Overview of oxidative stress findings in hepatic encephalopathy: From cellular and ammonium-based animal models to human data.

Oxidative stress is a natural phenomenon in the body. Under physiological conditions intracellular reactive oxygen species (ROS) are normal components of signal transduction cascades, and their levels are maintained by a complex antioxidants systems participating in the in-vivo redox homeostasis. Increased oxidative stress is present in several chronic diseases and interferes with phagocytic and nervous cell functions, causing an up-regulation of cytokines and inflammation. Hepatic encephalopathy (HE) occurs in both acute liver failure (ALF) and chronic liver disease. Increased blood and brain ammonium has been considered as an important factor in pathogenesis of HE and has been associated with inflammation, neurotoxicity, and oxidative stress. The relationship between ROS and the pathophysiology of HE is still poorly understood. Therefore, sensing ROS production for a better understanding of the relationship between oxidative stress and functional outcome in HE pathophysiology is critical for determining the disease mechanisms, as well as to improve the management of patients. This review is emphasizing the important role of oxidative stress in HE development and documents the changes occurring as a consequence of oxidative stress augmentation based on cellular and ammonium-based animal models to human data.

Central nervous system and systemic oxidative stress interplay with inflammation in a bile duct ligation rat model of type C hepatic encephalopathy.

The role and coexistence of oxidative stress (OS) and inflammation in type C hepatic encephalopathy (C HE) is a subject of intense debate. Under normal conditions the physiological levels of intracellular reactive oxygen species are controlled by the counteracting antioxidant response to maintain redox homeostasis. Our previous in-vivo1H-MRS studies revealed the longitudinal impairment of the antioxidant system (ascorbate) in a bile-duct ligation (BDL) rat model of type C HE. Therefore, the aim of this work was to examine the course of central nervous system (CNS) OS and systemic OS, as well as to check for their co-existence with inflammation in the BDL rat model of type C HE. To this end, we implemented a multidisciplinary approach, including ex-vivo and in-vitro electron paramagnetic resonance spectroscopy (EPR) spin-trapping, which was combined with UV-Vis spectroscopy, and histological assessments. We hypothesized that OS and inflammation act synergistically in the pathophysiology of type C HE. Our findings point to an increased CNS- and systemic-OS and inflammation over the course of type C HE progression. In particular, an increase in the CNS OS was observed as early as 2-weeks post-BDL, while the systemic OS became significant at week 6 post-BDL. The CNS EPR measurements were further validated by a substantial accumulation of 8-Oxo-2'-deoxyguanosine (Oxo-8-dG), a marker of oxidative DNA/RNA modifications on immunohistochemistry (IHC). Using IHC, we also detected increased synthesis of antioxidants, glutathione peroxidase 1 (GPX-1) and superoxide dismutases (i.e.Cu/ZnSOD (SOD1) and MnSOD (SOD2)), along with proinflammatory cytokine interleukin-6 (IL-6) in the brains of BDL rats. The presence of systemic inflammation was observed already at 2-weeks post-surgery. Thus, these results suggest that CNS OS is an early event in type C HE rat model, which seems to precede systemic OS. Finally, our results suggest that the increase in CNS OS is due to enhanced formation of intra- and extra-cellular ROS rather than due to reduced antioxidant capacity, and that OS in parallel with inflammation plays a significant role in type C HE.

Calcium-phosphate metabolism in patients with multiple sclerosis.

