The case for Douglas Merritte: Should we bury what is alive and well?

In 2012, we (Fridlund, Beck, Goldie, & Irons, 2012) suggested that a neurologically impaired infant, Douglas Merritte, was the likeliest candidate for John B. Watson's "Albert B." In advancing the case for their alternative candidate, Albert Barger, Harris (2020) and Digdon (2020) both pronounce the Merritte case moribund.

Little Albert: A neurologically impaired child.

Evidence collected by Beck, Levinson, and Irons (2009) indicates that Albert B., the "lost" infant subject of John B. Watson and Rosalie Rayner's (1920) famous conditioning study, was Douglas Merritte (1919-1925).

The brainstem auditory evoked potential in infants and children.

The brainstem auditory evoked potential (BAEP) is a neurophysiological study that provides functional information about the auditory system and brainstem. It provides information that is different from any other form of evaluation. This report tries to summarize technical and clinical information that will make the BAEP more meaningful for the practicing technologist and clinician.

Rhythmic coma in children.

We describe a syndrome of rhythmic coma in children that consists of an invariant, nonreactive, diffuse cortical activity of a specific frequency, such as alpha, beta, spindle, or theta, recorded from a comatose child. We report 11 cases of children who were found to be in rhythmic coma during their acute illnesses. Their ages ranged from 2 to 15 years, and their diagnoses included encephalitis, head trauma, seizures, near drowning, brain tumors, stroke, and metabolic derangements.

Neurological basis of respiratory complications in achondroplasia.

Evaluation of 32 individuals with achondroplasia revealed that 28% had a history of apnea and 22% had respiratory abnormalities on polysomnography. In those patients requiring posterior fossa decompressive surgery, improvement was noted in follow-up polysomnograms. Multimodality studies suggested that brainstem compression was common in achondroplasia and could account in part for the abnormal respiratory function in this disorder, including obstructive apnea, central apnea, and hypoxemia.

Brain stem auditory evoked potentials as a tool in the clinical assessment of children with posterior fossa tumors.

The use of brain stem auditory evoked potentials (BAEP) as a diagnostic modality in children with posterior fossa neoplasms is described. Thirty-one patients were examined; their diagnoses were medulloblastoma (12), brain stem glioma (9), cerebellar astrocytoma (6), and ependymoma (4). Distinct differences in the type and severity of waveform abnormalities were observed among the different tumor types, possibly related to location and invasiveness.

Foramen magnum stenosis in homozygous achondroplasia.

A 4-month-old female with homozygous achondroplasia and daytime apnea was found to have a small foramen magnum by computerized tomography. Following suboccipital craniectomy and C1-C2 laminectomy respiratory problems did not recur during a 7 month post-operative period. We suggest that the respiratory problems in homozygous achondroplasia may be due to brainstem compression from an abnormally small foramen magnum.

Postoperative neurological deficits may occur despite unchanged intraoperative somatosensory evoked potentials.

We describe 6 patients who demonstrated postoperative neurological deficits despite unchanged somatosensory evoked potentials during intraoperative monitoring. Although there is both experimental and clinical evidence that somatosensory evoked potentials are sensitive to some types of intraoperative mishap, the technique should be employed with an awareness of its possible limitations.

The spectrum of congenital facial diplegia (Moebius syndrome).

The Moebius syndrome consists of congenital facial diplegia with associated anomalies. No single pathophysiologic hypothesis accounts for all aspects of the syndrome. We present six cases which manifest a very broad spectrum of associated neurologic anomalies.

The 40 Hertz auditory event-related potential: normal values and effects of lesions.

A model of the 40 Hz auditory event-related potential (40 Hz AERP) was developed and evaluated in a group of normal subjects and two patient groups. The model views the 40 Hz AERP as a combination of the brain-stem auditory evoked potential (BAEP) and a sinusoidal component presumed to arise from structures rostral to the brain-stem. Fourier analysis techniques were used to quantify changes in the sinusoidal component.

Short-latency somatosensory evoked potentials in the management of patients with achondroplasia.

Twenty-three patients with achondroplasia were evaluated using short-latency somatosensory evoked potentials (SEPs) of median and peroneal nerves. Abnormal studies were found in 61%. All patients with neurologic signs or symptoms had abnormal SEPs, with good correlation between SEP results and the level of the lesion determined clinically and radiographically.

Brainstem auditory and short-latency somatosensory evoked responses in brain death.

Thirty-five patients who met all clinical criteria for brain death and 53 patients who did not were tested with brainstem auditory (BAER) and short-latency somatosensory (SER) evoked responses. Of the brain-dead patients, 77% had no waves present in the BAER, including wave I, whereas 69% had medullary components present in the SER. These data suggest that the SER has greater clinical utility in the brain-death setting, because it is important to have a wave present that established that the input signal has reached the central nervous system.

Seizures following intrathecal cytosine arabinoside in young children with acute lymphoblastic leukemia.

Two young children (3 1/2 years and 19 months) developed seizures within 24 hours of receiving intrathecal cytosine arabinoside. Both had previously received intrathecal cytosine and methotrexate as well as cranial irradiation without untoward effect. Possible mechanisms of causation are discussed and caution is stressed for use of intrathecal cytosine arabinoside in young children.

Hepatic Histological Changes in Ulcerative Colitis.

Operative liver biopsy was performed on 58 consecutive patients coming to radical excisional surgery for ulcerative colitis. The histological changes seen in the liver were: increased cellularity of the portal tracts (83 per cent); fatty infiltration (83 per cent); areas of focal necrosis (47 per cent); and early cirrhosis (2 per cent). Severe liver damage was shown to he associated with severe active colitis, and with a poor subsequent post-operative prognosis.