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[Psychiatric syndromes in epilepsy. Case contribution].

The Authors have taken into consideration the psychiatric disorders during epilepsy and subdivide them in: behavioural disorders, epileptic deterioration, Petit Mal status and epileptic psychoses. Epileptic psychoses have been divided in: episodic (confusional and disthymic) and chronic (syndromes where ideation troubles and schizophrenic syndromes prevail). On the basis of a nosographic approach the Authors consider the possibility to relate the latter to epilepsy, while for others the association of two diseases has probably taken place. The Authors agree with the assumption that the epileptic psychosis is the result of a multifactorial activity finally resulting in a real disorder at the level of the temporo-limbic structures, such activity is not always revealed by surface EEG.

Adolescent↗
PubMed1983

Social functioning and seizure status of young adults with onset of epilepsy in childhood. An epidemiological 20-year follow-up study.

The purpose of the present study was to examine the prognosis for epilepsy with a childhood onset by means of a follow-up study with a twenty-year follow-up period. Special attention was paid to the seizure outcome, the acquirement of basic and vocational education, working ability and actual working, social functioning, social adjustment and mortality. The study dealt with patients from a specified area in southwestern Finland who were initially under 16 years of age and who had had recurrent, non-sporadic seizures not caused by an acute infection or a progressive cerebral disease. The original series consisted of 245 patients, followed up retrospectively for approximately ten years. Extreme efforts were made to obtain as large a body of data on the patients and their epilepsy as possible. All patients were then examined clinically and by EEG by the present author personally. This took place in 1972. The first prospective follow-up evaluation was carried out in 1977 and the second in 1982. The method used in these two follow-ups was that of a mail inquiry. By 1982, 29 patients had died, ten were not reached and two refused to participate. The group studied in 1982 consisted of the remaining 204 patients. The shortest follow-up period was 17 years (mean 21.16 +/- 24 years). At the end of the follow-up the age of the youngest was 17 years and that of the oldest 34 years (mean 24.74 +/- 0.33 years). The data obtained on the patients were computerized, and multivariate methods of analysis were applied in addition to usual statistical methods. The seizure outcome was considered good if three years or more had elapsed from the last seizure. In 1982 such patients accounted for 60% of all cases. Stepwise logistic regression analysis showed that good seizure outcome is best explained by the occurrence of one seizure type only and good short-term treatment outcome. The nonoccurrence of status epilepticus, normal psychoneurological development status and the occurrence of grand mal only also contributed to the explanation. These variables predict the disappearance of seizures with a 95-100% probability. Normal compulsory basic education had been completed by 60% of the patients. Only two variables, good short-term treatment outcome and late age (preschool or school age) at onset of epilepsy, contributed to the explanation of this outcome. It appeared from logistic regression analysis that all those who had a normal psychoneurological development status had completed compulsory education.(ABSTRACT TRUNCATED AT 400 WORDS)

Achievement↗
PubMed1984

[Clinical and electroencephalographic features of the action of the psychic stimulant sydnocarb in various forms of epilepsy].

The qualitative and quantitative values of the baseline EEG differed significantly in patients with primarily generalized epilepsy and temporal epilepsy. The administration of anticonvulsants (phenobarbital, finlepsin) leads to a considerable clinical effect and a decrease in the values of the integrated EEG in the functional states studied in conscious subjects. Additional inclusion of sydnocarb into the multimodality treatment results in the intensification of the therapeutic response in patients with petit mal epilepsy which is accompanied by EEG desynchronization, whereas in temporal epilepsy with psychomotor paroxysms, sydnocarb addition produces an opposite effect.

Anticonvulsants↗
PubMed1980

Problems in family practice: Seizure disorders.

The current seizure classification recognizes two major categories, partial (focal) and generalized. Sublcasses of this system are determined by clinical and electroencephalographic manifestations of the seizures. Neonatal seizures are difficult to recognize and classify but require prompt and appropriate treatment for best results. Infantile spasms are important to recognize because of their grave prognosis and because they respond to steroid medications but not standard anticonvulsants. Febrile convulsions represent a continuing treatment controversy but have a good prognosis. The diagnosis of epilepsy is based on clinical history. Laboratory studies help classify the type of seizure and identify the etiology. The computerized tomography (CT) scan has simplified diagnostic evaluation. The extent of the evaluation must be adjusted to meet individual requirements. The choice of anticonvulsant is dependent on seizure type as well as the side effects and cost of the drug. Anticonvulsants have potential side effects which can be minimized by judicious dosage adjustments utilizing serum anticonvulsant levels when appropriate.

Adolescent↗