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A eletromiografia como auxílio na conduta terapêutica após cirurgia de craniotomia fronto-temporal: relato de caso
Oncins, Maristella Cecco;Douglas, Carlos Roberto;Paiva, Guiovaldo;
Revista CEFAC , 2009, DOI: 10.1590/S1516-18462009005000011
Abstract: background: electromyography and therapeutic behavior. procedures: this study was carried out with a woman, 45year old, after 4 months from being submitted to fronto-temporal craniotomy originated an aneurysm. the right anterior temporal muscle was removed from its insertion. after the surgery, the patient had dysfunction in temporal muscle and in temporo-mandibular joint, with reduction of the opening of mouth, pain while speaking and eating. electromyography was used to quantitatively record the electrical activity of the temporal and masseter muscles in the initial evaluation and during the therapeutic process. records were made at rest position, maximum occlusion and chew. they did miofuncional therapy throughout the process. results: examination data showed a significant increase in the electrical activity of the right anterior temporal muscle and a reduction in the activity of the left anterior temporal muscle. the initial record showed a lower electrical activity on the right side compared to the left. with the miofunctional exercises there was a more effective participation of the right anterior temporal muscle, greater openness of mouth, without pain, making easier chewing and speech tasks, harmonizing the stomatognathic system. conclusion: comparative records concerning electromyography in different stages of the therapeutic process helped and directed the best therapy, achieving a balance concerning the functions of breathing, sucking, chewing, swallowing and speech related to the stomatognathic system, considering the limitations of the case.
Clinical characterization of the fronto-temporal dementia patients.
Carlos Alberto Cano Gutiérrez,Rafael Antonio Ramírez Castro
MedUNAB , 2004,
Abstract: Three clinical and psychometric profiles of patients with fronto-temporal dementia (FTD) has been recently described as cases series from the most important research centers of the world, where there is the possibility for a diagnosis by a consensus criteria. In this article, a group of patients from the Memory Clinic at the Hospital Universitario de San Ignacio, in Bogotá City has been studied. Three hundred and forty eight patients were studied by the Memory Clinic Group, of which 45 had the criteria for FTD, 259 the criteria for Alzheimer’s disease (AD) and 44 were controls. The statistical analysis was realized with the best distinctions to define the FTD group were: predominance of men (73% vs. 31% in AD), younger age of onset (65 years vs. 76 years in AD) Columbia Behavioral Scale more compromised (10 vs. 7 in AD and 1 in controls) and MMS inferior to controls (24 vs. 27) but superior to AD (24 vs. 20). These distinctions aid to better define the profile of patients with FTD, but also open a new questions which we expect to answer, soon, in a longitudinal study of this persons.
Bilateral fronto-orbito-zygomatic craniotomy--a combined extended frontal and orbitozygomatic approach.
Gupta S,Khosla V,Sharma B
Neurology India , 2000,
Abstract: In extensive skull base lesions involving the spheno-ethmoido-clival region and extending into both the cavernous sinuses and infratemporal regions, a combination of approaches is usually required, either in the same operation or at a second stage. The bilateral fronto-orbito-zygomatic craniotomy described in this report is a combination of an extended frontal approach and fronto-orbito-zygomatic craniotomy. This gives a wide exposure of the spheno-ethmoido-clival regions of both the cavernous sinuses and both the infratemporal regions. The exposure is thus greatly improved with minimal frontal lobe retraction. The single bone piece can be speedily replaced obviating the need for a complicated reconstruction technique and gives a superior cosmetic result. The operative technique is described in detail.
Single flap fronto-temporo-orbito-zygomatic craniotomy for skull base lesions.  [cached]
Gupta S,Sharma B,Pathak A,Khosla V
Neurology India , 2001,
Abstract: Surgery was performed, through single flap fronto-temporo-orbito-zygomatic approach in 22 patients with skull base lesions. In two of these patients, this approach was combined with a transpetrosal approach. The pathological spectrum consisted of trigeminal neurofibromas (5), spheno-orbital meningiomas (4), carotico-ophthalmic aneurysms (4), basilar top aneurysms (2), cavernous sinus haemangiomas (2), invasive pituitary tumours (2) and one patient each of metastatic adenocarcinoma of the cavernous sinus, transcranial fungal granuloma and tubercular granuloma of the cavernous sinus. Of the 14 tumours, 10 were excised totally/near totally while a subtotal excision was achieved in four. Removal of the anterior clinoid process facilitated the clipping of all the carotico-ophthalmic aneurysms. One basilar top aneurysm was wrapped and the other clipped. One patient of fungal granuloma died of fungal meningitis and one patient of basilar top aneurysm expired as a result of thalamic infarct. The advantages of this approach included excellent exposure of the skull base lesions, making the dissection distance shorter and wider, minimal brain retraction and easy replacement of the single bone flap.
