the Pacific will contribute to unravelling the uncertainties in ALS.


Assuntos
Esclerose Lateral Amiotrófica/complicações , Esclerose Lateral Amiotrófica/epidemiologia , Doença dos Neurônios Motores/complicações , Doença dos Neurônios Motores/epidemiologia , Esclerose Lateral Amiotrófica/genética , Esclerose Lateral Amiotrófica/mortalidade , Ásia/epidemiologia , Progressão da Doença , Humanos , Doença dos Neurônios Motores/genética , Doença dos Neurônios Motores/mortalidade , Fenótipo , Síndrome
2.
Mult Scler ; 19(10): 1371-80, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23325588

RESUMO

Definite diagnosis of inflammatory demyelinating disease (multiple sclerosis (MS) and neuromyelitis optica (NMO)) may require time, but early treatment offers the opportunity to maximize patient outcomes. The purpose of this report is to provide guidance to facilitate early treatment decisions for patients with inflammatory demyelinating disease, before definitive diagnosis. Neurology experts reviewed the existing literature and clinical evidence. A treatment decision pathway was developed, defining patients for whom first-line MS disease-modifying therapies (a) are unlikely to be effective, (b) may be effective but require careful monitoring and (c) are likely to provide benefit. This algorithm seeks to ensure that patients, particularly those in Asia, receive appropriate treatment early in inflammatory demyelinating disease.


Assuntos
Algoritmos , Esclerose Múltipla/terapia , Neuromielite Óptica/terapia , Prevenção Secundária/métodos , Humanos
3.
Neuroscience ; 226: 510-6, 2012 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-23122444

RESUMO

High-mobility group box 1 protein (HMGB1) has cytokine activities and mediates systemic inflammation as well as immune responses. The aim of this study was to determine if plasma HMGB1 level can be used as a marker for neuromyelitis optica (NMO) and to differentiate NMO from multiple sclerosis (MS). We measured plasma levels of HMGB1, tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), and interleukin 17 (IL-17) in 29 patients with NMO and 20 patients with MS at enrollment and at 2years follow-up (at the time of definitive diagnosis) by enzyme-linked immunosorbent assay. Plasma HMGB1 level was significantly greater in the NMO group compared to the MS group (P<0.001). Plasma levels of TNF-α, IFN-γ, and IL-17 were significantly greater in the NMO group compared to the MS group, and HMGB1 level was positively correlated with TNF-α, IFN-γ, and IL-17 levels. Univariate logistic regression analysis showed a significant association of HMGB1 level, and IFN-γ level with NMO diagnosis. Although this study included a limited sample size, we attempted to determine an optimized cutoff point for HMGB1 (≥2 ng/ml), which provided 89.7% sensitivity and 95.0% specificity for the diagnosis of NMO. These results indicate that plasma HMGB1 level might serve as a surrogate marker for NMO disease activity and aid in the differentiation of NMO from MS at the early disease stage.


Assuntos
Proteína HMGB1/sangue , Neuromielite Óptica/sangue , Adulto , Idade de Início , Aquaporina 4/metabolismo , Área Sob a Curva , Azatioprina/uso terapêutico , Biomarcadores , Citocinas/sangue , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Imunossupressores/uso terapêutico , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/tratamento farmacológico , Esclerose Múltipla/metabolismo , Neuromielite Óptica/tratamento farmacológico , Estudos Prospectivos , Curva ROC , Reprodutibilidade dos Testes
4.
J Virol Methods ; 164(1-2): 14-8, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19944721

RESUMO

This study describes magnetically driven suppression of cross-reactions among molecules. First, the magnetic nanoparticles are coated with bio-probes and dispersed in liquid. The bio-probes can then bind with homologous or heterologous bio-targets. When alternating-current (ac) magnetic fields are applied, magnetic nanoparticles rotate driven by ac magnetic fields. Thus, the bio-targets bound on the surface of magnetic nanoparticles experience a centrifugal force. The centrifugal force can be manipulated by adjusting the angular frequency of the rotating magnetic nanoparticles. The angular frequency is determined by the applied ac magnetic field frequency. Since the binding force for good binding is much higher than that of poor binding, frequency manipulation is needed for the centrifugal force to be higher than the poor-binding force but lower than the good-binding force. Therefore, poor binding which contributes to cross reactions between molecules can be suppressed efficiently by control of the ac magnetic field frequency.


