Neurological Sciences LE JOURNAL CANADIEN DES Sciences Neurologiques

Volume 26 Number 4 November 1999

THE CANADIAN JOURNAL OF Neurological Sciences LE JOURNAL CANADIEN DES Sciences Neurologiques

AN INTERNATIONAL JOURNAL / UN JOURNAL INTERNATIONAL

REVIEW ARTICLE 255 EEG in Epilepsy: Current Perspectives M. Sundaram, R.M. Sadler, G.B. Young and N. Pillay ORIGINAL ARTICLES 263 Burden of Epilepsy: The Ontario Health Survey Samuel Wiebe, David R. Bellhouse, Christine Fallahay, Michael Eliasziw 271 Topiramate in Intractable Childhood Onset Epilepsy - A Cautionary Note J.M. Dooley, P.R. Cornfield, E. Smith, P. Langevin, G. Ronen 21A Consensus Statement of the Canadian MS Clinics Network on: The Use of Disease Modifying Agents in Multiple Sclerosis Joel Oger and Mark Freedman Dr. Charles G. Drake 1920-1998 276 Treatment with Interferon Beta- lb Improves Quality of Life in Multiple Sclerosis G.P. Rice, J. Oger, P. Duquette, G.S. Francis, M. Belanger, S. Laplante, J.F. Grenier 283 Responsiveness of the Scripps Neurologic Rating Scale During a Multiple Sclerosis Clinical Trial James A. Koziol, Adridna Lucero, Jack C. Sipe, John S. Romine, Ernest Beutler 290 MR Characteristics of Malignant Spinal Cord Astrocytomas in Children Abhaya V. Kulkarni, Derek C. Armstrong and James M. Drake 294 EMG Related Anxiety and Pain: A Prospective Study Mohammed M.S. Jan, Murray Schwartz, and Timothy J. Benstead EXPERIMENTAL NEUROSCIENCES 298 Biphasic Opening of the Blood-Brain Barrier Following Transient Focal Ischemia: Effects of Hypothermia Z. Gao Huang, Dong Xue, Edward Preston, Hasneen Karbalai, Alastair M. Buchan 305 Mevalonate Prevents Lovastatin-Induced Apoptosis in Medulloblastoma Cell Lines Wei Wang and Robert J.B. Macaulay Neuroimaging Highlight NEUROIMAGING HIGHLIGHT 311 Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) J.N. Scott, L. Metz, W.Y.Hu andM. Hudon CASE REPORTS 313 Utility of a Moveable 1.5 Tesla Intraoperative MR Imaging System: Case Report Taro Kaibara, John K. Saunders and Garnette R. Sutherland 317 Reversible Paraneoplastic Encephalomyelitis Associated with a Benign Ovarian Teratoma 35th CANADIAN R. Blaine Taylor, Warren Mason, Kester Kong, Richard Wennberg CONGRESS OF 321 Temporal Dermoid Cyst with a Partial Dermal Sinus Tract: A Case Report NEUROLOGICAL Joseph A. Shehadi, Ibrahim A. Alorainy, Karen M. Johnston SCIENCES 325 Acute Quadriplegic Myopathy Unrelated to Steroids or Paralyzing Agents: Quantitative EMG Studies June 13 - 17, 2000 Ahmet Hoke, N.B. Rewcastle and Douglas W. Zochodne Ottawa, Ontario IN MEMORIAM 330 Dr. Charles G. Drake 1920 - 1998 341 Canadian Association of Neuropathologists Abstracts of papers and cases presented at the 39th Annual Meeting SUPPLEMENT 3 SI The Scientific Basis of Migraine Management

The official Journal of: The Canadian Neurological Society, The Canadian Neurosurgical Society, The Canadian Society of Clinical Neurophysiologists, The Canadian Association of Child Neurology Downloaded from https://www.cambridge.org/core. IP address: 170.106.35.93, on 24 Sep 2021 at 17:13:12, subject to the Cambridge Core terms of use, available at https://www.cambridge.org/core/terms. https://doi.org/10.1017/S0317167100050058 <$vv « »

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JIPKA.!

LEVODORL Using RcQuip in ear!}' disease can sustain symptom control and has been shown to delay the need for ievodopa in the majority of patients (61 of 102) who completed a full 3 year study.M

CONTINUED BENEFITS IN ADJUNCT THERAPY. RcQuip allowed a 20% or greater reduction in Ievodopa dose and also increased patients' 'on' time by 20% or more alter 6 months of combination therapy."

SPARING LEVODOPA CAN DELAY COMPLICATIONS. Because ReQuip spares Ievodopa in both early and adjunct therapy, it can substantially reduce Ievodopa load for Parkinson's patients. As a result, ReQuip can delay and reduce long-term Ievodopa complications such as dyskinesias, 'on-off' effect and 'wearing off' effect.16 So starting ReQuip today can give Parkinsons patients a brighter outlook for tomorrow.

+Mean dosage: 9.7 mg (SD 6.0) RcQuip (n«179), 464.0 rag (SD 266.0) l-dopa (n-89). 95% CI of 0.28, 2.26 Stage 1 or 1.5: 0.43, 3.07 Siage II; 0.04, 0.35 Stage II.5 or III. AMean UPDRS improvement in the non-selegilinc subgroup. Mean dosage: rropinirole 9.0 mg (SD 5.2) ReQuip (n«109), 17.2 mg (SD 8.8) bromocriptine (n.101). j^-X °P' 95% CI of 6.0%. 21.1%. 'Achieved by 28% of ropinirole (n*94) and 11% of placebo (n=54) treated B patients. 95% CI of 1.533, 12.658.' In early thetapy\ nausea (59.9%), dizziness (40.1%) and somnolence (40.1%) CST1 SmithKhne Beecham REQUIP were the most common side effects of ReQuip. Postural hypotension occurred l3ft# Pharma in 6.4% of patients. Thtrapy Jf^^J^ Tag In adjunct therapy with Ievodopa', dyskinesias (33.7%) and nausea (29.8%) were the most common side effects of ReQuip. |PAAB| C^h RIGHT FROM THE START.

Downloaded from https://www.cambridge.org/core. IP address: 170.106.35.93, on 24 Sep 2021 at 17:13:12, subject to the Cambridge Core terms of use, available at https://www.cambridge.org/core/terms. https://doi.org/10.1017/S0317167100050058 For brief prescribing information see pages A-41, A-42 Volume 26 Number 4 November 1999

THE CANADIAN JOURNAL OF Neurological Sciences LE JOURNAL CANADIEN DES Sciences Neurologiques

A-39 MESSAGE FROM THE EDITOR CASE REPORTS 313 Utility of a Moveable 1.5 Tesla Intraoperative MR Imaging REVIEW ARTICLE System: Case Report 255 EEG in Epilepsy: Current Perspectives Taw Kaibara, John K. Saunders and Garnette R. Sutherland M. Sundaram, R.M. Sadler, G.B. Young and N. Pillay 317 Reversible Paraneoplastic Encephalomyelitis Associated ORIGINAL ARTICLES with a Benign Ovarian Teratoma R. Blaine Taylor, Warren Mason, Kester Kong, 263 Burden of Epilepsy: The Ontario Health Survey Richard Wennberg Samuel Wiebe, David R. Bellhouse, Christine Fallahay, Michael Eliasziw 321 Temporal Dermoid Cyst with a Partial Dermal Sinus Tract: A Case Report 271 Topiramate in Intractable Childhood Onset Epilepsy - Joseph A. Shehadi, Ibrahim A. Alorainy, Karen M. Johnston A Cautionary Note J.M. Dooley, P.R. Camfleld, E. Smith, P. Langevin, 325 Acute Quadriplegic Myopathy Unrelated to Steroids or G. Ronen Paralyzing Agents: Quantitative EMG Studies Ahmet Hoke, N.B. Rewcastle and Douglas W. Zochodne 274 Consensus Statement of the Canadian MS Clinics Network on: The Use of Disease Modifying Agents in IN MEMORIAM Multiple Sclerosis 330 Dr. Charles G. Drake 1920 - 1998 Joel Oger and Mark Freedman Gary G. Ferguson and Vladimir C. Hachinski 276 Treatment with Interferon Beta-lb Improves Quality of 331 Perspectives from Dr. Charles Drake: Early Training in Toronto Life in Multiple Sclerosis Charles G. Drake G.P. Rice, J. Oger, P. Duquette, G.S. Francis, M. Belanger, S. Laplante, J.F. Grenier 335 Bleeding Aneurysms of the Basilar Artery. Direct Surgical Management in Four Cases 283 Responsiveness of the Scripps Neurologic Rating Scale Charles G Drake (Reprinted from the Journal of During a Multiple Sclerosis Clinical Trial Neurosurgery, 1961) James A. Koziol, Adriana Lucero, Jack C. Sipe, John S. Romine, Ernest Beutler 341 Canadian Association of Neuropathologists Abstracts of papers presented at the 39th Annual Meeting 290 MR Characteristics of Malignant Spinal Cord Astrocytomas in Children 346 Letter to the Editor Abhaya V. Kulkarni, Derek C. Armstrong and 347 Books Received James M. Drake 347 Book Reviews 294 EMG Related Anxiety and Pain: A Prospective Study 352 Notes and Announcements Mohammed M.S. Jan, Murray Schwartz, and Timothy J. Benstead 353 Calendar of Events 354 Index to Volume 26 EXPERIMENTAL NEUROSCIENCES A-6 Call for Abstracts - 35th Canadian 298 Biphasic Opening of the Blood-Brain Barrier Following Congress of Neurological Sciences Transient Focal Ischemia: Effects of Hypothermia Z. Gao Huang, Dong Xue, Edward Preston, A-12 Preliminary Program - 35th Canadian Hasneen Karbalai, Alastair M. Buchan Congress of Neurological Sciences A-20, A-26 1999 Society Prize Announcements 305 Mevalonate Prevents Lovastatin-Induced Apoptosis in Medulloblastoma Cell Lines A-40 Information for Authors Wei Wang and Robert J.B. Macaulay A-18, A-32 25 Years Ago in the Canadian Journal of Neurological Sciences NEUROIMAGING HIGHLIGHT A-73 Advertisers Index 311 Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) SUPPLEMENT 3 J.N. Scott, L. Metz, W.Y.Hu andM. Hudon S1-S43 The Scientific Basis of Migraine Management

