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Frontal Lobe

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5161. Sleep-related minor motor events in nocturnal frontal lobe epilepsy. (Abstract)

Sleep-related minor motor events in nocturnal frontal lobe epilepsy. Nocturnal frontal lobe epilepsy (NFLE) is characterized by a wide spectrum of sleep-related motor manifestations of increasing complexity, ranging from major episodes to brief motor events (minor motor events, MMEs). NFLE patients may exhibit a large quantity of MMEs in the form of short-lasting stereotyped movements. Whereas major episodes are considered epileptiform manifestations, it remains unclear whether the MMEs

2007 Epilepsia

5162. rTMS reveals premotor cortex dysfunction in frontal lobe epilepsy. (Abstract)

rTMS reveals premotor cortex dysfunction in frontal lobe epilepsy. Studies of motor cortex excitability provided evidence that focal epilepsies may alter the excitability of cortical areas distant from the epileptogenic zone. In order to explore this hypothesis we studied the functional connectivity between premotor and motor cortex in seven patients with frontal lobe epilepsy and seizure onset zone outside the premotor or motor cortex.Low-frequency subthreshold repetitive transcranial magnetic (...) hemisphere failed to inhibit the motor cortex. The reduced inhibition of the motor cortex by remote areas was additionally supported by the significantly shorter cortical silent periods obtained after stimulation of the motor cortex of the epileptogenic hemisphere.These results show that the functional connectivity between premotor and motor cortex or motor cortex interneuronal excitability is impaired in the epileptogenic hemisphere in frontal lobe epilepsy while it is normal in the nonepileptogenic

2007 Epilepsia

5163. Impaired concentration due to frontal lobe damage from two distinct lesion sites. (Abstract)

Impaired concentration due to frontal lobe damage from two distinct lesion sites. Investigations of cognitive deficits after frontal lobe damage have commonly relied on multidimensional tests and relatively coarse specification of lesion anatomy. Some form of impairment in attention is often asserted to cause the revealed deficits.To describe a disorder of attention in patients with frontal damage using a theoretical model of the fundamental cognitive processes that underlie attention.The (...) energizing of attention to respond. Left lateral lesions cause defective setting of specific stimulus-response contingencies. Constrained tests of attention can demonstrate impairments in specific cognitive operations following lesions to different regions of the frontal lobes.

2005 Neurology

5164. Isolated conjugate gaze palsy after frontal lobe tumour surgery. (Abstract)

Isolated conjugate gaze palsy after frontal lobe tumour surgery. Isolated conjugate gaze palsy following unilateral frontal lobe surgery is uncommon. When it does occur, usually it recovers within hours. We report a case of isolated conjugate gaze palsy which persisted for four weeks post-operatively before recovery commenced.

2004 British Journal of Neurosurgery

5165. Continuum of frontal lobe impairment in amyotrophic lateral sclerosis. Full Text available with Trip Pro

Continuum of frontal lobe impairment in amyotrophic lateral sclerosis. To identify the nature and prevalence of cognitive and behavioral abnormalities in patients with amyotrophic lateral sclerosis (ALS).Survey of clinical characteristics.Multidisciplinary clinic within a university medical center. Patients A volunteer sample of 30 new patients with ALS were recruited consecutively. Of those invited, 23 participants (20 with sporadic ALS and 3 with familial ALS) enrolled. Participants ranged

2007 Archives of Neurology

5166. Nocturnal hypermotor seizures, suggesting frontal lobe epilepsy, can originate in the insula. (Abstract)

Nocturnal hypermotor seizures, suggesting frontal lobe epilepsy, can originate in the insula. To report three patients with drug-resistant nocturnal hypermotor seizures (NHSs), no detectable brain lesion, and clinically defined nocturnal frontal lobe epilepsy (NFLE) or autosomal dominant NLFE (ADNFLE), whose intracerebral EEG ictal onset primarily involved the insula, rather than the mesial or orbital frontal cortex.Fourteen to 15 intracerebral electrodes were implanted in each patient (...) , primarily sampling the frontal lobes with 80 to 91 recording leads covering the most likely side of seizure onset, and two to six leads placed within the ipsilateral insula. Electrical stimulation was used to test the epileptic threshold of frontal and insular brain regions at the various recording sites.In all three patients, a low-voltage fast activity was recorded within the anterosuperior aspect of the insula at ictal onset, either in isolation, or extending to the nearby frontal operculum

