ABSTRACT
The aim of our investigation was to identify frequencies and treatment quality of stroke risk factors in participants of a stroke prevention program in the province of Salzburg (Austria). A total of 9356 participants free of previous stroke were classified in three risk categories for suffering from ischemic stroke within the next 10 years and analyzed referring to history, therapy, and treatment quality of cerebrovascular risk factors. A total of 6519 (69.7%) participants were classified to be at low (<10%), 2232 (23.9%) at intermediate (10-20%) and 605 (6.5%) at high risk (>20%). Elevated blood pressure with the need for follow-up investigations was found in 5193 persons (55.5%); of 3713 (39.7%) persons with a history of hypertension, 3204 (86.3%) are under medical treatment, which is sufficient only in 765 patients (23.9%). Similar results were present for other well documented modifiable risk factors. In the investigated population there is high presence of stroke risk factors with inadequate treatment in most cases.
Subject(s)
Outcome Assessment, Health Care , Stroke/epidemiology , Stroke/prevention & control , Aged , Aged, 80 and over , Anticoagulants/therapeutic use , Atrial Fibrillation/complications , Atrial Fibrillation/epidemiology , Atrial Fibrillation/prevention & control , Austria/epidemiology , Blood Pressure/physiology , Coumarins/therapeutic use , Diabetes Mellitus/epidemiology , Diabetes Mellitus/prevention & control , Female , Follow-Up Studies , Humans , Hypertension/epidemiology , Hypertension/etiology , Hypertension/prevention & control , Male , Middle Aged , Prospective Studies , Risk Factors , Salicylic Acid/therapeutic use , Stroke/classificationABSTRACT
We report a patient with early infantile epileptic encephalopathy (EIEE) with suppression-burst (Ohtahara syndrome) associated with olivary-dentate dysplasia and agenesis of mamillary bodies is reported. Although those with Ohtahara syndrome are a heterogeneous group, virtually all reported cases are secondary to neuronal migrational disorders, sometimes only identified by detailed neuropathologic examination, as in this case report, which describes mamillary body agenesis as a not-yet-recognized anomaly associated with Ohtahara syndrome. All children with Ohtahara syndrome should have high-resolution magnetic resonance imaging (MRI) and detailed postmortem neuropathologic examinations.
Subject(s)
Cerebellar Nuclei/abnormalities , Epilepsy/diagnosis , Epilepsy/pathology , Mammillary Bodies/abnormalities , Olivary Nucleus/abnormalities , Cerebellar Nuclei/pathology , Cerebral Cortex/abnormalities , Cerebral Cortex/pathology , Electroencephalography/statistics & numerical data , Humans , Infant , Infant, Newborn , Magnetic Resonance Imaging/statistics & numerical data , Mammillary Bodies/pathology , Nervous System Malformations/diagnosis , Nervous System Malformations/pathology , Olivary Nucleus/pathology , Spasms, Infantile/diagnosis , Spasms, Infantile/pathology , Syndrome , Tomography, Emission-Computed, Single-Photon/statistics & numerical dataABSTRACT
We report two adults who received gabapentin (GBP) and subsequently developed behavioural side effects. Indications for GBP treatment were newly diagnosed epilepsy in one and painful paraesthesiae in the other. Both had no past history of psychiatric or behavioural disorder. Abnormal behaviour consisted of elevated mood, euphoria, and increased energy in both patients, and pressure of speech and decreased need for sleep in one of them. These symptoms were transient and fully reversible. One patient had to discontinue GBP. Behavioural changes were not related to seizure activity. They should be recognized as a possible side effect of GBP treatment in adults.
Subject(s)
Acetates/adverse effects , Affect/drug effects , Amines , Anticonvulsants/adverse effects , Chlamydia Infections/complications , Cyclohexanecarboxylic Acids , Encephalomyelitis/complications , Epilepsies, Partial/drug therapy , Paresthesia/drug therapy , gamma-Aminobutyric Acid , Adult , Chlamydia Infections/microbiology , Encephalomyelitis/microbiology , Female , Gabapentin , Humans , Paresthesia/etiology , Social Behavior Disorders/chemically induced , Treatment OutcomeABSTRACT
Stroke is an extremely frequent disorder and represents the third most frequent cause of death in industrial countries. It is associated with catastrophic sequelae not only for the patient but also for his family members, and imposes an enormous socioeconomic burden. The efficacy of treatment of modifiable risk factors in secondary prevention of stroke is beyond any doubt. Based on these experiences, a corresponding strategy for an efficient, economic, and low-risk primary prevention of stroke can be deduced, the efficacy of which again can not be seriously doubted.
Subject(s)
Stroke/epidemiology , Stroke/prevention & control , Austria/epidemiology , Government Programs , Health Education , Health Services Needs and Demand , Humans , Incidence , Mortality/trends , Prevalence , Risk Factors , Stroke/etiology , Stroke/mortalityABSTRACT
A case of complex partial status epilepticus (CPSE) with high dose treatment of tiagabine (TGB) is reported. Seizure aggravation and CPSE developed after stepwise increase of TGB to a dose of 60 mg per day as add-on treatment to carbamazepine (CBZ) 1200 mg/day and vigabatrine (VGB) 1000 mg/day. The EEG during CPSE showed bilateral rhythmic slow activity. Clinical symptoms of CPSE and the EEG normalized after i.v. treatment with clonazepam. The literature and the possible mechanism of this paradoxical phenomenon are discussed.