Assuntos
Anticorpos , Antígenos Virais/análise , Magnetismo , Nanopartículas , Virologia/métodos , Vírus/isolamento & purificação , Imunoensaio/métodos , Sensibilidade e Especificidade
6.
Scand J Rheumatol ; 38(2): 84-90, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-18821178

RESUMO

OBJECTIVES: To estimate the prevalence of spondyloarthritis (SpA) and the clinical features of human leucocyte antigen (HLA)-B27-associated acute anterior uveitis (HLA-B27 uveitis) in Chinese patients. METHODS: We conducted a retrospective cohort study using a structured chart review to record the complete ocular history, including the onset of uveitis, month of uveitis attack, specific eye involvement, the time of first attack, and rheumatic manifestations from 1987 to 2004. A total of 504 patients with HLA-B27 uveitis were consequently enrolled consecutively from the uveitis clinic of Taipei Veterans General Hospital. RESULTS: In total, 1719 attacks of uveitis in 504 patients were recorded. Females tended to have a higher frequency of attack than males, and those with a disease course of less than 5 years showed more uveitis recurrence. The same eye attacks were observed in 156 of 332 patients (47%), more than the expected percentage compared with attacks with random-eye occurrence (p < 0.001). A significantly higher number of uveitis attacks occurred in winter. SpA-related acute anterior uveitis (AAU) was found in 387 patients (76.8%). Ankylosing spondylitis (AS) occurred in 214 patients (42.5%), with a significantly higher prevalence in males than in females (p < 0.001). Undifferentiated SpA (USpA)-related AAU occurred in 150 patients (29.8%), with a significantly higher prevalence in females than in males (p < 0.001). Patients with SpA had an earlier onset of uveitis (p = 0.01) and a greater number (> or = 6) of attacks (p = 0.03). CONCLUSIONS: The prevalence of SpA was high in the Chinese population with HLA-B27-associated uveitis. The association with SpA indicated an earlier age of uveitis onset and a greater likelihood of having a higher number of uveitis attacks.


Assuntos
Antígeno HLA-B27/imunologia , Espondilartrite/epidemiologia , Uveíte Anterior/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , China/etnologia , Estudos de Coortes , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Espondilartrite/imunologia , Espondilartrite/patologia , Taiwan/epidemiologia , Uveíte Anterior/imunologia , Uveíte Anterior/patologia , Adulto Jovem
7.
Can J Neurol Sci ; 33(1): 95-100, 2006 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-16583730

RESUMO

Magnetic resonance imaging (MRI) of the brain is the most important paraclinical diagnostic test in multiple sclerosis (MS). The appearance of MRI in Asians with MS is not well defined. We retrospectively surveyed the first brain and spinal cord MRI in patients diagnosed to have MS, according to Poser's criteria in seven regions throughout Asia to define the MRI changes among Asians with MS. There were 101 patients with first brain, and 86 with first spinal cord MRI, 66 of whom had both. The brain MRI showed a mean of 17 lesions per patient in T2 weighted images, mostly asymptomatic. Almost all the lesions were in the white matter, particularly in the juxtacortical, deep and periventricular white matter. A third of the lesions were greater than 5 mm, 14% enhanced with gadolinium. There were more supratentorial than infratentorial lesions at a ratio of 7.5: 1. Ninety five percent of the spinal cord lesions were in cervical and thoracic regions, 34% enhanced with gadolinium. The lesions extended over a mean of 3.6 +/- 3.3 vertebral bodies in length. Fifty (50%) of the brain and 54 (63%) of the spinal MRI patients had the optic-spinal form of MS. The MRI of the optic-spinal and classical groups of patients were similar in appearance and distribution, except that the optic-spinal MS patients have fewer brain but longer and more severe spinal cord lesions. In conclusion, the brain and spinal cord MRI of Asian patients with MS was similar to that of the West, although, in this study, Asian MS patients had larger spinal cord lesions.


