Henry W. Dodge

Electroencephalographic rhythms from the depths of the parietal, occipital and temporal lobes in man ☆

Abstract Further studies have been done in an effort to establish additional patterns of the electric activity in the depths of the human brain. It has been demonstrated that somatic, sensory, motor, auditory and visual activity can be recorded from the depths of the brain. Synchronous activity recorded from the ventromedial part of the frontal lobe, parts of the temporal lobe, parts of the parietal lobe and the region of the hypothalamus indicates connections between these regions. Profound changes in the electric activity in these regions during acute episodes of agitation and hallucination have been observed.

Electroencephalographic rhythms from the depths of the frontal lobe in 60 psychotic patients.

Abstract The following waves were consistently recorded from the depths of the frontal lobes in 60 psychotic patients: (1) alphalike 8 to 12 c/sec. waves in the uppermost layers; (2) arrhythmic 2 to 4 c/sec. waves maximal in the ventral medial portions; (3) fast 25 c/sec. waves maximal in the lateral portions; (4) rhythmic 26 to 38 c/sec. waves from the olfactory bulb and (5) flat recordings, probably from the central white matter. Of 40 patients who had normal preliminary recordings from the scalp, 23 showed bilateral rhythmic bursts of high-voltage, 2 to 5 c/sec. waves, occasionally simulating slow sharp waves, in depth recordings. To allow assessment of the properties of the rhythms encountered in the depths of the frontal lobe, recordings were made under varied conditions, such as mental activity, hyperventilation, sleep, ether and barbiturate anesthesia, and various types of stimulation. Light ether anesthesia, as well as that induced by thiopental sodium, increased the voltage of the 25 c/sec. waves. Ether increased their frequency, whereas thiopental decreased it. Deep anesthesia further enhanced the changes in frequency. Evoked olfactory potentials were not abolished by deep anesthesia. Ether increased their frequency up to 48 c/sec. and thiopental sodium decreased it to 17 c/sec. We have attempted to contribute to the recognition and understanding of the wave forms in the frontal lobe and their distribution in the hope that such work will be of value in the establishment of base lines for depth electrography. As the recordings in this study were derived from psychotic patients, we have purposely avoided any statement regarding the normalcy of the waves described.

A multielectrode lead for intracerebral recordings

Abstract The various types of electrodes used for intracerebral recordings in human beings have been reviewed. A multielectrode lead is described which can be introduced into the brain externally to the needle-introducer. It can be used for recordings in the operating room as well as for “chronic” implantation (as “chronic” is defined herein). Localization of the tip of the electrode in the roentgenograms of the skull is fairly easy.

Effect of anosmia on the appreciation of flavor.

A CENTURY AGO a controversy existed as to the role of the lingual nerve in the determination of tzste and flavor. In the past 100 years, however, considerable evidence has been collected supporting the assumption of Brillat-Savarinl and others that the flavor of substances is largely, if not altogether, dependent on olfaction.2.s Moncrieff4 has stated the opinion that “people suffering from loss of smell lose also what they call their ‘sense of taste,’ but which is really their odour component of the flavour.’’ Best and TayloI3 have said that blocking of the nasal passages by an upper respiratory infection seems to blunt the appreciation of taste, and it may then be impossible to distinguish between the taste of an apple and a pear, or a potato and a turnip. While observing that other factors may be of importance, such authors of physiology and psychology textbooks as Starling,6 Geldard,’ and Andrew@ have noted that the flavor of substances depends for the most part on olfaction. Little opposition to this assumption is noted in the pertinent literature. However, Hutchison,Q Crosland, Goodman and Hockett,”J and Leigh11 have reported cases of patients said to be suffering from anosmia who apparently continued to enjoy and recognize the flavor of various foods. In view of the difference of opinion revealed in the literature as to the importance of olfaction in the appreciation of flavor, the following report of a case may be of interest.

INTRACEREBRAL ELECTROGRAPHIC STUDY OF 93 PSYCHOTIC PATIENTS 1

Il;lectro-encephalographic recording from electrodes on the scalp has given valuable information in the diagnosis and treatment of a number of neurologic disorders, such as brain injuries, brain tumors and epilepsy. However, the results have been rather disappointing with respect to mental disorders. On the other hand, recording from the depths of the brain by means of intracerebral microelectrodes has given valuable diagnostic, therapeutic and neurophysiologic information in patients suffering from mental disorders. It should be pointed out immediately that such examinations have been carried out only in connection with operations on the brain. The results of such recordings frequently have made it possible to limit substantially the final surgical operation.

Surgical treatment of trigeminal neuralgia in the older age groups.

Any discussion of the methods of surgical treatment of trigeminal neuralgia (lancinating paroxysmal pain in one or more branches of the fifth cranial nerve) in the older age groups is in essence simply a consideration of the disease as it occurs, for trigeminal neuralgia is primarily an affliction of older persons. Although in a large neurologic or neurosurgical practice trigeminal neuralgia, variously termed “Fothergill’s disease,” “tic douloureux” or “trifacial neuralgia,” is not a rare condition (approximately 200 patients a year for the past ten years have been treated for it a t the Mayo Clinic), this disease is still relatively uncommon in the general population. A large number of patients complaining of “pain in the face” may be relieved by simple measures dictated by careful preliminary diagnostic evaluation. Typical tic douloureux (trigeminal neuralgia) presents such a striking, unforgettable picture that the diagnosis is usually not difficult. However, unilateral or bilateral facial pain resulting from other causes and having some ticlike characteristics may be confusing and the relief of pain offered by ill-advised surgical treatment disappointing. Therefore, despite the seeming urgency dictated by severe pain, it is often rewarding to employ temporizing measures (narcotics and so forth) in order to allow adequate clinical investigation. The etiologic basis for primary (major) trigeminal neuralgia is as yet indeterminate, that is, presently there is no proved organic cause. Severe neuralgic facial pain may be experienced as a secondary manifestation of organic involvement of the fifth cranial nerve in its central or peripheral distribution. Careful general and neurologic examination, roentgenologic survey, blood serologic tests for syphilis, and routine and special laboratory tests may reveal the painful facial affection to be the result of a demonstrable organic lesion. Primary tumors may occur on the fifth cranial nerve or in adjacent areas in the posterior cranial fossa (pons, brain stem), along the gasserian ganglion in the middle cranial fossa, and along the peripheral branches innervating the face. Metastatic neoplasms or secondarily invasive nasopharyngeal tumors similarly may affect the nerves (Fig. 1). Aneurysms of the internal carotid artery and other vascular anomalies, inflammatory lesions of meninges, nervous tissues, neighboring bone or air sinuses, toxic or metabolic dysfunctions, and congenital or post-traumatic structural defects contribute to the wealth of organic lesions which have been known to incite facial neuralgia and are “discoverable.” Arteriosclerotic or thrombotic lesions of the thalamus and brain stem are associated with pain of this type. Severe neuralgia in the distribution of the trigeminal nerve may follow an attack of herpes zoster. Migraine headache, the