INTRODUCTION AND OBJECTIVES: The purpose of this study was to evaluate the concentration of 25-hydroxycholecalciferol and parameters of calcium-phosphate metabolism at different periods of relapsing-remitting multiple sclerosis (RRMS). MATERIALS AND METHODS: Forty-five patients, residents of Poland (49°-50°, N), were enrolled in the study, i.e. 15 immediately after the diagnosis of RRMS, 15 at the early stage and 15 at the advanced stage of RRMS. The results were compared to values obtained in 20 age- and sex-matched controls. RESULTS: Lower serum concentrations of 25-hydroxycholecalciferol and ionised calcium were found in patients compared to the control group. In patients with the disease duration of 5-6 years, concentrations of 25-hydroxycholecalciferol and ionised calcium were lower than in patients in the earlier period of RRMS. The inverse and clearer direction of changes was found in parathormone serum concentration in patients compared to the controls. In patients with a longer disease duration, a significantly lower 25-hydroxycholecalciferol concentration was found in female patients compared to male patients. In patients, more frequent 25-hydroxycholecalciferol and unsaturated fatty acids' supplementation was observed compared to the controls. CONCLUSIONS: In RRMS patients, calcium-phosphate metabolism is disturbed which increases during disease progression.

Proopiomelanocortin but not vasopressin or renin-angiotensin system induces resuscitative effects of central 5-HT1A activation in haemorrhagic shock in rats.

The aim of this study was to determine the effectory mechanisms: vasopressin, renin-angiotensin system and proopiomelanocortin-derived peptides (POMC), partaking in the effects of serotonin through central serotonin 1A receptor (5-HT1A) receptors in haemorrhagic shock in rats. The study was conducted on male Wistar rats. All experimental procedures were carried out under full anaesthesia. The principal experiment included a 2 hour observation period in haemorrhagic shock. Drugs used - a selective 5-HT1A agonist 8-OH-DPAT (5 µg/5 µl); V1a receptor antagonist [ß-mercapto-ß, ß-cyclo-pentamethylenepropionyl(1),O-me-Tyr(2),Arg(8)]AVP (10 µg/kg); angiotensin type I receptor antagonist (AT1) ZD7155 (0.5 mg/kg, i.v.); angiotensin-converting-enzyme inhibitor captopril (30 mg/kg, i.v.); melanocortin type 4 (MC4) receptor antagonist HS014 (5 µg, i.c.v.). There was no influence of ZD715, captopril or blocking of the V1a receptors on changes in the heart rate (HR), mean arterial pressure (MAP), peripheral blood flow or resistance caused by the central stimulation of 5-HT1A receptors (P≥0.05). However, selective blocking of central MC4 receptors caused a slight, but significant decrease in HR and MAP (P<0.05). POMC derivatives acting via the central MC4 receptor participate in the resuscitative effects of 8-OH-DPAT. The angiotensin and vasopressin systems do not participate in these actions.

Influence of melatonin supplementation on serum antioxidative properties and impact of the quality of life in multiple sclerosis patients.

The relationship between the prevalence of multiple sclerosis (MS) and sunlight's ultraviolet radiation was proved. Oxidative stress plays a role in the pathogenic traits of MS. Melatonin possesses antioxidative properties and regulates circadian rhythms. Several studies have reported that the quality of life is worse in patients with MS than in healthy controls, with a higher prevalence of sleep disturbances, depression and fatigue. The aim of study was to evaluate 5 mg daily melatonin supplementation over 90 days on serum malondialdehyde (MDA) concentration and superoxide dismutase (SOD) activity and its' influence on impact of the quality of life of MS patients. A case-control prospective study was performed on 102 MS patients and 20 controls matched for age and sex. The EDSS, MRI examinations and Multiple Sclerosis Impact Scale (MSIS-29) questionnaire was completed. Marked increase in serum MDA concentration in all MS patients groups was observed and after melatonin treatment decreased significantly in interferons-beta and glatiramer acetate-treated groups, but not in mitoxantrone-treated group. A significant increase in SOD activity compared to controls only in glatiramer acetate-treated group was observed. After 3 months melatonin supplementation the SOD activity increased compared to initial values in interferons beta-treated groups. A significant increase in both MSIS-29-PHYS and MSIS-29-PSYCH items mean scores only in the MX group as compared to other groups was observed. There were no significant differences in mean MSIS-29-PHYS was observed before and after melatonin therapy. Melatonin supplementation caused a decrease in mean MSIS-29-PSYCH scores compared to initial values in interferons beta-treated groups. Finding from our study suggest that melatonin can act as an antioxidant and improves reduced quality in MS patients.