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THE CANADIAN JOURNAL OF Neurological Sciences LE JOURNAL CANADIEN DES Sciences Neurologiques

Editor/Redacteur en chef The official journal of: / La Revue offlcielle de: Douglas W. Zochodne CALGARY, AB The Canadian Neurological Society La Societe Canadienne de Neurologie Associate Editors/Redacteurs associes The Canadian Neurosurgical Society Laurence E. Becker TORONTO, ON La Societe Canadienne de Neurochirurgie The Canadian Society of Clinical Neurophysiologists Andres M. Lozano TORONTO, ON La Societe Canadienne de Neurophysiologie Clinique The Canadian Association of Child Neurology Past Editors L'Association Canadienne de Neurologie Pediatrique James A. Sharpe TORONTO, ON The permanent secretariat for the four societies and the Canadian Robert G. Lee CALGARY, AB Congress of Neurological Sciences is at/ Robert T. Ross WINNIPEG, MB Le secretariat des quatre associations et du Congres Canadien des Sciences Neurologiques est situe en permanence a: (founding editor) 810, 906 - 12 Avenue S.W., Calgary, AB Canada T2R 1K7

Editorial Board/Conseil Scientifique The Canadian Journal of Neurological Sciences is published quarterly. The Harold P. Adams IOWA CITY, IA, USA annual subscription rate is $70 for members; $77 for non-members in Canada; Jack P. Antel MONTREAL, QC $88 for USA and elsewhere. Residents. Interns, Pre- and Post-Doctoral Students $35 per annum (members); $38.50 per annum (non-members). Single copies $22 Timothy J. Benstead HALIFAX, NS each plus postage and handling. All manuscripts and communications should be J. Gregory Cairncross LONDON, ON sent to: Canadian Journal of Neurological Sciences, P.O. Box 4220, Station C, Calgary, AB Canada T2T5N1. Courier to: 810,906- 12th Avenue S.W., Andrew A. Eisen VANCOUVER, BC Calgary, AB Canada T2R 1K7. Telephone (403) 229-9575; Fax (403) 229-1661. J. Max Findlay EDMONTON, AB E-mail: [email protected]; Web Site: www.canjneurolsci.org Anthony M. Hakim OTTAWA, ON COPYRIGHT© 1999 by THE CANADIAN JOURNAL OF NEUROLOGICAL SCIENCES INC. No part of this journal may be reproduced in any form without the Renn Holness HALIFAX, NS prior permission of The Canadian Journal of Neurological Sciences. Mailed under George Karpati MONTREAL, QC Publications Mail Registration number 09824. Postage paid at Calgary, Alberta. This journal is indexed by Index Medicus, EMBASE Excerpta Medica and Current Douglas Kondziolka PITTSBURGH, PA, USA Contents — Clinical Practice and Life Sciences, Elsevier Biobase/Current Mark J. Morrow CLEVELAND, OH, USA Awareness in Biological Sciences, Biological Abstracts, Chemical Abstracts, John H. Noseworthy ROCHESTER, MN, USA Current Advances in Ecological Sciences, Dent, index, Industrial Medicine, Industrial Science Reviews, 1N1S Automind, Nutrition Abstracts, Science Citation C. Warren Olanow NEW YORK, NY, USA Index, Weed Abstract.

Peter M. Richardson, MONTREAL, QC Le Journal Canadien des Sciences Neurologiques est publie trimestriellement. Guy Rouleau MONTREAL, QC L'abonnement annuel est de 70 $ pour les membres; 77 $ pour les non-membres au James T. Rutka TORONTO, ON Canada; 88 $ pour les Etats Unis et ailleurs. Internes, residents, fellows pre" et post doctoral: 35 $ par annee (membres); 38,50 $ par annee (non-membres). Shashi S. Seshia WINNIPEG, MB Copie simple: 22 $ plus affranchissement et manutention. Toutes les communica Alan M. Smith MONTREAL, QC tions et les manuscrits doivent etre adresses a Journal Canadien des Sciences Neurologiques, P.O. Box 4220, Station C, Calgary, AB Canada T2T 5NI. Par Paul Steinbok VANCOUVER, BC courrier: 810, 906 - 12th Avenue S.W., Calgary, AB Canada T2R 1K7. Jonathan A. Stoessl VANCOUVER, BC Telephone (403) 229-9575; Fax (403) 229-1661. E-mail cjnsiacanjneurolsci.org; Web Site: www.canjneurolsci.org Book Review Editor/Redacteur de DROITS D'AUTEUR© 1999: THE CANADIAN JOURNAL OF NEUROLOGICAL SCIENCES INC. Aucune partie de ce Journal ne peut etre critiques de livres reproduite, sous quelque forme que ce soit, sans la 1'authorisation du Journal Warren P. Mason TORONTO, ON Canadien des Sciences Neurologiques. Poste sous registration de poste-publications no 09824. Port paye a Calgary, Alberta. Le Journal est cite et indexe dans News Editor/Redacteur (nouvelles) Index Medicus, EMBASE Excerpta Medica el Current Contents — Clinical Practice et Life Sciences, Elsevier Biobase/Current Awareness in Biological John W. Norris TORONTO, ON Sciences, Biological Abstracts, Chemical Abstracts, Elsevier Biobase/Current Advances in Ecological Sciences, Dent, index, Industrial Medicine, Industrial Science Managing Director/Gerant directrice Reviews, INIS Automind, Nutrition Abstracts, Science Citation Index, Weed Abstract. Sally A. Gregg CALGARY, AB Advertising representative/Representant de publicite: Publications Committee/Comite de Redaction Sally Gregg, Canadian Journal of Neurological Sciences G. Bryan Young LONDON, ON 810, 906 - 12 Ave. S.W., Calgary, AB Canada T2R 1K7 Mark Hamilton CALGARY, AB Tel (403) 229-9575 Fax (403) 229-1661 E-mail: [email protected] Andrew Kertesz LONDON, ON Web Site: www.canjneurolsci.org Joseph Dooley STE-FOY, QC Printer/Imprimeur: Sundog Printing Limited, 1311 Ninth Avenue SW, Calgary, Alberta T3C 0H9

ISSN 0317- 1671

Downloaded from https://www.cambridge.org/core. IP address: 170.106.35.93, on 24 Sep 2021A-2 at 17:13:12, subject to the Cambridge Core terms of use, available at https://www.cambridge.org/core/terms. https://doi.org/10.1017/S0317167100050058 igraine relief with tolerability similar to placebo As shown in controlled dinical trials, AMERCE is a highly tolerable triptan with an incidence of adverse events similar to placebo.1"" AMERGE provided significant migraine relief maintained over 24 hours.12* A recent study demonstrated that 93% of attacks per patient did not require a second dose for recurrences.4* tIn controlled dinical tnals. the uuidente ol adverse ovtiils wdsMimhrt'ipUvbo {M% UH AMhRCl T Singi* 12'ljffn pLuibo J t Headache relief-reduction of moderate or severe pain to mild or no pain AMI Rfil 2 -> n]f> n=SKb p

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Lamotrigine ELamicta l LAMICTAL is the first and only of the newer* Low CNS side-effect profile antiepileptic drugs (AED) indicated as adjunctive maintained in patients with therapy for pediatric and adult patients with Lennox-Gastaut syndrome Lennox-Gastaut syndrome (LGS).1 LAMICTAL is also the first and only of the newer* AEDs indicated aged 3-25 for monotherapy after polytherapy in adults. • Low withdrawal rate compared to placebo:*1,2 group taking LAMICTAL 3.8% (mostly due to Significantly superior control over the rash§) vs. placebo group 7.8% (mostly due to wide range of seizure types associated deterioration of seizure control). with Lennox-Gastaut syndrome1 • No significant difference in the incidence of • Add-on LAMICTAL significantly reduced the adverse events between LAMICTAL and number of all major seizures, all drop attacks, placebo except for cold or viral illness 1 and all tonic-clonic seizures in patients with LGS. (LAMICTAL 5% vs placebo 0%; p=0.05).'il

MEDIAN NUMBER OF Improved neurological function ALL MAJOR SEIZURES/WEEK and cognitive skills=2,2 3

p=0.013 • | Baseline (week 0) • A greater proportion of LGS patients (age 3 to Treatment period 25 years) treated with add-on LAMICTAL (n=79) I (Weeks 1-16) vs add-on placebo (n=90) had a clinically 16.4 significant improvement in neurological 14.2 findings across the 16 week treatment period for: behaviour (30.4% vs. 14.4%); speech (11.4% vs. 2.2%); and non-verbal communication (11.4% vs. 7.8%).*3

LAMICTAL offers superior control over the seizure types associated with LGS and a low CNS side- effect profile. You may also improve the neurological Lamictal Placebo 2 3 (n=78; age 9.6 ± 5.2 years) (n=89; age 10.9 ± 5.9 years) function and cognitive skills of your patients. ' Add LAMICTAL** as soon as the diagnosis of LGS A double-blind, randomised, placebo-controlled trial in patients from 4 3 to 25 years of age is suspected.

