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Article ; Online: Persistent Hiccups Induced by Supratentorial Infarcts and Successful Treatment With a Combination of Perampanel and Baclofen: A Case Report.

Morita, Kohei / Nuki, Yoshitsugu / Hashizume, Hiroya / Togo, Masaya

2022 Volume 45, Issue 5, Page(s) 135–138

Abstract: Case: A 52-year-old man developed a cerebral infarction from the right middle cerebral artery occlusion, and the infarction extensively damaged the right insula. Three months after the onset of the cerebral infarction, persistent hiccups appeared, ... ...

Abstract	Case: A 52-year-old man developed a cerebral infarction from the right middle cerebral artery occlusion, and the infarction extensively damaged the right insula. Three months after the onset of the cerebral infarction, persistent hiccups appeared, occurring during sleep. The thoracic and abdominal cavities showed no lesions; hence, the hiccups were considered to be caused by central nervous system dysfunction. Administration of metoclopramide, chlorpromazine, and diazepam were ineffective, while levetiracetam had a partial effect. Combining perampanel with baclofen finally suppressed the symptoms. Discussion: Lesions at the right insula impair respiratory reflex and may present with hiccups as a symptom of respiratory reflex disinhibition. Here, we review similar cases of treatment-resistant hiccups, as well as perampanel and baclofen efficacy in myoclonus cases. Conclusions: Our patient's case suggested that perampanel with baclofen may be effective for myoclonus due to respiratory reflex disinhibition and can be used to treat hiccups derived from cerebral infarctions.
MeSH term(s)	Baclofen/therapeutic use ; Cerebral Infarction/complications ; Cerebral Infarction/drug therapy ; Chlorpromazine ; Diazepam ; Hiccup/drug therapy ; Hiccup/etiology ; Humans ; Infarction/complications ; Levetiracetam ; Male ; Metoclopramide ; Middle Aged ; Myoclonus ; Nitriles ; Pyridones
Chemical Substances	Nitriles ; Pyridones ; Levetiracetam (44YRR34555) ; Baclofen (H789N3FKE8) ; perampanel (H821664NPK) ; Metoclopramide (L4YEB44I46) ; Diazepam (Q3JTX2Q7TU) ; Chlorpromazine (U42B7VYA4P)
Language	English
Publishing date	2022-08-03
Publishing country	United States
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	199293-4
ISSN	1537-162X ; 0362-5664
ISSN (online)	1537-162X
ISSN	0362-5664
DOI	10.1097/WNF.0000000000000514
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Article ; Online: Hepatic encephalopathy revisited: Beyond the triphasic waves.

Togo, Masaya / Kinoshita, Masako

Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology

2018 Volume 130, Issue 3, Page(s) 408–409

MeSH term(s)	Electroencephalography ; Hepatic Encephalopathy ; Humans ; Liver Cirrhosis ; Nervous System Malformations
Language	English
Publishing date	2018-12-20
Publishing country	Netherlands
Document type	Editorial ; Comment
ZDB-ID	1463630-x
ISSN	1872-8952 ; 0921-884X ; 1388-2457
ISSN (online)	1872-8952
ISSN	0921-884X ; 1388-2457
DOI	10.1016/j.clinph.2018.12.003
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Article ; Online: [Cingulate seizure as a clinical manifestation of anti-myelin oligodendrocyte glycoprotein antibody-positive cerebral cortical encephalitis of two cases].

Tanaka, Tomoko / Togo, Masaya / Okayama, Kiminobu / Chihara, Norio / Ueda, Takehiro / Sekiguchi, Kenji / Matsumoto, Riki

Rinsho shinkeigaku = Clinical neurology

2023 Volume 63, Issue 7, Page(s) 441–449

Abstract: We report two male patients who had a sensory seizure, which evolved into a focal impaired awareness tonic seizure, and after that, focal to bilateral tonic-clonic seizure. The first case, a 20-year-old man had been treated with steroids for anti-myelin ... ...