Klüver-Bucy Syndrome Accompanied with Fronto-temporal Dementia
Marmara Medical Journal , 2012,
Abstract: Klüver-Bucy syndrome is characterized by visual agnosia, increased sexual engagement, placidity, hyperorality, hypermetamorphosis, alterations in affection and dietary habits. A right-handed 64-year-old man is presented with Klüver-Bucy syndrome. The clinical examination, psychometric tests and radiological examinations confirmed the diagnosis of Klüver-Bucy syndrome. The results obtained from positron emission tomography (PET) and cranial magnetic resonance imaging (MRI) showed bilateral involvement of the amygdala, defined as the basic mechanism in Klüver-Bucy syndrome. In this case report, a Klüver-Bucy syndrome with fronto-temporal dementia is discussed. (Marmara Medical Journal 2012;25:153-5)
Time Course of the Involvement of the Right Anterior Superior Temporal Gyrus and the Right Fronto-Parietal Operculum in Emotional Prosody Perception  [PDF]
Marjolijn Hoekert, Leonie Bais, René S. Kahn, André Aleman
PLOS ONE , 2008, DOI: 10.1371/journal.pone.0002244
Abstract: In verbal communication, not only the meaning of the words convey information, but also the tone of voice (prosody) conveys crucial information about the emotional state and intentions of others. In various studies right frontal and right temporal regions have been found to play a role in emotional prosody perception. Here, we used triple-pulse repetitive transcranial magnetic stimulation (rTMS) to shed light on the precise time course of involvement of the right anterior superior temporal gyrus and the right fronto-parietal operculum. We hypothesized that information would be processed in the right anterior superior temporal gyrus before being processed in the right fronto-parietal operculum. Right-handed healthy subjects performed an emotional prosody task. During listening to each sentence a triplet of TMS pulses was applied to one of the regions at one of six time points (400–1900 ms). Results showed a significant main effect of Time for right anterior superior temporal gyrus and right fronto-parietal operculum. The largest interference was observed half-way through the sentence. This effect was stronger for withdrawal emotions than for the approach emotion. A further experiment with the inclusion of an active control condition, TMS over the EEG site POz (midline parietal-occipital junction), revealed stronger effects at the fronto-parietal operculum and anterior superior temporal gyrus relative to the active control condition. No evidence was found for sequential processing of emotional prosodic information from right anterior superior temporal gyrus to the right fronto-parietal operculum, but the results revealed more parallel processing. Our results suggest that both right fronto-parietal operculum and right anterior superior temporal gyrus are critical for emotional prosody perception at a relatively late time period after sentence onset. This may reflect that emotional cues can still be ambiguous at the beginning of sentences, but become more apparent half-way through the sentence.
Dural based primary osteosarcoma in right fronto-temporal region with review of literature  [cached]
Ghosal Nandita,Dadlani Ravi,Furtado Sunil,Bagdi Naman
Neurology India , 2010,
Abstract: We report a case of primary dural based osteosarcoma in the right fronto-temporal convexity in a 43-year-old female who presented with a short history of seizure and headache. Radiologic evaluation revealed a well defined brightly enhancing extra-axial lesion in the right fronto-temporal region with a dural tail around the sylvian fissure. The overlying bone was uninvolved. Paraffin section of the tumor showed plump cells with moderate nuclear and cellular pleomorphism with eosinophilic extracellular material (osteiod) between the cells. At a few places, lace like osteiod was seen encasing individual cells signifying osteiod being formed by tumor cells. Immunohistochemistry for EMA was focally positive and negative for S-100 protein and GFAP. A final histopathological diagnosis of dural based primary osteosarcoma of the right fronto-temporal region was rendered. To the best of our knowledge this will be the eighth such case in literature.
Structural brain changes in first episode Schizophrenia compared with Fronto-Temporal Lobar Degeneration: a meta-analysis
Bayanne Olabi, Ian Ellison-Wright, Ed Bullmore, Stephen M Lawrie
BMC Psychiatry , 2012, DOI: 10.1186/1471-244x-12-104
Abstract: A systematic search was conducted for published, structural voxel-based morphometric MRI studies in patients with FES or FTLD. Data were combined using anatomical likelihood estimation (ALE) to determine the extent of gray matter decreases and analysed to ascertain the degree of overlap in the spatial distribution of brain changes in both diseases.Data were extracted from 18 FES studies (including a total of 555 patients and 621 comparison subjects) and 20 studies of FTLD or related disorders (including a total of 311 patients and 431 comparison subjects). The similarity in spatial overlap of brain changes in the two disorders was significant (p?=?0.001). Gray matter deficits common to both disorders included bilateral caudate, left insula and bilateral uncus regions.There is a significant overlap in the distribution of structural brain changes in First Episode Schizophrenia and Fronto-Temporal Lobar Degeneration. This may reflect overlapping aetiologies, or a common vulnerability of these regions to the distinct aetio-pathological processes in the two disorders.Schizophrenia is a disorder characterised by positive symptoms (hallucinations and delusions), thought disorder and negative symptoms (such as apathy). Brain imaging studies have identified structural changes both early in the presentation of the illness and more extensive changes later in the course of the illness [1]. The distribution of changes has been replicated between studies [2], and may be considered a ‘structural signature’ of schizophrenia within the brain. However, an adequate explanation for this spatial distribution remains elusive. Models have been proposed involving genetic factors coding neuro-protein variants resulting in abnormal development of limbic and frontal-temporal-subcortical networks [3]. However, it remains uncertain which neuro-chemical pathways are responsible and how they cause the spatial changes.FTLD is characterised by declines in social function, interpersonal conduct, emo
