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PubMed1980

Clinical experience with sodium valproate in children.

Good control was achieved with sodium valproate (Epilim) in 44 (71%) of a sample of 62 children with severe recurrent epileptic seizures. The medication was most effective in the control of petit mal; good results, however, were also achieved in some patients with previously poorly controlled grand mal epilepsy and psychomotor and myoclonic seizures. Twenty children required no other anti-convulsant and 28 required only one other. Side-effects were infrequent and mild. Only the high cost of sodium valproate in South Africa precludes its more general use in childhood epilepsy.

Adolescent↗
PubMed1980

[Functional relationship between central and peripheal motor signals. Use of averaging methods in epileptic problems (author's transl)].

For epileptic seizures with low-frequent and mild myoclinic components the existence of correlations between myoclonic and electroencephalographic activity is investigated. The method used is comparable to the evoked potential technique. The summation procedure is triggered by the occurrence of a pre-defined pattern in the peripheral recordings (EMG or acceletrometer) rather than by an external stimulus: 'Jerk-locked averaging' (JLA). Due to the small number of events it is necessary to control the validity of the results. For this aim, confidence intervals for the average signals are calculated. In three cases EEG-correlates have been found two of them showing spike-wave complexes in the EEG. The latency between the first positive spike and myoclonic activity was 12-14 ms and 22 ms, respectively. In the third case no spike pattern is found. JLA, however, shows a phase-locked relation between EEG and muscle activity. In order to interpret the findings different models of neuronal pathways are discussed. According to other studies a latency of 22 ms fits in with the concept of pyramidal activation, whereas latencies smaller than 15 ms are supposed to have subcortical origin spreading simultaneously toward cortex and subcortical efferent structures.

Adolescent↗
PubMed1980

[Radiotelemetric EEG and EKG studies of epilepsy patients].

In 17 epileptic patients the EEGs and ECGs were recorded in clinical conditions using a 7-channel bioradiotelemetric system designed at the Sverdlovsk Institute of National Economy. The recording was performed under various physical, mental, and emotional loads, as well as during the seizures. This method of examination made it possible to specify in a number of cases the localization of the pathological focus, to differentiate the forms of unconscious motions, to disclose a number of the factors provoking or inhibiting the pathological activity of the brain.

Brain↗
PubMed1980

[Serum anticonvulsant levels in therapy-resistant epileptics].

The continuous occurrence of particularly severe epileptic attacks represent a great stress for the patients. For this reason, we have conducted anticonvulsant blood-level studies particularly in these patients, this paper being based on 146 first determinations. Among the patients, most of whom are adults and are treated with combinations of drugs, only 24 per cent reached the assumed normal phenytoin range while 69 per cent remained below it. With the administration of phenobarbital, however, 50 per cent reached the therapeutic range and only 14 per cent reached the lower limiting value. It is only i the last-mentioned group that we assumed primarily an insufficient intake of the drugs while with DPH the problems of the determination of the plasma water range had to be discussed. In practice, blood level determinations have their special value for the detection of the intake of a wrong dosage of the drugs as well as bland anticonvulsant intoxications.

Adult↗
PubMed1980

[Epilepsy].

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Adult↗
PubMed1980

[Convulsions after whooping-cough vaccination].

Convulsions or status epilepticus in 11 infants after pertussis vaccination are reported. In 3 cases grand mal epilepsy persisted and 2 children developed infantile epileptic encephalopathy (Lennox syndrome). On the basis of our own experience, the incidence of seizures approximates 1:4800 infants vaccinated or 1:12 800 vaccinations. According to a recent prospective study from the USA, the incidence of seizures may be closer to 1:600 infants. Since there is a significant difference between the incidence of spontaneous fits in children of the same age group and the incidence after vaccination, a causal relationship between the seizures and vaccination appears to be confirmed. The following conclusions are drawn from these observations: 1. In view of the usually benign course of whooping cough today, current vaccination against pertussis is hardly satisfactory. Improvement of the available vaccines is an urgent necessity. The protection should include the population most at risk, i.e. infants during the first few months of life. 2. Parents should be better informed about the risks involved in pertussis vaccination. 3. Booster inoculations should be abandoned. 4. Health authorities should decide whether the current pertussis vaccination program should be continued. 5. Complications following vaccination should be registered at a national centre.

Adolescent↗
PubMed1981

[So-called intermediate forms of epileptic attacks - etiopathogenic, clinico-electrocencephalographic and therapeutic aspects].

Intermediate forms of epileptic attacks almost exclusively begin in child age. As a rule, the clinical picture shows partial attacks and electroencephalographically generalised activity. Epileptic predisposition and possibilities of exogenous damage are present in an equally high degree. In some cases, there are a large number of psychic pecularities, combination with tonoclonic attacks and therapy resistance. Sometimes asymmetry of the paroxysmal activity, focal peak potentials, varying findings in observation over a period of some years are found in the electroenzephalogram. Among our own patients there were 20 such intermediate forms among a total of 141 epileptics.

Adolescent↗
PubMed1982

[Study on the constancy of EEG characteristics in epileptic patients (author's transl)].

These investigations were based on the question regarding the reliability of a single EEG recording in patients with epilepsy. 114 patients patients (age 11-74 years, median 33 years) underwent five EEGs at an interval of three months during a period of one year. A "constant" characteristic was a continuously developed dysrhythmia. "Moderately constant" was an intermittent dysrhythmia, an alpha background activity and a general slowing of the background activity. "Inconstant" was a "parenrhythmia" and focal disturbances as well as epileptiform patterns. Similarly inconstant was the lateralization of epileptiform patterns. The lateralization of focal disturbances and a dysrhythmia was moderately constant. The great constancy of a continuously developed dysrhythmia makes it hardly suitable for a functional follow-up. The applications of epileptiform patterns and focal disturbances for therapy planning is, however, limited due to their inconstancy. Because of its moderate constancy the background activity (in different recordings) is a suitable indicator for an overdosage of antiepileptic drugs.

Adolescent↗
PubMed1982

[A situational psychological look at epileptic seizures].

Seven cases who developed paroxysm during adolescence and/or in a special situation were selected and subjected for studies of the existing pattern of the patients and also of the paroxysmal situation in relation to their individual life history. (1) "Schlafepilepsie" and psychomotor seizure were identified as being the pattern of epilepsy that developed exceedingly in a situational dependent fashion. (2) An intensive linkage between the patients and their parents was observed. (3) A forced separation from their parents allows to radicalize their conflicts. (4) Their existence is compounded further by the situation where their intrinsic order is compelled to change, and control of themselves becomes difficult to maintain. (5) This process permits the revelation of a latent process of epilepsy.

Adolescent↗