PDF File - Mahidol University

378
Abstracts
MS-04-2
Ethical decisions in neurology of early life
P. Evrard
Service de Neurologie Pediatrique et des Maladies Metaboliques,
Faculte de Medicine Xavier-Bichat, Hospital
Robert-Debre, Paris, France
Abstract not submitted
MS-05
Medical Informatics
MS-5
Medical Informatics
D. Stumpf
Department of Neurology, Northwestern University Medical
School, Evanston, Illinois, USA
Abstract not submitted
MS-6
Environmental Medicine
MS-06-1
Preventing lead neurotoxicity in Shanghai, China
X.-M. Shen
Child Development and Rehabilitation Center, Shanghai
Children’s Medical Center, Shanghai, China
Abstract not submitted
MS-06-2
Neurotoxic effects of lead in children
M. Markowitz
Henry and Lucy Moses Division, Montefiore Medical
Center The University Hospital for the Albert Einstein
College of Medicine, Bronx, NY, USA
The recognition that lead induces central and peripheral
nervous system disease dates back more than 2000 years.
Over the last two millennia these effects were recognized
only at the clinical level; the neurologic aspects of the
disease were characterized by symptoms of encephalopathy
and peripheral neuropathy. In the latter half of the 20th
century an appreciation of the subclinical effects grew as
cross-sectional and then longitudinal studies of children
with low level lead exposure demonstrated detrimental
effects on cognition and behavior. Laboratory studies elucidated
some of the biochemical mechanisms responsible for
these lead effects. Most recent studies raise the question of
whether there is any threshold below which lead is safe in
humans.
MS-07
Headache
MS-7
Headache
D. Rothner
Department of Neurology, Cleveland Clinic S-71, Cleveland,
OH, USA
Abstract not submitted
MD-08-1
Short introduction
MS-8
Rett Syndrome
Y. Nomura
Segawa Neurological Clinic for Children, Chiyoda-ku,
Tokyo, Japan
Abstract not submitted
MS-08-2
The autonomic problem in Rett disorder
A.M. Kerr
Academic Centre, Department of Psychological Medicine,
Gartnavel Royal Hospital, Glasgow Scotland, UK
The British Isles Survey data comes from clinical examination
and postal health questionnaires, providing a longitudinal
account of the natural history of the condition. 1094
individuals aged 2–66 years are under continuing review
(1982–2002). Indices of health and severity first developed
in 1996 are now matched to MECP2 test results (300 cases),
contributing to national and international projects linking
MECP2 mutation type and site to clinical presentation.
Non-invasive out-patient monitoring of autonomic function,
using the NeuroScope e (MediFit Diagnostics Ltd, London,
UK) developed by Drs Peter Julu and Stig Hansen, has
helped to explain the non-epileptic vacant spells which are
common in Rett and which seem to contribute to sudden
deaths accounting for at least 20% of all (74) UK deaths.
Detailed analysis of clinical events, electroencephalogram,
breathing rhythm, vagal tone and baroreflex sensitivity in 47
cases has revealed inadequate brainstem regulation of
central autonomic cardio-respiratory function. Episodes
have been documented of brainstem shut down and of inappropriate
brainstem activation. Without accurate autonomic
monitoring these potentially life-threatening events may
appear to the clinician as shallow, apneustic, deep or interrupted
breathing associated with brief periods of altered
consciousness and pallor or cyanosis, readily confused
with epilepsy. That the autonomic abnormality can be