Reduced Fronto-Temporal and Limbic Connectivity in the 22q11.2 Deletion Syndrome: Vulnerability Markers for Developing Schizophrenia?  [PDF]
Marie-Christine Ottet, Marie Schaer, Leila Cammoun, Maude Schneider, Martin Debbané, Jean-Philippe Thiran, Stephan Eliez
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0058429
Abstract: The 22q11.2 deletion syndrome (22q11DS) is a widely recognized genetic model allowing the study of neuroanatomical biomarkers that underlie the risk for developing schizophrenia. Recent advances in magnetic resonance image analyses enable the examination of structural connectivity integrity, scarcely used in the 22q11DS field. This framework potentially provides evidence for the disconnectivity hypothesis of schizophrenia in this high-risk population. In the present study, we quantify the whole brain white matter connections in 22q11DS using deterministic tractography. Diffusion Tensor Imaging was acquired in 30 affected patients and 30 age- and gender-matched healthy participants. The Human Connectome technique was applied to register white matter streamlines with cortical anatomy. The number of fibers (streamlines) was used as a measure of connectivity for comparison between groups at the global, lobar and regional level. All statistics were corrected for age and gender. Results showed a 10% reduction of the total number of fibers in patients compared to controls. After correcting for this global reduction, preserved connectivity was found within the right frontal and right parietal lobes. The relative increase in the number of fibers was located mainly in the right hemisphere. Conversely, an excessive reduction of connectivity was observed within and between limbic structures. Finally, a disproportionate reduction was shown at the level of fibers connecting the left fronto-temporal regions. We could therefore speculate that the observed disruption to fronto-temporal connectivity in individuals at risk of schizophrenia implies that fronto-temporal disconnectivity, frequently implicated in the pathogenesis of schizophrenia, could precede the onset of symptoms and, as such, constitutes a biomarker of the vulnerability to develop psychosis. On the contrary, connectivity alterations in the limbic lobe play a role in a wide range of psychiatric disorders and therefore seem to be less specific in defining schizophrenia.
Eletromiografia dos músculos temporal e masseter em crian as com mordida cruzada posterior direita = Electromyography of the temporalis and masseter muscles in children with right unilateral crossbite
Cristiane Neves Alessi Pissulin,Fausto Bérzin,Rúben de Faria Negr?o Júnior,Acary Souza Bulle Oliveira
Acta Scientiarum : Health Sciences , 2010,
Abstract: Sabe-se que a mastiga o unilateral e a hiperatividade muscular podem estar presentes nos indivíduos com mordida cruzada posterior unilateral. O objetivo do presente estudo foi avaliar as altera es eletromiográficas dos músculos mastigatórios em portadores de mordida cruzada posterior unilateral direita (MCPUD). Eletrodos bipolares passivo de superfície foram colocados bilateralmente sobre os músculos temporal (por o anterior) e masseter, de 20 crian as selecionadas, do sexo feminino com idade de 7 a 8 anos (X = 7.4 eDP 0.5). Os registros foram coletados durante as contra es isot nicas habitual, direita, esquerda e bilateral simultanea, além das contra es isométricas voluntárias máximas direita e esquerda, cujos sinais foram utilizados para a normaliza o da amplitude da atividade elétrica. Todas as contra es isométricas foram feitas com tubo de látex. Durante as mastiga es habitual e direita, observou-se uma hiperatividade do músculo temporal anterior esquerdo, e hipoatividade do músculo masseter esquerdo. Concluiu-se que opadr o eletromiográfico dos indivíduos com MCPUD sugere um padr o mastigatório unilateral, sendo os músculos masseter direito e por o anterior do músculo temporal esquerdo mais ativos que os outros músculos avaliados. This study proposal was to evaluate the changes at a masticatory muscle temporalis and masseter, through a eletromyographic, at ponters of the right unilateral bite posterior, verifying the difference at the eletric activity between right and left sides. Twenty female volunteers, with ages between 7 and 8 (x = 7.4). The eletromyographics signals were collected in both sides in all volunteers in rest situations and in an usual isotonic mastication, right, left and bilateral and the maximun isometric constriction, which sinal was used to the eletric activity amplitude normalization.The results signed that the right masseter muscle presents an expressive statistic difference, if compared with the left masseter muscle during the left and right mastication, suggesting a right unilateral mastication. The muscle haven't gotten any expressive variance in this amplitude which remained to a proximate flat noticed in a right and habitual mastication, suggesting a right and one sided mastication during the left mastication occurs a raise of the eletric signal amplitude of the muscle left masseter. The right masseter muscle haven't gained any expressive variance, which remained in a proximate flat observed in an usual and right mastication, suggesting a muscular pattern hyperfunction next to the dental crossing.
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