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Biomedical subjects

M Espir

Publications and source records attributed to M Espir.

13 recordsLinked to original sources

Paroxysmal tinnitus due to a meningioma in the cerebellopontine angle.

A 44 year old woman presented with frequent paroxysms of unilateral tinnitus and ataxia which were abolished by treatment with carbamazepine. Hearing was normal and initially there were no other symptoms or signs between paroxysms. Brain stem evoked responses from the affected left ear were absent and MRI showed a large tumour in the left cerebellopontine angle. This was completely removed and histologically proved to be a meningioma. There were striking similarities to trigeminal neuralgia and other paroxysmal brain stem symptoms which occasionally occur in multiple sclerosis and diseases of the cerebellopontine angle. Possible mechanisms are discussed.

Analgesics, Non-Narcotic↗

Occupational aspects of epilepsy in the civil service.

Eighty five civil servants with epilepsy who were referred to the Civil Service Occupational Health Service over an 18 month period formed the study population. The reasons for these referrals and their outcomes have been analysed. The main reasons for referral were prolonged or frequent sickness absence, unsatisfactory work performance, epilepsy starting during employment, the discovery of undisclosed epilepsy, and for advice on working conditions. In 30 the outcome was medical retirement, although in only 15 was this due to epilepsy alone. Of the other 15, medical retirement was necessary in four because of the combination of epilepsy with another medical disorder, and in 11 because of a coincidental condition unrelated to their epilepsy. Only six out of 15 referred on account of epilepsy related sickness absence, and none of the 14 referrals due to epilepsy related unsatisfactory work performance resulted in early retirement. This reflected the invaluable role that the occupational physicians had in recognising where problems were due to poor control of the epilepsy or to the side effects of the antiepileptic medication and in arranging through general practitioners or hospital doctors for appropriate adjustment of the drug regimen. Nine of the 22 subjects who developed epilepsy during employment, however, were retired on medical grounds.

Absenteeism↗

The management of epilepsy at work.

This paper examines the way in which health problems, resulting from epilepsy, are managed in one large organisation, the British Civil Service. The part played by stress in precipitating epileptic seizures is first of all considered. This leads on to a discussion of the problems of finding a medical regime that, on the one hand, prevents epileptic attacks at work and, on the other, does not result in side effects that adversely affect work performance. The importance of social support is also stressed. The paper concludes by highlighting the need to improve the process whereby information on the requirements of a job are related to information on an individual's epilepsy, in order to determine the risk of their having, or causing, an accident at work.

Accidents, Occupational↗

The framework of medical care for epilepsy.

In this article, the range of medical and other specialized services for epilepsy are reviewed. The objectives are outlined and the present shortcomings are highlighted. Suggestions are made for improvements and in particular we draw attention to the need and place for the development of epilepsy clinics for patients whose epilepsy poses continuing problems. Services for epilepsy have been reviewed in various government sponsored reports over a number of years. The latest is a wide ranging review with specific recommendations for improvements. In this paper, we describe the overall framework of case required to deal with epilepsy, emphasizing particularly the problems of chronic uncontrolled epilepsy and incorporating suggestions made in the recent report.

Epilepsy↗

Epilepsy and oral contraception.

A controlled cross-over trial in 20 epileptic women, receiving regular anticonvulsant therapy showed that an oral contraceptive with a low oestrogen/ progestogen content had no significant effect on the average frequency of fits compared with identical dummy tablets.

Adolescent↗