Valproic acid-induced pancreatitis: 16 new cases and a review of the literature.

Background: Acute pancreatitis is rarely seen in children, and, in contrast to cases in adults, it is often drug induced. One possible medication is the antiepileptic drug valproic acid (VPA), which is commonly prescribed for generalized and focal epilepsy, migraine, neuropathic pain, and bipolar disorder. The common side effects associated with VPA are typically benign, but less common but more serious adverse effects may occur.

Valproic acid induced encephalopathy--19 new cases in Germany from 1994 to 2003--a side effect associated to VPA-therapy not only in young children.

Valproic acid (VPA) is a broad-spectrum antiepileptic drug and is usually well-tolerated. Rare serious complications may occur in some patients, including haemorrhagic pancreatitis, bone marrow suppression, VPA-induced hepatotoxicity and VPA-induced encephalopathy. The typical signs of VPA-induced encephalopathy are impaired consciousness, sometimes marked EEG background slowing, increased seizure frequency, with or without hyperammonemia.

[Electromyography of the infrahyoid muscles - part 3: findings after transposition as a myofascial flap in tongue reconstruction].

Background: Due to the preservation of its nerval supply the neurovascular infrahyoid muscle flap in tongue reconstruction enables to prevent atrophy of the musculature. In this study the integrity of the infrahyoid muscles (IHM) after transposition into the oral cavity was examined by means of electromyography.

Methods: 17 patients after partial or complete reconstruction of the tongue with IHM were studied at varied times after surgery.

[Electromyography of the infrahyoid muscles - part 2: pathological findings].

Background: The infrahyoid muscles (IHM) can easily be used as a neurovascular myofascial flap for reconstructive surgery in the oral cavity and pharynx and especially for functional tongue reconstruction following tumor ablation.

Methods: In order to detect neurogenic lesions caused by neck pathologies, in particular lymph node metastasis, we studied ten patients (nine patients suffering from tongue carcinoma and one patient after traumatic tongue ablation) by preoperative electromyography of the IHM. These results were compared to ten healthy controls.

[Electromyography of the infrahyoid muscles - part 1: normal findings].

Background: The infrahyoid muscles (IHM) are very useful as a neurovascular myofascial flap in plastic reconstructive surgery of the upper aerodigestive tract, especially for restoration of the muscular component in larger tongue defects. As a base for further postoperative investigations on the function of transferred IHM this first part of the study describes the physiological function and the electromyographical features of the IHM.

Methods: In 17 patients with cancer of the upper aerodigestive tract the sternohyoid and sternothyroid muscles and in additionally eight patients the upper part of the omohyoid muscle were studied electromyographically.

Electromyography of the infrahyoid muscles: pathological and normal findings.

Unlabelled: In recent years, the infrahyoid muscles (IHM) have been used by plastic reconstructive surgeons as a neurovascular muscle flap in the neck and mouth region.

Methods: A preoperative electromyographic examination (EMG) of the IHM was performed in 10 patients, of whom 9 suffered from tongue cancer, in order to detect neurogenic lesions caused by possible metastases or lymph nodes. The results were compared to those of 10 healthy controls.

Lateralized human cortical activity for shifting visuospatial attention and initiating saccades.

Lateralized human cortical activity for shifting visuospatial attention and initiating saccades. J. Neurophysiol.

Basilar branch disease presenting with progressive pure motor stroke.

Objectives: Isolated infarcts of the pons cause well definable neurological syndromes with distinct pathomechanism, clinical course and prognosis.

Patients And Results: We report 8 cases suffering from a pure motor hemiparesis that was severely progressive within the 1st 3 days and unresponsive to aspirin. A relatively good recovery was observed in all patients, however, stroke recurrence occurred in 2 cases within 3 months and resulted in pseudobulbar paralysis and tetraparesis.

Apraxia of eyelid opening after bilateral stereotaxic subthalamotomy.

The case of a patient with apraxia of eyelid opening and blepharospasm occurring during the course of idiopathic torsion dystonia and previously treated with stereotaxic subthalamotomy is presented. The anatomic basis of this lid movement disorder is suggested to be located in the rostral brain stem. There was a considerable amelioration after treatment with trihexyphenidyl.

Slow saccades and other eye movement disorders in spinocerebellar atrophy type 1.

In order to study the relation between genotype and phenotype, a detailed study of the course of oculomotor deficits was performed in three patients with autosomal-dominant cerebellar ataxia, subtype spinocerebellar atrophy type 1 (SCA 1) using clinical testing and electrooculography. DNA analysis revealed a CAG repeat expansion of 65 in the SCA 1 gene on chromosome 6p in all patients. A progressive disorder of the saccadic system became obvious, leading to a marked slowing of saccadic eye movements and loss of pathological and physiological nystagmus.

Crossed R1 response of the blink reflex in peripheral facial palsy.

A patient with regenerated Bell's palsy showed a crossed R1 component of the blink reflex recorded from the healthy side while stimulating the affected side. Our observation supports the hypothesis that a short-circuit trigemino-facial pathway crossing the midline exists in normal subjects which is not activated under normal conditions, but may be engaged following peripheral facial nerve disease.

The presaccadic cortical negativity prior to self-paced saccades with and without visual guidance.

The presaccadic negativity (PSN) of the scalp EEG potential prior to self-initiated saccades aimed either at a visual target or at the remembered position of that target in total darkness was analysed in 10 normal subjects. Under both conditions a PSN with a negligible EOG contamination was found, showing 4 characteristics: (1) In both conditions, the PSN maximum is localized at the vertex, probably containing the activity of the supplementary motor area. (2) At an electrode placed over the frontal eye field (FEF) contralateral to the saccade direction, there is a temporary, circumscribed maximum prior to saccades to the visual target, thus probably reflecting activity of the FEF.

[Carbon monoxide poisoning: the importance of computed and magnetic resonance tomographic cranial findings for the clinical picture and follow-up].

Clinical, CT and MR imaging findings of 5 patients are presented who suffered from sudden coma due to carbon monoxide intoxication. Follow-up investigations were done for up to three years. 4 patients recovered with only minor deficits, while one patient survived with a severe choreatic syndrome.

[Unmasking congenital myotonia by hypothyroidism].

A case with the combination of hypothyroidism and true myotonia is reported, in which the latter first became manifest clinically together with the thyroid disorder and improved with L-thyroxine therapy. The hypothyroidism itself caused very few symptoms, and the diagnosis was not made until examination for myotonia. The effect of each disorder on muscle function seems to be additive.

[Musical pseudo-hallucination in acquired hearing loss].

Auditory hallucinations take various forms including the perception of tinnitus, voices, and, rarely, music. While formed hallucinations are usually ascribed to psychiatric illness, we describe a syndrome of musical hallucinations in mentally sane patients, who are hard of hearing or deaf. 26 cases from the literature are supplemented by 6 own observations, including the first description of two cases in a single family.

Carbon monoxide poisoning: clinical, neurophysiological, and brain imaging observations in acute disease and follow-up.

Five patients (aged 19-52 years) were treated for a midbrain syndrome due to acute carbon monoxide poisoning and had clinical follow-up investigations for up to 18 months. Three patients recovered with minor neurological and neuro-psychological deficits and resumed their premorbid life-style. One patient had normal findings, while the fifth remained in a permanent vegetative state.