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Biomedical subjects

C B Dodrill

Publications and source records attributed to C B Dodrill.

At least 73 records · Page 4Linked to original sources
PubMed1983

Cinromide in epilepsy: a pilot study.

Monotherapy with the experimental antiepileptic drug cinromide was evaluated in 11 adult outpatients with uncontrolled partial epilepsy. They were treated with phenytoin for 2 months, cinromide for 4 months, and carbamazepine for 4 months. Four patients withdrew from the study during or shortly after crossover to cinromide due to increased seizure frequency or severity. Of the remainder, three preferred carbamazepine, two cinromide, and two phenytoin, based on both seizure control and degree of toxicity. Overall seizure control was not significantly different with any of the three agents, but during cinromide administration secondarily generalized seizure control was uniformly worst and there was also a tendency toward decreased performance on neuropsychological tests. CNS toxicity and gastrointestinal toxicity were prominent during the first month of cinromide treatment, but subsided with time or dose reduction. No abnormalities requiring drug withdrawal were found with laboratory testing. The results suggested, at best, a very limited clinical usefulness for cinromide, and it has been withdrawn from testing by its manufacturer.

Adult↗
PubMed1983

Neuropsychological and linguistic correlates of atypical language lateralization: evidence from sodium amytal studies.

The intracarotid injection of sodium amytal is a technique that has been used to determine on which hemisphere language functions depend. Based on use of this technique in a series of patients (n = 99), three groups of patients - one with left hemisphere language lateralization, one right hemisphere language lateralization, and one bilateral language representation - were identified. These three groups were compared in relation to demographic variables, variables related to seizure disorder and neuropsychological variables. Comparisons were also made between the groups on incidence of speech blockage, naming errors and reading errors and on patterns of linguistic breakdown during reading under conditions of left and right amytal perfusion. The nature, potential etiology and effects of atypical (right hemisphere or bilateral) as opposed to the more common left hemisphere language organization are discussed.

Adult↗
PubMed1981

Clorazepate and phenobarbital as antiepileptic drugs: a double-blind study.

The antiepileptic effect of clorazepate when given with phenytoin was compared, in a randomized double-blind crossover study, to the effect of the standard regimen of phenobarbital plus phenytoin in patients with partial seizures. Thirty of 42 subjects preferred the clorazepate-phenytoin regimen (p less than 0.01). The same number of subjects had fewer seizures while taking clorazepate as had fewer seizures while taking phenobarbital. However, subjects had significantly more toxicity, objective and subjective, on the phenobarbital-phenytoin regimen (p less than 0.01 in both cases). In some subjects, increased toxicity due to phenobarbital outweighed better seizure control, so that clorazepate was preferred. As an add-on antiepileptic drug, clorazepate is well tolerated, effective, and preferred by most patients to phenobarbital.

Adult↗
PubMed1980

An objective method for the assessment of psychological and social problems among epileptics.

Numerous investigators have identified psychological and social problems among epileptics and in many instances, these appear to be more debilitating than the seizures themselves. However, assessment of these problems has most frequently been done by subjective means and when objective tests have been used, they were almost always developed for and standardized on populations other than epileptics. The development of the Washington Psychosocial Seizure Inventory (WPSI) is presented in this paper. After pilot work, 127 adult epileptics were evaluated for psychosocial problems and they completed the 132-item Inventory. Professional assessment of difficulties was made with respect to family background, emotional adjustment, interpersonal adjustment, vocational adjustment, financial status, adjustment to seizures, and medical management. Finally, an assessment of overall psychosocial functioning was made. Through an item-by-item correlation technique, scales were empirically developed for each of these areas and a profile was produced which gives both the absolute and the relative extents of difficulties for each patient with respect to each area. Potential applications for the WPSI are presented.

Adaptation, Psychological↗
PubMed1980

Futher validation of the WPSI vocational scale: comparisons with other correlates of employment in epilepsy.

