Eli S. Goldensohn

The EEG in centenarians

1. The EEGs of ten centenarians were described. 2. In most healthy centenarians, posterior dominant rhythms are within the lower part of the alpha range (average 8.62 c/sec). 3. Although slowing of the posterior dominant rhythm at age 100 is greater than in younger groups, there is no evidence in this study of a progressive decrease in frequency during the two decades between 80 and 100 years. 4. Most records of centenarians contained other abnormalities, either of diffuse slowing or of slow wave foci, the latter most often in the left temporal area. 5. The relationship of the observed EEG changes to the process of aging as distinct from reduced cerebral metabolism and blood flow resulting from disease is discussed.

Prolonged behavioral disturbances as ictal phenomena

THE RELATIOSSHIP between abnormal behavior and cerebral physiology has long interested the neurologist. Following the introduction of electroencephalography, a number of attempts were made to correlate problems of behavior in children with electroencephalographic abnormalities.’-5 Despite the absence of evidence of organic brain damage, many of the children were reported to have abnormal electrical activity. In one such study,4 74% of children in the 4to 9-year-old age group with behavior disorders were found to have abnormal records as compared to a control group in which 43% showed abnormalities. A recent study6 of electroencephalograms in children who were specially selected because of absence of neurologic or psychiatric disturbances both in themselves and in their families showed 42% to be abnormal by the criteria of Gibbs, Gibbs, and Lennox.7 This high incidence of “abnormality” in normal children brings the significance of the findings in children with behavior disorders into question. hvestigationss-l1 of patients of all ages with a wide variety of chronic behavioral and psychiatric disorders report changes in organization, frequency, and paroxysmal patterns. No consistent relationship has been found, however, between electroencephalographic abnormalities and chronic behavioral and psychiatric disorders.12 Putnam and Merrittl3 described electroencephalographic abnormalities in “subliminal” epileptic states which interfered with intellectual functions and were characterized by dullness, mental retardation, apathy, and confusion. They stressed that the objective means of differentiation between these seizure phenomena and other behavioral disturbances, such as psychologic reactions and the sedative action of drugs, could be made by the electroencephalogram. They cited a high degree of correlation in time between the prolonged alterations of intellectual function and the abnormal electrical activity. The most common ictal phenomena associated with behavioral disturbances are psychomotor seizures. Most of these are related to abnormalities in the temporal lobe. Gibbs, Gibbs, and Fuster14 demonstrated that, be-

Electroencephalographic abnormalities in addition to bilaterally synchronous 3 mper second spike and wave activity in petit mal

Abstract 1. 1. In 100 consecutive patients in whom clinical petit mal attacks were associated with 3 per sec. spike and wave activity the presence of focal, lateral and diffuse EEG abnormalities was studied. 2. 2. In 51 cases the background activity of the EEG was essentially normal. In 35 cases focal or lateralizing abnormalities were present. In 14 cases the background activity was diffusely abnormal. 3. 3. Sixty-two patients were female. The average age of onset of petit mal was seven years. Nineteen had close relatives with a history of convulsions. Six patients had abnormal neurologic findings. Eleven were low in intelligence. Forty patients had atypical features to their seizures. Forty-nine had other types of seizures in addition to petit mal. Possible etiologic factors were present in the histories of only six patients. 4. 4. Correlations were noted between the presence of EEG abnormalities other than synchronous 3 per sec. spike and wave activity and (a) mental retardation and (b) abnormal findings on neurologic examination. 5. 5. The possible meaning of the high incidence of abnormalities, other than 3 per sec. spike and wave discharges, in terms of the genesis of petit mal activity is discussed.

Paroxysmal abdominal pain as a manifestation of epilepsy.

PAROXYSMAL BDOMINAL PAIN as a form of epilepsy is a fairly well established clinical entity. Several groups of patients with this syndrome have been reported.1-4 In 31 children studied by Hoefer and co-workers,4 the pain was characteristically periumbilical or epigastric. I t usually persisted from a few minutes to several hours. In most instances other gastrointestinal symptoms such as anorexia, nausea, vomiting, diarrhea, or constipation were present. Four had experienced convulsive phenomena prior to or concurrent with the onset of abdominal complaints, while six develo ed seizures in later years. Eight had genera E ’zed seizures and one had psychomotor seizures only. The electroencephalogram showed abnormally slow activity in the resting records of 28 cases and was “borderline normal” in one. Sixteen patients had ra id or

Sensations of ocular movement in seizures originating in occipital lobe

Two patients with structural lesions had illusions of eye movement as the earliest manifestation of their seizures. One patient had a right occipitoparietal arteriovenous malformation and the other had a tentorial meningioma encroaching on the left occipital lobe. Symptoms were controlled by anticonvulsants and subsequent surgery in both cases. The characteristic feature of this rare form of seizure onset is a unilateral sensation of eye movement in the absence of oscillopsia.