Abstract	We report two male patients who had a sensory seizure, which evolved into a focal impaired awareness tonic seizure, and after that, focal to bilateral tonic-clonic seizure. The first case, a 20-year-old man had been treated with steroids for anti-myelin oligodendrocyte glycoprotein (MOG) antibody-positive optic neuritis. His seizure started with abnormal sensation in the little finger of the left hand, which spread to the left upper and then to the left lower limb. The seizure then evolved into tonic seizures of the upper and lower limbs and he finally lost awareness. The second case, a 19-year-old man experienced floating dizziness while walking, followed by numbness and a pain-like electrical shock in the right upper limb. The right arm somatosensory seizure evolved into a right upper and lower limb tonic seizure, which spread to the bilateral limbs, and finally he lost awareness. Symptoms of both patients improved after the treatment with steroids. Both patients shared a similar high-intensity FLAIR lesion in the posterior midcingulate cortex. Both patients were diagnosed with MOG antibody-positive cerebral cortical encephalitis because of a positive titer of anti-MOG antibody in the serum. Several reports showed involvement of the cingulate gyrus in MOG antibody-positive cerebral cortical encephalitis, but only a few reported seizure semiology in detail. The semiology reported here is consistent with that of cingulate epilepsy or the findings of electrical stimulation of the cingulate cortex, namely, somatosensory (electric shock or heat sensation), motor (tonic posture), and vestibular symptoms (dizziness). Cingulate seizures should be suspected when patients show somatosensory seizures or focal tonic seizures. MOG antibody-positive cerebral cortical encephalitis should be considered as one of the differential diagnoses when the young patient shows the unique symptoms of an acute symptomatic cingulate seizure.
MeSH term(s)	Humans ; Male ; Autoantibodies ; Dizziness ; Encephalitis/drug therapy ; Magnetic Resonance Imaging ; Myelin-Oligodendrocyte Glycoprotein ; Oligodendroglia ; Seizures/etiology ; Vertigo ; Young Adult
Chemical Substances	Autoantibodies ; Myelin-Oligodendrocyte Glycoprotein
Language	Japanese
Publishing date	2023-06-30
Publishing country	Japan
Document type	Case Reports ; English Abstract ; Journal Article
ZDB-ID	604200-4
ISSN	1882-0654 ; 0009-918X
ISSN (online)	1882-0654
ISSN	0009-918X
DOI	10.5692/clinicalneurol.cn-001724
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Article: [Pitfalls in Reading EEG for Temporal Lobe Epilepsy: The "Southern-hemisphere" Spike and Normal Variants].

Togo, Masaya / Morimoto, Kohei / Matsumoto, Riki

Brain and nerve = Shinkei kenkyu no shinpo

2020 Volume 72, Issue 4, Page(s) 425–436

Abstract: Electroencephalogram (EEG) reading in clinical settings commonly uses three montage types: referential montage, bipolar montage, and average montage. Since each montage type has its advantages and disadvantages, there is no single best montage. To ... ...

Abstract	Electroencephalogram (EEG) reading in clinical settings commonly uses three montage types: referential montage, bipolar montage, and average montage. Since each montage type has its advantages and disadvantages, there is no single best montage. To correctly read EEG, it is essential 1) to use the montage appropriate for the focus and distribution of epileptic activity and 2) to correctly recognize EEG waveforms that are often misdiagnosed as epileptic activity. In this article, we present the so-called "southern-hemisphere" epileptic activity, which is recognized as challenging to diagnose, along with two cases of temporal lobe epilepsy. Case 1 exhibited seizures that started with palpitations and epigastric discomfort, followed by loss of awareness and oral automatisms. Case 2 experienced recurrent episodes of syncope and was diagnosed with temporal lobe epilepsy based on EEG findings and the observed improvement with anti-epileptic medication. In both cases, the longitudinal bipolar montage ("double-banana montage") failed to visualize the epileptic activity, while the referential montages (ear lobe reference or average reference) clearly showed maximal activity at the earlobe electrode. Additionally, we present the normal variants of normal EEG waveforms that are often misdiagnosed as epileptic activity.
MeSH term(s)	Electroencephalography ; Epilepsy, Temporal Lobe/diagnosis ; Humans ; Seizures
Language	Japanese
Publishing date	2020-04-13
Publishing country	Japan
Document type	Case Reports ; Journal Article
ZDB-ID	390389-8
ISSN	1344-8129 ; 1881-6096 ; 0006-8969
ISSN (online)	1344-8129
ISSN	1881-6096 ; 0006-8969
DOI	10.11477/mf.1416201541
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Article ; Online: [A case of refractory generalized atonic seizure and hemifacial spasm with the possible causative pontocerebellar lesion].

Togo, Masaya / Inouchi, Morito / Matsumoto, Riki / Sawamoto, Nobukatsu / Ikeda, Akio / Takahashi, Ryosuke

Rinsho shinkeigaku = Clinical neurology

2020 Volume 60, Issue 5, Page(s) 362–366

Abstract: The patient was a 35-year-old woman. At the age of 1, she had undergone resection and radiation therapy for neoplastic lesions in the pons. She had a history of gelastic seizures when she was in elementary school, and brief lapses of the neck and truncal ...

