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AJMONE-MARSAN 167
- Frost was also chief of the NINDB Surgical Neurology Branch’s Section
on Clinical Psychology.
- Ernst Niedermeyer, “EEG and Clinical Neurophysiology at the Johns Hopkins
Medical Institutions: Roots and Development,” Journal of Clinical Neuro
physiology 10 (1993): 83-8.
- Video monitoring was not yet fully developed in the early 1950s.
- In 1965, after Shy left the NIH to become chairman of the Department of
Neurology at the University of Pennsylvania and then–for a too-brief
period–at Columbia University, Baldwin became clinical director of the
NINDB intramural program. He assumed greater administrative duties
and delegated progressively more and more surgical activity and responsi
bilities to John Van Buren, who had joined the NIH in 1955.
- Maitland Baldwin and Pearce Bailey, eds., Temporal Lobe Epilepsy: A
Colloquium (Springfield, Illinois: Charles C. Thomas, 1958).
- In 1970, after Baldwin’s sudden, premature death, Van Buren was named
acting chief of the Surgical Neurology Branch, and in 1972 became chief
in his own right. Van Buren continued Baldwin’s main research interests,
while extending the surgical approach to other forms of focal cortical (i.e.,
extratemporal) seizures, as well as to the management of involuntary move
ments, in keeping with the fashionable interest of that time, especially
popularized by Irving Cooper of St. Barnabas Hospital in New York. Although
the latter type of surgical activity was relatively short-lived, it provided a
good opportunity for gathering information on stereotactic localization of
anatomical targets. It allowed extensive investigations on thalamus and other
subcortical structures in humans and on their topographical variations (see,
e.g., the impressive two-volume monograph by Van Buren and Borke: John
M. Van Buren and R. C. Borke, Variations and Connections of the Human
Thalamus (New York: Springer-Verlag, 1972)), and yielded interesting in
formation on the results of electrical stimulation of many such structures
and their interconnections. Stimulation was carried out during simultane
ous recording, prior to the coagulation of specific targeted structures.
Of primary significance for the surgery of epilepsy, however, this
therapeutic investigation in the field of involuntary movements allowed Van
Buren to develop a practical type of stereotactic apparatus, and to identify
reliable and consistent anatomic/radiologic landmarks that could be util
ized for the placement of chronically implanted deep electrode sets. In
collaboration with Ajmone-Marsan, he also demonstrated, by the same
approach, that there was no evidence of interictal epileptiform activity in
any of the records derived from multiple insertions of such electrodes in a
number of different cortical and subcortical structures of over 40 patients
affected by abnormal movements but without seizure disorders. It was thus
apparent that the suspected acute “injury” effects, by insertion of needle
electrodes into the brain, do not commonly mimic electrographic epileptiform
phenomena, at least within nonlimbic structures.