Lamotrigine GEE) GlaxoWdlcome lamictal' Glaxo Wellcome Inc. ®Regi8tercdtradermricofTheWeUcoimFouridatiori Limited, Giaxo Wellcome Inc. licensed use. For & Brifkttr Fiitur*

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wttawai 20OM CCNS-CCSN 35th Meeting of the 34e Assemblee annuelle du Canadian Congress of Congres canadien des sciences Neurological Sciences neurologiques Ottawa, June 13-17, 2000 13- 17 juin2000

CALL FOR ABSTRACTS DEMANDE DE RESUMES Scientific Papers and Posters Presentations orales et par affiches des resumes 1. Abstracts for the scientific program must be submitted on the official 2000 Congress Abstract Form. 1. Les resumes pour le programme scientifique doivent etre soumis sur le formulaire officiel du congres design. 2. Work presented must conform with MRC guidelines for experimental procedures. 2. Le travail present, dans les resumes doit etre conforme aux principes du C.R.M. relatifs aux procedures 3. Scientific material presented at this meeting should not experimentales. have been published or presented at other national or international meetings. 3. Le materiel scientifique present, a ce congres ne doit pas avoir ete publie ou present, a d'autres congres nationaux 4. It is suggested that presentations emphasize the ou internationaux. significance of the results and general principles involved 4. II est recommand, de mettre I'emphase sur les resultats rather than ordinary methods and procedures. et les principes generaux plutot que d'elaborer sur la methodologie. 5. ABSTRACTS MUST BE RECEIVED BY JANUARY 14,2000. 5. LES RESUMES DOIVENT ETRE RECUSAVANT LE 14 JANVIER 2000. 6. Abstracts accepted for presentation will be published in the Canadian Journal of Neurological Sciences. 6. Les resumes acceptes paraTtront dans le Journal canadien des sciences neurologiques.

For further information, please contact I Pour de plus amples renseignements, veuillez contacter : Venue West Conference Services 645 - The Landing, 375 Water Street Vancouver, B.C., Canada V6B 5C6 Tel / Tel.: (604) 681 -5226 Fax: (604) 681 -2503 E-mail: [email protected]

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Probability of confirmed disability progression*

t 1 p-UOUtift r23>Wb -, T r36.7% -n 0.56 - P-C0U.M 0.47 0.30 • - wnH • • ^^^B ^ < • year 1 year 2 year 3

1 Placebo (n-358) * SPM5 patients I BETASERON 8 M1U (n-360) * Relative reduction

BETASERON reduces relapse rate in both relapsing-remitting2 and secondary progressive MS1

<% Reduction of mean annual v Reduction of mean annual relapse rate i^ RR patients" ™ relapse rate in SP patients" + r26.3% -, £

"I: VI*'

i ••Multicentre, doable-blind, contrails**, randomised, S-yea&sttniy; popM M«irdata , I—^•Placebo •fowiaa) no statistical stgntf*»i«i«£ placebfr years 3-5 ••(BBTASERON 8 UtU (n-124) "Relative reduction

BETASERON has a manageable »#»,*: side-effect profile1 S*^ The most common side effects related to BETASERON in patient; with SPMS are: flu-like syndrome (61%); fever (40%); chills (23%]. injection-site inflammation (48%); injection-site reactions (46%);ifr 1 myalgia (23%); hypertonia (41%); rash (20%)' - ' 3$a$*F'"-" Ffu-like symptoms and injection-site, .:=.^isr"^ $9*1** reactions are manageable andllfsseYi*^***! 1 markedly with time ' .. '&f-^ •fiB-Jfti

•s -^

$' V "

BETASERON

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ONCE IT TOOK EXCEPTIONAL EFFORT OR EXTRAORDINARY TALENT FOR PEOPLE WITH EPILEPSY TO SUCCEED. LUCKILY, DOTH YOUR ADULT AND PEDIATRIC PATIENTS CAN Nflltf ENJOY LESS TAXING ALTERNATIVES.

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TOPAMAX* topiramate Tablets and Sprinkle Capsules: indicated as adjunctive therapy for the management of patients ;'--> (adults and children two years and older) with epilepsy who are not satisfactorily controlled with conventional therapy. There is limited information on the use of topiramate in monotherapy at this time.'

Efficacy In Partial Onset Seizures: An appropriate first choice adjunctive therapy for many of your patients: Dosage Individualized to Patient Response: Favourable Side-effect Profile: a50'.'» Secure Redactor Se zuie F'ee • Like most antiepileptic drugs, the most common side Adults' 450 59c: Wo effects are CNS related*'": 1 Children 73"i u: - Usually mild to moderate occurring early in therapy

Adapted fror references 4 anc> b and transient'' a Open Uoel 20 week trial in adulis Ait!1 pntial rrtet seizure OPAMAX aui.im.tfec1 - If encountered: b.i d. as adjunctive tf*er3Pj, optiTial oosace appea'ed to be 3W i50 *z "us b Open label trial in clulp'en .vrh partlai-oisrt seizjre» 'uUc virg pa-t ~ipar en were *eie"-'',pJ • for children tieated to- el least 3 mon'rs TCAMAX ao i-ii'te-ed !> • o a> *dj > "\\.r titration, and/or the concomitant AED dosage? therapy. Children received open labeltojnra-nate to- a inear. di,'dt o" of 8 rintln at -> average dose or 10 mg/kg. cay u-20 "vkg da>,i • In children, there were no discontinuations due to For reco'nmerdtid do«e *efeT to "OPAMAX* Presc cms *' *°r naroi adverse events at 5 to 9 mg/kg/day in the controlled Improved control over a wide range of seizure types: clinical trials: ., • With additional data demonstrating efficacy as >, - adjunctive therapy from randomized, double-blind, Safety Considerations: ' placebo-controlled trials in adults and a small number • No evidence to date of a proven association of of children for: TOPAMAX usage and the following: life threatening • Primary Generalized Tonic-Clonic Seizures' rash, permanent visual field constriction or . • Seizures associated with Lennox-Gastaut syndrome1 polycystic ovary disease!1' • Weight loss EFFICACY Adults: Modest weight loss may be sustained P«0.001 £ 12 months with the greatest weight loss occurring between 3 and 6 months and peaking at 9 months.' P-0.003 Pediatrics: Of those pediatric subjects treated in clinical P-0.002 trials for at least a year who experienced weight loss, 96% showed a resumption of weight gain within the period tested."

Convenient BID dosing1 Now available in a convenient 15 mg and 25 mg Sprinkle 1 Generalized Lennox* Capsule formulation : Seizures "'' Gastaut •*"• Swallow whole or sprinkle on food I TOPAMAX I Placebo Bioequivalent to TOPAMAX Tablets

Adapted fror refererces 2 and 3 **20 week doucie-bl id feafenl phase 18 Aew oase we di d a 12 week tiearmen:

period) with either TOPAMAX (n«39 wcurVg 11 chilc'ei *. .o ,r I s da' (->d]ii', dizziness (28.314) ataxia (21.2%), speech 6 mcitg/'day £ so-sers (IS 8',,.), psychOiiio*or slowiro. (16.8%), nystagmus (U Ott). paresthesia (13 0*W. ""Drop attacks and tomc-domc seizjres .1 veek no iDit L* H d *ii>alniei r --asp **-h o?rvcjsness f 15.9P*) crPicultv with ccncentratior/attention f8.0V>>, cen-uswn (9.?%} either TOPAMAX (n-^) bi a as ac^uictvp therapy cp^reha ,rt SO, pa'iei: .-ar dep'f-ssvii (3 0%), anorexia (S.3"*}> langjase problens (6 2%), and mood smbletis (3 S"4) age 11 2 yrs TOPAMAX was ti'ia'ed to a target eojt o' aLp-juTa-teh, fj -> z ki o.^ It an ai.oit of 1«46 adjlts arte 303 children there appeared to be a similar pattern o' advese events

"lease -e*ei to the TOPAMAX Prescribing Infb-riarJan for complete preicnbtig details c 3aU OP tile JANS5EN-0RTH0 trc May 1M9 'Alt trademark nghts used under bcense

>99 JANSSEN-OFTTHO Inc. oallSat 3ATXV91005A TABLETS NOW ON FORMULARY* r*t:i pTQPAMAX topiramate t United WK tonefMntaita. Nov* Scotia tlew Brunswick, PH. rUKemnt-Quebcc. Sastatchewar, British Columbia, Alberta. Hamt.iba Helping patients with epilepsy make mom of their lives

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Ottawa, June 13-17, 2000 wttawtfi

PRELIMINARY PROGRAM 200M CCNS-CCSN

As we move to the millenium, the CCNS will celebrate over 50 years of progress and promise. Participate in the new developments leading to neurosciences for the future. Mark your calendar for Ottawa in June!