Resistance to acetylsalicylic acid in patients with type 2 diabetes mellitus is associated with lipid disorders and history of current smoking.

BACKGROUND: Diabetes mellitus (DM) is an important risk factor for stroke. Acetylsalicylic acid (ASA) is the most frequently used medication for prevention of cardio-cerebral vascular diseases. However, some patients experience ischaemic vascular events despite the use of ASA. This phenomenon is known as "aspirin resistance" (AR). The aim of this study was to assess the prevalence of AR in diabetic patients and search for factors associated with it. MATERIALS AND METHODS: The examined group consisted of 96 subjects with diagnosed type 2 DM. Platelet function test was performed by the method of whole blood impedance aggregometry. RESULTS: Among examined subjects, 51 patients (53.1 %) were sensitive to ASA action (ASA responders) and 45 patients (46.9 %) were resistant to ASA action (ASA non-responders). No association was found between platelet aggregation and gender, age, dose of ASA, known duration of diabetes, BMI, heart rate, mean systolic and diastolic blood pressure, and risk factors except for current smoking (p = 0.030). ASA non-responders were treated shorter with ASA than ASA responders (p = 0.010). The mean total cholesterol (p = 0.020), LDL concentration (p = 0.005), HCT (p = 0.010), WBC (p = 0.030), and PLT (p = 0.050) were significantly higher in ASA non-responders. No association was found between AR and results of other laboratory tests and medications. Multiple logistic regression analysis revealed factors associated with AR: current smoking and LDL concentration higher than 3.5 mmol/l. CONCLUSIONS: Results of our study did not confirm the association between poor glycaemic control in the diabetic patients and AR. Resistance to ASA in diabetic patients is associated with lipid disorders and history of current smoking.

Labeled [³H]--thymidine incorporation in the DNA of 3T3-L1 preadipocytes due to MT2- and not MT3- melatonin receptor.

The discovery of MT1, MT2, and MT3 melatonin receptors on adipose tissue cells gives grounds for considering the possibility of melatonin as a factor which influences energy storage through modulation of metabolism and adipocyte proliferation. To date only a few contradictory studies have been published on the influence of melatonin on preadipocytes. The aim of the present study is to evaluate the influence of melatonin at physiological and supraphysiological concentrations on the proliferation of 3T3-L1 murine preadipocytes after 3 and 24 hours of the experiment and to determine the participation of membrane melatonin MT2 receptors, and for the first time--MT3, in its melatonin action during a 24-hour experiment. The 3T3-L1 murine preadipocyte cell line were cultured with or without melatonin at 10⁻³ and 10⁻9 mol/L, with or without melatonin antagonists luzindole (10⁻4 mol/L) and prazosin (10⁻5 mol/L). Cell proliferation was determined by means of labeled [³H]-thymidine incorporation in the DNA of the cell. Melatonin at both physiological and supraphysiological concentrations has a stimulating effect on the number of 3T3-L1 preadipocytes. The application of luzindole inhibits the above effect of melatonin both at 10⁻³ mol/L and 10⁻9 mol/L concentrations (P<0.05). The presence of prazosin does not have a statistically significant influence on the effects of melatonin action. Summarizing, it has been proven that melatonin exerts a proproliferative effect on 3T3-L1 preadipocytes at physiological and supraphysiological concentrations, partially by MT2, and not by MT3 receptors.

The role of serotonergic 5-HT1A receptors in central cardiovascular regulation in haemorrhagic shock in rats.

