ABSTRACT
Single fits and epileptic illness are more frequent in advanced age; their occurrence reaches the same frequency as in the neonatal period. Their origin and the possibilities of treatment are tightly connected to the process of ageing, a fact that requires special consideration. The main reasons for new epileptic attacks in the group of age 65 or more are structural changes, i.e. ischemic infarctions, tumors and atrophic involution. For certain patients, the use of antiepileptic drugs may be limited by unavoidable side effects. Complete cure of the attacks in advanced age is rare, but with a well selected treatment sufficient control is often possible.
Subject(s)
Aging/physiology , Anticonvulsants/therapeutic use , Epilepsy/physiopathology , Aged , Anticonvulsants/adverse effects , Brain Diseases/physiopathology , Epilepsy/drug therapy , Epilepsy/epidemiology , Humans , Incidence , Middle Aged , PrevalenceABSTRACT
A 51-year-old Italian woman developed migraine-like headaches with increasing frequency 5 years after menopause. The simultaneous onset of severe bilateral uveitis, neurological signs such as vertigo, hearing loss, small sensomotor hemisyndrome, cognitive brain dysfunction and lymphocyte liquor pleocytosis confirmed the diagnosis of Vogt-Koyanagi-Harada syndrome, a rare disease of probably autoimmune origin with destruction of pigment containing neuroepithelium. Other vasculitic diseases, especially those of infectious or rheumatologic origin, were excluded. Systemic corticoid treatment suppressed the activity of the illness but on dose reduction relapses occurred. Additional immunosuppressive medication prevented uveitic relapses and made it possible to reduce the corticoid dose.
Subject(s)
Uveomeningoencephalitic Syndrome/diagnosis , Cyclophosphamide/administration & dosage , Diagnosis, Differential , Drug Therapy, Combination , Female , Humans , Middle Aged , Prednisone/administration & dosage , Uveitis/diagnosis , Uveomeningoencephalitic Syndrome/drug therapyABSTRACT
A 20-year-old Turkish patient presented with superior sagittal sinus thrombosis which led to the final diagnosis of Behçet's disease. The frequency of cerebral venous thrombosis is generally underestimated and may be the first clinical manifestation of Behçet's disease. Uveitis as a main diagnostic criterion of Behçet's disease may be absent, especially in young men. In cases of intracranial hypertension, cerebral venous thrombosis and Behçet's disease should be taken into consideration, especially in a high risk population from eastern Mediterranean countries and Japanese islands. Treatment with early anticoagulation in cerebral venous thrombosis, and corticosteroid-pulse therapy in active Behçet's disease, seems to be established today. As a basic therapy of Behçet's disease cyclosporin A and the classic immunosuppressive agents, especially azathioprine, are available. Clinical course and prognosis in cerebral venous thrombosis are generally both benign, provided that adequate management is started in time.