Tuesday, ]une 13 Thursday, ]une 15 • Neurobiology Review Course 2000 • Meet the Expert Breakfast - Neurosurgery and Neurology • ALS Symposium • Breakfast/posters/exhibits • Clinical Epilepsy Video Session (evening) • Plenary Session I: • Vascular Dementia (evening) The Millenium and the Future of Clinical Neuroscience • Oral Platform Sessions Wednesday, )une 14 • Lunch/posters/exhibits • Meet the Expert Breakfast - Pediatric Neurology • Plenary Session II: • Courses Cerebrovascular Disease 1. Evidence-based Neurology (am) Interventional Neuroradiology 2. Management of Disorders of the Craniocervical Junction • Social evening (full day) 3. Current Educational Issues in the Clinical Neurosciences Friday, ]une 16 (am) • Breakfast/posters/exhibits 4. Medical Legal Issues in Child Neurology (am) • Plenary Session III: Molecular Genetics and Clinical 5. Molecular Mechanisms of Epileptic Syndromes (am) Neuroscience 6. Medical Ethics in Neurology (pm) • Oral Platform Sessions 7. Molecular Mechanisms of Neuromuscular Disease (pm) • Lunch/posters/exhibits 8. Case Studies in Neurocritical Care (Neurocritical Care • Debates: Neurosurgery; Neurology Group) (pm) 9. Epilepsy (pm) Saturday, )une 17 • Welcome Reception • Child Neurology Day: Neurobehavioural Disorders • Courses 1. Emergent Therapies in Acute Stroke (full day) For additional information contact: 2. Multiple Sclerosis (am) The Canadian Congress of Neurological Sciences 3. Migraine 2000: A New Era in Migraine Therapy (pm) PO Box 4220, Station C • Child Neurology Dinner Calgary, Alberta, Canada T2T 5NI Tel: (403) 229-9544 Fax: (403) 229-1661 Email: [email protected]

Downloaded from https://www.cambridge.org/core. IP address: 170.106.35.93, on 24 Sep 2021A-12 at 17:13:12 , subject to the Cambridge Core terms of use, available at https://www.cambridge.org/core/terms. https://doi.org/10.1017/S0317167100050058 PARKINSON'S DISEASE A world in which the therapeutic options are limited1

or those who have it, treat it, live Today, however, there is another Successful treatment with Permax can 4,5 with it; managing their Parkinson's way to renew their hope. Even after last for up to 3-5 years and Fdisease can be quite frustrating. its discovery more than fifteen years renewed improvement has been Yet there are moments that can be ago, Permax (pergolide mesylate) is demonstrated when Permax was most rewarding. Motor function improves, still considered the most potent given to patients (n=10) in whom the the number of "off" hours decreases, dopamine agonist available for the beneficial effect of bromocriptine had treatment of Parkinson's disease!3 waned,4 whereas the reverse was not rigidity subsides, gait improves. Their With its unique mode of action, true in a separate, non-comparable levodopa seems to be working... at i.e. stimulating both Di and D2 study (n=ll) when bromocriptine least for today! Then there are times dopamine receptors, Permax has was given to Parkinson's patients in when nothing seems to help. Even their demonstrated (n=376) statistically whom Permax had waned.6 medication seems to be causing problems. significant improvement in virtually So, when given an opportunity to manage It seems hopeless... all those numerous parameters of Parkinson's disease, there may be a way parkinsonian function, including of renewing hope. bradykinesia, rigidity, gait, dexterity, etc. Equally important, these benefits were achieved with significantly less ® levodopa... 24.7% (p <.001), and TERMAX by starting Permax at low doses pergolide mesylate "Adverse reactions were, for the most part, mild, reversible, and not of major clinical significance."3*

DRAXIS

Draxis Health Inc. PAAB * Rapid escalation of pergolide dosage may cause severe adverse reactions. Therefore a slow increase combined with a concomitant Mississauga, Ontario gradual and limited reduction of levodopa is recommended. See ADVERSE REACTIONS section in Prescribing Information

Downloaded from https://www.cambridge.org/core. IP address: 170.106.35.93, on 24 Sep A-132021 at 17:13:12, subject to theFo rCambridge brief prescribin Core termsg ofinformatio use, availablen atsee pages A-59 https://www.cambridge.org/core/terms. https://doi.org/10.1017/S0317167100050058 Downloaded from https://www.cambridge.org/core. IP address: 170.106.35.93, on 24 Sep 2021 at 17:13:12, subject to the Cambridge Core terms of use, available at https://www.cambridge.org/core/terms. https://doi.org/10.1017/S0317167100050058 V E T R E A LION MIGRAINES.

m IMITREX ® SUMATRIPTAN SUCCINATE SUMATRIPTAN NASAL SPRAY A faster way back.™* milable in tablets, nasal spray and subcutaneous formats.

% January 1999. Data on file, Glaxo Wellcome Inc. ; 10-15 min. subcutaneous, 15 min. nasal spray, 30 min. tablet, an succinate/sumatriptan) is a selective 5-HT, receptor agonist indicated for the acute treatment of migraine attacks with or .IMITREX is not indicated for prophylactic therapy of migraine, or for the management of hemlplegic, basilar, ophthalmoplegic ^Safety and efficacy have not been established for cluster headache. IMITflEX Is contralndlcated In patients with history, symptoms, or >.Of ischemic cardiac, cerebrovascular, or peripheral vascular syndromes, valvular heart disease or cardiac arrhythmias. In addition, patients BfOfter significant underlying cardiovascular diseases should not receive IMITREX. IMITREX is also contralndlcated In patients with f^'liticoriMed or severe hypertension. . IMfTREX* is a registered trademark of Glaxo Group Limited, Glaxo Wellcome Inc. licensed use. Product Monograph available to health care professionals upon request

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lamotrigine 0 Lamictal LAMICTAL est le premier et le seul parmi les Maintien d'un faible profit d'effets •liouveaux antiepileptiques* qui soit indique comme indesirables touchant le SNC chez s traitement d'appoint chez les enfants et les adultes 1 les patients de 3 a 25 ans atteints .JBtteints du syndrome de Lennox-Gastaut (SLG) . , tAMICTAL est egalement le premier et le seul du syndrome de Lennox-Gastaut parmi les antiepileptiques recents* qui soit indique • Faible taux d'abandons comparativement au ^ comme monotherapie apres polytherapie chez placebo*1-2: 3,8 % pour le groupe LAMICTAL 1'adulte. (principalement relies aux eruptions cutanees§) contre 7,8 % pour le groupe placebo (principale Une superiority significative pour ment relies a une deterioration de la maitrise maifriser les divers types de crises des crises). liees au syndrome de Lennox-Gastaut* • Aucune difference significative dans la frequence • L'adjonction de LAMICTAL reduit, de fa^on des effets indesirables entre LAMICTAL et le significative, le nombre de crises majeures, les placebo, sauf pour le rhume ou des maladies effondrements epileptiques et les crises tonico- virales (LAMICTAL, 5 % contre placebo, 0 %; 1 cloniques chez les patients atteints de SLG . p = 0,05)*\ Amelioration de la fonction neuro- NOMBRE MEDIAN 23 DES CRISES MAJEURES/SEMAINE logique et des facultes cognitives • Une plus forte proportion de patients (de 3 a 25 ans) p = 0,013 IValeur initiale (semaine 0) Periode de traitement atteints de SLG, traites a l'aide de LAMICTAL I (semaines 1 a 16) comme traitement d'appoint (n = 79) c. un placebo 16,4 d'appoint (n = 90), ont connu une amelioration 14,2 cliniquement significative des symptomes neurologiques durant la periode de traitement de 16 semaines : comportement (30,4 % c. 14,4 %), parole (11,4 % c. 2,2 %) et communication non verbale (11,4 % c. 7,8 %)*3. LAMICTAL offre une plus grand maitrise des divers types de crises liees au SLG, avec faible profil Lamictal Placebo d'effets indesirables touchant le SNC. Vous pouvez (n = 78; age 9,6 ± 5,2 ans) (n = 89; age 10,9 ± 5,9 ans) aussi ameliorer la fonction neurologique et les facultes cognitives de vos patients23. Ajoutez Essai a double insu, a repartition aleatoire et a controle placebo chez des patients 4 de 3 a 25 ans LAMICTAL** des que Ton soupgonne un SLG .

