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PubMed1971

Nosology of epilepsy: some comments on the problem.

In the classification of epilepsy, there is no uniform system which can successfully combine consideration of seizure type, etiology, anatomic substrate and other factors such as circumstances of occurrence, age and the electroencephalogram. The most logical system is seen to be similar to that proposed by an international committee. In such a system each observational set of data is classified in accordance with its own characteristics, and correlations made between data obtained by different means of observation.

Adolescent↗
PubMed1970

[Clinical and electroencephalographic findings in subdural effusions (report of 17 cases)].

The author gives an account of 17 children aged 1 month to 1;1 years, in whom uni- or bilateral subdural effusions had occurred. Etiologically, toxicoses due to infantile enteritides were made responsible in 5 cases, pneumococcic meningitides in 3 cases, and encephalitides in 3 cases. For 6 children it was not possible to obtain clear etiological results. It is emphasized that subdural effusions subsequent to toxicoses are perhaps a more frequent occurrence than has been believed heretofore. The clinical symptomatology of subdural fluid accumulations, which is described in the literature, failed to be observed in nearly all cases. E. E. G. derivations were particularly indicated under such diagnoses as propulsive petit mal and grand mal epilepsies. Electroencephalographically, the leading characteristic symptom in 13 cases was a uni- or bilateral reduction of potentials. The derivation thus provided for an almost pathognomonic interpretation. However, by reference to the electroencephalograms of 4 other children it is possible to demonstrate that, in agreement with the information and data given in the literature, it is not possible to obtain any reliable indications of subdural accumulations of fluid. Therefore, in case of doubt one should not dispense with a test puncture of the fontanel even in case of nonspecific E. E. G. variations.

Dominance, Cerebral↗
PubMed1970

[Experiences with surgical therapy of epilepsy in children].

A group of 15 children aged 13 months to 15 years and operated upon for focal epilepsy has been analyzed. Hemispherectomy was performed in 3 cases, lobectomy in 6 cases, and cortical excision of different extents in another 6 cases. Within a period of 5 months to 7 years from the surgical intervention 60% of the patients were practically restored to health, 20% improved, and 20% virtually unimproved. The authors discuss the problems of indication in connection with age as well as the therapeutical failures. In cases where conservative therapy failed the intervention prevented the epileptic process from encroaching upon the centrencephalic system. It is essential that the intervention be made before the occurrence of irreversible psychic changes, as these may then no longer be influenced by the intervention. There are no age limits to a surgical intervention. An accurate analysis of the functional capability of the brain tissue is absolutely necessary; what is also important, however, is specific care, in order to avoid postoperative complications.

Adolescent↗