Mean daily plasma concentrations of beta-endorphin, leu-enkephalin, ACTH, cortisol, and DHEAS in epileptic patients with complex partial seizures evolving to generalized tonic-clonic seizures.

INTRODUCTION: A multitude of mechanisms have been implicated in the pathophysiology of epilepsy. OBJECTIVE: To assess mean daily plasma concentrations of ACTH, cortisol, DHEAS, leu-enkephalin, and beta-endorphin in epileptic patients with complex partial seizures evolving to tonic-clonic in relation to frequency of seizure occurrence (groups with seizure occurrences - several per week and several per year) and duration of the disease (groups less than and more than 10 years). We decided to analyse mean daily values of beta-endorphin and leu-enkephalin because of significant differences in concentrations of these substances in blood during the day. MATERIAL AND METHODS: The study was performed on 17 patients (14 males + 3 females; mean age 31.8 yrs) treated with carbamazepine (300-1800 mg/day). The control group consisted of six age-matched healthy volunteers. Blood was collected at 8 a.m., 2 p.m., 8 p.m., and 2 a.m. Intergroup analysis was performed with the use of ANOVA Kruskal-Wallis test. RESULTS: Mean daily concentrations of ACTH and cortisol in the blood of the patients with epilepsy were higher in comparison with those of the healthy volunteers, independently of the frequency of seizures and duration of the disease. Mean daily concentrations of beta-endorphin in the blood of the patients with epilepsy were higher in the groups of patients with more severe clinical course of disease (with more frequently occurring epilepsy seizures and longer duration of the disease) in comparison with healthy subjects. Mean daily concentrations of leu-enkephalin in the blood of the patients with epilepsy were higher in the group of patients with short duration of the disease in comparison with the group with long duration of the disease. CONCLUSIONS: 1. Pituitary-adrenal axis hyperactivity is observed in patients with clinically active epilepsy, independently of the frequency of seizures and duration of the disease. 2. Changes in endogenous opioid system activity are related to the clinical activity of epilepsy - beta-endorphin concentrations are connected with frequency of seizures and duration of the disease and leu-enkephalin concentrations with duration of the disease. 3. Endogenous opioid peptides might take part in the neurochemical mechanism of human epilepsy. (Pol J Endocrinol 2010; 61 (1): 103-110).

[Atypical clinical presentation of pseudohypoparathyroidism coexisting with autoimmune disorders]. / Nietypowy obraz kliniczny rzekomej niedoczynnosci przytarczyc wspólistniejacej z chorobami autoimmunologicznymi.

Pseudohypoparathyroidism includes a genotypically diverse group of syndromes that resembles primary hypoparathyroidism but is caused by primary resistance to parathormone. Several variants of pseudohypoparathyroidism have been identified, and pseudohypoparathyroidism type 1a is the best understood form of the disease. In many but not all patients, the disease results from heterozygous inactivating mutations of Gs a, the alpha-subunit of the heterotrimeric stimulatory G-protein. In this article, we describe the case of a 51-year-old male with clinical picture of atypical pseudohypoparathyroidism. The coexistence of this disorder with chronic thyroiditis and pernicious anemia suggested that autoimmune processes were involved in the mechanism of resistance to parathormone in this patient.

[Guillain-Barré syndrome with central nervous system symptoms. Report of two cases]. / Zespól Guillaina-Barrégo z objawami z osrodkowego ukladu nerwowego. Opis dwóch przypadków.

Guillain-Barré syndrome - acute inflammatory demyelinating polyradiculoneuropathy - is characterized by symmetrical flaccid paresis of limbs and areflexia or hyporeflexia which progress over a few days, up to 4 weeks. The central nervous system lesion is rarely reported in the course or treatment of the disease. In the paper two cases of patients with diagnosed Guillain-Barré syndrome with the central nervous system manifestations were discussed. A case of a 55-year-old woman was presented, who during hospitalization, on the last day of intravenous immunoglobulin therapy developed a hallucinatory syndrome. Furthermore, a case of a 18-year-old female patient with classic features of Guillain-Barré syndrome was described, because of its atypical initial presentation (headache, drowsiness and meningismus).

[Increased cerebrovascular reactivity and risk factors for ischaemic stroke in patients with inadequate circulation in the posterior circle of Willis]. / Reaktywnosc naczyn mózgowych a czynniki ryzyka udaru niedokrwiennego u chorych z niedostatecznoscia krazenia w tetnicach tylnej czesci kola Willisa.

UNLABELLED: Since ischaemic stroke (IS) is very widespread, a rapid development of ultrasound diagnostic techniques searching the relationship between cerebral circulation efficiency and pathophysiology of ischemic lesions is observed. The aim of our study was to evaluate blood flow velocity (BFV) and cerebrovascular reactivity (CVR) of some anterior circulation arteries (MCA) and posterior circulation arteries (PCA, VA) in relation of IS risk factors in patients with posterior circulation insufficiency. MATERIAL AND METHODS: The study group consisted of 40 patients (13 female, 27 male) of mean age 56.9 +/- 12.9 yr. Neurological examination, brain CT and TCD were performed in each patient. All patients underwent TCD examination including evaluation BFV of both MCA's, PCA's and VA's using TC 2020 Pioneer (EME). Control group consisted of 22 healthy volunteers of mean age 59.6 +/- 6.3 yr. RESULTS AND CONCLUSIONS: BFV and CVR of MCA, PCA, VA in examined patients were similar compared to controls. CVR of MCA's were not significant different compared to CVR of PCA's and VA's. Impaired CVR may be connected with ischaemic heart disease and TIA, while coexisting arterial hypertension may cause increased CVR.

[Evaluation of blood flow velocity and cerebrovascular reactivity in patient with posterior circulation stroke]. / Ocena przeplywu krwi i reaktywnosci tetnic mózgowych u chorych z udarem niedokrwiennym w obszarze unaczynienia tylnej czesci kola tetniczego willisa. Doniesienie wstepne.

UNLABELLED: The aim of our study was to determine the type of blood flow disturbances and cerebrovascular reactivity of major anterior and posterior circulation cerebral vessels in patients with posterior stroke (POCI). The examined group consisted of 17 patients, mean age 57 +/- 12 yr, with posterior circulation infarct. Neurological examination, brain CT and Doppler examination including evaluation of BFV and CVR of MCA, PCA and VA was performed in each patient. Doppler examination was done using Pioneer TC 2020 and capnograph Tidal Wave sp Novametrix. RESULTS: BFV of ICA's, MCA's, ACA's and PCA's were diminished while BFV of VA's were significantly diminished in the examined patients compared to healthy controls. CVR of MCA in posterior circulation stroke patients was significantly lower compared to controls. CVR of PCA and VA was significantly lower compared to CVR of MCA in patients with posterior circulation stroke. CONCLUSION: Impairment of CVR, especially in posterior circulation, plays an important role in posterior circulation stroke pathogenesis.