lamotrigine GEE) GlaxoWellcome Lamictal* Glaxo Wellcome Inc. ®Marquc d£pos6e de The Wellcome Foundation Limited, utilised sous licence par Glaxo Wellcome Inc. L'&v«t\ir

MECHANISMS IN MOTOR CONTROL A SYMPOSIUM ON CLINICAL AND BASIC RESEARCH IN NEUROSCIENCE June 20-21, 1975 London, Ontario

CLINICAL PROBLEMS OF MOTOR SYSTEM DISEASE J.C. Richardson Summary: This prologue to a symposium of research studies on motor mechanisms is a general commentary by a clinical neurologist. The vast extent and intricacy of modern basic neurological scientific knowledge presents a rather bewildering challenge to reasonable clinical application. In some degree this is being handled by complex and diverse neurological subspecialization. It is recalled that many past advances in the knowledge of neurological disease were achieved by a series of alternating and supporting bedside and laboratory observations and studies. The varied disorders of movement and muscle tone which signal disordered motor mechanisms will continue to demand explanation and will keep the human model in a leading research position. Clinical and laboratory research leading to part discoveries of mechanisms of disease is sometimes productive of dramatic new means of therapy. The story of Wilson's disease is briefly reviewed in that context. Some recent studies on hypoxic myoclonus are described with the evidence of a serotonin defect and useful related therapy. Can. J. Neurol. Sci. 1975;2:(Suppl 1):223

CENTRAL MECHANISMS OF TREMOR IN SOME FELINE AND PRIMATE MODELS Y. Lamarre, A.J. Joffroy, M. Dumont, C. de Montigny, F. Grou, J.R Lund Summary: For several years our interest has been in a postural Parkinson-like tremor at 4-6/sec. which can be produced in the monkey by lesions of the central nervous system. We have also studied the effects of harmaline, a drug which evokes or intensifies the Parkinson-like tremor in lesioned animals and which also induces a fine, generalized tremor at 7-12/sec. in normal animals. The results obtained so far indicate that these two types of tremor are generated by two independent central mechanisms which do not require the integrity of peripheral feedback loops. The experimental Parkinson-like tremor is generated by a thalamo-cortical mechanism while the olivo-cerebellar system is responsible for the faster 'physiological' tremor. Similar tremor mechanisms may be involved in some movement disorders in man. Can. J. Neurol. Sci. 1975;2:(Suppl 1):227

PRINCIPLES UNDERLYING NEW METHODS FOR CHRONIC NEURAL RECORDING R.B. Stein, D. Charles, L. Davis, J. Jhamandas, A. Mannard, T.R. Nichols Summary: Chronic recording is possible from nerve fibers which have grown through holes in an insulating medium (regeneration electrodes) or which are enclosed by an insulating sheath (cuff electrodes). Use of three electrodes in a balanced configuration permits good rejection of electromyographic (EMG) signals and other sources of electrical interference (fluorescent lights, 60Hz signals form the mains, etc.). Equations are derived and tested for predicting the amplitude and form of the signals expected for a given cuff length and diameter. These equations can be used to design electrode units optimally for a given application. Finally, the use of transformers permits the neural signals to be carefully matched to the recording apparatus and further optimizes the neural signal-to-noise and signal-to-EMG ratios. Use of these methods in several physiological and clinical applications, as well as potential abuses, are discussed. Can. J. Neurol. Sci. 1975;2:(Suppl 1):235

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f4$^\gX$r Diarize these dates! Don't miss these exciting wf/am% w events and much more at the 35th Meeting of the .200M

Neurobiology Review Course 2000 Case Studies in Neurocritical Care ALS Symposium Epilepsy Vascular Dementia The Millenium and the Future of Clinical Neuroscience Evidence-based Neurology Cerebrovascular Disease Medical Ethics in Neurology Interventional Neuroradiology Management of Disorders of the Craniocervical Junction Molecular Genetics and Clinical Neuroscience Current Educational Issues in the Clinical Neurosciences Neurobehavioural Disorders Medical Legal Issues in Child Neurology Emergent Therapies in Acute Stroke Molecular Mechanisms of Epileptic Syndromes Multiple Sclerosis Molecular Mechanisms of Neuromuscular Disease Migraine 2000: A New Era in Migraine Therapy

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Neurontin* was effective when titrated to individual effectiveness12:

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tLast 8 weeks of study Study included patients with complex partial seizures and was a prospective, open-label, 20-week, multicentre study, tLast 4 weeks of study. Study examined patients with partial seizures with or without secondary generalizations. STEPS was a prospective, open-label, 16-week, multicentre study.

Doses higher than 1200 mg/day may increase the efficacy in some patients'; however, higher doses may also increase the incidence of adverse events.' The maximum recommended dose is 2400 mg/day.1

To help them through the storm - consider moving patients to a higher dosage of Neurontin *

NEURONTINJ* two studies highlight USER FRIENDLY EFFICACY ^V Neurontin's* improved efficacy as add-on therapy M1MW ^^ * TM Warner-Lambert Company, Parke-Davis Div. . . at higher doses. @RARKE-DAV1S Warner-Lambert Canada Inc., lie. use Scarborough, 0NT M1L 2N3 ICCPPI

fin previous fixed dosage studies somnolence and ataxia appeared to exhibit a positive dose-response relationship. Patients treated with 1800 mg/day (n=54) experienced approximately a two-fold increase as compared to patients on lower doses of 600 to 1200 mg/day in the incidence of nystagmus (20.4%), tremor (14.8%), rhinitis (13%), peripheral edema (7.4%), abnormal coordination, depression and myalgia (all at 5.6%). Neurontin is indicated as adjunctive therapy for the management of patients with epilepsy who are not satisfactorily controlled by conventional therapy.'

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Prix de la Societe, canadienne de neurologie Le College royal des medecins et PRIX COMMEMORATIF chirurgiens du Canada FRANCIS McNAUGHTON en collaboration avec la et le prix Societe canadienne de neurochlrurgie COMMEMORATIF ANDRE BARBEAU 2000 presente LES PRIX COMMEMORATIFS La Societe, canadienne de neurologie accepte des soumissions K. G. MCKENZIE de communications pour ses deux prix: le prix commemoratif 2000 Francis McNaughton pour la recherche clinique et le prix Le prix McKenzie pour la recherche fondamentale en sciences commemoratif Andre Barbeau pour la recherche fondamentale. neuroiogiques et le prix McKenzie pour la recherche clinique en sciences neuroiogiques. Les prix commemoratifs Francis McNaughton et Andre Barbeau ont pour but d'encourager les residents en neurologie Dans chacune des categories de la recherche fondamentale et a entreprendre des projets de recherche, lis sont decernes aux de la recherche clinique en sciences neuroiogiques, on meilleures communications pour un travail execute au cours attribuera une mention et un prix de I 000 $ au (-a la) d'un programme de formation en residence ou post-residence resident(e) en neurochirurgie qui est le principal auteur du en neurologie. II n'est pas necessaire que les candidats soient meilleur manuscrit soumis au comit, du prix McKenzie de la les seuls auteurs, mais ils doivent etre les principaux Societe canadienne de neurochirurgie. Les prix comprendront responsables de la communication presentee. egalement les depenses des laureats, y compris le transport aerien, I'hebergement a I'hotel et les frais d'inscription. Un Les communications gagnantes dans chaque categorie seront deuxieme prix de 500 $ pourrait egalement etre remis dans presentees a I'assemblee annuelle du Congres canadien des chaque categorie. sciences neuroiogiques. La date limite pour la soumission des communications est fixee au 31 decembre 1999. La date limite des soumissions pour les prix de 2000 est fixee au 31 decembre 1999 et cette date est ferme.

Societe canadienne de neurophysiologie clinique L'Association canadienne de LE PRIX HERBERT JASPER neurologie pediatrique Le prix Herbert Jasper est decerne chaque annee au resident LE PRIX DU PRESIDENT ou au chercheur qui a soumis la meilleure communication dans Le prix du president est decern, chaque annee au resident ou le domaine de la neurologie fondamentale ou clinique. Ceux au chercheur qui a soumis la meilleure communication dans le qui doivent obtenir leur doctorat ou leur bourse de recherche domaine de la neuroscience chez I'enfant. Le prix comprend d'ici trois ans sont aussi admissibles. une somme de 500 $ et un parchemin commemoratif, et I'inscription a I'assemblee annuelle. La communication gagnante Le prix comprend une somme de 250 $, I'hebergement a sera presentee a I'assemblee du Congres canadien des sciences I'hotel, les frais d'inscription, et un billet d'avion en classe neuroiogiques. economique pour assister au Congres canadien des sciences neuroiogiques ou sera presentee la communication gagnante. La date limite de la reception des soumissions est fixee au 31 decembre 1999. La date limite des soumissions est fixee au 31 decembre 1999.