Assuntos
Encéfalo/patologia , Imageamento por Ressonância Magnética , Esclerose Múltipla/patologia , Medula Espinal/patologia , Adulto , Povo Asiático , Feminino , Humanos , Masculino , Estudos Retrospectivos
9.
Genet Epidemiol ; 21 Suppl 1: S317-22, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11793691

RESUMO

Tree-based linkage analyses and association studies are introduced and applied for two data sets on asthma from Genetic Analysis Workshop 12. Consistent and strong evidence of linkage and association to markers on chromosomes 1 and 11 is revealed. Linkage to chromosome 16 in one data set and association with D6S276 in the other data set are also detected.


Assuntos
Asma/genética , Mapeamento Cromossômico/estatística & dados numéricos , Adulto , Asma/epidemiologia , Asma/etnologia , População Negra/genética , Criança , Cromossomos Humanos Par 1 , Cromossomos Humanos Par 11 , Feminino , Marcadores Genéticos/genética , Variação Genética/genética , Genética Populacional , Alemanha , Humanos , Escore Lod , Masculino , Computação Matemática , Estados Unidos , População Branca/genética
10.
Eur Neurol ; 44(2): 79-85, 2000.
Artigo em Inglês | MEDLINE | ID: mdl-10965158

RESUMO

Miller Fisher syndrome (MFS), characterized as ataxia, areflexia and ophthalmoplegia, is generally considered as a variant of Guillain-Barré syndrome (GBS). However, some investigators believed that the syndrome could be explained by a central origin. To obtain more information about MFS for comparison with GBS, we conducted a retrospective study by analyzing the clinical data of MFS patients admitted to our hospital over a period of 11 years. The calibrated male/female ratio was 1.65. A seasonal clustering in winter was noted. The percentage of MFS among GBS was especially high (18%, 11/60) in Taiwan when compared with other series. Involvement of limb muscle strength, autonomic function and cranial nerves, except ocular motor nerves, was rarely found in our patients. When MFS is accompanied by limb weakness, it might represent a transitional form between MFS and GBS. Bulbar palsy and dysautonomia might predict a relatively poor prognosis. To obtain more reliable information, lumbar puncture should be done 1 week after disease onset, and electrophysiological tests should be done serially in every MFS patient. Eighty percent (80%, 4/5) of our patients were positive for IgG anti-GQ(1b) antibody activity. In our study, there is more evidence indicating that MFS is a peripheral nervous system disorder; however, no definite conclusion could be made as to whether MFS is exclusively a peripheral or central nervous system disorder. We think MFS is an immune-mediated clinical entity which mainly involves the peripheral nervous system with rare involvement of other parts of the central nervous system.


Assuntos
Hospitalização , Síndrome de Miller Fisher/epidemiologia , Síndrome de Miller Fisher/fisiopatologia , Adulto , Idade de Início , Idoso , Sistema Nervoso Autônomo/fisiopatologia , Criança , Nervos Cranianos/fisiopatologia , Feminino , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores Sexuais , Resultado do Tratamento
11.
Vet Microbiol ; 74(3): 207-16, 2000 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-10808089

RESUMO

Sequence diversity was assessed of the complete VP1 gene directly amplified from 49 clinical specimens during an explosive foot-and-mouth disease (FMD) outbreak in Taiwan. Type O Taiwan FMD viruses are genetically highly homogenous, as seen by the minute divergence of 0.2-0.9% revealed in 20 variants. The O/HCP-0314/TW/97 and O/TCP-022/TW/97 viral variants dominated FMD outbreaks and were prevalent in most affected pig-raising areas. Comparison of deduced amino acid sequences around the main neutralizable antigenic sites on the VP1 polypeptide showed no significant antigenic variation. However, the O/CHP-158/TW/97 variant had an alternative critical residue at position 43 in antigenic site 3, which may be due to selective pressure in the field. Two vaccine production strains (O1/Manisa/Turkey/69 and O1/Campos/Brazil/71) probably provide partial heterologous protection of swine against O Taiwan viruses. The type O Taiwan variants clustered in sublineage A1 of four main lineages in the phylogenetic tree. The O/Hong Kong/9/94 and O/1685/Moscow/Russia/95 viruses in sublineage A2 are closely related to the O Taiwan variants. The causative agent for the 1997 epidemic presumably originated from a single common source of type O FMD viruses prevalent in neighboring areas.