Abstract	The patient was a 35-year-old woman. At the age of 1, she had undergone resection and radiation therapy for neoplastic lesions in the pons. She had a history of gelastic seizures when she was in elementary school, and brief lapses of the neck and truncal muscular tone and convulsions on the left face occurred at the age of 23. After a generalized sharp wave in the ictal electroencephalogram and electromyogram recording, left orbicularis oris muscle contraction was observed followed by sudden cervical extensor atonia. Seizure propagation was noted in the cerebral cortex, left facial nerve nucleus, and brainstem reticular formation. In a simultaneous electroencephalography with functional MRI, the blood oxygen level-dependent effect related to generalized sharp waves was observed in the vicinity of brainstem lesions in addition to a decrease in bilateral frontal and parietal lobes signals, as detected in generalized seizures. These findings suggest that the lesion could be a part of the epilepsy network. Although most epileptic seizures are derived from the cerebral cortex, it is important to note that brainstem lesions are involved in seizures in the patient presented in this study.
MeSH term(s)	Adult ; Brain Neoplasms/complications ; Brain Neoplasms/radiotherapy ; Brain Neoplasms/surgery ; Electroencephalography ; Female ; Hemifacial Spasm/etiology ; Humans ; Magnetic Resonance Imaging ; Pons/diagnostic imaging ; Seizures/etiology
Language	Japanese
Publishing date	2020-04-18
Publishing country	Japan
Document type	Journal Article
ZDB-ID	604200-4
ISSN	1882-0654 ; 0009-918X
ISSN (online)	1882-0654
ISSN	0009-918X
DOI	10.5692/clinicalneurol.cn-001368
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Article ; Online: Distinct connectivity patterns in human medial parietal cortices: Evidence from standardized connectivity map using cortico-cortical evoked potential.

Togo, Masaya / Matsumoto, Riki / Usami, Kiyohide / Kobayashi, Katsuya / Takeyama, Hirofumi / Nakae, Takuro / Shimotake, Akihiro / Kikuchi, Takayuki / Yoshida, Kazumichi / Matsuhashi, Masao / Kunieda, Takeharu / Miyamoto, Susumu / Takahashi, Ryosuke / Ikeda, Akio

NeuroImage

2022 Volume 263, Page(s) 119639

Abstract: The medial parietal cortices are components of the default mode network (DMN), which are active in the resting state. The medial parietal cortices include the precuneus and the dorsal posterior cingulate cortex (dPCC). Few studies have mentioned ... ...

Abstract	The medial parietal cortices are components of the default mode network (DMN), which are active in the resting state. The medial parietal cortices include the precuneus and the dorsal posterior cingulate cortex (dPCC). Few studies have mentioned differences in the connectivity in the medial parietal cortices, and these differences have not yet been precisely elucidated. Electrophysiological connectivity is essential for understanding cortical function or functional differences. Since little is known about electrophysiological connections from the medial parietal cortices in humans, we evaluated distinct connectivity patterns in the medial parietal cortices by constructing a standardized connectivity map using cortico-cortical evoked potential (CCEP). This study included nine patients with partial epilepsy or a brain tumor who underwent chronic intracranial electrode placement covering the medial parietal cortices. Single-pulse electrical stimuli were delivered to the medial parietal cortices (38 pairs of electrodes). Responses were standardized using the z-score of the baseline activity, and a response density map was constructed in the Montreal Neurological Institutes (MNI) space. The precuneus tended to connect with the inferior parietal lobule (IPL), the occipital cortex, superior parietal lobule (SPL), and the dorsal premotor area (PMd) (the four most active regions, in descending order), while the dPCC tended to connect to the middle cingulate cortex, SPL, precuneus, and IPL. The connectivity pattern differs significantly between the precuneus and dPCC stimulation (p<0.05). Regarding each part of the medial parietal cortices, the distributions of parts of CCEP responses resembled those of the functional connectivity database. Based on how the dPCC was connected to the medial frontal area, SPL, and IPL, its connectivity pattern could not be explained by DMN alone, but suggested a mixture of DMN and the frontoparietal cognitive network. These findings improve our understanding of the connectivity profile within the medial parietal cortices. The electrophysiological connectivity is the basis of propagation of electrical activities in patients with epilepsy. In addition, it helps us to better understand the epileptic network arising from the medial parietal cortices.
MeSH term(s)	Humans ; Brain Mapping ; Epilepsies, Partial ; Evoked Potentials/physiology ; Gyrus Cinguli/physiology ; Limbic System/physiology ; Magnetic Resonance Imaging ; Neural Pathways/physiology ; Parietal Lobe/physiology ; Electrophysiology ; Male ; Female ; Young Adult ; Adult ; Middle Aged ; Imaging, Three-Dimensional
Language	English
Publishing date	2022-09-23
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1147767-2
ISSN	1095-9572 ; 1053-8119
ISSN (online)	1095-9572
ISSN	1053-8119
DOI	10.1016/j.neuroimage.2022.119639
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Article ; Online: Multiple small hemorrhagic infarcts in cerebral air embolism: a case report.