Envoyer votre application au Congres canadien des sciences neuroiogiques 810, 906-12th Avenue SW, Calgary AB Canada T2R IK7 Telephone : (403) 229-9544 Telecopieur: (403) 229-1661 Courrier electronique : [email protected]

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BETASERON reduit le taux de poussees dans la SEP remittente2 et dans la SEP progressive secondaire1

Reduction du taux annuel rooyen Reduction du taux annuel des poussees chez les patients mqyen des poussees atteints de; SEP remittente" ^ chez les patients atteints de SEP progressive secondaire*' ,-30,0%*-, 1| I r |-

v t2 * frude rwJilticentriqoe corrtrdlee, a double insu et a repartition aWatoire, d'une duree de 5 am; doitn&s sw 5 arts combinte, auttme dif%w« statfstiqucmeittjsigtifficative par rapport u placebo au COurs des aimees 3 a 5 I BETASERON 8 MU1 (n * 124) * Reduction relative

Effets indesirables pouvant etre prisjeft:ePfatee Chez les patients atteints de la SEP progressive secondaire, les effefs Jndesirable: les plus frequents de BETASERON sont:., " .^,;... *^'^.^-C*.i'* - syndrome pseudo-grippal (61"'%), fievre (40 °/o), friss'bns (23 %), '#?; ^tfW«; inflammation au point d'injection (48 %), reactions au pfbint d'injection (46 %), myalgie (23 %), hypertonic (41 %) et eruption cutanee (20 %)j?^i ^.lir.. >v Les symptomes pseudo-grippatix et lessreactions>?. . *#* :;,^wf •' ^1.., , : au point d'injection" peuvent eife,pfis eri|C'ri'a't^'fe». ,-' Jg /jk. •".-, • •?5,0;,. et diminuent de fa^on marquee a\/ecle*^rffpsH t 1*% lb#* :/-::?.f^ •-

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et capsules a saupoudrer* TOPAMAX* (topn airaiH; : roiquei, en taut que trartement d'appoint dans la pnse en _ . des patients (adjltes et enfants de deux arts OL \,\>i') epilep:iqaes annt I'etat n est oas rnaitnse de fac,on satisfaisante tetraitementtiadltionnet. Lei rei.seignements sjr I PPIPIIH UJ top ramate en monother3Die sont encore limites*. I en cas de crises partieUes Initiates: Un traitement d'appoint approprie* en premiere intention pour nombre de vos patients: Pomtogie ajustee en fonction de la reponse P'rf I d'ef'ets secondares favorabte : de chaque patient' : • COP me pour a piupatt fies antiepileptMle.Tieiit tegers, a modetes, its SLrviennent a un U fnfarts" 1 stdde p-ecoie du traiterrent et sont pa^agers'* JTjprt pwi* *.,. i •^JC*** *e "* - - ».' *i • i e* .' - bn Mi de M-rveiue d'effeti secondares : fji~tvdi* t (*" i i Aw •• o"» • 1 F Efi./Kagu de reduie la posologie dt TOPAMAX, le taux 'ttfVpgc* t i* (K '•»- 3 •• -'ii fr < *i • j'4 « i-t ' * IP IF* I'jntiepiieotiqiie 3dmimstre de faccn concointarte". 'ties rises CM t «•h" In *. "- * iftjr JPITf A-1! ••• •"'• *.» !,«. * 1 * P SAW* • Vrei les enfarr., trades da.is le cadre des essais i*s i^eb u 1'*, >"-a

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lANSRTNOntHUInr lIBll. •>*{ WSIWIF* C0MPRIME5 DESGRMAIS INSCRITS AU FORMULAIRE* O TOPAMAX p»rB»U» - Ontom. HBn.ttlt-t'iiW *I\H*JJ ftrmiwhi. ' '-c TT topiramate Pour aider les patients tpflaptiqiics a mteux profttwr de la vie

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Canadian Neurological Society announces the The Royal College of 2000 FRANCIS McNAUGHTON Physicians and Surgeons of Canada MEMORIAL PRIZE with the co-operation of the and the Canadian Neurosurgical Society ANDRE BARBEAU MEMORIAL PRIZE announces the 2000 K.G. McKENZIE MEMORIAL PRIZE AND The Canadian Neurological Society invites submissions for its two prizes: the Francis McNaughton Memorial Prize for AWARD clinical research and the Andre Barbeau Memorial Prize for The McKenzie Prize for Basic Neurosciences Research and the basic research. McKenzie Prize for Clinical Neuroscience Research

The Francis McNaughton and Andre Barbeau Memorial Prizes, There will be one citation and prize of $1,000.00 in each of the designed to encourage Neurology Trainees to undertake Basic Neuroscience and Clinical Neuroscience categories for research projects, are awarded for the best submitted papers the best manuscripts submitted to the McKenzie Award based on work done during the Neurology residency or in Committee of the Canadian Neurosurgical Society, by a post-residency training. The contestants need not be the sole neurosurgical resident, in which he or she is the principal authors but should have been primarily responsible for the author.The recipients will have their expenses, including air work to be presented. fare, 2 nights hotel accommodation and registration fees, paid for as part of the Prizes. A second prize of $500.00 may also The winning papers in each category will be presented at the be awarded in each category. annual meeting of the Canadian Congress of Neurological Sciences. The deadline for submission is December 31, 1999. The deadline for the Prize for 2000 is December 31, 1999 and it is firm.

Canadian Society of Clinical Neurophysiologists The Canadian Association for announces Child Neurology THE HERBERT JASPER PRIZE announces The Herbert Jasper Prize is awarded annually for the best THE PRESIDENT'S PRIZE submitted paper in clinical or basic neurophysiology by a The President's Prize is awarded annually for the best paper in resident or fellow in training. Others who are within three pediatric neuroscience by a resident or fellow in training. The years of receiving a doctorate or fellowship are also eligible. prize consists of a $500.00 honorarium, registration to the annual meeting and a commemorative scroll. The winning The prize consists of an honorarium of $250.00, economy air paper will be presented at the annual meeting of the Canadian transportation and 2 nights hotel accommodation to attend Congress of Neurological Sciences. the annual meeting of the Canadian Congress of Neurological Sciences where the winning paper will be presented. The deadline for submission is December 31, 1999. The deadline for submission is December 31, 1999.

Apply to: Canadian Congress of Neurological Sciences 810, 906-12th Avenue SW, Calgary AB Canada T2R IKJ Telephone: (403) 229-9544 Fax: (403) 229-1661 Email: [email protected]

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Downloaded from https://www.cambridge.org/core. IP address: 170.106.35.93, on 24 Sep 2021 at 17:13:12, subject to the Cambridge Core terms of use, available at https://www.cambridge.org/core/terms. https://doi.org/10.1017/S0317167100050058 v • fa Turn the agony of migraine into the beauty of relief Introducin 03 Zomig. Consistent migraine relief that patients can depend on time after time.

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•improvement from severe or moderate headache to mild o • fThe most common side effects reported wtth 7OMI0 compared to placebo were nausea (9% vs * • head/face sensations (8.6% vs. 1.7%), dizziness (8 • " o * and neck/throat/jaw sensations (7% vs. 35- ZOMtG® is not intended for use prophylactif -: * o- in hemiplegic, basilar; or ophthalmoplegic mtg .. 15 ty and efficacy have not been established for clu '.3' re< vhich is present in an older, predominantly male JQ^JR ZOMIG® is contraindicated in patients with 1 -'or^ * symptoms, or signs of ischemic, cardiac, cerebrc*.--scu,ifj or peripheral vascular syndromes, valvular hear: jiSi or cardiac arrhythmias (especially tachycarn In addition, patients with other significant unc—y*i( cardiovascular disease should not receive ZO'-'IG*. Please see Product Monograph. For more information about ZOMIG®, please .; Leca Pharma Medical Information by phone at i-^SS- 90S) 821-8882 or e-mail at canada.medmfo@ca* Zomi zolmitriptan tablets 2,5 mg Consistent migraine rel

Downloaded from https://www.cambridge.org/coreZENEC. IP address:A Pharm 170.106.35.93a Mississauga, on 24, Ontari Sep 2021o LSN at 5R 17:13:127 • A Membe, subjectr o! thtoe theZenec Cambridgea Group Core-"Registere termsd of use, available at https://www.cambridge.org/core/terms. https://doi.org/10.1017/S0317167100050058 A-31 For brief prescribing i 25 Years Ago in the Canadian Journal of Neurological Sciences

THE EFFECTS OF MOTOR CORTICAL STIMULATION ON THE EXCITABILITY OF SPINAL MOTONEURONS IN MAN S.H. Milner-Brown, J.R Girvin, W.F. Brown Summary: The pyramidal tract and particularly the direct cortico-motoneuronal components (DCM) have become increasingly important in the higher primates. Minimal single pulse precentral stimulation in man evokes EMG discharges from the contralateral hand muscles with a latency of 18-21 milliseconds. The excitability changes produced by such cortical stimulation on the upper limb H-reflex has been observed to include a short duration early facilitation probably corresponding to the DCM input and a later, longer lasting facilitation mediated by the same and probably other corticofugal projections. Potentiation of the H-reflex in the upper limbs by means of postcentral excitation required much higher single pulse stimulus intensities and the changes in excitability produced on the spinal motoneurons could have been explained by physical extension of the stimulus current to the precentral region. Isometric contraction potentiated the H-reflex produced by combinations of precentral cortical and peripheral nerve stimulation but no direct evidence was found to support a possible transcortical basis for the V9 stretch reflex. Can. J. Neurol. Sci. 1975;2:(Suppl 1):245