Assuntos
Aphthovirus/genética , Surtos de Doenças/veterinária , Febre Aftosa/virologia , Filogenia , Doenças dos Suínos/virologia , Sequência de Aminoácidos , Animais , Aphthovirus/classificação , Aphthovirus/imunologia , Sequência de Bases , Sequência Consenso , Primers do DNA/química , DNA Viral/química , Eletroforese em Gel de Ágar/veterinária , Epitopos/química , Febre Aftosa/epidemiologia , Variação Genética/genética , Dados de Sequência Molecular , RNA Viral/química , RNA Viral/isolamento & purificação , Reação em Cadeia da Polimerase Via Transcriptase Reversa/veterinária , Alinhamento de Sequência , Análise de Sequência de DNA , Homologia de Sequência de Aminoácidos , Homologia de Sequência do Ácido Nucleico , Suínos , Doenças dos Suínos/epidemiologia , Taiwan/epidemiologia , Proteínas Virais/química , Proteínas Virais/genética , Proteínas Virais/imunologia
12.
Zhonghua Yi Xue Za Zhi (Taipei) ; 62(1): 1-5, 1999 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-10063705

RESUMO

BACKGROUND: Hemifacial spasm and blepharospasm are both dystonic disorders. They may seriously affect individuals' lifestyle and social activities. In 1990, the Food and Drug Administration of the USA approved botulinum toxin A as a therapeutic agent in the treatment of hemifacial spasm and blepharospasm. We present a therapeutic review of botulinum toxin A in 80 patients in Taiwan. METHODS: Fifty-eight patients with hemifacial spasm and 22 with blepharospasm. Botulinum toxin A was prepared and injected into the facial and eyelid muscles. Patients were monitored every two weeks and classified into four groups (excellent, moderate, mild and no improvement) according to the clinical improvement scale. Complications were also recorded. RESULTS: A total of 86.2% of hemifacial spasm patients and 81.8% of blepharospasm patients had excellent improvement on the spasm intensity scale, while 6.8% of hemifacial spasm and 9.0% of blepharospasm patients had moderate improvement. The complication rate was low and included transient mild facial weakness (5%), ptosis (3.8%), eyelid swelling and/or ecchymosis (3.8%), nausea/vomiting (2.5%) and transient severe facial weakness (1.3%). CONCLUSION: Botulinum toxin A is an excellent therapeutic agent to improve spasm intensity and has a low complication rate.


Assuntos
Blefarospasmo/tratamento farmacológico , Toxinas Botulínicas/uso terapêutico , Espasmo Hemifacial/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Toxinas Botulínicas/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
13.
J Biomed Sci ; 5(6): 441-5, 1998.
Artigo em Inglês | MEDLINE | ID: mdl-9845848

RESUMO

About half of the Caucasian patients with chronic polyneuropathy and IgM paraproteinemia show serum anti-myelin-associated glycoprotein (MAG) and anti-sulfoglucuronosyl glycosphingolipid (SGGLs) activities. These antibody activities have been demonstrated to react with a carbohydrate epitope known as the HNK-1 or sulfoglucuronic acid (SGA) epitope. However, in Asian populations the occurrence of serum anti-SGA activities has been reported to be relatively rare. We investigated 5 cases of chronic polyneuropathy with IgM paraproteinemia from Taiwan and found that 3 of them had high-titer serum anti-SGA (SGGL/MAG) antibody activities. The clinical symptoms of these 3 patients were consistent with sensory dominant polyneuropathy with a severer involvement of the lower limbs than of the upper limbs. Electromyography and nerve conduction studies revealed severe sensory nerve involvement (no response in 3 cases) and moderate slowing of motor conduction velocity (MCV) without conduction block. The decrease in MCV correlated well with anti-SGA antibody titer (less than 30 m/s with the titration of 1:12, 800, normal 55-60 m/s). Pathological findings showed active demyelinating polyneuropathy with myelin ovoid and myelinated fiber loss. Our data suggest that anti-SGGL antibody activities may not be very rare among Asian populations. Additionally, there seems an intriguing possibility that the titer of this antibody correlates with the severity of peripheral nerve involvement in patients of demyelinating polyneuropathy with IgM paraproteinemia.


