[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.

[Depression in epileptic patients with and without history of suicidal attempts: preliminary report]. / Depresja u chorych na padaczke z próbami i bez prób samobójczych w wywiadzie--doniesienie wstepne.

Depression is a significant problem in epilepsy. Suicides occur in epileptic patients five times more often than in general population. Material included 34 epileptics with 76 suicidal attempts and 24 patients with no history of suicide. Psychical state was studied with Beck Depression Inventory and Hamilton Depression Rating Scale. In the group with suicidal attempts 65% of patients had depression (54.5% of them had major depression) and in group without suicide attempts depression was noted in 54% (23% with major depression). Patients with depression were divided into two groups: group I with suicidal attempts and group II without history of suicide. In group I more patients were alcohol abusers (50% vs 31%), more were treated because of epilepsy longer than 10 years (59% vs 46%) and more had tonic-clonic seizures (82% vs 46%). In group I, 54% of patients were on polytherapy (more than half of them with fenobarbital). In group II, 31% of epileptics were on polytherapy (no one with fenobarbital). Major depression was significantly more frequent in epileptics with suicidal attempts. The severity of depression may influence the risk of suicide. Major depression may be associated with late age of onset of epilepsy, longer treatment duration, tonic-clonic seizures, polytherapy (mainly with fenobarbital) and alcohol abuse.

[Triiodothyroxine (T3), thyroxine (T4), thyreotropine (TSH) and myoglobin levels in patients with myasthenia gravis]. / Stezenie T3, T4, TSH oraz mioglobiny w surowicy chorych na myasthenia gravis.

T3, T4, TSH and myoglobin levels were determined in 14 patients with myasthenia gravis and compared with thirty one healthy control subjects. Significant decrease of myoglobin concentration and increase T3, T4 levels as compared to control group was found. TSH concentration was in normal range. Duration of myasthenia, level of disease (according to Osserman classification) and kind of therapy not influenced on detectable variations myoglobin, T3, T4 and TSH concentration.

[Suicide attempts in epileptic patients during the years 1990-92. Analysis of patients in the Regional Poison Control Center in Sosnowiec]. / Próby samobójcze chorych na padaczke w latach 1990-92. Analiza chorych Regionalnego Osrodka Ostrych Zatruc w Sosnowcu.

During the years 1990-92 in the Regional Poisons Control Center in Sosnowiec 42 epileptics (20 females and 22 males) were hospitalized because of suicide attempt. It amounted to 9% of all attempters, treated there in this period. The majority of patients were males of age range from 21 to 62 years. In 23 patients the suicide attempts were performed for the first time. the main reason for suicide was the family conflicted situation. Additionally, in 14 patients the poisoning attempts have been done during alcohol abuse. In the suicide attempts the antiepileptic drugs were most frequently used, mainly carbamazepine (23 cases).

[Influence of hemodialysis on changes in cerebral artery blood flow velocity in patients with chronic renal failure]. / Wplyw hemodializy na zmiane predkosci przeplywu krwi w ttnicach mózgowych u chorych na przewlekla niewydolnosc nerek. Doniesienie wstepne.

The effect of hemodialysis on the cerebral circulation have been inadequately studied. Because of repeatability, safety and non-invasiveness transcranial Doppler sonography is well suited for evaluation of cerebral circulation and for estimation of cerebral blood flow during hemodialysis as well. The aim of our study was to find out whether hemodialysis affects the velocity of blood flow in extra- and intracranial arteries and in what way. 41 patients aged 18-71 (mean 43.9 +/- 13) years suffering from chronic renal failure made up the investigation group. We investigated 17 men and 24 women. Doppler examination was done to each dialized patient immediately before and then 120 and 240 minutes after the onset of hemodialysis. We used pulsed wave Doppler (TC2-64B, EME). Mean blood flow velocities were obtained from extracranial (CCA, ICA, ECA) and intracranial vessels (MCA, ACA, PCA). Simultaneously the series of biochemical blood parameters and arterial blood pressure were monitored. On the basis of investigation results the following conclusion have been drawn: Hemodialysis significantly affects on changes of blood flow velocities in extra-an intracranial arteries. Above mentioned changes consist in decrease of blood flow velocity in both CCA, left ICA, both MCA and PCA and right ACA.