PHYSIOPATHOLOGY OF EXPERIMENTAL PARKINSONISM IN THE MONKEY Louis J. Poirier, Michel Filion, Louis LaRochelle, Jean-Claude Pechadre Summary: Postural or Parkinson-like tremor, which results from the impairment of mechanisms which are predominantly lateralized in the brain, is most likely related to the combined impairment of the dopaminergic nigrostriatal pathway and the corresponding rubro-olivo-cerebello-rubral loop (without excluding the possibility that other nervous mechanisms interconnected with these structures may represent an alternative disturbance). The integrity of the internal division of the pallidum and the ventrolateral area of the thalamus and their efferent fibers as well as the motor cortex and certain of its cortico-subcortico-spinal pathways is apparently an essential feature for the elaboration of the rhythmic burst associated with the appearance of postural tremor. The integrity of the spinal sensory roots and the rubro-tegmentospinal tract is not a prerequisite for the expression of postural tremor, a condition which seems essential for the production of rigidity. The latter facts suggest that the disturbances which subserve these two types of motor impairment, often concomitantly present in Parkinsonism, partially involve the impairment of different mechanisms although the loss of the DA fibers originating in the substantia nigra and ending in the neostriatum appears to represent a disturbance common to both types of disorders. Bradykinesia which may be associated with an impairment of catecholamine metabolism (and more especially the neostriatal DA mechanisms) on both sides of the brain may also result from bilateral lesions of the pallidum or of its outflow corresponding, in the main, to the pallidothalamic fibers ending in the ventrolateral thalamus. The latter types of lesions most likely exclude the influence of the monoaminergic, cholinergic and gabaminergic activities normally originating in the striopallidal system and influencing the activity transmitted to other CNS mechanisms. Severe akinesia, however, apparently depends on more profound and generalized disturbances of brain monoamine metabolism with or without the involvement of other ill-defined mechanisms. At any rate the impairment of the brain DA mechanisms (and especially those of the neostriatum) seems to represent a major feature in the production of the Parkinsonian type of akinesia. Further work is needed to establish the relative importance of the loss of catecholaminergic mechanisms other than those of the neostriatum in the production of akinesia. Can. J. Neurol. Sci. 1975;2:(Suppl 1):255

Downloaded from https://www.cambridge.org/core. IP address: 170.106.35.93, on 24 SepA-32 2021 at 17:13:12, subject to the Cambridge Core terms of use, available at https://www.cambridge.org/core/terms. https://doi.org/10.1017/S0317167100050058 ROLES OF CEREBELLUM AND BASAL GANGLIA IN INITIATION AND CONTROL OF MOVEMENTS V.B. Brooks Summary: Theories of function of the cerebellum and basal ganglia are examined in the light of recent experimental findings obtained with the local cooling method, and both are matched against clinical observations. Evidence is summarized for a programming and initiating role in monkeys' elbow movements of the lateral, and to a lesser degree, intermediate, cerebellum. Cooling either nuclei affected movements, but neither seemed to be important for precentral cortical unit discharge accompanying compensation for suddenly applied load pulses. The globus pallidus seemed to be importantly involved in movement guidance in the absence of vision. Can. J. Neurol. Sci. l975;2:(Suppl 1):265

PHYSIOLOGICAL BASIS OF CEREBELLA DYSMETRIA John T. Murphy, Hon. C. Kwan, William A. MacKay, Yiu C. Wong Summary: A primary control system for the arm position is formulated. The hypothesis that the cerebellum is a part of the system controller is checked by studying the nerve cells responses in the cerebellum, and motor cortex, to natural activation of muscular receptors. The results show that the cerebellum receives feedback information related to the speed of these receptors. The discussion concentrates on how the interruption of this feedback may result in excessive oscillations to instability. These observations are the base for evaluating how the cerebral lesion produce dismeasurements. Can. J. Neurol. Sci. 1975;2:(Suppl 1):279

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Downloaded from https://www.cambridge.org/core. IP address: 170.106.35.93, on 24 Sep 2021A-33 at 17:13:12 , subject to the CambridgeFor brief Core prescribin terms ofg use, informatio available atn see pages A-46 https://www.cambridge.org/core/terms. https://doi.org/10.1017/S0317167100050058 25 Years Ago in the Canadian Journal of Neurological Sciences

MOTOR RESPONSES TO SUDDEN LIMB DISPLACEMENT IN PRIMATES WITH SPECIFIC CNS LESIONS AND IN HUMAN PATIENTS WITH MOTOR SYSTEM DISORDERS R.G. Lee, W.G. Tatton Summary: Central feedback pathways for motor control were studied by recording EMG responses to sudden upper limb displacements in humans and monkeys using a precision torque motor to generate step load changes. Normal human subjects showed three short-latency EMG responses (Ml, M2 and M3) which appear to correspond to those recorded from trained monkeys. The M2 and M3 components, thought to represent feedback in supraspinal pathways, were significantly increased when the subjects were instructed to actively compensate for the load changes. Parkinsonian patients with rigidity showed evidence of markedly increased feedback over the interval of the M2 and M3 responses and appeared to have lost the ability to modulate feedback according to the motor task being performed. The results are discussed with reference to recent research on motor control mechanisms in primates and a tentative model for the basis of Parkinsonian rigidity is proposed. Can. J. Neurol. Sci. 1975;2:(Suppl 1):285

WHY TRANSCORTICAL REFLEXES? Mario Wiesendanger, Dieter G. Riiegg, Gregory E. Lucier Summary: Experiments in humans and in monkeys have indicated that load perturbations, occurring during voluntary movements and postural activity, may be automatically compensated for. Overall muscle stiffness opposing load changes is determined by the visco-elastic properties of the muscle, by segmental reflex actions and finally by long-loop reflexes. Under certain circumstances, for instance when the subject or the experimental monkey is "prepared" to counteract perturbations which are unpredictable in time, the long-loop "reflexes" appear to be responsible for most of the corrective muscle tension. Experiments in anaesthetized monkeys revealed that signals from stretch afferents reach neurons of the motor cortex, possibly via a relay in the cortical area 3a. The latencies of these responses to well controlled muscle stretches were in the same range as motor cortical cell discharges recorded in alert monkeys subjected to load perturbation. Furthermore, these responses of cells in the motor cortex also had the appropriate timing to indicate a causal relationship with the long-latency electromyographic responses to load changes referred to above. These experimental results therefore strongly support the hypothesis, first proposed by Phillips (1969), of a transcortical servo-loop adjusting motor cortical output according to the load conditions in which movements are performed. The major advantage of transcortical regulations as opposed to segmental regulations, seems to be a powerful gain control acting at the cortical level; it was repeatedly shown that the long-loop reflexes are strongly modifiable and under voluntary control. It is suggested that an adaptive gain control at the cortical level is a prerequisite to preserve the complex capabilities of the motor cortex as the chief "executive" for skilled, preprogrammed movements. A loss of this adaptive gain control may be, at least partly, the cause of motor disorders such as rigidity in Parkinsonian patients, as reported by Tatton and Lee (1975). It is suggested that further investigations of the control of transcortical reflexes may aid in the understanding of the pathophysiology of motor disabilities. Can. J. Neurol. Sci. 1975;2:(Suppl 1):295

Downloaded from https://www.cambridge.org/core. IP address: 170.106.35.93, on 24 Sep 2021A-34 at 17:13:12 , subject to the Cambridge Core terms of use, available at https://www.cambridge.org/core/terms. https://doi.org/10.1017/S0317167100050058 25 Years Ago in the Canadian Journal of Neurological Sciences

DECORTICATE SPASTICITY: A RE-EXAMINATION USING QUANTITATIVE ASSESSMENT IN THE PRIMATE R.R. Tasker, R Gentili, K. Sogabe, M. Shanlin, P. Hawrylyshyn Summary: Decorticate spasticity in the squirrel monkey was chosen as a convenient laboratory model of spasticity capable of quantitative assessment upon which to evaluate various currently popular clinical spasmolytic measures. The effects of a wide variety of cortical lesions were studied involving primary and supplementary motor, premotor and parietal cortex unilaterally, measuring muscle tone with the evoked integrated EMG technique. Measurable spasticity resulted only if primary motor cortex was ablated bilaterally usually but not always preferentially involving biceps brachii and quadriceps. Resulting postures were variable offering no justification for the term "decorticate posture". The integrated evoked EMG was proportional to rate of stretch and chiefly phasic in type as in hemiplegic man. Stereotactic dentatectomy resulted in this spasticity, but was without effect in intercollicular or anemic decerebrate cats. The mechanism of the spasticity and of the cerebellar effects are discussed. Can. J. Neurol. Sci. 1975;2:(Suppl 1):303

To help them through the storm - consider moving patients to a higher dosage of Neurontin* Cumulative > 50% Cumulative % Seizure Free Improvement

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tin previous fixed dosage studies somnolence and ataxia appeared to exhibit a positive dose-response relationship. Patients treated with 1800 mg/day (n=54) experienced approximately a two-fold increase as compared to patients on lower doses of 600 to 1200 mg/day in the incidence of nystagmus (20.4%), tremor (14.8%), rhinitis (13%), peripheral edema (7.4%), abnormal coordination, depression and myalgia (all at 5.6%). Neurontin is indicated as adjunctive therapy for the management of patients with epilepsy who are not satisfactorily controlled by conventional therapy.'