2006 Epilepsia

5167. Ipsilateral head deviation in frontal lobe seizures. (Abstract)

Ipsilateral head deviation in frontal lobe seizures. The lateralizing value of ictal head deviation (HD) in frontal lobe epilepsy (FLE) is a matter of debate. Although FLE is typically associated with tonic or clonic HD contralateral to seizure onset, ipsilateral HD has been noted in numerous reports. Whether both types of HD can be distinguished according to their clinical patterns has not yet been specifically investigated.We studied the clinical pattern and time of occurrence of HD of 129 (...) % of seizures. Ipsilateral HD occurred earlier than contralateral HD (p < 0.03), with a mean delay of 1 +/- 2 s after the first detectable ictal sign, as compared with a delay of 17 +/- 11 s for contralateral HD. Moreover, ipsilateral HD always occurred before contralateral HD when both signs coexisted in the same seizure. Our patients with ipsilateral HD demonstrated either an anterior or dorsolateral frontal EZ.Ipsilateral HD is a common ictal sign during FLE and can be distinguished from contralateral HD

2005 Epilepsia

5168. Surgical treatment of drug-resistant nocturnal frontal lobe epilepsy. Full Text available with Trip Pro

Surgical treatment of drug-resistant nocturnal frontal lobe epilepsy. Of the cases with nocturnal frontal lobe epilepsy (NFLE) approximately 30% are refractory to antiepileptic medication, with several patients suffering from the effects of both ongoing seizures and disrupted sleep. From a consecutive series of 522 patients operated on for drug-resistant focal epilepsy, 21 cases (4%), whose frontal lobe seizures occurred almost exclusively (>90%) during sleep, were selected. All patients (...) (6 cases), hyperkinetic automatisms (10 cases), combined tonic posturing and hyperkinetic automatisms (4 cases) and mimetic automatisms (1 case). All patients reported some kind of subjective manifestations. Interictal and ictal EEG provided lateralizing or localizing information in most patients. MRI was unrevealing in 10 cases and it showed a focal anatomical abnormality in one frontal lobe in 11 cases. Eighteen patients underwent a SEEG evaluation to better define the epileptogenic zone (EZ

2007 Brain

5169. Surgical outcome and prognostic factors of frontal lobe epilepsy surgery. Full Text available with Trip Pro

Surgical outcome and prognostic factors of frontal lobe epilepsy surgery. Frontal lobe epilepsy (FLE) surgery is the second most common surgery performed to treat pharmacoresistant epilepsy. Yet, little is known about long-term seizure outcome following frontal lobectomy. The aim of this study is to investigate the trends in longitudinal outcome and identify potential prognostic indicators in a cohort of FLE patients investigated using modern diagnostic techniques. We reviewed 70 patients who (...) underwent a frontal lobectomy between 1995 and 2003 (mean follow-up 4.1 +/- 3 years). Data were analysed using survival analysis and multivariate regression with Cox proportional hazard models. A favourable outcome was defined as complete seizure-freedom, allowing for auras and seizures restricted to the first post-operative week. The estimated probability of complete seizure-freedom was 55.7% [95% confidence interval (CI) = 50-62] at 1 post-operative year, 45.1% (95% CI = 39-51) at 3 years, and 30.1

2007 Brain

5170. Theory of mind and frontal lobe pathology in schizophrenia: A voxel-based morphometry study. (Abstract)

Theory of mind and frontal lobe pathology in schizophrenia: A voxel-based morphometry study. Impaired ability to infer the mental states of others (theory of mind; ToM) is considered to be a key contributor to the poor social functioning of patients with schizophrenia. Although neuroimaging and lesion studies have provided empirical evidence for the neural basis of ToM ability, including the involvement of several prefrontal and temporal structures, the association between pathology

2008 Schizophrenia Research

5171. Interictal rhythmical midline theta differentiates frontal from temporal lobe epilepsies. Full Text available with Trip Pro

Interictal rhythmical midline theta differentiates frontal from temporal lobe epilepsies. We evaluated the role of interictal rhythmical midline theta (RMT) in the identification of frontal lobe epilepsy (FLE) and its differentiation from temporal lobe epilepsy (TLE) and nonepileptic controls.We included 162 individuals in the study: 54 FLE patients, 54 TLE patients, and 54 nonepileptic controls. Continuous electroencephalographic (EEG)-video monitoring was performed in all individuals

2008 Epilepsia

5172. Persistent metabolic crisis as measured by elevated cerebral microdialysis lactate-pyruvate ratio predicts chronic frontal lobe brain atrophy after traumatic brain injury. (Abstract)

