RESUMEN
The accuracy of five bedside hearing tests was evaluated in 107 consecutive adults, using pure-tone audiometry as the standard reference. Bedside tests had poor sensitivity (< or =0.60), relatively good specificity (> or =0.74), and variable positive predictive value (0.24 to 1.0) for detecting hearing loss. Sensitivity improved when bedside tests were combined with case history. The diagnostic utility of bedside tests routinely administered by neurologists to detect hearing loss in adults requires further study.
Asunto(s)
Pérdida Auditiva/diagnóstico , Pruebas Auditivas/normas , Anciano , Anciano de 80 o más Años , Audiometría/normas , Reacciones Falso Negativas , Femenino , Pérdida Auditiva/epidemiología , Pérdida Auditiva/fisiopatología , Pruebas Auditivas/métodos , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Prevalencia , Distribución por Sexo , Encuestas y CuestionariosRESUMEN
Subdural grid electrodes are implanted routinely for the pre-surgical work up of epilepsy. While different approaches are available, many centers, including ours, visualize electrode locations by co-registering pre-operative 3-D MR images with post-implantation 3-D CT images. This method allows the determination of the electrode positions in relation to the individual patient's anatomy, but does not easily allow comparison across patients. The goal of this study was to develop and validate a method for transforming electrode positions derived from 3-D CT images into standardized space. We analyzed data from twelve patients with subdurally implanted electrodes. Volumetric CT and MRI images were co-registered and then normalized into common stereotactic space. Electrode locations were verified statistically by comparing distances between the anterior commissure and a representative sampling of 8 electrode sites per patient. Results confirm the accuracy of our co-registration method for comparing electrode locations across patients.
Asunto(s)
Mapeo Encefálico/métodos , Epilepsia/fisiopatología , Imagenología Tridimensional , Imagen por Resonancia Magnética/métodos , Tomografía Computarizada por Rayos X/métodos , Adolescente , Adulto , Electrodos Implantados , Epilepsia/diagnóstico , Epilepsia/cirugía , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Sensibilidad y EspecificidadRESUMEN
A 32-year-old patient with seizures experienced decreased right-ear hearing during electrocortical stimulation mapping of the left lateral superior temporal gyrus. Audiometric testing under headphones confirmed a reversible, moderate unilateral hearing loss. Under binaural listening conditions, auditory comprehension was impaired at the same site, whereas word repetition, environmental sound recognition, naming, and spontaneous speech remained intact.