Assuntos
Autoanticorpos/imunologia , Doenças Desmielinizantes/imunologia , Glucuronatos/imunologia , Imunoglobulina M/imunologia , Paraproteinemias/imunologia , Idoso , Especificidade de Anticorpos , Autoanticorpos/sangue , Doenças Desmielinizantes/sangue , Doenças Desmielinizantes/complicações , Ácido Glucurônico , Glicoesfingolipídeos/imunologia , Humanos , Epitopos Imunodominantes , Imunoglobulina M/sangue , Pessoa de Meia-Idade , Glicoproteína Associada a Mielina/imunologia , Paraproteinemias/sangue , Paraproteinemias/complicações
14.
FEMS Microbiol Lett ; 148(2): 153-8, 1997 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-9084142

RESUMO

Twenty-six strains of Borrelia burgdorferi sensu lato were subjected to polymerase chain reaction (PCR)-based restriction fragment length polymorphism (RFLP) analysis for assessing the sequence divergence of rpoD gene encoding the primary sigma factor. Four and five RFLP patterns were observed from two fragments of rpoD gene. Sequence analysis of a subgenic fragment covering region 1 through 4 from 13 strains of Borrelia burgdorferi s. 1. revealed that 21 of 450 deduced amino acid residues were diverged. These results indicate that the sequence heterogeneity of rpoD is present in different strains of Borrelia burgdorferi s. 1., and agreed well with the current classification of genospecies.


Assuntos
Proteínas de Bactérias/genética , Grupo Borrelia Burgdorferi/genética , RNA Polimerases Dirigidas por DNA/genética , Fator sigma/genética , Sequência de Aminoácidos , Sequência de Bases , Dados de Sequência Molecular , Polimorfismo de Fragmento de Restrição
15.
Zhonghua Yi Xue Za Zhi (Taipei) ; 59(1): 42-6, 1997 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-9134822

RESUMO

The clinical effect of high-dose intravenous immunoglobulin (IVIg) is reported as correlated with electrophysiological study in a 15-year-old boy with chronic inflammatory demyelinating polyneuropathy (CIDP). Within three months the patient developed from progressive paraparesis to complete quadriplegia with relative preservative of sensory and bulbar functions. High dose IVIg with 0.4 gm/kg per day was given for five consecutive days, and recovery occurred during the first week, particularly in both the lower limbs. Maximal benefit was achieved by another course of IVIg treatment. The effect maintained for six weeks, but muscle power deteriorated rapidly one week later. Muscle power improved again after another two courses of IVIg infusion. Serial nerve conduction velocity studies showed an improvement in the distal latencies and the amplitudes of compound muscle action potentials (CMAPs) which were not, however, well correlated with the clinical improvement. No improvement in nerve conduction velocities was ever noted.


Assuntos
Doenças Desmielinizantes/terapia , Imunoglobulinas Intravenosas/uso terapêutico , Doenças do Sistema Nervoso Periférico/terapia , Potenciais de Ação , Adolescente , Doença Crônica , Doenças Desmielinizantes/fisiopatologia , Humanos , Masculino , Condução Nervosa , Doenças do Sistema Nervoso Periférico/fisiopatologia
16.
Zhonghua Yi Xue Za Zhi (Taipei) ; 58(1): 62-5, 1996 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-8870331

RESUMO

A 55-year-old woman with a several-decade history of thyroid goiter is presented here as a case of myasthenia gravis complicated with hyperthyroidism and thymoma with serological evidence of systemic lupus erythematous (SLE). She had had right eyelid ptosis since July 1992, with a positive tensilon test. The acetylcholine receptor antibody titer was 4.01 nmol/L. A thyroid function test revealed T3: 162 ngidl, T4: 14.98 micrograms/dl, TSH:0.09 microIU/ml and positive anti-microsomal antibody (1:400). An MRI of the chest showed a thymoma in the left thymus. Other autoantibody screenings include ANA (1:320, speckled pattern) and anti-ds DNA (+) suggesting a serological association with SLE. After three courses of plasmapheresis, she received an extended maximal thymomectomy and a subtotal thyroidectomy. She was then treated with prednisolone, Mestinon, Eltroxin and discharged without complications. The coexistence of myasthenia gravis, hyperthyroidism, thymoma and a serological evidence of SLE have not previously been documented in the literature.


