[Differential diagnosis in multiple sclerosis: description of selected cases]. / Diagnostyka róznicowa stwardnienia rozsianego--omówienie na podstawie wybranych przypadków.

Multiple sclerosis (MS) should be differentiated with diseases causing disseminated lesions of central nervous system or imitating clinical course of MS. Clinical course and results of laboratory investigations also immunological tests should be taken into account in differential diagnosis of MS. We present four patients whose proper diagnoses were based on the immunological investigations.

[Convulsive status epilepticus--clinical analysis of patients treated iin the Neurological Clinics, Medical Academy in Lublin in the years 1986-1995]. / Stan padaczkowy napadów drgawkowych--analiza kliniczna chorych leczonych w Klinice Neurologii AM w Lublinie w latach 1986-1995.

The authors reviewed clinical records of 57 consecutive adults (age: 17-78, 63%--men) treated in the intensive care unit to convulsive SE that was refractory to first-line medication (BDZ,PB). They were divided into three groups: up to 30 (mean 21 years, 28%), between 31-50 (43 y, 32%) and above 50 (59 y, 40%), 58% had previously had epilepsy with prevalence in the youngest (85%). Among the oldest in whom epilepsy occurred de novo as much as 42% experienced it in the form of convulsive SE. Generalized SE was observed in 83% of cases; exclusively in patients up to 50 and in 61% of the oldest. The identifiable precipitating causes of SE were determined in 72% cases but in 25% there were two or more of them. Among previously epileptics leading etiologies for SE were: alcohol abuse, infection or drug withdrawal. Recent brain injury (stroke, neuro-infection, trauma) accelerated refractory seizures in epilepsy-free cases. Time to recovery varied from 0.5-2 (6%) to 2-6 or above 6 hrs (46% each) after continuous i.v. administration of BZD or chlormethiazole (53%) when ineffective. No side effects were noted. The commonest complications during SE were hyperthermia and transient dysregulation of circulatory or/and respiratory systems. Everyone was led out of SE. Overall mortality amounted to 12%. Among the deceased 71% were in the oldest group and everyone with recent brain lesion. This study highlights differences in the course of convulsive SE according to age and underlying etiology and the importance of intense care in therapeutic schedule. A more common chlormethiazole administration, a useful therapeutic tool in management of convulsive SE in adults had been discussed.

[Urinary uropepsin activity in patients with encephalomalacia as an index of the activity of the hypothalamo- hypophyseal-adrenal axis]. / Aktywnosc uropepsyny w moczu chorych z rozmieknieniem mózgu jako wykladnik aktywnosci ukladu podwzgórze--przysadka--nadnercza.

The determinations were carried out in 25 patients with thrombotic encephalomalacia. The changes in 24-hour urine uropepsin activity were studied after administration of metopirone and dexamethasone. The uropepsin activity in a sample of 24-hour urine was determined by the method of West, Ellis and Scott. A statistically significant fall of uropepsin activity was observed in 24-hour urine after metopirone, with a rise in the activity of this enzyme after dexamethasone administration.

[Urinary uropepsin activity in patients with different forms of stroke]. / Aktywnosc uropepsyny w moczu chorych z róznymi postaciami udaru mózgu.

The investigations were carried out in 30 control cases, in 20 patients with acute transient cerebral circulatory failure, 20 patients with intracerebral haemorrhage, and 22 patients with thrombotic encephalomalacia. The determinations of uropepsin activity were done on the 1st, 3rd, 7th and 14th days of the disease. Uropepsin activity in 24-hour urine was determined by the method of West, Ellis and Scott. In the group of patients with acute transient cerebral circulatory failure abnormalities in urinary uropepsin activity were not significant. The mean activity of uropepsin in 24-hour urine in patients with intracerebral haemorrhage and brain infarction on the 1st day of the disease was significantly higher than in controls. The rise in the activity of this enzyme in patients with encephalomalacia was lower in relation to patients with intracerebral haemorrhages. During improvement of the condition of patients with brain stroke the uropepsin activity in 24-hour urine decreased.

[Urinary uropepsin activity in patients with closed cranial trauma]. / Aktywnosc uropepsyny w moczu chorych z zamknietymi urazami czaszki

The authors determined uropepsin activity in 24-hour urine in 30 cases of mild craniocerebral trauma. The determinations were done on the 1st, 3d and 7th days after trauma. The control group consisted of 15 healthy subjects. The activity of the enzyme was raised only on the 1st day after trauma and it may be explained as a result of stress.