Algorithm for the treatment of rapid cycling.

Rapid cycling is a clinical subtype of bipolar mood disorder that has four or more episodes during the previous 12 months and has poor response to lithium (Li) prophylaxis treatment. Therefore it is said the refractory mood disorder and algorithm for treatment of rapid cycling is to be expected. The first choice of drug for rapid cycling is Li, the second choice is carbamazepine (CBZ) or valproic acid (VPA), in addition to Li, the third choice is clonazepam (CNZP) in addition to Li, and CBZ or VPA, the fourth choice is levothyroxine or bromocriptine in addition to them, and the fifth choice is electroconvulsive therapy.

Topographical differences in the developmental profile of central motor conduction time.

Objectives: To study the topographical difference in the developmental profile of the central motor conduction time (CMCT) in upper extremity muscles, electromyographic (EMG) responses to transcranical magnetic stimulation (TMS) were examined in the first dorsal interosseous, extensor carpi radialis (ECR), biceps (BCP), and deltoid (DT) muscles of 25 neurologically normal subjects aged from 2 to 26 years.

Methods: The motor cortex and cervical spinal roots were magnetically stimulated, and CMCT was measured as the onset latency difference between these EMG responses.

Results: CMCT in children was shorter in the more proximal muscle of each adjacent muscle pair, despite the tendency of a higher threshold intensity for TMS of the more proximal muscle.

Functional recovery in hemiplegic cerebral palsy: ipsilateral electromyographic responses to focal transcranial magnetic stimulation.

The patterns of functional recovery after unilateral cerebral damage occurring in the prenatal to infantile periods were studied in nine patients with hemiplegic cerebral palsy. Motor evoked potentials (MEPs) recorded from the small hand muscles were investigated using focal transcranial magnetic stimulation (TMS). The MEPs findings could be separated into three subtypes based on the features of ipsilateral MEPs elicited by TMS over the unaffected motor cortex.

Electromyographic study in an infant with benign paroxysmal torticollis.

The findings of surface electromyography (s-EMG) in a female with benign paroxysmal torticollis in infancy (BPT) are reported. This disease is characterized by (1) a self-limiting condition that appears in early infancy and disappears spontaneously, (2) recurrent episodes of sudden, stereotypic torticollis, usually alternating from side to side, and (3) episodes that usually continue for several hours to a few days. The pathogenesis of this disease has not been determined.

Characteristic response to transcranial magnetic stimulation in Rett syndrome.

To pathophysiologically evaluate the corticospinal tracts (CSTs) in Rett syndrome (RS), transcranial magnetic stimulation (TMS) was performed in 3 patients aged 4, 6 and 13 years. The two younger cases exhibited the clinical characteristics of the pseudostationary stage (stage III), while ambulation was lost in the oldest case at the age of 11 years (stage IV). The motor cortex and cervical spinal roots were magnetically stimulated to obtain motor evoked potentials (MEPs) from the relaxed first dorsal interosseous muscle.

Clinical and radiological variability of influenza-related encephalopathy or encephalitis.

Background: Influenza-related encephalopathy or encephalitis is not rare in children. However, it is not well understood why the brain lesion develops from influenza infection. The purpose of this study was to clarify its pathogenesis by analyzing the clinical and neuroradiological findings in patients having influenza-related brain lesions.

[Clinical studies on 35 patients with infection-related acute encephalopathy].

The findings on magnetic resonance imaging (MRI) or computed tomographic scan in 35 children with acute encephalopathy (AE) induced by infections were categorized into five groups: (1) normal findings (11 cases), (2) normal findings in the acute phase followed by mild brain atrophy (1 case), (3) severe brain edema which developed within 48 hours after the onset of AE (7 cases), (4) diffuse cortical necrosis which appeared around 4 days after the onset of AE (9 cases), and (5) symmetric thalamic lesions (7 cases). Their outcomes were as follows: three cases developed epilepsy in (1) and (2); six died and one had a sequel of severe brain damage (SBD) in (3); all cases survived but had SBD in (4), and four died, one had SBD, and 2 recovered in (5). Serum AST were elevated in 7.

Two cases of essential myoclonus, epilepsy, mental retardation and anxiety disorders.

We examined an 18-year-old female and an 18-year-old male with mild mental retardation who suffered from the oscillatory form of sporadic essential myoclonus from an age of 3 years. Although the generalized oscillatory myoclonus resembled severe essential tremor, surface electromyography revealed small myoclonic jerks with frequencies of 6-8 Hz. As concomitant symptoms, the female case exhibited overanxious irritability from early childhood and generalized epileptic seizures occurred from the age of 4 years.

Effect of digitalis on conduction dysfunction in Pelizaeus-Merzbacher disease.

We studied the effect of digitalis on nerve conduction dysfunction in Pelizaeus-Merzbacher disease (PMD). The patients were three Japanese boys with PMD, aged 7-10 years. Digitalis was administered orally in a daily dose of 0.

Home program of physical therapy: effect on disabilities of patients with total hip arthroplasty.

Objective: To study the effect of a home program of physical therapy.

Design: Nonrandomized control trial.

Setting: Home based.

Acute leucoencephalopathy during cyclosporin A therapy in a patient with nephrotic syndrome.

A 13-year-old girl with nephrotic syndrome (NS) developed acute leucoencephalopathy during combination therapy with cyclosporin A (CyA) and prednisolone (PSL). The patient had a generalized motor seizure followed by coma at 19 days after CyA administration. Magnetic resonance scanning performed on the 1st hospital day revealed white matter lesions in the subcortices of the parietal and occipital lobes, brain stem and cerebellum.

Two cases of glutaric aciduria type 1: clinical and neuropathological findings.

We report clinical and neuropathological studies of 2 patients with glutaric aciduria type 1. A 10-month-old male with involuntary movements expired suddenly at home. The second, a 15-year-old female, died after three episodes of acute encephalopathy including a Reye syndrome-like episode and an episode of severe hypoglycemia.

Zonisamide-induced behavior disorder in two children.

Zonisamide (ZNS)-induced behavior disorders are reported in a 1-year-old girl and a 3-year-old boy. Both patients, who had no previous developmental or mental problems, displayed secondarily generalized motor seizures. Serum concentrations of ZNS were not high, 8.