Assuntos
Hipertireoidismo/etiologia , Lúpus Eritematoso Sistêmico/etiologia , Miastenia Gravis/complicações , Timoma/etiologia , Feminino , Humanos , Pessoa de Meia-Idade
17.
Gene ; 168(1): 123-4, 1996 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-8626058

RESUMO

Utilizing a polymerase chain reaction-based approach, the gene (rpoD) encoding the primary sigma factor from Borrelia burgdorferi strain B31 was cloned and sequenced. Nucleotide sequence analysis revealed an open reading frame (ORF) of 1632 bp (543 amino acids (aa), 63.7 kDa). Comparison with Escherichia coli sigma 70 and Bacillus subtilis sigma 43 showed a high degree of similarity in the aa sequences, especially for the regions that are known to be required for promoter recognition and core binding.


Assuntos
Grupo Borrelia Burgdorferi/genética , Fator sigma/genética , Sequência de Aminoácidos , Sequência de Bases , Grupo Borrelia Burgdorferi/química , Clonagem Molecular , Sequência Conservada/genética , Primers do DNA/química , Genes Bacterianos , Dados de Sequência Molecular , Fases de Leitura Aberta/genética , Análise de Sequência , Homologia de Sequência do Ácido Nucleico , Fator sigma/química
18.
Epilepsia ; 37(1): 45-9, 1996 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-8603623

RESUMO

To evaluate ictal speech manifestations in complex partial seizures (C PS), we reviewed videotapes of 68 consecutive patients who underwent anterior temporal lobectomy (ATL) for treatment of intractable epilepsy in Taiwan. In all, 261 CPS were collected from their video-EEG (VEEG) recordings. Cerebral speech dominance was determined by intracarotid injection of sodium amobarbital (Wada test) in all cases. Ictal speech manifestations, classified as verbalization or vocalization, occurred in 32 patients (47.1%) with 96 seizures (36.8%). Ictal verbalization occurred in 10 patients (14.7%). Ictal vocalization was observed in 28 patients (41.2%); including 6 patients who also had ictal verbalization. Thirty-six patients (52.9%) had no seizure with ictal speech manifestations. Ictal verbalization had significant lateralization value: 90% of patients with this manifestation had seizure focus in the nondominant temporal lobe (p = 0.049). Seizures of patients with ictal vocalization were not more likely to arise from either temporal lobe. We also observed bilingual patients who exclusively spoke in their mother tongue (Taiwanese) rather than the acquired language (Mandarin) in 72.2% of seizures with verbalization. This finding is significant and contrary to a commonly held notion that the acquired language is used in seizures associated with speech behaviors.


Assuntos
Eletroencefalografia , Epilepsia do Lobo Temporal/diagnóstico , Fala/fisiologia , Lobo Temporal/fisiologia , Adolescente , Adulto , Amobarbital/farmacologia , Epilepsia Parcial Complexa/diagnóstico , Epilepsia Parcial Complexa/fisiopatologia , Epilepsia do Lobo Temporal/fisiopatologia , Feminino , Lateralidade Funcional/efeitos dos fármacos , Lateralidade Funcional/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fala/efeitos dos fármacos , Lobo Temporal/efeitos dos fármacos , Gravação em Vídeo
19.
Zhonghua Yi Xue Za Zhi (Taipei) ; 56(1): 66-9, 1995 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-7553414

RESUMO

The following report is a case of multifocal demyelinating motor neuropathy (MMN) presenting as a gradual development of asymmetric motor weakness without sensory involvement. Electrophysiological studies showed mainly a conduction block with normal or slightly slow nerve conduction velocity. Cerebrospinal fluid (CSF) protein and serum protein electrophoresis were normal, but serum IgM anti-GM1 ganglioside antibody was elevated. The patient had a poor response to steroid, plasmapheresis and chemotherapy with cyclophosphamide, but significant improvement was noted after intravenous immunoglobulin (IVIG) infusion. MMN is a potentially treatable condition which clinically mimics a motor neuron disease; if treatment with steroid, plasmapheresis and cyclophosphamide have failed, IVIG may be effective.


Assuntos
Doenças Desmielinizantes/terapia , Imunoglobulinas Intravenosas/uso terapêutico , Doença dos Neurônios Motores/terapia , Doenças Desmielinizantes/imunologia , Gangliosídeo G(M1)/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Doença dos Neurônios Motores/imunologia
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