Hemiplegic migraine with CSF abnormalities.

A 30-year-old woman with hemiplegic migraine and an elevated CSF protein level with considerable pleocytosis is described. Fourteen other cases of hemiplegic migraine with cerebrospinal fluid abnormalities reported in the literature are reviewed.

[T3, T4 and TSH serum levels in patients on long-term treatment for epilepsy]. / Poziom T3, T4 I TSH w surowicy chorych dlugotrwale leczonych z powodu padaczki.

The serum T3, T4 and TSH concentrations were assessed by RIA method in 25 (14 females, 11 males) long-term treated (mean treatment duration 12.8 years) epileptic patients. The mean serum T3, T4 and TSH levels were lower than in control group according to clinical picture of epilepsy and treatment applied. The lowest mean serum TSH concentration was in patients with known aetiology of epilepsy. Patients with tonic-clonic seizures had lower serum levels of all hormones measured in comparison with the patients with partial seizures. Mean serum T3, T4 and TSH levels were low in patient group receiving valproic acid. The lowest mean TSH serum concentration as compared to control group was in the patients treated with phenytoin. None of the epileptic patients developed clinical symptoms of hypothyreoidism.

[Serum ACTH levels in patients treated for epilepsy]. / Poziom kortykotropiny (ACTH) w surowicy chorych leczonych z powodu padaczki.

In 27 epileptic patients (16 females and 11 males) aged 23-61 years, the serum ACTH levels were estimated by radioimmunoassay (RIA). The men serum ACTH level in epileptic patients was lower than in control group. In epileptic patients there were differences depending on the course of epilepsy and treatment applied. There were lower mean serum ACTH levels in patients with earlier age of epilepsy onset, frequent seizures and generalized discharges in eeg records. Lower serum ACTH amounts were found in patients with long-term treatment with phenytoin and polytherapy applied. It may be supposed that in patients long-term treated because of epilepsy the hormonal disturbances involve not only adrenal cortex but also higher parts of neuroendocrinological system.

[Neurocysticercosis: benign natural course]. / Wagrzyca mózgu: lagodny przebieg naturalny.

In a waiter aged 51 without clinical symptoms, but with a history of sporadic epileptic seizures in young age, radiological examination demonstrated multiple calcifications in the brain corresponding to calcified cysticerci. Similar lesions were found in the muscles of the thighs and left lower leg. After another 18 years without cerebral symptoms these calcifications were demonstrated in CT. The case indicates that the natural course of cerebral cysticercosis may be asymptomatic or oligosymptomatic, and that it is useful to distinguish between active and inactive cysticercosis.

[Level of myoglobin in serum of patients with epilepsy after generalized tonic-clonic seizure]. / Poziom mioglobiny w surowicy krwi u chorych na padaczke po uogólnionym napadzie toniczno-klonicznym.

In 11 patients with epilepsy serum myoglobin level determinations were performed by the RIA method 10 minutes, 1 hour, 4, 12, and 24 hours after tonic-clonic seizure and were compared with myoglobin concentrations in a group of 30 healthy persons. A statistically significant increase of myoglobin concentration was shown already in the first hour after the seizure with maximal level, almost five times exceeding the baseline level in the fourth hour, and slightly lower--four times exceeding the baseline--12 hours after the seizure. The correlative studies, comparing the profile of myoglobinaemia with the clinical picture (duration of the disease, age and sex, presence or lack of EEG changes, type of therapy used) showed no statistical significance.

[Diagnostic difficulties in the case of 57-year-old woman suffering from encephalitis lethargica]. / Trudnosci rozpoznawcze w przypadku spiaczkowego zapalenia mózgu u 57-letniej kobiety.

The case of encephalitis lethargica in 57 years woman was described. The basal ganglia was already damaged after 7 months from illness onset, and control examination after 15 months showed Parkinsonian syndrome. Serological and CSF viral titres and cultures were negative.

[Epilepsy and pregnancy]. / Padaczka a ciaza.

