Summary
1. The electroencephalograms of 5 patients having lesions in the midbrain, pons and medulla were presented.
2. One case of mesencephalopontine hemorrhage exhibited bilateral synchronous delta waves in addition to alpha activity. The former was observed mainly in the anterior and the latter in the posterior part of the head.
3. The electroencephalograms in 4 other cases of pontomedullary lesions were considered within normal limits in 3 and abnormal with sharp waves in 1.
4. The difference of findings were discussed on the viewpoint of reticular activating system and its function.
Myasthenia gravis has frequently been diagnosed mistakenly as hysteria or neurosis at the onset and it became obvious that myasthenia gravis is combined with epilepsy or schizophrenia. The purpose of this study was to determine the EEG abnormalities of myasthenia gravis with regard to epilepsy.
MATERIALS AND METHODSThis study concerned 41 patients with myasthenia gravis who were admitted to Toranomon Hospital between 1970 and 1978. The study included 13 males and 28 females whose ages were between 17 and 63 years. The EEG examinations were performed in 22 cases, and 29 traces of 22 cases were studied.
RESULTSOne of the 41 patients had tonic convulsions and was given antiepileptic drugs for over seven years before the onset of myasthenia gravis.One of the 41 patients was regarded as having epilepsy before the onset of myasthenia gravis.One of the 41 patients was wrongly diagnosed as an epileptic and after the onset of myasthenia gravis she was treated with antiepileptic drugs for over two years.In the studies of 22 patients with myasthenia gravis, the EEGs showed: normal in 12 (41g'), borderline in six (21%) and abnormal in 11 (38%).The abnormal EEGs were: slow wave in one, spike or spike and wave complex during the awake state in two, spike wave during sleep in four and slow wave bursts and sharp wave during the hyperventilation test in four.Borderline EEGs were: diffuse slow alpha wave in one and a small amount of slow waves in five.I n 19 patients who were not medicated with anticholinesterase, the EEGs showed: normal in 10, borderline in four and abnormal in five.One who was treated with anticholinesterase for over three years and medicated over four years showed normal EEGs.One of the cases observed over four years showed abnormal EEGs before and after medication. All the 41 patients with myasthenia gravis were classified as:Osserman type I in 17, type IIa in four, type IIb in 10 and type V in 10.In type 1, the EEGs showed: normal in nine and borderline in two.In type IIa normal EEGs were observed. In type Ilb, the EEGs showed: normal in one, borderline in two and abnormal in nine.In type V, the EEGs showed: normal in one, borderline in two and normal in two.A case with epileptic seizures was type IIb and the EEGs showed the spike and wave complex in the awake state.One, doubtful of having epilepsy before
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