Downloaded from https://www.cambridge.org/core. IP address: 170.106.35.93, on 24 Sep 2021A-35 at 17:13:12 , subject to the CambridgeFor brief Core prescribin terms of guse, informatio available atn see pages A-46 https://www.cambridge.org/core/terms. https://doi.org/10.1017/S0317167100050058 Safety and efficacy of COPAXONE® beyond 2 years have not been adequately studied in placebo-controlled trials. A correlation between reduction in attack frequency alone and decreased risk of future disability remains to be established. Most commonly observed adverse events associated with use of COPAXONE® in controlled trials which occurred at a higher frequency than placebo were injection site reactions (2.4%-66.4%, depending on reaction); vasodilation (27.2%); chest pain (26.4%); asthenia (64.8%); infection (12.8%); back pain (26.4%); nausea (23.2%); arthralgia (24.8%); anxiety (5.6%) and hypertonia (35.2%).

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Downloaded from https://www.cambridge.org/core. IP address: 170.106.35.93, on 24 Sep 2021A-36 at 17:13:12 , subject to the Cambridge Core terms of use, available at https://www.cambridge.org/core/terms. https://doi.org/10.1017/S0317167100050058 COPAXONE (glatiramer acetate for injection)

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It is with great pleasure and delight that I have assumed the Drake just before his death, on his early training years in role as Editor of the Canadian Journal of Neurological Sciences. Toronto; a reproduction of one of his famous "Track Sheets" The Journal has had strong leadership through its founding used to record details of his aneurysm surgery; and a Editor Dr. R. Ross followed by the guidance of Dr. Robert G. Lee reproduction of one of Dr. Drake's articles originally published and more recently Dr. James Sharpe. We are all indebted to these in the Journal of Neurosurgery. It is my hope that these articles editors and the editorial staff at the Journal for creating a self in our Journal will help to highlight the outstanding contributions sufficient, strong and internationally recognized Journal. Unlike made by Dr. Drake to neurosurgery internationally. a number of its contemporaries, The Canadian Journal of In this issue we introduce a new educational article Neurological Sciences is unique in its combination of clinical "Neuroimaging Highlight" edited by Drs. Mark Hudon and neurology, neurosurgery, child neurology and clinical William Hu. Each subsequent issue of the Journal will include neurophysiology, the four components of our Canadian Congress a Neuroimaging Highlight and I hope it will serve as an of Neurological Sciences. important feature for our readers. We have a number of challenges ahead of us that include This editor would like to acknowledge the superb editorial maintaining our leadership over newer journals of limited scope staff that will help me to guide the Journal, including Sally and making a smooth transition into the era of electronic Gregg, Sue Impey and Margaret Peterson. I will continue to call publishing. For this we have important local expertise and you on Canadian and international neuroscientists to help in our well will be hearing more about our electronic initiatives in the near established review process. In advance, I would like to thank future. those of you who can continue to contribute to our peer review. In the last issue and in this issue, we honor several Our Journal has international contributors and readership and outstanding Canadian neuroscientists. This issue honors Dr. the strength of its citations will depend on the quality of the work Charles Drake a Canadian neurosurgeon who revolutionized the we can attract. We encourage Canadian and international authors treatment of vertebral-basilar territory cerebral aneurysms. We to send us their best work. include an introductory "In Memoriam" by his colleagues, Gary Ferguson and Vladimir Hachinski; an address prepared by Dr. Douglas Zochodne

Downloaded from https://www.cambridge.org/core. IP address: 170.106.35.93, on 24 Sep 2021A-39 at 17:13:12 , subject to the Cambridge Core terms of use, available at https://www.cambridge.org/core/terms. https://doi.org/10.1017/S0317167100050058 INFORMATION FOR AUTHORS Avoid "personal communications" and, if necessary, include them in the body of the text, not among the references. Reference citations The Canadian Journal of Neurological Sciences publishes original should not include unpublished presentations or other non-accessible articles in neurology, neurosurgery and basic neurosciences. material. Books or chapter references should also include the place Manuscripts are considered for publication with the understanding of publication and the name of the publisher. Examples of correct that they, or the essence of their content, have not been published forms of reference follow: elsewhere except in abstract form and are not under simultaneous Journals consideration by another journal. Articles undergo peer review. Yang JF, Fung M, Edamura R, et al. H-Reflex modulation during Manuscripts should be submitted to: James A. Sharpe, M.D., Editor. walking in spastic paretic subjects. Can J Neurol Sci 1991; 18: 443- Canadian Journal of Neurological Sciences, P.O. Box 4220, Station 452. C, Calgary, AB Canada T2T 5N1 Chapter in a book McGeer PL, McGeer EG. Amino acid neurotransmitters. In: Manuscript Preparation Siegel GJ, Albers RW, Agranoff BW, Katzman R, eds. Basic Neurochemistry. Boston: Little, Brown & Co., 1981: 233-254. • Submit five high quality copies of the manuscript and original illus trations. Papers will be accepted in English or French. Manuscripts • Illustrations Submit five original sets of illustrations. We will not must be double spaced throughout including references, tables and return illustrations; therefore, authors should keep negatives for all legends for illustrations. Margins of at least 25mm should be left on photographs. Submit high quality glossy black and white pho all sides. tographs preferable 127 x 173 mm (5" x 7"). This includes graphs and diagrams. Do NOT send photocopies of illustrations. Original • After a paper has been reviewed, the author will be requested to artwork and radiographs should not be submitted. The additional cost submit four copies of the revised manuscript, including illustrations. of coloured illustrations must be borne by the author; quotations are Supply a computer diskette (3 1/2" size) containing the article saved available upon request from the Journal office. Identify each figure in an RTF format. Identify clearly first author's name, file name, with a label at the back indicating top, figure number and first author. word processing program and version, and system (i.e. PC or Mac). Letters and arrows applied to the figures to identify particular find Clearly indicate the order and importance of headings. ings should be professional appliques suitable for publication. • For detailed instructions regarding style and layout refer to Photomicrographs should include a calibration bar with a scale indi "Uniform requirements for manuscripts submitted to biomedical cated on the figure or in the legend. Legends for illustrations should journals". Copies of this document may be obtained by writing to be typed on a separate page from the illustrations. the Journal office, but the main points are summarized here. Articles • Tables Type tables double-spaced on pages separate from the text. should be submitted under conventional headings of introduction, Provide a table number and title for each. Particular care should be methods and materials, results, discussion, but other headings will taken in the preparation of tables to ensure that the data are presented be considered if more suitable. Clinical trials must be reported in clearly and concisely. Each column should have a short or abbreviat Consort format (JAMA 1996; 276: 637-639). Pages of text should be ed heading. Place explanatory matter in footnotes, not in the heading. numbered consecutively. Do not submit tables as photographs. • A title page should identify the title of the article which should be • Review articles on selected topics are also published. They are usu no more than 80 characters including spaces; name of institution(s) ally invited, but unsolicited reviews will be considered. It is recom from which the work originated; and the name, address, telephone, mended that authors intending to submit review articles contact the and fax number of the corresponding author. Editor in advance. • Abstract Original Articles should be accompanied by an abstract of • Letters to the Editor concerning matters arising in recent articles 250 words or less on a separate page, preferably in English and are welcome. Letters should be limited to two double-spaced pages French, although the Journal will provide translation if required. and may include one illustration and a maximum of four references. 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Temperatures are reported in degrees celsius. English lan responsible for delaring it to the Editor. Any financial interest, research guage text may use either British or American spelling, but should be grant, material support, or consulting fee associated with the contents consistent throughout. of the manuscript must be declared to the Editor. These guidelines • References should be numbered in the order of their citation in the apply to each author and their immediate families, conflicts of interest text. Those cited only in tables and legends for illustrations are num are not necessarily wrong nor do they necessarily change the scientific bered according to the sequence established by the first identification validity of research or opinion, but the Journal and readers should be in the text of a particular table or illustration. Titles of journals aware of the conflict. If the Editor considers the conflict to compro should be abbreviated according to the style used in Index Medicus. mise the validity of the paper, it will not be accepted for publication. References should list the names of up to five authors; if there are Authors, editorial staff and reviewers are asked to declare any relation more, cite the first three, then et al. Provide the full title, year of pub ship that would be considered as a conflict of interest whether or not lication, volume number and inclusive pagination for journal articles. they believe that a conflict actually exists. Information that the Journal For any reference cited as "in press", five copies of the article must receives about conflict or potential conflict will be kept confidential accompany the author's manuscript. Do not reference unpublished or unless the Editor or Associate Editor considers it to be important to "submitted" papers; these can be mentioned in the body of the text readers. Such conflicts will be published in the author credits or as a and authors must provide five copies of "submitted" manuscripts. footnote to the paper, with knowledge of the authors.

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