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Hypothermia and Cerebral Vascular Lesions

I. Experimental Interruption of the Middle Cerebral Artery During Hypothermia

Lieut. Hubert L. Rosomoff

suggest that such conditions may be attained with the use of hypothermia. METHODS Thirty-seven mongrel dogs weighing between 10.0 and 22.0 kg. and unselected as to age and sex were used in this investigation. Twenty-four hours before each experiment, the dogs were given long-acting Benzathine penicillin G, 600,000 units, intramuscularly, and diphenylhydantoin sodium, 0.4 gm., orally. The diphenylhydantoin sodium was administered daily through the 5th postoperative day in order to suppress convulsions. Anesthesia was achieved with intravenous pentobarbital

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Studies of Trigeminal Nerve Potentials

Overreaction to Tactile Facial Stimulation in Acute Laboratory Preparations

Robert B. King and Joseph C. Barnett

was activated by induction coils and had a 1-cm. excursion. The increased delayed activity and the associated overreaction were abolished by small intravenous doses of several drugs. Anectine (1.0 mg.) reduced even the delayed activity in strychnine preparations to a flat base line ( Fig. 2 ). * Veratrine (0.25 mg.), decamethonium bromide (Syncurine) (0.2 mg.), mephenesin (Tolserol) † ( Fig. 6 ), ether (20 to 30 sec. after introduction into the airway) and diphenylhydantoin sodium (Dilantin) (50 mg.) had a similar effect. Chlorpromazine hydrochloride

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José M. R. Delgado

the precentral gyrus while it increased 640 per cent the threshold for electrical after-discharge in the amygdaloid nucleus. Trimethadione did not affect the thresholds in the amygdala but increased them considerably in the thalamus and precentral gyrus. The same cerebral area might respond specifically to different tests. For example, in one point of area 4 parenteral administration of diphenyl-hydantoin did not modify the threshold for minimal motor activity but increased the threshold for motor convulsive activity. The use of implanted electrodes thus permits

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The Medical Control of Tic Douloureux

Preliminary Report on the Effect of Mephenesin on Facial Pain

Robert B. King

preparations but disappeared when the potential was blocked by mechanical interruption of conducting pathways or by a number of drugs given intravenously in small doses. Mephenesin (Tolserol®) ‡ was one of the more effective preparations tested. Diphenylhydantoin sodium (Dilantin®), ¶ although less effective, had a similar influence. CASE MATERIAL Since February 1956, 41 consecutive patients with facial pain have been studied and are included in this preliminary report ( Table 1 ). TABLE 1 No Pain Mild Pain Moderate Pain No

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Hubert L. Rosomoff

, a control group of animals was subjected to brain injury at normal body temperature. A second group was injured during hypothermia; their temperature was maintained at 25°C. or less for 18 hours, and then they were rewarmed. Both groups were observed for life expectancy and survival. At the start of each experiment, each animal received long-acting Benzathine penicillin G, 600,000 units, intramuscularly. Diphenylhydantoin sodium, 0.4 gm. daily, was given to suppress convulsions; this was continued through the 5th post-traumatic day in surviving animals

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Maitland Baldwin, Robert Farrier, Frances MacDonald and A. K. Ommaya

empirical exploitation of this suggestion, d-tubocurarine, dimethyl penicillin, and diphenylhydantoin sodium were given by vein under comparable conditions of profound cerebral hypothermia. The brain substance then was assayed for evidence of cerebral deposition. These drugs were chosen because of their pharmacological significance, chemical difference, and different predilection for cerebral deposition under ordinary conditions. Thus, according to Bovet, 3 d-tubocurarine (in the circulation) ordinarily is excluded from the brain, while Noach et al. 11 reported a

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John L. Fox

elevated K + /Ca ++ ratio) lowers and DOCA raises the threshold of electroshock (and stimulation of seizures) of the brain. 210, 254, 716, 719 This may be related to the apparent K + binding (to the nerve-cell membrane?) effect of cortisone with subsequent increased permeability of brain cells. In fact diphenylhydantoin suppression of seizures may mediate some of its activity via the adrenocortical axis. 117 Wilmer 703 has reviewed the importance of the steroid molecule in the proteolipidic structure of cellular surfaces. Cortisone is a constituent of human nerve

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Psychomotor Seizures and Mirror Focus Secondary to Retained Knife Blade in Temporal Lobe

Resolution of Mirror Focus after Extirpation of Primary Lesion

Herbert Lourie and Ken'ichi Uemura

after operation. Note complete disappearance of both spike and slow-wave abnormalities. All subsequent waking and sleep tracings have been normal during the 43-month follow-up period. Psychomotor attacks have not occurred since operation. Single grand-mal convulsions occurred approximately 4 and 12 months postoperatively. Rare “blackouts” or “faints” have continued, usually precipitated by alcoholic intake or exposure to very warm temperatures. Diphenylhydantoin (300 mg. daily) has been continued. Discussion The late development of seizures from retained

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Robert Raskind

operation well, and was discharged 7 days later ambulatory, in good condition, with no abnormal neurological signs except for unchanged papilledema. He was given diphenylhydantoin, 300 mg. daily. Histologic study of the tumor again confirmed the diagnosis of meningioma. The aneurysm was also examined, but no conclusion was reached as to its origin ( Figs. 4 , 5 ). Fig. 4. The recurrent meningioma slightly more cellular than the original tumor (see Fig. 2 ); ×150. Fig. 5. Aneurysm, showing the typical wall, and the clot within; ×7. When seen in

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The Thalamic Syndrome and Its Mechanism

Report of Two Cases, One Due to Arteriovenous Malformation in the Thalamus

Thomas A. Waltz and George Ehni

shocks. Her pains were increased by the slightest stimulus to her right side such as in walking, contact with clothing or the blowing of a cold wind. Diphenylhydantoin had been given without significant effect. In February, 1964, intrathecal injection of 6.0 mg. of pontocaine in hyperbaric solution was made with the patient lying on her right side. She experienced immediate abolition of leg pain—even before remaining sensation for touch and motor power were impaired. As the anesthetic level ascended the body, it swept the pain before it until she was anesthetic and