Demonstration of primary cytotoxic T cells in venous blood and cerebrospinal fluid of children with mumps meningitis.

Cryopreserved lymphocytes from venous blood and cerebrospinal fluid (CSF) of 10 children with mumps meningitis were tested in 5-hr 51Cr-release assays against uninfected and mumps virus-infected PHA-blasts. Lymphocytes from all patients were cytotoxic to autologous mumps virus-infected target cells, but completely failed to lyse histoincompatible virus-infected PHA-blasts. Cytotoxicity was specific for the infecting virus, and was mediated by E rosette-forming lymphocytes. The effector cells were present over 2 to 3 wk after onset of meningitis. Mumps viral antigens appeared to be preferentially recognized in association with HLA B determinants. The results show that specifically sensitized cytotoxic T cells (CTL) are induced in patients with mumps meningitis. These cells circulate in venous blood and are locally enriched in CSF. Based on clinical observations, it is proposed that mumps-specific CTL play an immunopathologic role.

[Prognosis and therapy of sporadic seizures (author's transl)]. / Prognose und Therapie sporadischer Anfälle.

Eighty-five patients were admitted to the hospital under the preliminary diagnosis of epileptic seizures. None of them had more than five seizures before admission. Sixty-five of these 85 patients had a neurological and electroencephalographic follow-up examination 5 to 7 years later. Another 8 had been readmitted before. From these 8 the diagnosis of cerebral tumor was made in 3 patients. In almost half of the remaining 70 cases the etiology of seizures remained uncertain. The leading known etiologic factors were chronic alcoholism, head injury and perinatal brain damage. Before admission seizures recurred once or twice a year in most patients. After discharge from the hospital 25 patients were without further seizures, 15 of the seizure-free group never received anti-epileptic treatment. The remaining 10 were without medication for a period of time before the follow-up. All seizure-free patients were given the diagnosis of very rare grand mal seizures or seizures of uncertain origin. Only two of the untreated group (total of 17) had seizures after discharge. These findings show that recurrence of seizures was predictable, when patients were discharged. Predictors of recurrance were "treatment" or "no treatment" given initially. Antiepileptic medication should be given in cases of one seizure or more a year, when epileptic origin is certain. Very rare seizures and seizures of uncertain origin may stay without antiepileptic treatment. Sporadic seizures are benign in most cases - comparable to seizures of late onset. Both groups overlap.