ABSTRACT
Disturbances of and difficulties in psychosocial adaptation were analysed in 63 epileptics (with generalized convulsions and partial complex seizures) and in 31 subjects without diseases of the central nervous system (control group). The disturbances of adaptation were not more frequent in epileptics than in controls. On the other hand, it was observed that patients with partial complex seizures constituted a group non-homologous with respect to the degree of difficulties in functioning (disturbances and difficulties) which was probably due to their greater dependence on the conditions of realization of their psychosocial needs in relation to healthy subjects and patients with generalized seizures.
Subject(s)
Adaptation, Psychological , Epilepsy/psychology , Social Adjustment , Adolescent , Adult , Anxiety Disorders/epidemiology , Attitude , Epilepsy/rehabilitation , Family , Humans , Middle Aged , Work Capacity EvaluationABSTRACT
The intensity of perseveration was tested in 70 patients with generalized convulsive seizures and with partial seizures of complex symptomatology, and in 37 subjects without central nervous system diseases (controls). The results suggest that the tendency for perseveration is a feature occurring not only in epilepsy but also in healthy subjects (probably of constitutional character); the disease process responsible for epileptic seizures can intensity this feature in a degree depending on its duration.
Subject(s)
Epilepsy/psychology , Habituation, Psychophysiologic , Seizures/psychology , Adolescent , Adult , Cattell Personality Factor Questionnaire , Female , Humans , Male , Middle Aged , Time FactorsABSTRACT
Depakine Labaz in doses from 30 to 1200 mg daily was given to 52 patients in an outpatient clinic. In 13% of cases symptoms of drug intolerance developed and the treatment had to be discontinued. In 45 cases treatment was continued. The drug was given usually to patients refractory to previous drugs, with evidence of organic brain disease. The highest degree of clinical improvement was observed in patients with grand mal seizures and seizures without convulsions. The influence of this treatment of partial complex seizures was slightly smaller. The number of patients treated was too small for evaluation of the effects in partial simple seizures. The total proportion of improved patients was about 60%. In EEG curves normalization of background activity was the most frequent findings, without appearance of rapid activity. In some cases manifestation of focal changes was observed. The favourable effect of Depakine on seizure activity manifested itself in later period of treatment and was slight. The drug had a favourable effect on the wellbeing of patients and had no significant toxic effect in the liver or kidneys.
Subject(s)
Epilepsy/drug therapy , Valproic Acid/therapeutic use , Administration, Oral , Adolescent , Adult , Drug Evaluation , Drug Tolerance , Female , Humans , Male , Middle AgedABSTRACT
A study of the paroxysmal activities in the course of all night sleep was carried out on 6 children aged 6 to 12 years, who were previously recored by means of biotelemtry during the day (cf. Findji et al. 1978). The discharges were analysed and quantified in the same way as in daytime but here in relation to the organization of sleep. The latter shows serious disturbances by comparison with normal children or children who only have sleep problems. The global quantifications (average densities of discharges per stage) do not, in our population, evidence any effect of facilitation or diminution which would be specific to a given stage. Comparison of the chronological evolutions of the densities of paroxysmal activities with the different stages of sleep shows that the connections between these phenomena can be either nil, or very close, according to the subject, and in one case, according to the time of night. This raises the problem of the heterogeneity of the 'states' gathered under the same codification of stages and shows the multiplicity of factors which can interfere with the modulation of the discharges, even during sleep. The analysis of long duration day or night records underlines the extreme complexity of the temporal organization of paroxysmal discharges, in which both hypotheses formulated at the beginning of this study seem to find partial support: internal modulation connected to more or less stable biological rhythms, and the role of environmental factors and the subject's reactions, which more or less mask the intrinsic rhythms.
Subject(s)
Electroencephalography , Sleep Stages , Spasms, Infantile/physiopathology , Child , Humans , Sleep Stages/physiologyABSTRACT
The temporal organisation of infra-clinical paroxysmal discharges was recorded in waking children using biotelemetry. This was studied in terms of two hypotheses: firstly regulation of discharges by an "internal clock" which would explain their periodic modulation; secondly the influence of certain induced or spontaneous psychophysiological situation which could increase or decrease their density. By statistical analysis using semi-automatic programmes, the density of paroxysmal discharges was studied for each experimental situation; the chronological evolution of density was also worked out. These programmes were applied to 6 long biotelemetric recordings. The results obtained show that neither of the hypotheses alone can explain the phenomena observed, and that the paroxysmal discharges probably occur at times determined by a combination of internal factors and multiple situations: modulation linked to more or less stable biological rhythms, and the role of the environment and the subjects' reactions, which intervene to a varying extent to mask natural rhythms.