The bleeding and haemorrhage is strictly related with accidents and many medical procedures. In some conditions it leads to hypovolaemia and further to hypovolaemic shock. Under conditions of haemorrhagic shock, heart rate and blood pressure critically collapse. Reversing the sympathoinhibitory phase of hypovolaemia could be crucial for clinical management of injured patients after haemorrhage. Systemic administration of 5-HT1A agonists seams to produce resuscitating effects. The aim of this study was to investigate the participation of central serotonin and, in particular, 5-HT1A receptors in cardiovascular regulation in haemorrhagic shock in rats. Intracerebroventricular (i.c.v.) administration of serotonin (5-HT) increased the heart rate (HR), mean arterial pressure (MAP) and implicated that all haemorrhaged animals survived for the whole observation time (2 hours). Similar, although significantly more minor, effects were achieved after selective 5-HT1A activation. Moreover, the i.c.v. administration of selective 5-HT1A antagonist before i.c.v. 5-HT injection partially inhibited 5-HT induced changes. The results of the present work indicate that 5-HT plays an important role in the reversal of the haemorrhagic shock in rats. These effects are at least partially dependent on activation of 5-HT1A receptors.

Antioxidative enzymes activity and malondialdehyde concentration during mitoxantrone therapy in multiple sclerosis patients.

Mitoxantrone (MX) is approved for the treatment of aggressive relapsing-remitting, secondary-progressive and progressive-relapsing form of multiple sclerosis (MS). The mechanism of its action is multiaxial, however, it is not free from side effects. The causes of the side effects are still unknown and require further investigation. The aim of this study was to investigate the influence of MX therapy on enzymatic parameters of endogenous antioxidative status: manganese and copper/zinc superoxide dismutase (MnSOD, Cu/ZnSOD), catalase (CAT), glutathione peroxidase (GSH-Px) and lipid peroxidation marker--malondialdehyde (MDA) in blood serum and cerebrospinal fluid (CSF) in patients suffering from MS. After the MX therapy serum and the CSF MDA concentrations increased significantly. We reported that MnSOD activities decrease in serum and the CSF, while, surprisingly, the serum Cu/ZnSOD activity increases after the MX therapy. We also noted a marked decrease in CSF CAT and GSH-Px activity after the MX treatment. Our results strongly suggest the influence of MX therapy on oxidation/antioxidation status of serum and the CSF. These findings open up new opportunities for a better understanding of underlying physiopathological events in MS and provide a new insight into MX's mechanisms of action, especially its potent side effects.

Impact of low frequency pulsed magnetic fields on pain intensity, quality of life and sleep disturbances in patients with painful diabetic polyneuropathy.

AIM: The aim of this randomized, placebo-controlled, double-blind study was to assess whether a low frequency magnetic field can influence pain intensity, quality of life and sleep, and glycaemic control in patients with painful diabetic polyneuropathy. METHODS: Sixty-one patients were randomized into two groups: the study group comprised 32 patients exposed to a low frequency magnetic field, average pain duration 23 months; the control group included 29 patients who received sham exposure, average pain duration 28 months. Patients were exposed for three weeks, 20 min a day, five days a week. The magnetic field generator was a Viofor JPS device (Med & Life, Komorow, Poland). All subjects filled out the following questionnaires five times (at the beginning and after one, two, three and five weeks): SFMPQ-VAS (pain evaluation), EuroQol EQ-5D and MOS Sleep Scale. HbA(1c) was evaluated at baseline and after five weeks. RESULTS: Significant reductions in pain intensity were seen in both the study group (visual analogue scale [VAS] value of 73 mm at baseline versus 33 mm after three weeks) and controls (VAS 69 mm at baseline versus 41 mm after three weeks). The extent of pain reduction did not differ significantly between the groups at any time. Also, both groups had similar improvements in EuroQol, MOS and HbA(1c) values. CONCLUSION: Genuine magnetic field exposure has no advantage over sham exposure in reducing pain intensity, improving quality of life, and decreasing sleep disturbances and HbA(1c).

Role of leptin, ghrelin, angiotensin II and orexins in 3T3 L1 preadipocyte cells proliferation and oxidative metabolism.