Persistent metabolic crisis as measured by elevated cerebral microdialysis lactate-pyruvate ratio predicts chronic frontal lobe brain atrophy after traumatic brain injury. To determine whether persistent metabolic dysfunction in normal-appearing frontal lobe tissue is correlated with long-term tissue atrophy.Prospective monitoring with retrospective data analysis.Single-center academic neurointensive care unit.Fifteen patients with moderate to severe traumatic brain injury (Glasgow Coma Scale (...) score 3-12).None.Hourly cerebral microdialysis was performed for the initial 96 hrs after trauma to determine extracellular levels of glucose, glutamate, glycerol, lactate, and pyruvate in normal appearing frontal lobes. Six months after injury, the anatomical outcome was assessed by measures of global and regional cerebral atrophy using volumetric brain magnetic resonance imaging. The lactate/pyruvate ratio was elevated >40 after traumatic brain injury in most patients, with a mean percent time

2008 Critical Care Medicine

5173. Reduced striatal D1 receptor binding in autosomal dominant nocturnal frontal lobe epilepsy. (Abstract)

Reduced striatal D1 receptor binding in autosomal dominant nocturnal frontal lobe epilepsy. Mutations of the neuronal nicotinic acetylcholine (nACh) receptor identified in patients with autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE) lead to increased sensitivity to ACh. As activation of presynaptic nicotinic receptors augments the release of dopamine in the striatum and the prefrontal regions, we tested the hypothesis that that the alpha4-Ser248Phe mutation affects dopaminergic (...) frontal lobe epilepsy.

2008 Neurology

5174. Diffusion tensor magnetic resonance imaging finding of discrepant fractional anisotropy between the frontal and parietal lobes after whole-brain irradiation in childhood medulloblastoma survivors: reflection of regional white matter radiosensitivity? (Abstract)

Diffusion tensor magnetic resonance imaging finding of discrepant fractional anisotropy between the frontal and parietal lobes after whole-brain irradiation in childhood medulloblastoma survivors: reflection of regional white matter radiosensitivity? To test the hypothesis that fractional anisotropy (FA) is more severely reduced in white matter of the frontal lobe compared with the parietal lobe after receiving the same whole-brain irradiation dose in a cohort of childhood medulloblastoma (...) survivors.Twenty-two medulloblastoma survivors (15 male, mean [+/- SD] age = 12.1 +/- 4.6 years) and the same number of control subjects (15 male, aged 12.0 +/- 4.2 years) were recruited for diffusion tensor magnetic resonance imaging scans. Using an automated tissue classification method and the Talairach Daemon atlas, FA values of frontal and parietal lobes receiving the same radiation dose, and the ratio between them were quantified and denoted as FFA, PFA, and FA(f/p), respectively. The Mann-Whitney U test

2007 Biology and Physics

5175. Hypertension and hypothalamo-pituitary-adrenal axis hyperactivity affect frontal lobe integrity. Full Text available with Trip Pro

Hypertension and hypothalamo-pituitary-adrenal axis hyperactivity affect frontal lobe integrity. Chronically elevated cortisol levels have been associated with elevated blood pressure, brain atrophy, and cognitive impairments. In this cross-sectional exploratory study, we assessed whether hypertension was related to hypothalamo-pituitary-adrenal axis hyperactivity and whether this may in part explain prefrontal brain atrophy and cognitive impairments in this population. We studied 27 patients (...) with hypertension and 27 normotensive control subjects. Glucocorticoid feedback was assessed using the combined dexamethasone-CRH test. All participants completed a neuropsychological battery and received brain magnetic resonance imaging for volumetric measurement of frontal and medial temporal lobe regions. Hypertension was significantly associated with impaired glucocorticoid feedback control after statistically controlling for age, gender, and body mass index (P = 0.01). Hypertensive patients also showed

2005 Journal of Clinical Endocrinology and Metabolism

5176. Brachycephaly and frontal lobe hypoplasia in fetuses with trisomy 21 at 11 + 0 to 13 + 6 weeks. Full Text available with Trip Pro

Brachycephaly and frontal lobe hypoplasia in fetuses with trisomy 21 at 11 + 0 to 13 + 6 weeks. To investigate the incidence of brachycephaly and frontal lobe hypoplasia in fetuses with trisomy 21 at 11 + 0 to 13 + 6 weeks of gestation.A three-dimensional (3D) volume of the fetal head was obtained before fetal karyotyping at 11 + 0 to 13 + 6 (median, 12 + 5) weeks of gestation in 100 fetuses that were subsequently found to have trisomy 21 and in 300 fetuses subsequently found (...) to OFD ratio (mean difference = 0.004; 95% CI, -0.006 to 0.013, P = 0.448).In fetuses with trisomy 21 at 11 + 0 to 13 + 6 weeks of gestation there is evidence of brachycephaIy but not of frontal lobe hypoplasia.Copyright 2006 ISUOG. Published by John Wiley & Sons, Ltd.