Togo, Masaya / Hoshi, Taku / Matsuoka, Ryosuke / Imai, Yukihiro / Kohara, Nobuo

BMC research notes

2017 Volume 10, Issue 1, Page(s) 599

Abstract: Background: Cerebral air embolism is a rare cause of cerebral infarction. In cerebral air embolism, T2 star-weighted imaging shows numerous spotty hypointense signals. Previous reports have suggested that these signals represent air in the brain and are ...

Abstract	Background: Cerebral air embolism is a rare cause of cerebral infarction. In cerebral air embolism, T2 star-weighted imaging shows numerous spotty hypointense signals. Previous reports have suggested that these signals represent air in the brain and are gradually diminished and absorbed. We experienced two cases of cerebral air embolism, and in one of them, we conducted an autopsy. Case presentation: Case 1 was a 76-year-old Japanese man with lung cancer and emphysema. A spasmodic cough induced massive cerebral and cardiac air embolisms and the patient died because of cerebral herniation. T2 star-weighted imaging of brain magnetic resonance imaging showed multiple spotty low signals. Brain autopsy showed numerous spotty hemorrhagic infarcts in the area of T2 star-weighted imaging signals. Case 2 was an 85-year-old Japanese man with emphysema who suffered from acute stroke. Similar spotty T2 star-weighted imaging signals were observed and remained unchanged 2 months after the onset. Conclusions: These findings indicate that T2 star-weighted imaging in cerebral air embolism partially represents micro-hemorrhagic infarction caused by air bubbles that have migrated into the brain.
MeSH term(s)	Aged ; Aged, 80 and over ; Autopsy ; Brain/pathology ; Cerebral Infarction/etiology ; Cerebral Infarction/pathology ; Embolism, Air/complications ; Emphysema/complications ; Humans ; Intracranial Embolism/complications ; Intracranial Hemorrhages/etiology ; Intracranial Hemorrhages/pathology ; Lung Neoplasms/complications ; Magnetic Resonance Imaging ; Male ; Stroke/etiology ; Stroke/pathology
Language	English
Publishing date	2017-11-16
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2413336-X
ISSN	1756-0500 ; 1756-0500
ISSN (online)	1756-0500
ISSN	1756-0500
DOI	10.1186/s13104-017-2925-x
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Article ; Online: Electroencephalographic findings in Bickerstaff's brainstem encephalitis: A possible reflection of the dysfunction of the ascending reticular activating system.

Yoshimura, Hajime / Togo, Masaya / Ishii, Junko / Ishiyama, Hiroyuki / Tamura, Ryota / Kimura, Masamune / Kuroda, Takehito / Kusunoki, Susumu / Kawamoto, Michi / Kohara, Nobuo

Clinical neurophysiology practice

2020 Volume 6, Page(s) 29–35

Abstract: Objectives: Bickerstaff's brainstem encephalitis (BBE) is a rare post-infectious inflammatory disease, which causes impaired consciousness by the dysfunction of the ascending reticular activating system (ARAS). We aimed to clarify EEG changes possibly ... ...