There is now growing evidence that the reactive oxygen species have an influence on proliferation and antioxidative status of various cell types. The aim of the study was to investigate the effects of different concentrations of leptin, ghrelin, angiotensin II and orexins on proliferation, culture medium malondialdehyde (MDA) levels and antioxidative enzymes activities: superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and catalase (CAT) in 3T3 L1 preadipocytes cell culture. Cell proliferation was measured using [(3)H]tymidine incorporation. In 3T3-L1 cells leptin caused a significant reduction in proliferation (by 36%) compared to control. Ghrelin increased preadipocyte proliferation, and the effect was stronger in higher dose (by 39%), while proproliferatory effect of angiotensin II was stronger in lower doses (by 47%). All used doses of orexin A significantly increased 3T3 L1 cell proliferation (from 21% to 160%), while orexin B caused a marked reduction (from 35% to 70%) of this proliferation. The effects of both orexins were dose-dependent. Leptin and ghrelin increased activity of SOD, CAT, GSH-Px and decreased level of MDA. Angiotensin II treatment stimulated only SOD and CAT activities. Influence of orexins was different on various enzymes. Orexin A increased MDA levels, while orexin B caused a marked decrease in MDA levels. Our results strongly suggest the effects of appetite affecting hormones such as leptin and ghrelin on proliferation and antioxidative enzyme activities of preadipocyte cell lines. Orexin A was found to be the most efficient proliferative-signalling hormone, while orexin B revealed the most significant inhibitory effect on preadipocytes proliferation.

[Bone complication in diabetic subjects with good metabolic control and without any late complications: selected problems. Part I: calcium, phosphorus and magnesium metabolism]. / Powiklania kostne u chorych z dobrze wyrównana i niepowiklana cukrzyca typu 1 i 2--wybrane zagadnienia. Czesc I: Gospodarka wapniowo-fosforanowo-magnezowa.

The aim of the study was to evaluate whether in diabetics with good metabolic control and without any diabetic complications, disturbances of calcium, phosphorus and magnesium metabolism or hormonal regulation (parathormone/calcitonin) were present, and if they depended on type of diabetes, duration time of diabetes, kind of hypoglycaemic treatment, sex or age of patients. 83 subjects were examined, including: 14 with type 1 diabetes mellitus, 49 with type 2 diabetes mellitus and 20 healthy persons. All tests were performed in standarized low-calcium diet conditions. In basal conditions both serum concentrations and daily urine excretion of calcium, phosphorus, magnesium were estimated. Oral and intravenous calcium load tests with simultaneous parathormone, calcitonin, calcium, magnesium and phosphorus concentrations estimation were done. The final conclusions were as follow: Both in type 1 diabetes mellitus and type 2 diabetes mellitus subjects with good metabolic compensation and without advanced diabetic complications a tendency to early disturbances of calcium-phosphorus metabolism is observed. Physiological hormonal control (parathormone/calcitonin) is preserved. Correlations between mineral metabolism and type of diabetes, duration time of diabetes, daily insulin dose, body mass index and sex are observed. Kind of hypoglycaemic treatment has only slight influence on the mineral metabolism.

[Possibilities and methods of evaluating the quality of life in patients after stroke]. / Mozliwosci i sposoby oceny jakosci zycia chorych po udarze mózgu.

The Quality of Life involves such aspects of life as: fitness, psychosocial and economical status, which are of great significance in chronic neurological diseases. Strokes due to their large incidence, frequent permanent motor disability, mood disturbances and the necessity of constant assistance demand specific medical and social care. Authors present a short review of questionnaires and scales used for assessing the Quality of Life in patients with a history of stroke.

[Bone complication in diabetes subjects with good metabolic control and without longterm complications: certain problems. Part II. Basal parameters of bone turnover]. / Powiklania kostne u chorych z dobrze wyrównana i nie powiklana cukrzyca typu 1 i 2--wybrane zagadnienia. Czesc II: Podstawowe wskazniki obrotu kostnego.