The present study evaluates the relationships between employment status and five types of variables: years of education, intelligence, emotional adjustment, neuropsychological impairment, and psychosocial adjustment. The latter two areas were evaluated by procedures specifically developed for work with seizure patients and include use of the Neuropsychological Battery for Epilepsy and the Washington Psychosocial Seizure Inventory. Fifty-eight patients were divided into groups based on their employment histories and classified as unemployed, underemployed, and employed. Results indicated that the two types of procedures developed specifically for work with clients having seizures demonstrated the most potent and consistent relationships with employment status. The study suggests that the use of these procedures in the evaluation of employability may be more effective than using only those variables which traditionally have been applied.

Adolescent↗
PubMed1980

Rapid evaluation of intelligence in adults with epilepsy.

This study evaluates the Wonderlic Personnel Test and its ability to duplicate the Wechsler Adult Intelligence Scale (WAIS) Full Scale IQ. The Wonderlic can be given and scored by a clerk in approximately 15 min and is suitable for both individual and group administration. With the use of original (n = 100) cross-validational (n = 50) adult epileptic samples, no biases or distortions in predictability were observed across the variables of sex, age, years of education, level of intelligence, neuropsychological impairment, emotional status, primary seizure diagnosis, etiology of seizure disorder, age at onset of seizure disorder, and seizure activity. The average error in estimation of WAIS Full Scale IQs from Wonderlic IQs ranges from 0.1 to 0.3 of a single IQ point. In individual cases, there is a 90% probability that the Wonderlic will render an IQ score within 10 points of the WAIS Full Scale IQ. The Wonderlic appears to be useful in both clinical and research contexts in evaluating people with seizure disorders.

Adolescent↗
PubMed1979

Sex differences on the Halstead-Reitan Neuropsychological Battery and on other neuropsychological measures.

Evaluated differences in performance between adult males and females with respect to Halstead's Neuropsychological Battery, additional tests employed by Reitan (Trail Making Test, Aphasia Screening Test, Perceptual Examination, dynamometer), and other neuropsychological measures (Seashore Tonal Memory Test, Logical Memory and Visual Reproduction portions of the Wechsler Memory Scale). In evaluating differences, 47 matched pairs of non-neurologic males and females were employed, as well as 47 pairs of neurologic patients. A small number of statistically significant differences were found, all of which favored males. Some of these differences occurred with respect to tasks that have very strong motor components, and these differences were shown to be related to hand size. Others pertained to tasks that have strong visual-spatial components. In general, the differences were less prominent with the neurologic than the non-neurologic samples. The question was raised as to possible over-representation of male-superior components in these tests.

Adolescent↗
PubMed1979

EEG operant conditioning for control of epilepsy.

We report the results of 23 severely epileptic patients who were given EEG feedback training. The paradigm reinforced the patients' 18 Hz activity over the scalp approximation of their focus while suppressing temporalis EMG and low frequency EEG activity. In contrast to other studies using EEG feedback, only 43% of patients showed significant changes in seizure occurrence and a lesser number were felt to have benefited clinically. None of our neuropsychological test parameters were helpful in identifying (prospectively or retrospectively) patients most likely to respond to this treatment. Although a few patients were significantly helped by this training, the mechanism for this effect is unclear.

Adolescent↗
PubMed1978

Carbamazepine and the electroencephalogram of epileptics: a double blind study in comparison to phenytoin.

In double blind crossover 4 month trials, carbamazepine was compared to phenytoin as sole treatment for 45 patients with uncontrolled partial and generalized epilepsy. EEGs performed at the end of these trials revealed that while using carbamazepine the patients manifested a significant overall increase in diffuse slow waves and an increase in generalized epileptiform discharges without significant accompanying changes in seizure incidence. Also, during the carbamazepine trial generalized epileptiform discharges activated by hyperventilation were more frequent in patients with a higher seizure incidence compared to subjects with a lower seizure incidence of patients taking phenytoin. No significant focal EEG changes occurred.

Adult↗
PubMed1978

A neuropsychological battery for epilepsy.