2006 Ultrasound in Obstetrics and Gynecology

5177. Frontal brain lobe impairment in obstructive sleep apnoea: a proton MR spectroscopy study. Full Text available with Trip Pro

Frontal brain lobe impairment in obstructive sleep apnoea: a proton MR spectroscopy study. Patients with obstructive sleep apnoea syndrome frequently have cognitive deficits, especially related to executive functions, which cannot be fully explained by daytime sleepiness and are partial irreversible after nasal continuous positive airway pressure treatment. The causal mechanism of these cognitive deficits is not yet known, but it has been proposed that they are associated with chemical (...) in the frontal white matter of obstructive sleep apnoea patients when compared to controls. Absolute concentrations of N-acetylaspartate and choline were also significantly reduced in the frontal white matter of patients with sleep apnoea. Frontal lobe white matter lesions are known to be associated with cognitive executive dysfunction. The findings of this study may offer an explanation for the sometimes irreversible cognitive deficits associated with sleep apnoea.

2004 European Respiratory Journal

5178. Sonographic biometry of the frontal lobe in normal and growth-restricted neonates. Full Text available with Trip Pro

Sonographic biometry of the frontal lobe in normal and growth-restricted neonates. Assessing the impact of restricted intrauterine growth on neonatal frontal lobe (FL) dimensions is important. We aimed to create a sonographic nomogram of FL dimensions in neonates at different gestational ages (GA) and evaluate the impact of small head circumference (HC) on FL dimensions. We conducted sonographic biometry of the FL at birth. We included 218 newborn infants born at GA of 24-43 wk: appropriate (...) measured the three sides of the triangle, Sylvian-fontanellar distance, Sylvian-callosal distance, and fontanellar-callosal distance, and calculated the frontal triangular area. All four FL dimensions increased significantly between 24 and 43 wk of gestation in both appropriate for GA-normal HC and small for GA-small HC neonates, and were strongly correlated with HC and birth weight. Regression lines of GA against Sylvian-fontanellar distance, Sylvian-callosal distance, fontanellar-callosal distance

2004 Pediatric Research

5179. Capillary-oxygenation-level-dependent near-infrared spectrometry in frontal lobe of humans. Full Text available with Trip Pro

Capillary-oxygenation-level-dependent near-infrared spectrometry in frontal lobe of humans. Brain function requires oxygen and maintenance of brain capillary oxygenation is important. We evaluated how faithfully frontal lobe near-infrared spectroscopy (NIRS) follows haemoglobin saturation (SCap) and how calculated mitochondrial oxygen tension (PMitoO2) influences motor performance. Twelve healthy subjects (20 to 29 years), supine and seated, inhaled O2 air-mixtures (10% to 100 (...) %) with and without added 5% carbon dioxide and during hyperventilation. Two measures of frontal lobe oxygenation by NIRS (NIRO-200 and INVOS) were compared with capillary oxygen saturation (SCap) as calculated from the O2 content of brachial arterial and right internal jugular venous blood. At control SCap (78%+/-4%; mean+/-s.d.) was halfway between the arterial (98%+/-1%) and jugular venous oxygenation (SvO2; 61%+/-6%). Both NIRS devices monitored SCap (P<0.001) within approximately 5% as SvO2 increased from 39

2007 Journal of Cerebral Blood Flow and Metabolism

5180. Frontal Lobe syndrome

Frontal Lobe syndrome Frontal Lobe Syndrome. FLS information. Frontal Lobe Lesions | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Frontal Lobe Syndrome Authored by , Reviewed by | Last edited 6 Nov 2014 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK (...) and European Guidelines. You may find one of our more useful. In this article In This Article Frontal Lobe Syndrome In this article Frontal lobe syndrome (FLS) reflects damage to the prefrontal regions of the frontal lobe. It is characterised by deterioration in behaviour and personality in a previously normal individual. Aetiology Head injury. Cerebrovascular event. [ ] Infection. Neoplasm. Degenerative disorders - eg, Pick's disease, a type of dementia with histopathological findings of Pick's bodies

2008 Mentor

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