The resorption and osteogenesis equilibrium is commonly known basal condition of bone tissue homeostasis. For the purpose of bone turnover analysis in the group of good controlled diabetic patients without any diabetic complications basal biochemical parameters of osteogenesis and resorption were estimated. During low-calcium diet conditions both serum concentration and urine excretion of creatinine, hydroxyproline, hydroxylysine and uric acid were investigated. Serum alkaline phosphatase activity and oxalic acid urine excretion were also measured. As the result of the study the higher serum alkaline phosphatase activity and hydroksyproline urine excretion in type 1 diabetic patients as well as higher hydroxyproline and hydroxylysine urine excretion in type 2 diabetic patients were found.

[Bone complications in diabetic subjects with good metabolic control and without any long-term complications--certain problems. Part III: The influence of hypertension and type 2 diabetes mellitus co-incidence of calcium, phosphorus and magnesium metabolism]. / Powiklania kostne u chorych z dobrze wyrównana i nie powiklana cukrzyca typu 1 i 2--wybrane zaganienia. Czesc III: Wplyw wspólistnienia nadcisnienia tetniczego z cukrzyca typu 2 na gospodarke wapniowo-fosforanowo-magnezowa.

Both high morbidity and potentiation of systemic complications emphasise significance of diabetes mellitus and hypertension co-incidence. The aim of the study was to analyse the influence of hypertension accompanied with type 2 diabetes mellitus on calcium phosphorus and magnesium metabolism. The study was performed in standard low-calcium diet conditions on the group of 49 patients with type 2 diabetes mellitus (among them 27 had hypertension), 14 patients with essential hypertension and 20 healthy persons. Both serum and urine concentration of creatinine, calcium, phosphorus, hydroxyproline, hydroxylysine and uric acid were analysed. Oral calcium load test was done. Serum alkaline phosphatase activity and oxalic acid urine excretion were also estimated. There were no significant differences between diabetic patients with and without hypertension as far as calcium, phosphorus or magnesium metabolism were concerned.

Evaluation of cerebrovascular reactivity in children [corrected] with chronic renal failure.

Developmental disturbances and encephalopathy have been observed in children with chronic renal failure (CRF). The aim of this study was to investigate the efficiency of the cerebral circulation in uremic children. The study group consisted of 10 children with CRF on conservative treatment, 8 children on continuous ambulatory peritoneal dialysis (CAPD), and 8 children on maintenance hemodialysis (HD). Examination was performed using a TC2-64B, EME Doppler flowmeter machine and capnograph Datex, Normocap. Blood flow velocity in both middle cerebral arteries (MCA), at rest and after spontaneous hyperventilation for 30 s, was analyzed. The vascular reactivity coefficient was calculated as the percentage ratio of decline of blood flow velocity in MCA to PCO2 decrease. Baseline mean blood flow velocities of MCA in euvolemic children under conservative treatment and on CAPD were significantly higher than those in children on HD and healthy control children. The highest value of the vascular reactivity coefficient was significantly higher in the group of children with CRF on conservative and CAPD treatment, than in children on HD and healthy controls. We suggest that hyperreactivity of the cerebral circulation could be the result of impaired autoregulation of blood flow. Evaluation of cerebrovascular reactivity in uremic children requires further examination.

[Stimulating amino acids in epilepsy: possibilities of treatment]. / Aminokwasy pobudzajace w padaczce. Mozliwosci interwencji leczniczej.

Stimulating amino acids (glutamine and aspargine) play an essential role in epileptogenesis. Activating receptors NMDA, AMPA, kainate and metabotropic influence a conduction of ion canals and a beginning, duration and extinction of epileptic discharges. Some of the new anti-epileptic drugs introduced in the recent years modify functioning of glutamine receptors subtypes. It is expected that they can also decrease a release of glutamines, amplify a GABA-ergic suppression and block sodium channels. Most information about these drugs in epileptogenesis was received in animal experiment which is an excuse for a lack of certainty in a parallel referring their mechanisms to the central nervous system in a man. Treatment resistant focal or general epilepsies and some epileptic syndromes are the most often appearing indications for using agents producing an effect on activating amino acids system. They are most often used in an added therapy, more rarely in a monotherapy. Some negative comments concern not very clear influence on cognitive functions, however some hope arises due to a potential neuroprotective mechanism being a result of a decreased glutamine release. The drugs blocking a stimulating transmission should be a good supplement for a present possibilities of epileptic treatment.