A survey of available literature on the influence of pregnancy on first seizure onset as well as on the course of epilepsy. Causes of changes in seizure frequency during pregnancy are presented. The influence of epilepsy on the course of pregnancy has also been discussed.

[Epilepsy and the menstrual cycle]. / Padaczka a cykl miesieczny.

A survey of the available literature on the relationship between epileptic seizures and menstrual cycle. Course of epilepsy during puberty, reproductive age and menopause is presented. The influence of ovarian steroid hormones on brain seizure excitability, and the possibility of hormonal treatment in women with epilepsy have also been discussed.

[Recurrent skull neuropathy during the course of diabetes mellitus--case report]. / Nawracajaca neuropatia czaszkowa w przebiegu cukrzycy--opis przypadku.

This study presents a case of a 73 year old woman who has suffered from diabetes mellitus for 8 years and has had 6 isolated cranial nerves palsies within a period of 7 years. The last are-because of which she was treated in Department of Neurology in July 1992--concerned left oculomotor nerve. The coincidence of metabolic and vascular disorders provoke authors to take a wide diagnostics and discussion on diabetic ophthalmoplegia problem.

[Adult age phenylketonuria with extrapyramidal syndrome: therapeutic management]. / Fenyloketonuria wieku dojrzalego z zespolem pozapiramidowym--postepowanie terapeutyczne.

A young male with phenylketonuria diagnosed in his 9-th month of life is presented. At the age of 20 years signs of central nervous system involvement became more pronounced, with extrapyramidal syndrome and with simultaneous very striking increase of phenylalanine level. The neurological signs were reduced after administration of Levodopa (Nakom) and return to more strict diet and Lofenalac.

[Serum levels of vitamin B12 in epileptic patients treated with carbamazepine]. / Poziom witaminy B12 u chorych na padaczke leczonych karbamazepina.

In 21 epileptic patients (11 females and 10 males) aged 18-55 years on carbamazepine (CBZ) therapy the serum levels of vitamin B12 were measured. Mean serum level of vitamin B12 in epileptic patients was in the same range as compared to the values in healthy subjects. However, there were differences depending on the drug dose, treatment duration and course of epilepsy. The mean serum level of vitamin B12 was lower in epileptic patients with earlier age of disease onset, frequent seizures and with higher drug dose (above 600 mg/d). In patients treated longer than 15 years the vitamin B12 serum level amounted to 65 per cent of the values in control group.

[A case of coexistence of hypophyseal adenoma and epileptic seizures]. / Przypadek wspólistnienia gruczolaka przysadki i napadów padaczkowych.

A case of hypophyseal adenoma with epileptic seizures in a man aged 61 years is reported. The generalized seizures developed 21 years earlier, and partial complex seizures 2 years before the diagnosis of adenoma. The patient had two sons, one died of suprasellar tumour, the other one has generalized and partial complex seizures.

[Contribution to the clinical polymorphism in Huntington's disease]. / Przyczynek do polimorfizmu klinicznego w chorobie Huntingtona.

A family is described in which closely consanguineous parents had Huntington chorea and in their son a severe hypertonic-hypokinetic syndrome with pellagra-like cutaneous changes was present. In two generations of the family in 6 subjects involuntary movements and gait disorders were reported.

[Severe case of basilar migraine treated with flunarizine]. / Ciezka postac migreny podstawnej z dobrym efektem zapobiegawczym flunaryzyny.

In a man aged 40 years frequent attacks of basilar migraine with consciousness disturbances and signs of central nervous system defects developed due to circulatory failure in the posterior cerebral arteries and cerebellar arteries. The frequency and intensity of migraine attacks decreased only after treatment with flunarizine.

Adrenal cortex hormones in male epileptic patients before and during a 2-year phenytoin treatment.

Serum levels of progesterone, cortisol and phenytoin as well as the excretion of 17-OHCS were determined in 45 male epileptics before and during 24 months of the therapy. A significant decrease of the hormones was found in untreated patients. Phenytoin administration caused further decrease of cortisol and its metabolite 17-OHCS levels and a compensation of progesterone serum concentration.