Subject(s)
Electroencephalography , Child , Humans , Periodicity , Telemetry , Wakefulness/physiologyABSTRACT
Three biotelemetric examinations and a whole night sleep recording were carried out in a 8 year old child whose behavior alternated between exicitation and autism. The E.E.G. showed 5 Hz. temporo-parietal sharp wave discharges lasting from 1 second to 20 minutes. These discharges were at times unilateral and predominantly right sided, at other times being bilateral without clinical signs and unrelated to changes in behavior. The possibility of internal regulation of discharge of discharge production or their dependence on induced situations or psychophysiological states is considered.
Subject(s)
Autistic Disorder/physiopathology , Electroencephalography , Sleep , Child , Humans , Male , TelemetryABSTRACT
Treatment with Rivotril in doses of 2-10 mg daily was given to 26 patients with various forms of epilepsy, mostly refractory to previous treatment. In 2 cases the drug was withdrawn on account of intolerance, in 4 cases treatment was stopped after several days in view of greatly increased frequency of seizures. In the remaining cases the drug was administered during 2 to 27 months, (mean 7 months) in 3 cases as the only medication and in 17 with other anticonvulsants. The best therapeutic results were obtained in patients with partial seizures of complex symptomatology and in generalized non-convulsive seizures, the worst results in generalized seizures. Electroencephalographic findings included particularly disappearance of seizure activity, while focal changes persisted and even grew worse in some cases. Apart from 2 cases of acute intolerance in another 4 cases side effects were observed with somnolence, dizziness, equilibrium disturbances, and in one case granulocytopenia developed. Allergic changes and liver or renal damage were never observed. The authors suggest introduction of the drug in treatment of epilepsy in view of its favourable clinical effect even in cases refractory to previous treatment, especially since the drug is relatively well tolerated.
Subject(s)
Benzodiazepinones/therapeutic use , Clonazepam/therapeutic use , Epilepsy/drug therapy , Administration, Oral , Adolescent , Adult , Child , Child, Preschool , Chronic Disease , Clonazepam/administration & dosage , Drug Evaluation , Electroencephalography , Female , Humans , Injections, Intravenous , Male , Time FactorsABSTRACT
Sixty polygraphic all-night sleep tracings were obtained, including 40 from 20 patients with epileptic attacks occurring during sleep (during treatment with anticonvulsants and after their withdrawal), and 10 tracings in each of two groups serving as controls: a group of patients with seizures occurring in the waking state and a group of healthy controls. A significant difference was observed in the sleep pattern of the patients with nocturnal attacks (who were good sleepers and received no anticonvulsants) and healthy controls. These patients had a significantly higher proportion of III + IV stages of the slow-wave sleep phase. Besides that, in all epileptics disruption and lability of the REM phase was observed, without a statistically significant reduction in the proportion of its duration during the whole sleep. Clinical seizures developed usually in the SW phase but one seizure occurred during the REM phase. The effects of anticonvulsants on sleep EEG tracings require further investigation. A significant difference was observed in the morphology and dynamics of EEG changes in both groups of epileptics. The patients with nocturnal attacks had much more frequently normal tracings in the waking state. During sleep focal changes were often found. Seizure activity of the spike-wave type was less frequent than in patients with waking attacks and the dynamics of this activity were different. It seems possible that the pathways of spread of epileptic discharges are different in these two groups of epileptics.
Subject(s)
Epilepsy/physiopathology , Sleep , Adolescent , Adult , Anticonvulsants/pharmacology , Child , Female , Humans , Male , Middle Aged , Sleep/drug effects , Sleep Stages , Sleep, REM , WakefulnessABSTRACT
Benzonal was given to 52 epileptics. In 50 cases the duration of treatment ranged from 3 months to 7 years (mean 18 months) in doses of 100-500 mg daily, in 2 cases it had to be withdrawn after a short-term treatment because of intolerance. In all cases the drug was given together with other anticonvulsants: hydantoin, derivatives, mysodin, Tegretol, pheneturid or Ospolot in place of previously administered phenobarbital. It was found that benzonal reduced significantly the frequency of partial simple seizures (in 6 out of 20 cases) and grand mal seizures (in 24 out of 34 cases), while its action on the partial complex seizures was much weaker (improvement in only 7 out of 20 cases). The drug was usually well tolerated, side effects of greater intensity developed in 2 cases only, transient somnolence was observed in another 6 cases. In EEG records a slight favourable effect was exerted on pathological background activity with absent effect in focal changes and increase of seizure activity. The authors believe that in view of its favourable clinical action and good tolerance the drug may be widely used in properly selected cases of epilepsy.