[Secretion of catecholamines in urine of patients with tonic-clonic epileptic seizures]. / Wydalanie amin katecholowych z moczem u chorych z padaczka napadów pierwotnie uogólnionych toniczno-klonicznych.

UNLABELLED: Epileptic seizures are concerned with temporary neuronal activation of adrenal medulla, manifested by increase of adrenaline and noradrenaline concentration in plasma and clinical symptoms as, among others, an increase in blood pressure, tachycardia and temporary hyperglycaemia. This adrenergical activation may be probably due to reactivity changes in adrenal-sympathetic system in patients with epilepsy also in interseizure periods. AIM: Evaluation of adrenaline, noradrenaline and dopamine excretion in 24-hour period urine collection in epileptic patients and examination, if there is a correlation between epilepsy clinical picture and catecholamines urine elimination. MATERIAL: 32 epileptic patients (16 women, 16 men) in mean age 31.1 +/- 7.1 and 29 healthy age-matched subjects in control. The age of falling ill, disease duration, etiology, family history, type and frequency of seizures, results of neurological and EEG examinations and the applied treatment, have all been taken into account in epilepsy clinical picture. METHOD: Daily urine collection was performed on a day-off, and time lapse since the last epileptic seizure was at least 48 hours. Quantitative determination of adrenaline, noradrenaline and dopamine in urine was performed by fluorimetric method. Differences among the obtained values were compared by t-Student's test, additionally, correlation coefficient was calculated. RESULTS: Significantly lower mean quantities of dopamine excreted within 24 hours in the whole group of epileptic patients and no significant differences in adrenaline and noradrenaline excretion were found, in relation to control group. Differences in catecholamines excretion in some cases occurred, in correlation with epilepsy clinical picture (onset of epilepsy, results of neurological and EEG examination, phenytoin treatment). CONCLUSIONS: Obtained results suggest the reactivity disturbance of dopamine-noradrenaline-adrenaline system in the epilepsy course. It may result in changes of catecholamines, especially dopamine, excretion with urine.

[Prophylactic treatment in children with migraine presenting changes in electrophysiological and cerebral blood flow examinations: preliminary report]. / Leczenie profilaktyczne dzieci z migrena przy obecnosci zmian w badaniach elektrofizjologicznych i UDP--doniesienie wstepne.

Idiopathic headache is common in children, but lack of specific tests makes diagnosis and treatment of migraine difficult. It has been proved, that in some migrainous children paroxysmal changes in eeg records can be found. The aim of the study was to examine the influence of prophylactic treatment on clinical course and bioelectric brain activity in children. The group examined consisted of 50 migrainous children (29 girls and 21 boys aged 6-18 years, mean 11.5 y.). In every patient routine eeg and ecg were recorded, and in 30 of them cerebral blood flow was examined. Some ecg abnormalities were observed in 6 children (12%) and cerebral blood flow disturbances--in 23 (77%). In 15 patients, in whom paroxysmal changes in routine eeg were found, an average 6-month prophylactic antimigrainous treatment (with Hydacorn in 14 and with Sermion in 1 patient) was performed and then control routine eeg and 24-hours eeg were recorded. In all children clinical improvement was observed after prophylactic medication. Paroxysmal changes in eeg records persisted in 6 children. The coexistence of electroencephalographic changes with disturbed cerebral blood flow migrainous children can indicate some connection between migraine and epilepsy, and/or reflect an influence of angiospasm resulting in hypoxia on the incidence of epileptiform changes in eeg records. The obtained results show clinical efficiency of combined treatment in child migraine and they reflect its good influence on bioelectrical brain activity.