Abstract	Objectives: Bickerstaff's brainstem encephalitis (BBE) is a rare post-infectious inflammatory disease, which causes impaired consciousness by the dysfunction of the ascending reticular activating system (ARAS). We aimed to clarify EEG changes possibly caused by the dysfunction of the ARAS in BBE. Methods: We retrospectively investigated 15 EEGs from 5 patients with definite BBE (i.e., the positivity for serum IgG anti-GQ1b antibodies was mandatory for the diagnosis) admitted to our hospital from January 2014 through December 2019, particularly focusing on whether N1 and N2 sleep patterns were maintained. Results: All of the 10 EEGs recorded when patients had consciousness disturbance were abnormal. Stereotypical EEG changes correlating with their level of consciousness were identified: poorly organized posterior dominant rhythms with maintenance of sleep patterns in patients with mild consciousness disturbance (n = 5); predominant N1 and/or N2 sleep patterns even with external stimuli, including spindle coma pattern, in patients with moderate consciousness disturbance ("unarousable sleep-like" EEG) (n = 4); and generalized slow waves without N1 and N2 sleep patterns in patients with severe consciousness disturbance (n = 1). Among 5 patients, 3 (60%) had "unarousable sleep-like" EEG in their clinical course. Conclusions: Patients with BBE showed stereotypical EEG changes correlating with their level of consciousness, mostly with maintenance of N1 and N2 sleep patterns, and often exhibited characteristic "unarousable sleep-like" EEG. Significance: This study revealed characteristic EEG changes possibly caused by the dysfunction of the ARAS, which can be a diagnostic clue for BBE.
Language	English
Publishing date	2020-12-26
Publishing country	Netherlands
Document type	Journal Article
ISSN	2467-981X
ISSN (online)	2467-981X
DOI	10.1016/j.cnp.2020.11.004
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Article ; Online: Multiple small hemorrhagic infarcts in cerebral air embolism

Masaya Togo / Taku Hoshi / Ryosuke Matsuoka / Yukihiro Imai / Nobuo Kohara

BMC Research Notes, Vol 10, Iss 1, Pp 1-

a case report

2017 Volume 7

Abstract: Abstract Background Cerebral air embolism is a rare cause of cerebral infarction. In cerebral air embolism, T2 star-weighted imaging shows numerous spotty hypointense signals. Previous reports have suggested that these signals represent air in the brain ... ...

Abstract	Abstract Background Cerebral air embolism is a rare cause of cerebral infarction. In cerebral air embolism, T2 star-weighted imaging shows numerous spotty hypointense signals. Previous reports have suggested that these signals represent air in the brain and are gradually diminished and absorbed. We experienced two cases of cerebral air embolism, and in one of them, we conducted an autopsy. Case presentation Case 1 was a 76-year-old Japanese man with lung cancer and emphysema. A spasmodic cough induced massive cerebral and cardiac air embolisms and the patient died because of cerebral herniation. T2 star-weighted imaging of brain magnetic resonance imaging showed multiple spotty low signals. Brain autopsy showed numerous spotty hemorrhagic infarcts in the area of T2 star-weighted imaging signals. Case 2 was an 85-year-old Japanese man with emphysema who suffered from acute stroke. Similar spotty T2 star-weighted imaging signals were observed and remained unchanged 2 months after the onset. Conclusions These findings indicate that T2 star-weighted imaging in cerebral air embolism partially represents micro-hemorrhagic infarction caused by air bubbles that have migrated into the brain.
Keywords	Cerebral air embolism ; Small hemorrhagic infarction ; T2 star-weighted imaging ; Medicine ; R ; Biology (General) ; QH301-705.5 ; Science (General) ; Q1-390
Language	English
Publishing date	2017-11-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
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Article ; Online: Ischemic stroke in a young woman with anti-phosphatidylserine/prothrombin (aPS/PT) complex antibody: a case report.

Todo, Kenichi / Togo, Masaya / Murakami, Yasutaka / Kono, Tomoyuki / Yoshimura, Hajime / Hoshi, Taku / Kawamoto, Michi / Kohara, Nobuo

Journal of the neurological sciences

2018 Volume 397, Page(s) 77–79

MeSH term(s)	Adult ; Autoantibodies/blood ; Brain/diagnostic imaging ; Brain Ischemia/blood ; Brain Ischemia/diagnostic imaging ; Brain Ischemia/immunology ; Female ; Humans ; Magnetic Resonance Imaging ; Prothrombin/immunology ; Stroke/blood ; Stroke/diagnostic imaging ; Stroke/immunology ; Ultrasonography
Chemical Substances	Autoantibodies ; Prothrombin (9001-26-7)
Language	English
Publishing date	2018-12-07
Publishing country	Netherlands
Document type	Case Reports ; Letter
ZDB-ID	80160-4
ISSN	1878-5883 ; 0022-510X ; 0374-8642
ISSN (online)	1878-5883
ISSN	0022-510X ; 0374-8642
DOI	10.1016/j.jns.2018.12.012
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