The development of the Neuropsychological Battery for Epilepsy is presented. The tests are designed to be helpful in the evaluation of adult epileptics. The battery consists of General Measures which include tests in the areas of intellectual functioning, emotional status, and lateral dominance. The development of a series of 16 Discriminative Measures is presented in detail through the discussion of a pilot study, the principal investigation, and a cross-validational effort. In the principal study, 50 epileptics were individually paired with individuals having no history of neurological disease, and their performances on a wide range of ability measures were compared. Tests were eliminated if they did not appear sensitive to the brain-related problems of epileptics, if they demonstrated excessive duplication with other measures, or if they did not cross-validate with a new sample of 25 epileptic--normal pairs. The advantages of the battery were discussed, including coverage of areas previously not adequately assessed, elimination of tests with limited utility, greater uniformity and accuracy in the classification of individual subjects, and standardization of the tests with epileptics.

Adult↗
PubMed1978

Neuropsychological correlates of the electroencephalogram in epileptics: III. Generalized nonepileptiform abnormalities.

A broad battery of neuropsychological tests was given to 111 adult epileptics treated primarily with phenytoin. The patients were grouped according to degree of generalized nonepileptiform EEG abnormalities in waking EEGs. In patients classified as None/Mild, Moderate, or Marked in terms of these EEG abnormalities performances on 15 neuropsychological measures were contrasted. Statistically significant differences across the groups were found on 13 of the 15 neuropsychological variables. An orderly decrease in performance occurred as a correlate of an increase in EEG abnormalities. These results were compared to a similar analysis of the correlates of topographic distribution of epileptiform discharges (Absent, Focal, Generalized). It was discovered that degrees of generalized slow wave EEG abnormalities were more potent in differentiating levels of neuropsychological performance than epileptiform discharges. Nevertheless, when discharges and degree of nonepileptiform abnormalities were simultaneously considered, a maximal level of correlation was reached.

Adolescent↗
PubMed1978

Neuropsychological correlates of anticonvulsants and epileptiform discharges in adult epileptics.

Neuropsychological correlates of anticonvulsants and of EEG epileptiform discharges were examined through the administration of neuropsychological measures to groups of adult epileptics. Among the anticonvulsants, performances with high and low serum phenytoin levels were compared and performances with sulthiame vs. phenytoin and carbamazepine vs. phenytoin were evaluated. Various drug effects from these studies were noted and there was some suggestion that the neuropsychological impacts of specific anticonvulsants may be selective rather than general. The neuropsychological correlates of the topographic distribution and average rate of occurrence of discharges were considered. Striking neuropsychological correlates were found with the poorest performances in connection with discharges which were generalized and those which were at a rate greater than 1/min. The importance of using a broad range of neuropsychological measures was stressed.

Adolescent↗
PubMed1977

Psychotropic effects of carbamazepine in epilepsy: a double-blind comparison with phenytoin.

The "psychotropic" effects of carbamazepine were evaluated with phenytoin (Dilantin) as reference agent in a counterbalanced, crossover study. Forty adult epileptics were given a series of neuropsychologic tests and the MMPI after 4 months on each agent. Most abilities were much the same with either anticonvulsant, but there were fewer errors with carbamazepine on mental tasks requiring attention and problem solving, and some improvement in emotional status was suggested. The findings were consistent with patient reports of improvement in alertness and mental functioning. These results combine with the excellent anticonvulsant properties of carbamazepine to support its use as an anticonvulsant.

Adult↗
PubMed1976

Seizures and adaptive abilities. A case of identical twins.

The effects of seizures on performance were investigated in a pair of identical twins who were concordant for incidence of epilepsy, but who had highly contrasting histories of seizure frequency. An evaluation of abilities focused on intelligence, academic achievement, neuropsychologic functions, and emotional and social adjustments. While both twins showed some disabilities, the twin with the larger number of seizures was less able in every area examined. The results suggest that the greater seizure frequency is related to the lesser abilities.

Adaptation, Psychological↗