1/17. A case of post-anoxic encephalopathy with initial massive myoclonic status followed by alternating Jacksonian seizures.To contrast stimulus-sensitive generalized myoclonus with ensuing multifocal localized myoclonus in a patient with post-anoxic coma, we stressed the clinical as well as electroencephalographical differences between his initial generalized and subsequent focal myoclonus. While generalized myoclonus was presumably of extracortical origin and responsive to valproic acid, alternating Jacksonian seizures were definitely cortical and suppressed with phenytoin. These two different types of myoclonus should not be confused in post-anoxic coma.- - - - - - - - - - ranking = 1keywords = coma (Clic here for more details about this article) |
2/17. Carotid brainstem reflex myoclonus after hypoxic brain damage.A patient comatose after acute anoxia developed bilaterally synchronous, periodic myoclonic jerks most prominently in the bilateral upper limbs. Although the myoclonus seemed to occur spontaneously, electrophysiological studies showed that the myoclonic jerks correlated in timing and size with arterial pulses, and was suppressed by massage over the carotid sinus. It is proposed that the present myoclonus is a variant of brainstem reflex myoclonus in which arterial pulses served as intrinsic trigger stimuli via the carotid sinus and the medullary reticular formation.- - - - - - - - - - ranking = 0.5keywords = coma (Clic here for more details about this article) |
3/17. Recurrent high altitude pulmonary edema with blunted chemosensitivity.A young man who had had two episodes of high-altitude pulmonary edema in the absence of any respiratroy distress was noted to have a depression of his hypoxic and hypercapnic ventilatory drives. It is postulated that because of his blunted ventilaory drives, the patient progessed to coma on exposure to low ambient oxygen tensions (i.e., high altitude) without ever increasing his ventilation. The importance of including highaltitude pulmonary edema in the differential diagnosis of any patient who is admitted with coma after a sojourn at high altitude is stressed.- - - - - - - - - - ranking = 1keywords = coma (Clic here for more details about this article) |
4/17. Area-selective stimulus-provoked seizures in post-anoxic coma.We describe the case of a 70-year-old patient in whom hemiconvulsive seizures occurred during metabolic derangement, multiple stroke and post-anoxic coma following cardiac arrest. We employed the methods of clinical and EEG evaluation and CT brain scan. We found that hemiconvulsive seizures were provoked following a light tactile stimulus in the left-trigeminal area and occasionally a strong tapping in the right-trigeminal area. We conclude that this type of stimulus-provoked seizure is extremely rare and could be explained by diffuse and severe brain damage.- - - - - - - - - - ranking = 2.5keywords = coma (Clic here for more details about this article) |
5/17. Decerebrate rigidity with preserved cognition and gait: a possible role of anoxic-ischemic brain damage.A case of stable decerebrate posture in the upper limbs following sudden loss of consciousness and prolonged coma is described. The patient recovered most of her cognitive functions and gait, without clinical, neurophysiological or neuroradiological evidence of brainstem lesion. MRI shows borderzone infarcts. It is suggested that anoxic-ischemic cortical damage, affecting specially corticoreticular neurons, could explain the development of decerebrate rigidity in patients without apparent brainstem lesion.- - - - - - - - - - ranking = 0.5keywords = coma (Clic here for more details about this article) |
6/17. Acute stimulus-sensitive postanoxic myoclonus: description of a case.We describe the clinical and electroencephalographic features of a comatose patient with severe anoxic encephalopathy who experienced acute reflex myoclonus precipitated by passive eye opening/closure and painful stimulation. Acute stimulus-sensitive postanoxic myoclonus is an underdiagnosed epileptic condition. Shortly after the anoxic insult, the diagnosis should be based on EEG evaluation and various types of stimulation. These should include passive eye opening/closure and painful stimuli.- - - - - - - - - - ranking = 0.5keywords = coma (Clic here for more details about this article) |
7/17. A case of high altitude pulmonary edema followed by brain computerized tomography and electroencephalogram.A case of high altitude pulmonary edema with high altitude cerebral edema was reported. A young Japanese male complained of severe palpitation and shortness of breath on the third day of climbing at 3,000 m above sea level. During the next 2 d at altitude, the following symptoms occurred: cough with foamy sputum, cyanosis, and loss of consciousness. Soon after evacuation, he showed severe hypoxemia and deep coma with decerebrate rigidity; electroencephalogram showed diffuse alpha waves, indicating "alpha wave coma." Brain computerized tomography revealed brain edema, showing small compressed ventricles and diffuse low density of the cerebrum. pulmonary edema on chest roentgenogram disappeared by the fifth hospital day, and his consciousness recovered gradually during the next 2 weeks after the admission. He was examined serially by electroencephalography and brain computerized tomography. He recovered fully, but there were transient psychological abnormalities soon after discharge and mild brain atrophy was observed by brain computerized tomography 6 years later.- - - - - - - - - - ranking = 1keywords = coma (Clic here for more details about this article) |
8/17. Multiple deaths from argon contamination of hospital oxygen supply.During the course of routine hospital surgical procedures, three patients lapsed into hypoxic cyanosis. Two expired immediately, another after four days of coma. Investigation of the hospital's central liquid oxygen tank revealed that it had been refilled recently and was labelled both "oxygen" and "argon." Mass spectrometric analysis of gas sampled from the questioned tank revealed a predominance of argon. A discussion of the sampling technique, method of analysis, role of the criminalist, and causes of this accident is presented.- - - - - - - - - - ranking = 0.5keywords = coma (Clic here for more details about this article) |
9/17. Coexistence of ectopic rhythms and periodic EEG pattern in anoxic encephalopathy.In this paper, we reported unique EEG patterns in two patients with anoxic encephalopathy. In the patient with a longer survival, the early EEG showed: suppression-burst pattern and theta pattern coma during quiet states; and quasi-periodic, generalized, epileptiform discharges associated with alpha-theta pattern coma during periods of arousal. A second EEG showed a disappearance of suppression-burst pattern and alpha coma. A third EEG demonstrated a disappearance of quasi-periodic epileptiform discharges. Such distinct evolution of the electroencephalogram was associated clinically with increased responsiveness despite a fatal course of illness. The second patient who had a more dramatic course, had an EEG immediately preceding death, which showed a combination of periodic pattern and theta pattern coma.- - - - - - - - - - ranking = 2keywords = coma (Clic here for more details about this article) |
10/17. Ocular dipping.Ocular dipping consists of cycles of eye movements occurring spontaneously, which are characterized by a slow conjugated downward deviation followed after a delay by a quick return to mid position. Ocular dipping is only described in unconscious patients, especially in anoxic comata. Three new patients with this syndrome are described. Electronystagmographic registrations are shown.- - - - - - - - - - ranking = 0.5keywords = coma (Clic here for more details about this article) |
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